{"nodes":[{"node":{"title":" Estimating the catastrophic and impoverishing health expenditure risk among malnourished under-five children in Uganda: secondary analysis of national panel data","field_subtitle":"Maurice M R; Sam O; Francis O; et al: Journal of Health, Population and Nutrition 44(371), 1-9, https://doi.org/10.1186/s41043-025-01098-5, 2025","URL":"https://tinyurl.com/bdrxjfx4","body":"This study estimated the risk of catastrophic and impoverishing health expenditures (CHE/IHE) among households with under-five children affected by malnutrition in Uganda. Using data from the 2019/2020 Uganda National Panel Survey (UNPS), this study estimates the risk of CHE and IHE, with CHE defined as out-of-pocket health expenditures exceeding 10% of total household consumption, and IHE as health expenditures that push a household below the poverty line. Both measures were evaluated on a per capita basis to ensure consistency and equity in the comparison of financial hardship across households of different sizes. The study found that 18% of households experienced CHE/IHE, with 17% facing CHE and 5% facing IHE. Wasting was significantly associated with increased risk of CHE/IHE, and households with wasted children were 55% more likely to experience CHE/IHE compared to those without wasted children. Households in the second and third wealth quintiles had higher odds of incurring CHE/IHE. The study identified a U-shaped relationship between socio-economic status and CHE/IHE risk, where wealthier households did not significantly differ from the poorest households. This study underscores the intersection between child malnutrition and health-related financial vulnerability in Uganda, highlighting acute malnutrition as a key marker of risk for catastrophic or impoverishing health expenditures. The analysis supports the need for an integrated, equity-sensitive approach to financial protection in health that considers both the nutritional and economic vulnerabilities of households. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"18th World Congress On Public Health: Health Without Borders: Equity, Inclusion, and Sustainability, Cape Town, South Africa, September 2026","field_subtitle":"Deadline for Abstracts: 31 January 2026","URL":"https://www.wcph.org/","body":"The World Congress on Public Health (WCPH) is held biennially by the World Federation of Public Health Associations (WFPHA). The 18th WCPH 2026, organized in collaboration with the Public Health Association of South Africa (PHASA), will be held in Cape Town. Over 2,000 delegates are expected to attend, exchanging insights on critical global public health challenges and advancing sustainable and equitable public health worldwide. For the first time, the WCPH will take place in Southern Africa, offering a powerful platform for African voices to engage and contribute to global public health conversations and collaborations. The theme of this congress is, \u201cHealth without Borders: Equity, Inclusion, and Sustainability,\u201d highlighting the global public health community\u2019s unwavering commitment to envisioning and implementing fair and practical solutions to the world\u2019s complex challenges.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"2nd Uganda National Conference on Health, Human Rights and Development (UCHD 2025) ","field_subtitle":"Uganda Ministry of Health, CEHURD: Kampala, Uganda, September 2025","URL":"https://www.uchd.ug/","body":"The 2nd Uganda National Conference on Health, Human Rights and Development (UCHD 2025) brought together policymakers, leaders, civil society actors, development partners, academia and grassroots advocates. Over the three days, delegates engaged in conversations that strengthened movements, forged partnerships and laid a foundation for lasting change and sustainable multi-sectoral collaborations that will accelerate the country\u2019s progress to universal health coverage. The conference launched The Uganda Declaration on Social Determinants of Health - a shared commitment to advancing health equity in Uganda. The authors note \" the seeds of change are planted; now the work is carried forward into action.\"","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"9th Global Symposium on Health Systems Research (HSR2026), Dubai, November 2026","field_subtitle":"Deadline for Abstracts: Organised and Capacity Strengthening 14 Jan; Individual Sessions 13 March","URL":"https://hsr2026.healthsystemsresearch.org/submit-an-abstract/","body":"The theme for HSR2026 is \"Future-Focused Health Systems in a Changing World\" will focus discussion around four sub-themes: Politics and Polycrises; Plurality and Partnerships; Platforms and Participation; Pathways and Planet. Detailed information about the sub themes can be found on the website. Across all four sub-themes, there are three session types in which one can submit an abstract.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A heart of the man is lighter than that of the woman\u2026.exploring men\u2019s motivation and capability to access HIV services in Lusaka, Zambia: findings from the Yaba Guy Che study","field_subtitle":"Mwansa C; Phiri M M; Belemu S; et al. BMC Public Health 25(3353); 1-12; https://doi.org/10.1186/s12889-025-23703-2, 2025","URL":"https://tinyurl.com/bdh8n9kb","body":"This paper explored how social norms and social networks influence men\u2019s engagement with services in Lusaka, Zambia. The authors conducted seven focus group discussions (FGDs) with 70 men and women in an urban community in Lusaka. Pervasive negative community narratives around HIV, negative social and gender norms, the influence of men\u2019s social networks, including stigma related to a positive HIV test result and fear of social isolation, were among the key factors influencing men\u2019s access to HIV services. For HIV testing, the organization and delivery of services in health facilities, including location of HIV testing, waiting times, and likelihood of being seen accessing services, dissuaded men from testing for HIV. In general, health facilities were seen as women\u2019s spaces and unresponsive to men\u2019s needs. However, provider-initiated initiatives, including couples testing in antenatal care and an offer of HIV testing prior to medical male circumcision, and community-based HIV testing facilitated service use. Though condoms were the primary HIV prevention tool mentioned by study participants, norms of their use in marriage and sexual relations limited use. Despite HIV having evolved to a chronic condition and various HIV prevention tools available, fear, social isolation, stigma, and harmful gender norms continue to negatively impact men\u2019s motivation and capability to engage with available HIV services. Measures to facilitate men\u2019s use of these services should consider how to increase social support alongside the delivery of services in spaces that meet men\u2019s needs.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"A simulation-based policy analysis of anticipatory action for cholera outbreaks, Democratic Republic of the Congo","field_subtitle":"Loo P; Rajah J; de Leon H; et al: Bulletin of the World Health Organisation 103(11), 607-618, doi: 10.2471/BLT.25.293226, 2025","URL":"https://pubmed.ncbi.nlm.nih.gov/41035558/","body":"This study explored the effect of anticipatory action on outcomes during a cholera outbreak in a hypothetical health zone in the Democratic Republic of the Congo by means of a cholera response model. Using a system dynamics approach, a cholera response model was developed on the basis of a published cholera response simulation model for Yemen. The model evaluated four intervention scenarios: (i) existing responses to cholera outbreaks; (ii) anticipatory action (that is, immediate interventions); (iii) anticipatory action plus one vaccine dose; and (iv) anticipatory action plus two vaccine doses. The model showed that immediate interventions can function as an essential bridge to comprehensive vaccination, particularly in resource-constrained settings where timely coordination is crucial. Anticipatory action can reduce the total number of cholera cases and booster vaccinations are crucial for preventing subsequent waves of infection due to waning immunity following single-dose vaccination.  The authors argue that dynamic models are useful for simulating outbreaks and can foster proactive, evidence-based public health planning, thereby supporting the shift from reactive to anticipatory strategies. Continuous refinement of the model with real-world data will enhance its applicability.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"A wish to all for a healthier and more just 2026","field_subtitle":"EQUINET steering committee","body":"As we approach the end of 2025 we hope that you have the opportunity to re-energise, reflect, and re-invigorate for the year ahead. In a year that has seen dehumanising genocide, crises and inequality, we know that the most harmful consequence of injustice is when people lose the confidence and understanding that they have the power to produce change. As EQUINET we have learned and been nourished with ideas and a sense of the possible, for our region and globally, by the diversity of people, perspectives, experiences and knowledge in our various exchanges, work and partnerships. Thank you, and we wish you buen vivir, wellbeing and progress in struggles for a more just world in 2026.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Artificial intelligence in traditional medicine: policy and governance strategies","field_subtitle":"Pujari S; Singh R; Soon GC; et al: Bulletin of the World Health Organisation 103(11), 738-740, doi: 10.2471/BLT.24.292888, 2025","URL":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12578530/","body":"Artificial intelligence (AI) is transforming traditional, complementary, and integrative medicine by enhancing patient-centred care, diagnostics, personalized treatment, and knowledge digitization across four domains: end users, practitioners, practices, and interventions. AI applications include machine learning for syndrome classification, deep learning for tongue and facial diagnostics, clinical decision support systems for personalized prescriptions, and digitization initiatives like India's Traditional Knowledge Digital Library. However, critical challenges persist: regulatory complexities and legal accountability, ethical concerns regarding intellectual property and cultural sensitivity, data privacy and security risks, scarcity of standardized data, preservation of human-centred care relationships, and need for global collaboration. This paper proposes comprehensive policy strategies including adapted regulatory frameworks, protection of traditional knowledge through mechanisms like the Nagoya Protocol, robust data governance aligned with global standards, standardized data infrastructure, practitioner capacity building, and multistakeholder collaboration through organizations like WHO's Global Centre for Traditional Medicine. Responsible AI integration requires balancing technological innovation with respect for cultural heritage, ecological values, and ethical standards to advance equitable and sustainable global health outcomes.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Community and health workers\u2019 perspective on impacts of climate change on reproductive, maternal, and child health outcomes in Kilwa district council, Tanzania: a qualitative study","field_subtitle":"Mnyigumba R; Mohamed H; Mwanga S; et al. BMC Public Health 25(3185), 1-12, https://doi.org/10.1186/s12889-025-24343-2, 2025","URL":"https://tinyurl.com/3dk49cvz","body":"This paper explored in October 2024 community and healthcare workers\u2019 perspectives on the impacts of climate change and related extreme weather events on reproductive, maternal, and child health outcomes in Kilwa District, Tanzania through 10 focus group discussions with women and 15 key informant interviews with healthcare workers in 10 flood-prone villages in Kilwa District. High temperature, floods, and prolonged dry spells were perceived by community and healthcare workers to have direct and indirect impacts on reproductive, maternal, and child health outcomes, including limited accessibility to health facilities during the flooding season, a surge in climate-sensitive diseases such as malaria and diarrhoea in the aftermath of floods, and increased food insecurity leading to malnutrition. The increased frequency of climate-related disasters has driven changes in fertility intentions, as women have expressed a desire to have smaller families, fearing that climate-related extreme weather events would further strain their financial capacity to support larger families. Participants described that women faced heightened vulnerabilities due to patriarchal gender norms. Travelling long distances searching for water, increased burden of household chores, and climate-induced economic instability were reported to put women and girls at increased risk of experiencing sexual and gender-based violence. In response to these impacts, the community has implemented several adaptation measures such as utilizing maternity waiting homes during the flooding season, provision of psychosocial support for disaster victims, and relocation of vulnerable populations from flood-prone areas. The findings underscore the urgency to ensure the continuity of healthcare service provision during and after climate-related disasters and to take into account the differential vulnerability and impacts of climate change.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Cradle to Grave: The Health Toll of Fossil Fuels and the Imperative to Just Transition ","field_subtitle":"Global Climate and Health Alliance, September 2025","URL":"https://tinyurl.com/4fbs5tr9","body":"This document presents the comprehensive health toll of fossil fuels across their entire lifecycle\u2014from extraction through combustion to post-use waste\u2014documenting severe health impacts including respiratory diseases, cardiovascular illness, cancers, neurological disorders, and premature mortality that disproportionately affect marginalized communities in \"sacrifice zones.\" It presents policy recommendations including halting new fossil fuel exploration, ending subsidies and redirecting funds to health infrastructure, internalizing health costs through the \"polluter pays\" principle, implementing community-led research, regulating industry disinformation, ending fossil fuel finance, and healthcare sector leadership in decarbonization. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Economic evaluation of financial incentives for maternal and child health in the Democratic Republic of the Congo: a decision-tree modelling based on a cluster randomized controlled trial","field_subtitle":"Zeng W; Shapira G; Gao T; et al: Global Health Research and Policy 10(41), 1-12, ttps://doi.org/10.1186/s41256-025-00435-9, 2025","URL":"https://tinyurl.com/3u6ypu7t","body":"This paper assessed the cost-effectiveness of performance-based financing in comparison with the direct facility financing. A decision-tree model incorporating key maternal and child health (MCH) services was developed to estimate cost-effectiveness. A total of US$205.9 million in 2021 dollars was spent on the PBF arm over the five years, with 71% allocated as incentive payments to health facilities and 19% as financial transfers to provincial purchasing agencies for contracting performance-based financing facilities and managing the performance-based financing programme. On average, the annual cost per capita was estimated at US$2.05 and US$1.71 for implementing the performance-based financing and direct facility financing program, respectively. Without the quality adjustment, the improvement in MCH services resulted in 1,372 lives saved over 2017\u20132021. The incremental cost-effectiveness ratio of the performance-based financing program reached US$1374 per quality-adjusted life years with substantial variation. After adjusting for quality, the incremental cost-effectiveness ratio of performance-based financing became smaller. Using three times the gross domestic product per capita in 2021 as the threshold, while performance-based financing was cost-effective, it had substantial variation. .","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Effects of a gender-responsive maternal, newborn and child health program on health and economic outcomes during COVID-19 in Kenya: a mixed-methods study","field_subtitle":"Adeniyi A; Ikemeri J E; M\u0169rage A; et al: International Journal for Equity in Health 24(242), 1-16, https://doi.org/10.1186/s12939-025-02579-z, 2025 ","URL":"https://tinyurl.com/48spm8wk","body":"This study evaluated the program\u2019s effectiveness in mitigating pandemic-related health and economic inequities in Trans-Nzoia County, Kenya, a region with significant pre-existing vulnerabilities. The authors conducted a mixed-methods study using an explanatory sequential design in 2023, collecting data from 609 women in 3 cohorts: continuous participants, discontinued participants and women without exposure. Continuous participants achieved significantly higher rates of postpartum visits and exclusive breastfeeding, with reduced disparities in essential maternal health services, albeit with lower health insurance uptake and minimal improvements in Poverty Probability Index scores. While the pandemic disrupted health services, membership provided continuity of care through adapted community health worker services. Pandemic-related restrictions limited the program\u2019s economic benefits, potentially due to the program\u2019s shift in focus toward health service delivery, intensifying existing economic inequities. The results highlight the need for robust government support and social protection to address underlying economic vulnerabilities for women, integrating community health workers into formal health systems and strengthening their linkages with formal financial systems. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Emotional dimensions of nurses\u2019 daily work in newborn units in Kenya: a qualitative study","field_subtitle":"Sen D; Boga M; Musitia P; et al. BMC Public Health 25(3632), 1-10, https://doi.org/10.1186/s12889-025-24832-4, 2025","URL":"https://tinyurl.com/5ftjwb6t","body":"This paper focuses on the emotional dimensions of nurses\u2019 daily work in newborn units in Kenya. These dimensions of newborn nurses\u2019 work are rarely documented and are under-supported in policy and practice. The authors conducted an empirical qualitative study design in two public hospital newborn units, with in-depth interviews with 21 health workers, and self-administered questionnaires. Neonatal nurses reported emotions ranging from pride and satisfaction to devastation, heartache, and indifference, with handling infant deaths and communicating bad news to families particularly distressing. Influenced by individual, interpersonal, and structural factors, emotions play a central role in nurses\u2019 interactions with their peers, supervisors, ward-in charges, and parents. Interactions with supervisors and in-charges have an especially powerful impact on staff emotional well-being and team cohesion, and informal support from peers is a key coping strategy. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Engaging with an Industrial Pandemic: Drivers of and Responses to the Expansion of Ultra-Processed Foods in East and Southern Africa","field_subtitle":"Loewenson R: Recent Progress in Nutrition 5(3), 1-10, doi:10.21926/rpn.2503018, 2025","URL":"https://www.lidsen.com/journals/rpn/rpn-05-03-018","body":"Intensified marketing and expanding consumption of ultra-processed foods (UPFs) that contain high sugar, salt, trans-fats and other additives and sugar sweetened beverages in Sub-Saharan Africa (SSA) are associated with rising obesogenic environments and non-communicable diseases, termed by some an \u2018industrial pandemic\u2019 due to its commercial drivers and cross border nature. This review paper addresses the question of how far SSA, positioned at an early point of a rising wave, is controlling this growing health challenge. It presents information on responses underway in SSA on (i) generating and sharing evidence and information as a form of discursive power; and on engaging (ii) on policy, regulation and other institutional measures; and (iii) at structural level, on taxes on UPFs and sugar sweetened beverages (SSBs) and investment measures, including to promote healthy food system alternatives, particularly in urban areas. While there is clear policy recognition of the need to respond effectively, the findings suggest that the response is not yet matching the scale or pace of the challenge. The paper examines the challenges in and options for implementing regulatory, policy, tax, and institutional interventions to prevent the health harms of UPFs and SSBs. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 243: How do we deliver equity in this age of inequality, extraction and impunity? ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Gaza\u2019s health emergency: impact of armed conflict and its global health repercussions","field_subtitle":"Ali M; Rehman I; Lee K; et al: Global Health 21(65), 1-6,  https://doi.org/10.1186/s12992-025-01161-0, 2025","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-025-01161-0","body":"The Gaza Strip, characterized by its dense population and persistent geopolitical instability, has experienced decades of armed conflict, resulting in systematic healthcare infrastructure deterioration. The healthcare delivery system has been collapsed by Israeli military operations, creating cascading effects that extend beyond regional boundaries. The medical facilities have been targeted, combined with humanitarian aid restrictions, has created unprecedented challenges in providing essential healthcare services to the affected population. The environmental degradation resulting from infrastructure destruction poses additional threats to regional and global health systems. This analysis examines the multifaceted health crisis encompassing healthcare system dysfunction, pharmaceutical supply chain disruption, infectious disease proliferation, and the consequent implications for global health security. The conflict and military support raise trade-offs between military expenditures and other critical sectors, including international healthcare and development funding. The failure to protect healthcare infrastructure in Gaza establishes concerning precedents for similar conflicts globally and undermines the fundamental principle of medical neutrality. The Gaza crisis demonstrates the urgent need for strengthened global health security mechanisms capable of responding to conflict-induced health emergencies.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Global market trends and financial performance of the corporate fast-food industry and their potential contributions to diets high in meat and ultra-processed foods","field_subtitle":"Sievert K; Botha T; Wood B; et al: Global Health 21(60),1-18, https://doi.org/10.1186/s12992-025-01158-9, 2025","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-025-01158-9","body":"Corporate fast-food retailers (FFRs) represent a key retail channel through which both ultra-processed foods and intensively produced animal source foods are consumed and normalised within corporate-industrial food systems. These dietary patterns are strongly associated with increased risks of diet-related diseases and contribute significantly to environmental degradation, including greenhouse gas emissions, land use change, and biodiversity loss. Despite the growing significance of FFRs, there has been limited analysis of their financial strategies and implications for global food system transformation. The authors conducted a global analysis of market data from 54 countries and financial data of publicly listed FFRs, examining trends in FFR sales (2009\u20132023), market dominance, and the financial performance of leading publicly listed firms (1980\u20132023). While sales in high-income countries were stagnating, leading firms maintained stable net profit margins and delivered relatively high shareholder returns, facilitated by financial strategies such as franchising and private equity ownership. U.S.-based corporations dominated the global market, with substantial expansion into countries outside the global North. These trends reflect the consolidation of power within the corporate food regime. The global expansion of corporate FFRs underscore their growing influence over diets and food systems, with critical implications for public health, ecological sustainability, and social justice. Policies targeting structural leverage points, for example, democratising corporate governance, reducing the influence of private equity, and re-orienting agri-food subsidies, are essential to countering the entrenchment of this model and supporting more democratic and sustainable food systems.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Global South-led responsible AI solutions to strengthen health systems: an emergent research landscape","field_subtitle":"Sinha C: Oxford Open Digital Health 3, https://doi.org/10.1093/oodh/oqaf016, 2025","URL":"https://academic.oup.com/oodh/article/doi/10.1093/oodh/oqaf016/8193400","body":"Artificial intelligence (AI) solutions are being adopted across the globe, including the Global South, to address health needs and strengthen health systems. The rapid adoption of AI solutions provides tremendous potential to redress health inequities and strengthen health systems. It also entails substantial risks of deepening inequities, creating new forms of exclusion and weakening fragile health systems. Drawing on field-based case studies and interdisciplinary consultations, this paper presents an emergent research landscape that prioritizes health equity, gender equality, ethical safeguards, inclusive governance and Global South leadership. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health Impact Assessment of a Small-Scale Mining and Milling Operation in Bubi District, Zimbabwe","field_subtitle":"University of Zimbabwe, EQUINET, TARSC, AEGT: September, 2025","URL":"https://tinyurl.com/3rx56yhf","body":" This HIA examined the Small-Scale Mining and the Milling Operation in Bubi District, Zimbabwe. Artisanal and small-scale mining (ASM) and custom milling in Bubi District expose miners and communities to high risks of accidents, respiratory diseases, and chemical poisoning. An estimated 35% of miners suffer accidents, while 19% develop silicosis and a tuberculosis prevalence of up to 40%. Poor mining practices and management of custom milling effluent of mercury, cyanide, and heavy metals threaten the Mbembesi River, a water source for the downstream community and domestic animals. The projected health impacts raised a number of recommendations, including for: frequent inspection of mining sites and stronger regulatory enforcement; safer technologies; awareness campaigns to mitigate potential health impacts, as reinforced by the Public Health Act, Environmental Management Act, and Mines and Minerals Act; enclosed milling systems and automated controls to minimize dust and noise exposure for workers; and stricter requirements for waste discharge. The authors propose that a policy requiring Environmental Impact Assessments (EIAs) and HIAs should be applied and enforced in all ASM operations as a condition for licensing.\r\n","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Health Impact Assessment of legal formalization of Artisanal and Small-Scale mining of critical minerals in the DRC. Lessons from the Ministerial Decree 19/15 in Lualaba province ","field_subtitle":"Centre of Expertise in Mining Governance and Environment, EQUINET, TARSC, AEGT: September 2025","URL":"https://tinyurl.com/mt355ddn","body":"This Health Impact Assessment (HIA) examined the health impacts of artisanal and small-scale mining (ASM) in the Lualaba province, Democratic Republic of Congo (DRC), to assess the effectiveness and application of Ministry of Mines 2019 Decree N\u00b019/15. The recommendations for improving and implementing the decree included legal revisions to enable voluntary retirement or redeployment of vulnerable workers; to include affected communities and local ASM associations in meetings and decisions impacting their wellbeing and promote improved living and working environments for ASM and adjacent communities. Recommendations to improve the decree\u2019s implementation included encouraging informal artisanal and small-scale miners to join cooperatives; strengthening capacities to enforce the decree, together with training ASM associations on health and safety at work; intensifying the monitoring of the health and environmental impacts of mining activities in communities neighbouring ASM sites and developing remediation plans for environmental or health impacts.\r\n","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Health Impact Assessment of the 2024 Zambia Minerals Regulation Commission Act. ","field_subtitle":"Southern African Institute for Policy and Research (SAIPAR), EQUINET, TARSC, AEGT: September 2025","URL":"https://tinyurl.com/waks2cw2","body":"This Health Impact Assessment (HIA) examined Zambia\u2019s Minerals Regulation Commission Act No. 14 of 2024. The Act has been enacted and assented to on 20th December, 2024, but awaits regulations. The HIA examined the Act through the lens of specific health impacts of mining activities on the Copperbelt Province, drawing evidence from Kankoyo Township in Mufurila District. The projected health impacts raised recommendations for the Ministry of Mines and Community development to: Strengthen health and safety conditions in mining by mandating ventilation standards, personal protective equipment (PPE), ergonomic monitoring, and routine health checks.; Prevent mine-related air and water pollution by enforcing emission thresholds with real-time monitoring; and  Legally bind developers to replace lost infrastructure and services such as health and education for displaced communities, where mining results in unavoidable displacement. The Ministry of Health was also recommended to ensure that health is embedded in local development plans through its own institutional mechanisms and community engagement.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Health Impact Assessment of the Draft Tanzania Critical and Strategic Minerals Strategy","field_subtitle":"Mkwawa University College of Education, EQUINET, TARSC, AEGT: September 2025","URL":"https://tinyurl.com/bdfccxf8","body":"Tanzania is an emerging critical minerals development frontier. This Health Impact Assessment (HIA) examined the inclusion of health impacts in the Tanzania draft Critical and Strategic Minerals Strategy. . This included the health impact of air and water pollution and hazardous work; of social changes in mining sites and the mental ill health impact of lack of engagement in mining plans. The projected health impacts led to recommendations, including for: monitoring, and managing health risks and outcomes for the various population groups and along different phases of the extractive process; legislating for mandatory HIA in all critical minerals projects; building key agency and community capacities to protect health; ensuring a mechanism for communities to monitor and report on mining compliance with environmental, social and governance (ESG) standards and requiring periodic reporting by state and mining companies on their engagement and awareness campaigns in affected communities. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"How do we deliver equity in this age of inequality, extraction and impunity? ","field_subtitle":"EQUINET Steering committee","body":"In our August newsletter we asked what constitutes a just response when our global political economy is generating deepening deprivation, conflict and inequality, and when powerful actors fuelling and gaining from these conditions appear to be able to act without penalty? You contributed on the realities we are facing and what a just response demands. \r\n\r\nFrom different countries in east and southern Africa you pointed to global issues- conflict, climate extremes, and economic shocks - that are deepening inequality and insecurity.  You noted that intensified extraction of minerals and biodiversity and rising debt burdens in the past decade are depleting public funds for health, education and other services, and that households are struggling with food security.  Of the 6.6 million Zambian children, 71% are suffering from multiple dimensions of deprivation. Poverty conditions are associated with crime, gender-based violence (where rates in South Africa are among the highest in the world), discrimination and other forms of conflict.  \r\n\r\nInformal workers make up a large share of producers in our region. In Zimbabwe they are around 80% of the labour force, contributing about 60% of GDP. They work in harsh, often hazardous conditions for minimal fluctuating income, trading health for survival. Many are young people, facing insecure futures and bearing the brunt of climate impacts and economic shocks, with minimal social or institutional protection. Many small-scale miners in our region are extracting lithium and cobalt used in green transition technologies in high income countries, harming their health while generating wealth largely earned outside the region.  \r\n\r\nThis situation represents daily violations of rights to health and its determinants, and a gap in the implementation of laws and policies that protect these rights. Those most affected are largely excluded from the national, international and corporate systems that are planning, accumulating, distributing and using the wealth from resources in the region. \r\n\r\nViolence and rights violations reach their extreme when people are caught in military conflict. Not surprisingly this is often in areas of significant resources for wealth extraction. A humanitarian crisis and genocide in Sudan that has been ongoing since 2019 was profiled in October, with report of thousands of people massacred, and over 20 000 fleeing Al-Fashir alone. Of 40 million Sudanese people, over 20 million are reported to be nearing starvation and 10 million forced to leave their homes. Uganda, the largest refugee-hosting country in Africa, shelters over 1.6 million displaced people, despite its systems already being overstretched. In Sudan, cholera, malaria, dengue and malnutrition have escalated. Health services have not escaped violence. The World Health Organization reports that 460 patients and their companions were killed at the Saudi Maternity Hospital in El Fasher in October 2025. Director-General Tedros Ghebreyesus said that prior to this latest attack, WHO had verified 285 attacks on healthcare in Sudan with at least 1204 deaths and over 400 injuries of health workers and patients since the start of the conflict.\r\n\r\nIn 2018, Sudanese women, youth, workers, and professionals protested en masse against economic hardship and authoritarian rule, with demands for freedom, peace, and justice.  Yet interests in Sudan\u2019s significant gold resources by countries and military forces contradict these social demands for equitable revenue distribution. Violence appears to serve, rather than disrupt extraction, with gold, livestock, and agricultural exports continuing, and in some cases increasing, during the conflict, despite the social devastation and rhetorical commitments to peace.\r\n\r\nWhat is the response to these various dimensions of injustice?   \r\n\r\nOne response has been as protest. In Madagascar in September, young Gen Z protesters took to the streets to demand economic opportunities, a leadership that will improve their quality of life, and to participate in the decisions that affect their lives. Disillusioned with the government, protestors rejected government calls for talks, demanding the president\u2019s resignation. The president fled in October, and the military took power, forming a transitional committee with the promise to restore civilian rule. Whether this will produce the change that motivated the protests remains to be seen. \r\n\r\nAs for young people in Madagascar, the responses to our question in August showed clear aspirations for a more just society: One that invests in secure jobs, livelihoods, communities and services, where people access affordable water, housing, clean energy, infrastructures and services; that prioritises social development over individual wealth accumulation and respects human rights.  The call is also for dehumanising violence to end. As WHO noted in relation to the military attacks in Sudan, \u201cAll attacks on healthcare must stop immediately and unconditionally,\u201d and health workers and civilians should be protected under international law. \r\n\r\nThese changes call for communities everywhere to be protected, organised, empowered and heard, in a culture of solidarity and accountable, democratic governance.  Recognising people as active agents in inclusive, locally-grounded approaches is seen to be an essential foundation for building a fairer, just future. This demands a clear strategy to rebuild societies from the damage of neoliberalism, debt, structural adjustment, extraction and violence. Without this, protest simply brings new hands on the steering wheel, while the inequity continues. \r\n\r\nThe responses pointed to the role of regional solidarity, self-determination, strategies and standards in generating more inclusive economies, providing space and accountability for policy innovation. They indicate confidence that we have the assets, capacities and social demand in the region to build a fairer alternative, if we reclaim resources, states, and collective values.\r\n\r\nHowever, whether locally, nationally or regionally, people struggle within global systems that protect existing privilege and wealth, and that encourage leaderships to do the same. \r\n\r\nHence the disappointment that multilateralism and United Nations institutions have failed to enforce international law, or to set a global political economy framework that confronts inequality. Of the 140 targets in the Sustainable Development Goals (SDGs) set in 2015 to be met by 2030, only 12% are said to be on track, 50% to be moderately or severely off track, and 30% have either stagnated or regressed. While some point to a funding barrier, and there is indeed a reported $4 trillion yearly funding deficit to meet the SDG targets, there is a deeper critique. There is no shared vision of the alternative global political economy that can embed such development goals, and an unwillingness to disrupt powerful economic interests. So global financial institutions and private lenders continue to prioritise fiscal wellbeing over social or planetary wellbeing, UN institutions fail to protect vulnerable populations against deprivation, exploitation and even genocide, and powerful actors globally spin narratives that hide the realities on the ground. \r\n\r\nIssa G. Shivji, the prominent Africa thinker asks: will naming and shaming over these violations shake power into action? Or if power is amoral, how do you confront it?  His answer is to keep unmasking a capitalist political economy that trumps morality, values and humanity in its relentless pursuit of profit and insatiable thirst for accumulation. Samir Amin argues for \u2018delinking\u2019 and building sufficient political power in the region to construct self-determined development strategies that are not in servitude to global value chains.  Some point to China, with its large public sector and high levels of public investment that override private corporate interests in the economy. Others point to successful wellbeing economies. There are options. They demand social debate at all levels, and accountability to public interest.\r\n\r\nNeither can we let multilateralism off the hook, given its role in transnational taxes, pricing, financial flows, trade, intellectual property and other global processes affecting the region. While the UN is being weakened and subjugated by market forces and power imbalances, it cannot be lost to drivers of inequity. When established in October 80 years ago, the UN aimed to promote peace, human rights and international co-operation. This mandate is still undelivered. One commentator observed that if the UN was disbanded on a Friday, it would be reinvented by Monday.  Protecting what is democratic, such as the one state, one vote in the WHO and the General Assembly, and changing what is not, such as the undemocratic composition of the Security Council or health-harming intellectual property rules are part of that reinvention. \r\n\r\nThe most harmful consequence of injustice is when people lose the confidence and understanding that they have the power to produce change. However, your responses highlight that inequality, extraction and impunity are not inevitable. There are building blocks, ideas, strategies, alliances and diverse terrains of action that show this. \r\n\r\nWe welcome your feedback or queries on the issues raised in this oped \u2013 please send them to the EQUINET secretariat. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Ideas matter: An analysis of the effects of framing on health system strengthening in Zimbabwe","field_subtitle":"Mhazo A T; Maponga C C: Health Research Policy and Systems 23(111), 1-16, doi: https://doi.org/10.1186/s12961-025-01327-7, 2025","URL":"https://tinyurl.com/4n2jrbp6","body":"This paper examined changes in the portrayal of health system strengthening (HSS) in Zimbabwe from the mid-2000s to the period post-2020 using a framing analysis methodology. Four main frames were identified, namely HSS as an external funder imperative, a pathway to resolve crisis, a strategy for achieving long-term stability and a foundational investment for a resilient health system. HSS as a remedy for a crisis frame has been the most influential, but the greater involvement of external funders and reductions in their funding has shifted towards more governmental responsibility, resulting in health system shocks in critical areas such as  personnel. The vulnerability and emotional frames that attracted external funding during peak crisis are found to have lost potency over time, and the shifts require policy response, to avoid missed opportunities for improvement and a loss of public trust in government effectiveness and responsiveness. Nascent, overly futuristic framings such as resilience are noted to be interpreted with caution, as they may cloud the reality that HSS is simply sufficient investment in basic functions. The authors argue that HSS needs to be reframed as a routine, country-owned strategy aimed at improving health system performance rather than a crisis response shaped by external funder interventions. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Implementation context and stakeholder perspectives on routine immunization data among lower-level private for-profit providers in an urban setting: experiences from Kampala, Uganda","field_subtitle":"Ssegujja E; Kiggundu P; Karen S Z;et al: Health Research Policy and Systems 23(112), 1-13, https://doi.org/10.1186/s12961-025-01351-7, 2025 ","URL":"https://tinyurl.com/yarj86zh","body":"This paper documented the current implementation context of immunization data among urban lower-level private for-profit immunization service providers in Kampala, Uganda, using an exploratory qualitative design. Overall, private for-profit immunization service providers showed both barriers and opportunities in immunization management. The barriers included: high staff turnover; data overload and manipulation tendencies; a transient population that access immunization services from different service providers without data linkage systems; computation of catchment populations, which affects utilization coverage data; financial barriers to the collection of community-level data; and inadequate facilitation leading to lean human resources at EPI departments managing immunization data from private providers. Nonetheless, opportunities to improve immunization data included the ability to widen data coverage through their services, enhanced public\u2013private-partnership through data sharing arrangements, linkage of urban data among providers, improved recording of urban surveillance data, additional human resource to record data, widened scope for capturing adverse events data, improved community data linkages, and transitioning from paper-based to electronic data capture. The authors call for innovative strategies to address barriers and tap these opportunities. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Implementation of the WHO Pandemic Agreement","field_subtitle":"Jon W: Bulletin of the World Health Organisation 103(10), 638-640, doi: 10.2471/BLT.25.294146, 2025","URL":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12481221/","body":"The WHO Pandemic Agreement, adopted 20 May 2025 as WHO's second legally binding health treaty, mandates a One Health approach for preventing zoonotic spillovers (75% of emerging infectious diseases) and establishes a Pathogen Access and Benefit-Sharing system requiring manufacturers to provide WHO with 20% of pandemic product production in exchange for pathogen genetic sequence data access. Learning from COVID-19's inequitable distribution (low-income countries: ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Integration of traditional and complementary medicine into primary health care systems: a systematic review","field_subtitle":"Wang M; Liu Z; Sun Y; et al: Bulletin of the World Health Organisation 103(11), 675-684C, doi: 10.2471/BLT.25.293465, 2025","URL":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12578535/","body":"This study explored the integration of traditional and complementary medicine in health systems and identify the enablers and barriers to the process, with a focus on low- and middle-income countries, with 56% of included papers from African countries. Traditional and complementary medicine was found to have the potential to strengthen various aspects of health systems, particularly in health-service delivery and products. The most commonly mentioned determinants influencing integration of traditional and complementary medicine were policies and finance, resource availability, and efficacy, quality and safety. The findings highlight the role of policies and finance in supporting integration of traditional and complementary medicine, and the need to ensure the quality and safety of traditional products through scientific methods. Reforms in medical education and strategic resource allocation are argued to be needed to create the conditions for successful integration of traditional and complementary medicine.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Legal Action Taken to Address Environmental Mismanagement in Kiteezi, Uganda","field_subtitle":"Centre for Health, Human Rights and Development (CEHURD): May 2025","URL":"https://tinyurl.com/3umcne8z","body":"Together with the communities of Kiteezi, in Wakiso District, CEHURD filed a landmark case in the Civil Division of the High Court of Uganda against the Kampala Capital   City Authority (KCCA) and the National Environment Management Authority (NEMA) challenging the rights violations that followed the August 2024 catastrophic collapse of the Kiteezi landfill. This tragedy resulted in fatalities, displacement, and extensive environmental contamination. The legal intervention seeks to compel KCCA and NEMA to decommission the landfill, comprehensively restore the surrounding environment, and adopt sustainable waste management systems for the betterment of the communities in Kiteezi. Through this action, CEHURD further aims to address the failure of KCCA and NEMA to fulfil their constitutional and statutory mandates to safeguard the right to a clean, safe, and healthy environment, an omission that escalated risks, including hazardous waste leakage and water source contamination to the communities.  CEHURD aims to set a precedent for environmental accountability and the protection of health-related human rights.  ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Menstruation and period poverty as an obstacle for girls\u2019 equal participation in education, Tanzania","field_subtitle":"V\u00e5genes V; Grevstad C: BMC Public Health 25(3637), 1-10, https://doi.org/10.1186/s12889-025-24864-w, 2025","URL":"https://tinyurl.com/4jrbjxp8","body":"This paper noted that monthly menstruation can complicate participation and achievement for schoolgirls. On a global scale, and in Tanzania, school enrolment of girls and boys are becoming equal, or even in favour of girls. However, in contrast to many other countries, Tanzanian boys on average score better than girls on secondary school exams. The authors argue that menstrual health management difficulties are probably a barrier to female participation and success in secondary education. Factors like cultural beliefs and taboos, poverty, inadequate infrastructure at school and at home, lack of pads, and of relevant knowledge, are challenging to girls who are pursuing an education and at the same time balancing norms and ideals of traditions and of modernity. The authors argue that knowledge and openness concerning menstrual health management is needed, and that the school has an essential part to play in this.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Migrants are human beings and they don\u2019t sleep with animals: healthcare workers and migrants\u2019 experiences of the impact of inadequate antiretroviral therapy provision in Botswana","field_subtitle":"Balekang G B; Galvin T; Rakgoasi D S: International Journal for Equity in Health 24(239), 1-11, doi: https://doi.org/10.1186/s12939-025-02621-0, 2025 ","URL":"https://tinyurl.com/4vmrat6z","body":"This study explores the perceptions of healthcare workers and cross-border migrants on the impact of inadequate antiretroviral therapy provision to migrants and the consequences for the local population. A qualitative study was conducted in Gaborone and Francistown, Botswana with 12 healthcare providers and 20 cross-border migrants. Participants highlighted that excluding migrant from antiretroviral therapy exacerbates health inequalities and contributes to HIV transmission. Migrants, particularly those involved in sex work were perceived as both vulnerable to HIV and as potential vectors of transmission to the broader population. Denying treatment in critical contexts such as during childbirth, was regarded by both groups as a major public health and ethical failure. Healthcare workers expressed moral distress in being unable to provide care due to institutional restrictions, and emphasized that access to essential health services should not be contingent on migration status. The findings underscore an urgent need for inclusive health policies that extend antiretroviral therapy and related HIV services to all individuals in Botswana, regardless of migration status, for both migrant and population health. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Mobilizing for Health Justice: Global Health Watch 7 ","field_subtitle":"People\u2019s Health Movement (PHM): September 2025","URL":"https://phmovement.org/mobilizing-health-justice-global-health-watch-7","body":"There are three innovations with Global Health Watch 7 (GHW7). First, almost all of the chapters involved writing groups and contributions representing the geographic breadth of People\u2019s Health Movement (PHM). As an exercise in \u2018movement building,\u2019 writing groups were encouraged to use their chapters as opportunities to discuss and engage across these geographies, allowing activists to learn with each other. PHM published with a solidarity publisher (Daraja Press) where each chapter could be posted for free download and distribution as soon as it was completed, and is now downloadable as a single book PDF or as an on-demand print version in English and Spanish. GHW7 comes to life with contributions from over one hundred activists around the world, sharing experiences and analysis on issues affecting people\u2019s health in the contexts they live in and efforts to progress towards greater health justice. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Navigating stigma: a qualitative study of barriers to opioid treatment engagement in Tanzania","field_subtitle":"Admase A; Cooney E E; Atkins K; et al: Substance Abuse Treatment, Prevention, and Policy 20(43), 1-7, doi: https://doi.org/10.1186/s13011-025-00660-y, 2025","URL":"https://tinyurl.com/39hxnrtw","body":"This paper draws on 40 in-depth interviews with current and former medication for opioid use disorder clients and four focus groups with 35 current clients at an opioid treatment clinic in Dar es Salaam, Tanzania. Transcripts were thematically analyzed to explore how stigma influenced medication for opioid use disorder adherence and retention. Five themes emerged: stigma encountered while using public transportation; employment-related stigma; lack of family support due to misinformation; institutional stigma within the treatment setting; and stigma management strategies, including altering appearance and distancing from peers. Gendered expectations intensified stigma for women, while assumptions of untrustworthiness shaped client interactions across settings. These experiences posed significant barriers to consistent treatment engagement. To support medication for opioid use disorder retention, the authors propose integrating stigma reduction through expanded family engagement, more flexible clinic policies, client-informed approaches and public education. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Online meeting: Strategies for engaging with the public health impacts of climate change and fossil fuels ","field_subtitle":"EQUINET; Global Climate and Health Alliance; Federal University of Rio Grande do Sul: October 2025","URL":"https://youtu.be/zJcZeG_xJkg","body":"EQUINET through TARSC in association with colleagues from the Global Climate and Health Alliance and Federal University of Rio Grande do Sul held an online meeting on Tuesday 30th September on 'Strategies for engaging with the public health impacts of climate change and fossil fuels\". The meeting was attended by 42 participants from different countries and heard from two international presenters: Shweta Narayan, Global Climate and Health Alliance on a Public health strategy to challenge health and climate impacts of the fossil fuel industry, and Carlos Dora, Federal University of Rio Grande do Sul, Brazil, on Health impact assessment to respond to commercial determinants of climate change. The presentations were followed by discussion. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Prevalence and determinants of chronic non-communicable diseases among prison inmates in the city of Tete, Mozambique: a cross-sectional study","field_subtitle":"Xavier S P; Motivo N J C; Xavi R; et al. BMC Public Health 25(3110), 1-9, https://doi.org/10.1186/s12889-025-24387-4, 2025","URL":"https://tinyurl.com/39fht4sv","body":"This paper analyzes the prevalence and determinants of chronic diseases among prisoners in the city of Tete, Mozambique in a cross-sectional study among inmates at the Tete City Prison. The prevalence of hypertension, diabetes and obesity was 37%, 10% and 1.4%, respectively. A family history of diabetes and being female were identified as risk factors associated with diabetes and hypertension, respectively. The study revealed high rates of diabetes and hypertension among inmates, and is observed to call for preventive measures for hypertension, along with early screenings for individuals with a family history of diabetes to mitigate complications in the prison environment.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Reflections on the UN General Assembly: Better together - 80 years and More for Peace, Development and Human Rights","field_subtitle":"Pambazuka News Editors: Pambazuka News, October 2025","URL":"https://www.pambazuka.org/UN-General-Assembly","body":"The 80th session of the UN General Assembly (September 2025) convened amid rising geopolitical tensions, authoritarianism, climate crises, and the genocide in Palestine, highlighting urgent calls for UN power redistribution. This critical reflection examines the UN's historical evolution from its 1945 founding after the League of Nations' failure, through early peacekeeping successes like the 1956 Suez crisis, to current structural limitations exposed by its inadequate response to Palestinian genocide. Global South leaders condemned the concentration of binding and veto power in the five-member Security Council over the 193-member General Assembly's non-binding recommendations, arguing this structure perpetuates colonial-era power imbalances and prevents timely humanitarian intervention. Leaders called for urgent restructuring to transfer decision-making authority from the Security Council to the General Assembly, arguing that true multilateralism requires equality among nations in both theory and practice to fulfil the UN Charter's foundational commitments to human rights, dignity, and social progress.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Report: Meeting on the Implementation of Health Impact Assessment in Zimbabwe, August 22, 2025 ","field_subtitle":"Ministry of Health and Child Care, TARSC, EQUINET: Harare, August 2025","URL":"https://tinyurl.com/bdzxjc2f","body":" In recognition of the critical mass of people with health impact assessment (HIA) capacities in Zimbabwe and inclusion of HIA in Zimbabwe's Public Health Act (Chapter 15:09, 2018) the Ministry of Health and Child Care (MoHCC) in co-operation with the Training and Research Support Centre (TARSC) and EQUINET invited key stakeholders to a meeting on Friday 22nd August 2025 to discuss practical steps for advancing regulatory guidance, capacities and implementation of health impact assessments in Zimbabwe. The meeting included an overview on HIA, presentation of HIA work already implemented in Zimbabwe, followed by discussion on proposals for priority sectors for HIA implementation, and the provisions in the Public Health Act and other laws related to HIA. This document reports the proceedings of the meeting. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Survival probability and under-five mortality predictors in Western Kenya between 2015 and 2020","field_subtitle":"Owuor H O; Amolo A S; Aol G; et al: BMC Public Health 25(3874), 1-9, https://doi.org/10.1186/s12889-025-25052-6, 2025","URL":"https://tinyurl.com/k42kmeda","body":"This paper estimated the survival probability and determine predictors of under-five mortality in Siaya County, Kenya, using secondary data from the Siaya Health Demographic Surveillance System from 2015 to 2020 and semi-annual population-based longitudinal surveillance. The cumulative survival probability among children under five was 92% with children of younger age being at increased risk of death. The risk of under-five mortality increased with decreasing maternal education and number of Antenatal Clinic visits. Delivery at home/way to the hospital, maternal age less than 18 years, no latrine and male gender were associated with reduced survival. Under-five mortality in Siaya was 63/1000 live births, higher than the national average of 41.6/1000 live births. Gender, maternal education, number of anti-natal care visits, maternal age, delivery in hospital, and availability of toilets at home were the main predictors of under-five mortality. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The Perspectives of Key Informants on Programs and Policies Pertaining to HIV Prevention and Treatment for Farm Workers in Rural South Africa","field_subtitle":"Mlangeni N; Lembani M; Adetokunboh O; et al: Advances in Public Health (7937775), 1-13, https://doi.org/10.1155/adph/7937775, 2025","URL":"https://academic.oup.com/heapol/article/40/1/75/7842825","body":"This study explored perspectives on the challenges and opportunities in providing HIV prevention and care to people working on farms in three provinces of South Africa. Eight policy documents were analyzed, and eight key informants were interviewed. Several challenges in providing HIV care to farm workers were presented, including their high mobility which leads to treatment interruptions and loss to follow-up. As a result, farm workers easily get lost to follow-up and are likely to have poor treatment outcomes. Some of the effective strategies included community-based prevention, treatment and support services, and the use of health passports to improve linkages to care. Community health workers, mobile clinics, and community-based pick-up points improve access to HIV counselling and testing, adherence to antiretroviral therapy, and retention in care. Program and policy recommendations included customized HIV services and designing sector-specific HIV policies.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Unlocking value: a comprehensive costing study of primary health care service delivery in Tanzania","field_subtitle":"Margini F; Mahera W C; Kapologwe N; et al: BMC Primary Care 26(307), 1-11, https://doi.org/10.1186/s12875-025-02985-w, 2025","URL":"https://tinyurl.com/4zfuk76j","body":"A top-down approach was used to understand the costs incurred by the government to provide PHC services in public health facilities. All facility and community-level expenditures incurred by the government and development partners on human resources, medicines, medical supplies, and facility operations were collected and included in the costing. The total funding gap was calculated as the difference between actual expenditure and estimated normative cost. Government expenditure on PHC substantially increased between fiscal year 2021/22 and 2022/23. Nevertheless, the spending level is significantly lower than global benchmarks, and the resources required to deliver quality PHC services according to the basic service standards. Moreover, the analysis revealed there are important differences in the levels of spending per capita across regions and health service delivery productivity. The Government of Tanzania\u2019s PHC spending increased significantly over the two years, raising the per capita PHC expenditure and the expenditure per outpatient visit. As the Government of Tanzania increasingly finances health services from domestic sources, the authors note a key consideration for long-term planning in the context of declining partner funding to be the total funding required to provide quality PHC services equitably to the population. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"VIDEO: Health equity as a lever: Health and climate justice in mineral extraction in East and Southern Africa ","field_subtitle":"EQUINET, CITE: November 2025","URL":"https://youtu.be/fCOsb8hpGS0","body":"The global race for critical minerals (lithium, cobalt, rare earth) to enable green energy transition has sparked mining expansion across East and Southern Africa, yet extraction operations contaminate air, water, and soil, causing respiratory diseases, kidney problems, miscarriages, and elevated heavy metal exposure in workers and communities (including pregnant women and children), with chronic illnesses extending into future generations while environmental impact assessments fail to prevent these harms and export profits bypass local communities. The video advocates for mandatory health impact assessments, citizen monitoring by mining associations and unions, stricter pollution and occupational safety standards, mine-funded cleanup and health services, community rights to refuse harmful projects, and establishment of sovereign wealth funds from mineral exports to finance regional technology development and healthcare infrastructure, reframing the green transition around health equity to ensure corporate accountability, patent-free green technology access, and fair trade that values people and planet equally.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"VIDEO: Health equity as a lever: Tackling climate and agribusiness challenges for local farmers ","field_subtitle":"EQUINET, CITE: October 2025","URL":"https://www.youtube.com/watch?v=V7cQ2KqjXHA","body":"Across East and Southern Africa, accelerating climate change through droughts, heat waves, floods, and storms threatens farming-dependent communities with harvest losses, food insecurity, and displacement, while creating health crises including malaria, diarrhoea, and malnutrition that disproportionately impact poor households, women, and youth who lack resources to adapt or relocate, even as transnational agribusiness corporations clearing smallholder land for export-oriented production profit amid widespread poverty. This video documents community-led adaptation strategies including seed saving, rainwater harvesting, agroecology, tree food processing for income generation, health impact assessments for new investments, and demands for agribusiness taxation to support local services, emphasizing that climate change deepens existing inequalities while transnational corporations externalize costs onto vulnerable populations, but collective action at local, national, regional, and global levels linking health equity and climate justice offers pathways to protect communities, share knowledge, develop local solutions, strengthen solidarity, and ensure well-being for all.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"We might have been prescribing antibiotics to clients who do not need them: a mixed-methods study of knowledge, attitudes, and practices related to antibiotic use for pediatric acute respiratory illness among community health workers in Uganda","field_subtitle":"Ciccone E J; Gutierrez A T B; Nyangoma G; et al: BMC Public Health 25(3398), 1-11, doi:  https://doi.org/10.1186/s12889-025-24712-x, 2025","URL":"https://tinyurl.com/3utd3jnz","body":"This study assessed knowledge, attitudes, and practices related to antibiotics among community health workers (CHW) for children with acute respiratory illness in rural Uganda. A total of 63 of 67 CHW completed both baseline and follow-up surveys, and 15 CHW were interviewed. The median age of the full cohort was 40 years with 9.5 years of CHW experience. Almost all CHW identified amoxicillin as an antibiotic at baseline, and most associated antibiotics with treating bacterial diseases. Most perceived antibiotics as harmful to patients when prescribed unnecessarily. At follow-up, more CHW disagreed that antibiotics should be prescribed when in doubt. They welcomed additional education about antimicrobial resistance and diagnostic tools to advance antimicrobial stewardship. CHW were overall familiar with antibiotics and their potential harms. They were eager to gain knowledge regarding advance antimicrobial stewardship and AMR and share it with their communities. CHW are argued to represent an underutilized resource for advance antimicrobial stewardship interventions and should be included in their design and implementation.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Young Scientist Summer Program (YSSP) at the International Institute for Applied Systems Analysis (IIASA)","field_subtitle":"Deadline for Applications: 12 January 2026","URL":"https://iiasa.ac.at/early-career/yssp","body":"The Young Scientist Summer Program (YSSP) at the International Institute for Applied Systems Analysis (IIASA), is currently accepting applications to its 2026 program. The program, which takes place from June to August, is designed for PhD students (ideally about 2 years prior to receiving their PhD) working on a topic compatible with ongoing research at IIASA and a wish to explore the policy implications of their work. Participants will be working under the direct mentorship of an experienced IIASA scientist in a unique interdisciplinary and international research environment. They will produce a paper (serving as first step towards a publishable journal article) and will get the opportunity to build up contacts for future collaboration within the institute's worldwide network. Applications are particularly welcome from candidates interested in human-centred and population-based approaches to understanding drivers of population change, sustainable development, and wellbeing.","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Zimbabwe Conducts Joint External Evaluation to Strengthen Health Security and IHR Core Capacities","field_subtitle":"East Central and Southern Africa Health Community: ECSA HC, Tanzania, September 2025","URL":"https://tinyurl.com/nx4dctxh","body":"This paper assessed the country\u2019s progress in implementing the International Health Regulations (IHR 2005). The joint external evaluation, Zimbabwe\u2019s second since joining the IHR framework, brought together national experts and international evaluators from WHO, Africa CDC, ECSA-HC, Kenya and Uganda National Public Health Institutes, IFRC, UNFPA, and other partners. Using the WHO joint external evaluation Tool version 3.0, the evaluation reviewed 19 technical areas covering prevention, detection, and response capacities, as well as points of entry, chemical, and radiation emergencies. The evaluation highlighted commendable progress in several areas of IHR implementation, including strong political commitment and legal frameworks supporting health security coordination, functional national and subnational laboratories capable of timely detection of priority diseases, established coordination mechanisms and surge capacity during public health emergencies and competent human resources across multiple levels of government to support implementation. ","php":"","field_issue_date":"2025-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"2nd biennial Uganda National Conference on Health, Human Rights and Development (UCHD 2025) ","field_subtitle":"3-5 September, 2025, Kampala, Uganda","URL":"https://www.uchd.ug/","body":"The 2nd biennial Uganda National Conference on Health, Human Rights and Development (UCHD 2025) will build on the momentum and successes of the UCHD 2023 conference, which emphasized health as a human right and a cornerstone for realizing Sustainable Development Goals. The 2023 conference, through its outcome document, the Kampala Declaration on Health, Human Rights, and Development recognized the right to health as fundamental to achieving Uganda\u2019s Vision 2040.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A Biodigester for clean energy at ENSOA, Antsirabe, Vakinakaratra,Madagascar","field_subtitle":"E-TAntsoroka ho an'ny Fampandrosoana ny maha Olona: EQUINET, Harare, July 2025","URL":"https://tinyurl.com/4dcnevav","body":"EQUINET\u2019s recommendations on integrated urban health in 2024 in Eastern and Southern Africa include measures to BUILD health promoting integrated improvements for urban health, including supporting the locally produced technologies for this. This case study exemplifies the \u2018BUILD\u2019 agenda in its domestic investment in technology R&D, and in a supportive technology ecosystem for locally appropriate, climate-sensitive technologies and infrastructures that build links between food, waste and energy systems. This case study illustrates a promising practice in the construction of a biodigester at the Ecole Nationale des Sous-Officiers d\u2019Active (ENSOA) in Antsirabe Madagascar.It is based on key informant interviews after consent and review of published documents collected in May 2025. Despite the initial challenges, the biodigester at ENSOA has yielded notable results. The use of firewood has decreased by 30%, reducing pressure on forest resources and lowering greenhouse gas emissions. Organic waste now has effective value, strengthening the environmental sustainability of ENSOA. The biogas produced enables the school to partially meet its energy needs, providing around eight hours of cooking time per day for approximately 700 people.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Association between nutrition literacy and diet quality among adolescents and young adults in the rural district of Mayuge, Eastern Uganda","field_subtitle":"Buyinza T; Buzigi E; Bukenya J; et al: BMC Public Health 25 (2335), 1-13, doi:  https://doi.org/10.1186/s12889-025-23498-2, 2025 ","URL":"https://tinyurl.com/27tp3vrw","body":"This paper assessed nutrition literacy and its association with diet quality among 1206 adolescents and young adults aged 10\u201324 years in Mayuge district, Eastern Uganda. Using a structured questionnaire, the Global Diet Quality Score was adapted to estimate diet quality, and the Adolescent Nutrition Literacy Scale was used to assess nutrition literacy status. Among 1206 respondents, 85.9% were still in school, over 62% were from low socioeconomic status households, and only 14% used mobile phones. Low nutrition literacy was prevalent, with many unfamiliar with a balanced diet or ignoring dietary advice, although 62% were willing to promote healthy eating. Overall, 12.6% had poor diet quality marked by frequent refined grain consumption and low fruit/vegetable intake. Having low nutrition literacy was associated with a close to five-fold increase in poor diets, while mobile phone use was associated with better diet quality by 56%. The authors propose that targeted interventions to improve nutrition literacy can enhance diet quality among adolescents and young adults. .","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Brief on climate-related migration and health equity in East and Southern Africa","field_subtitle":"Training and Research Support Centre, EQUINET: Online, March 2025","URL":"https://tinyurl.com/ya4947fs","body":"The final thematic webinar in EQUINET's climate and health equity webinar series was held in March 2025, It brought together 52 participants from east and southern Africa and internationally, focusing on the interplay for health equity between climate and migration in and beyond the region. Organised and moderated by TARSC, three panellists gave presentations: Mr Francis Pawandiwa, Coordinator, Nyahunure Community Trust, Mutoko district, Zimbabwe, from a community lens; Dr Moeketsi Modisenyane, School of Health Systems and Public Health, Faculty of Health, University of Pretoria, from a national and regional lens and Hannah Marcus, Environmental Health Working Group, World Federation of Public Health Associations, covering the international lens. People migrate to exploit new resources and opportunities, or are forced to migrate due to conflict, land expropriations, economic, food and water insecurity, emergencies and loss of livelihoods. When climate changes intensify these drivers, it also increases migration. The webinar interrogated the relationships between climate, migration and health equity at the local, national and global levels, and suggested actions to be taken to mitigate the impacts. This brief summarises the key issues raised on the role of climate change as a risk multiplier of drivers in sending communities leading to migration, for affected migrants along the route, and in the receiving communities. It highlights their health equity impacts in these three groups, the responses to these impacts and areas for further research. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Can equity survive in an age of impunity?","field_subtitle":"EQUINET Steering committee","body":"We are daily confronted by images of vulnerable people, including children, starving and dying in situations of preventable conflict. We are weekly confronted with stories of hospitals being attacked and health workers killed in military attacks. We are constantly hearing of floods and extreme weather destroying lives and homes of already precarious communities. We keep hearing about toxic pollution of rivers, harmful emissions and extreme hazards in work that are causing injury and disability. There are international human rights norms and standards that were set to prevent and respond to these realities and new, important standards being set, but they appear to be ignored and inadequate for new challenges, including from transnational corporate control of artificial intelligence. International and national institutions that were supposed to ensure their implementation appear to be disregarded and ineffective, and solidarity resources cut and redirected to military budgets. Powerful actors who are generating these conditions and their consequences appear to be able to act without penalty. If such a global situation is taking hold, the consequences can and are impacting on our national and local realities. What is a just response? There are interesting developments, and podcasts in this newsletter and the editorial from the Global Health Watch share some proposals. Please send us your contributions and experience on this as we explore these realities and their consequences and discuss the responses further in our next issue. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Climate Change Litigation before the African Human Rights System: Prospects and Pitfalls","field_subtitle":"Suedi Y; Fall M: Journal of Human Rights Practice 16 (1), 146-159, doi: https://doi.org/10.1093/jhuman/huad024, 2023","URL":"https://academic.oup.com/jhrp/article/16/1/146/7223102","body":"Africa is a promising regional venue for climate change-related complaints\u2014not least because it is distinctively vulnerable to climate harms. Yet, neither the African Commission on Human and Peoples\u2019 Rights nor the African Court of Human and Peoples\u2019 Rights had been theatres to such disputes at the time of writing (this may have since changed). Understanding that climate litigation will emerge before the African human rights system, this practice note provides information to the non-State actors and their lawyers on the procedural challenges that may arise, demonstrating how such challenges may be circumventable in the African context.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Engaging communities in climate change and health research and practice in Sub-Saharan Africa","field_subtitle":"Dowou R; Bain L: Journal of Global Health Science 6(2), 1-9, doi: https://doi.org/10.35500/jghs.2024.6.e10, 2024","URL":"https://tinyurl.com/25z3kzar","body":"Climate change is a major threat to sustainable growth and development in Sub-Saharan Africa (SSA). The efforts of SSA to achieve the Sustainable Development Goals by 2030 may be seen as a mirage if the adverse effects of climate change are not addressed. This review discusses the motivations for and importance of engaging communities in climate change and health research, the extent to which communities have been engaged in this in SSA and the barriers and facilitators faced. The findings highlight the demand to engage communities using strategies and processes that are sensitive to the community context in which it occurs, using participatory rural appraisal and community-based participatory approaches for interventions to address the effects and impacts created by climate change that are effective and responsive to community needs and interests. The authors argue that involvement and support by communities is design is essential for this. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 242: Can equity survive in an age of impunity?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. \r\n","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Header"}},{"node":{"title":"Generating political priority for breastfeeding and the adoption of Kenya\u2019s 2012 BMS act: the importance of women\u2019s leadership","field_subtitle":"Wamahiu M; Baker P; Dorlach T: Globalisation and Health 32(21), 1-14, doi: https://doi.org/10.1186/s12992-025-01127-2 , 2025 ","URL":"https://tinyurl.com/mu6bef8n","body":"This qualitative case study identified the political enablers of the successful adoption of an important law to support breastfeeding in Kenya. The strict Breast Milk Substitute (BMS) Act adopted in 2012 has since facilitated and protected remarkable improvements in breastfeeding rates. BMS legislation was first politically debated in Kenya in the 1980s following mobilization of women-led civil society organizations, namely the Breastfeeding Information Group and the Maendeleo ya Wanawake Organization. The issue re-emerged on the political agenda in the 2000s but faced opposition from the transnational formula milk industry. Kenya\u2019s BMS Act was ultimately adopted during a policy window opened by a constitutional reform. The Kenyan case illustrates how women\u2019s political leadership can counteract the power of the transnational formula milk industry and help achieve strict BMS legislation. Effective female leadership for BMS legislation can occur in various political offices and positions, including those of ministers, legislators and bureaucrats. Female leaders can leverage their own influence by strategically exploiting policy windows and recruiting male allies.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Global health development aid initiatives and the quality of medical laboratory services in sub-Saharan: a narrative review","field_subtitle":"Musuka H; Mano O; Iradukunda P; et al: Global Health Journal, doi:https://doi.org/10.1016/j.glohj.2025.06.006, 2025 ","URL":"https://tinyurl.com/mv68ksm9","body":"This study used a narrative review study design to identify five sub-themes from successful global health development aid initiatives with medical laboratory services. The themes were capacity building and training programs, infrastructure development, partnership models, policy advocacy and regulatory support, quality control and standardization of laboratory services. The sub-themes from the challenges and barrier theme were insufficient funding and resource allocation, human resource constraints, inadequate infrastructure and equipment, and political and institutional barriers. The authors observe that achieving long-term sustainability requires strategies that ensure financial self-sufficiency, foster a skilled and stable workforce, and integrate laboratory services into national health frameworks.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Global Health Watch 7: Mobilizing for Health Justice","field_subtitle":"Ronald Labont\u00e9, Chiara Bodini, People\u2019s Health Movement, co-editors of Global Health Watch 7","body":"From the \u201cshadow of the COVID-19 pandemic\u201d  that set a context for Global Health Watch 6, the Global Health Watch 7 (GHW7) is being released under a different and more ominous shadow, that of Donald Trump\u2019s return to the US presidency. We are in the midst of a massively disruptive transition in which the former US-dominated (neo)liberal world order is being transformed into a form not yet clear. The new Trump administration is driving this change, leaving global health churning in its chaotic wake, affecting all regions including east and southern Africa. Hence the heightened imperative to continue our activist mobilizing for health justice. \r\n\r\nGHW7 begins with the \u2018big picture\u2019 issues in the global political economy, including chapters on ecofeminisms and ancestral health knowledge systems. Together these three chapters outline a new scenario for a global economy based on planetary health and human wellbeing. A  second section delves into the state of play across health systems, opening with an update on the privatization, financialization and corporatization challenges affecting health systems, and provides public health alternatives. It raises the pros and cons of the increased use of artificial intelligence (AI) in health systems, makes proposals for equitable health systems from an intersectional gender perspective, and presents an analysis of \u2018abolition medicine\u2019 which draws important connections between the social organization of prisons and health care systems. It includes a commentary on \u2018decolonizing\u2019 global health. \r\n\r\nHowever, the GHW7 is not only focused on the health system, It goes \u2018beyond health care\u2019 to discuss issues that are critically important for health, beginning with the rise in conflicts globally. It includes a focus on the genocide in Gaza, but the discussion of conflicts is equally important for east and southern Africa given conflicts in Sudan and DRC. It points to the role of capitalism\u2019s \u2018military-industrial complex\u2019 in sustaining conflict for purposes of profit and geopolitical power, and provides an analysis of the drivers of migration and displacement, which are the highest ever recorded.  There is a focus on some of the core dynamics linking work, employment, and health in the context of neoliberal capitalism. This raises attention to the importance of tax justice and progressive tax reforms at national and global scales, as also advocated from Africa. In  discussing the commercial or corporate determinants of health, or those commercial influences in health, it  covers the capitalist consumptogenic marketing of unhealthy commodities (tobacco, ultra-processed foods, alcohol)  and provides a critique of the consultancy/accountancy transnationals (the \u2018Big Four\u2019 firms) that increasingly dominate global health policy making, including for east and southern Africa. \r\n\r\nThere is a fourth \u2018watching\u2019 section in the GHW7 that looks at what is new in global governance for health. It begins with an analysis of the health of the World Health Organization (WHO), noting its declining leadership worsened by the US withdrawal of funding, albeit with the potential uptick of having reached agreement on a new Pandemic Treaty.  There is an assessment of the strengths and weaknesses of the Pandemic Treaty (referred to as a Pandemic Accord), particularly in terms of the still-to-be-negotiated annexes that will deal with improved access to pandemic tools for the Global South and global financing for pandemic prevention, preparedness, and response. Some of these funding issues are explored in greater detail in a subsequent chapter that focuses on future pandemic financing models.\r\n\r\nWith the current situation demanding the activist mobilisation for health justice noted earlier. \r\nThe final chapters in GHW7 document health activism at different scales, celebrating acts of resistance (some successful, others not) and describing new activist modalities for healthful change. Its closing chapter draws from the 5th People\u2019s Health Assembly held in Mar del Plata, Argentina, in April 2024, and its declaration calling on activists worldwide to continue advancing the struggle for liberation and against capitalism.\r\n\r\nThe GHW7 is  affirmative for its content and focus, However, it is also innovative for its content coming from writing groups and contributions representing the geographic breadth of People\u2019s Health Movement (PHM).It is a co-production of PHM, ALAMES, EQUINET, Health Poverty Action, Medact, Medico International, Sama, Third World Network, and Viva Salud.In striving to have this edition be an exercise in \u2018movement building\u2019 and not simply an analytical synopsis of global health issues, writing groups were encouraged to use their chapters as opportunities to discuss and engage across these geographies, allowing activists to learn with each other. As with previous editions, scores of activists worldwide contributed to its production. \r\n\r\nIt is published by a solidarity publisher (Daraja Press) rather than a conventional academic or trade book publisher. Each chapter could thus be downloaded and distributed free of charge as soon as it was completed. With all chapters now completed, we will soon produce all  as a single book, downloadable for free as a PDF or available for purchase as a printed book. It is available in both English and Spanish, partly with contribution from Latin American PHM activists in convening the 2024 5th People\u2019s Health Assembly in Argentina. It is thus a resource for the many areas and forms of health equity activism in east and southern Africa. \r\n\r\nPlease send any feedback on and contribution to editorials to admin@equinetafrica.org. You can read more about PHM and freely access the Global Health Watch 7 chapters on the PHM website https://phmovement.org/global-health-watch, where all previous editions can also be found, and on the publisher\u2019s website https://darajapress.com/publication/mobilizing-for-health-justice-en. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Global priorities in HIA research: a new agenda for the next decade","field_subtitle":"Haigh F; Green L; Hirono K; et al. Global priorities in HIA research: a new agenda for the next decade. BMC Public Health 25, 791 https://doi.org/10.1186/s12889-025-21983-2, 2025","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-025-21983-2","body":"Health Impact Assessment (HIA) advances Health in All Policies by identifying impacts of proposed actions on health and equity and recommending changes to address these impacts. Since the Gothenburg Consensus Statement in 1999, HIA has been applied to policies, plans, programmes and projects in multiple sectors and settings across the world. Despite demonstrated effectiveness, its use across the world is inconsistent with few nations systematically using HIA. In a global context of increasing health inequities, pandemics, climate change, and economic crises, HIA can help integrate health and equity into decision making. There is a need for research to support the ongoing evolution and development of HIA. This paper presents a research agenda for the field of HIA, drawn a mixed method approach utilising insights of approximately 280 participants through an international online survey and participatory workshops. The authors identified four research priorities: (1) Institutionalisation - Sustaining and institutionalising HIA in varying contexts and levels. (2) Influence - Identifying mechanisms and strategies that can be employed to effectively influence stakeholders and decision making. (3) Equity and Participation - Analysing the role of equity, justice, power and participation in HIA, and (4) Methodology - Improving HIA Methods to understand the complex relationships between proposed actions, health and health equity outcomes and identifying what to do. We developed research questions for each theme. The research agenda advocates for sustained research and practice to strengthen impact and address knowledge gaps in the field. Functioning as a roadmap for both researchers and funders, it aims to contribute to a healthier and more equitable world. Recognising the valuable role of HIA in addressing global health challenges, the agenda encourages researchers to investigate, develop, and advance the field of HIA.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health Equity in Focus","field_subtitle":"Thirs World Network, Online, Malaysia","URL":"https://healthequityinfocus.buzzsprout.com/","body":"Health Equity in Focus is a series of podcasts that delve into the intricate dynamics of global health, examining how historical legacies continue to shape present-day realities in the Global South. Global health institutions, when failing to address deep-rooted issues, can perpetuate inequalities between North and South. Across various episodes, the podcast explores issues like the implications of intellectual property to access to medicines, the use of policy space through TRIPS flexibilities, international regulatory standards, the intersection of biological diversity with health, and developments regarding these topics in international fora, through an equity perspective. While they involve technical contributions, they advocate for a reimagined global order, where development equips countries with the means to uplift their populations and foster a fairer, more equitable world..","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Hospitals Under Fire: Lawfare and the attack on care","field_subtitle":"Geneva Graduate Institute, Queen Mary University: Online Tuesday, September 23, 2025 12:30-14:00 CET","URL":"http://www.ghplatform.org","body":"Despite the protections of international humanitarian law, the systematic targeting of healthcare facilities in modern warfare remains a tragic and increasingly recurring reality. From Gaza to Syria, Ukraine to Sudan and Myanmar, the destruction of healthcare facilities raises urgent questions about the limits of the law, the elasticity of the Geneva Conventions, and the moral failure of the international community to enforce basic protections. Legal frameworks provide for the safeguarding of healthcare facilities during conflict, yet wide gaps exist in the way such laws can be interpreted, allowing belligerents to justify, obscure, or deny such attacks. Bringing together researchers, humanitarian professionals, and global health experts, this event will interrogate the normative failures and political complicities that allow such attacks to proliferate. Registration opens August 25, 2025 at  www.ghplatform.org. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Inequalities in full immunization coverage among one-year-olds in the Democratic Republic of the Congo, 2007\u20132017","field_subtitle":"Bwira E M; Bukele T K; Mutombo P B; et al:  BMC Public Health 25 (2354), 1-14, doi: https://doi.org/10.1186/s12889-025-23297-9, 2025 ","URL":"https://tinyurl.com/mvnss2ax","body":"This paper assessed the extent and trends of inequalities in full immunization coverage among one-year-olds from the 2007 and 2013 rounds of the DRC Demographic and Health Surveys, and the 2010 and 2017 rounds of the DRC Multiple Indicator Cluster Surveys. The national coverage of full immunization among one-year-olds significantly decreased from 30.7% in 2007 to 21.7% in 2017. Significant disparities in full immunization coverage across the four dimensions of inequality were observed in all study periods. In 2017, for example, the authors recorded substantial economic, maternal education-based, place of residence-based and regional inequalities in full immunization coverage. Economic, urban\u2012rural, and regional relative inequalities followed a U-shaped trend, while absolute inequalities remained constant or decreased. However, inequality based on maternal education remained constant across all summary measures over time. The decreasing trend of the national full immunization coverage among one-year-olds over the ten-year study period masked substantial and persistent socioeconomic and geographic inequalities. To reduce inequalities in full immunization coverage in the DRC, the authors call for urgent equity-driven interventions to address poverty, illiteracy, and inadequate infrastructure, particularly in rural and underserved regions. Strengthening the health workforce and improving the vaccine supply chain are also seen to be crucial to ensuring equitable access to immunization services.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"It's me who supports. How are you going to refuse to have a child?: The social norms and gender dynamics of men\u2019s engagement in family planning practices in the Democratic Republic of the Congo","field_subtitle":"Ekambi S; Sugg K; Mpata F; et al: Reproductive Health 22 (120), 1-14, doi: https://doi.org/10.1186/s12978-025-02029-7, 2025 ","URL":"https://tinyurl.com/yhytnr6e","body":"This paper explored the social norms shaping perceptions, attitudes, and decision-making around family planning among men in three provinces of Kasai Central, Lualaba, and Sankuruthe of the Democratic Republic of the Congo through semi-structured interviews and focus group discussions. The authors found that while social norms oppose the use of modern contraceptive methods and advocate for larger family size, there is notable social support for birth spacing. Some men reported they would support their wives in learning about contraceptive methods if they were able to make the final decision. However, other men felt that allowing their wives to seek a method would undermine their authority, or their virility. To increase modern contraceptive uptake, the authors recommend that interventions address the underlying issues that contribute to non-adherence, addressing the three categories and their associated norms individually and engaging reference groups important to each, including healthcare providers, religious leaders, and male peer groups, in family planning programming.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Litigation to challenge large extractive projects is gaining traction in Africa","field_subtitle":"Moodley P: Open Global Rights, South Africa, 2020","URL":"https://tinyurl.com/4rrxmtw3","body":"This article is a part of Open Global Right's Litigating the Climate Emergency series on how human rights and strategic litigation might best be leveraged in the climate action movements. Communities in Africa are increasingly using litigation to challenge large extractive projects that exacerbate the climate emergency and loss of biodiversity. Climate-related litigation is a growing focus within the Africa context. Several communities and legal environmental organisations have gone to court to stop harmful projects or to assert the rights of communities where there have been violations of justice. While these communities are living in very uncertain times, the cases brought before the courts show that they are not passive bystanders, using strategic climate litigation as one avenue to challenge corporations and governments. While it is time- and money-consuming, the author argues that each victory creates a ripple effect in communities in Africa and in the boardrooms of multi-national companies.      ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Mobilizing for Health Justice: Global Health Watch 7","field_subtitle":"People's Health Movement: Daraja Press, 2025","URL":"https://phmovement.org/mobilizing-health-justice-global-health-watch-7","body":"This seventh edition of Global Health Watch, the flagship publication of the People's Health Movement (PHM), features contributions from over one hundred activists worldwide and is published open access in both English and Spanish. It is structured around five main sections examining:  The global political and economic architecture,  privatization and financialization of health systems, tax justice, artificial intelligence and digital technologies in health, gender-transformative health systems, abolition medicine, and decolonizing global health approaches; key social and environmental determinants of health, and global governance for health. The final \"Resistance, struggles and alternatives\" section highlights transformative change areas by health activists, including in contexts of increasing repression. The publication concludes by emphasizing that collective action represents the most powerful medicine against ill health and health inequality at human and planetary levels.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Money can\u2019t buy health, but taxes can improve healthcare","field_subtitle":"Etter-Phoya R; O'Hare B; Loewenson R; et al: Blog, Tax Justice Network Africa, 2025","URL":"https://taxjustice.net/2025/07/21/money-cant-buy-health-but-taxes-can-improve-healthcare/","body":"Most people who have the greatest health needs don\u2019t have enough money in their pockets to pay for expensive private care. In contrast, enough money in the government\u2019s public purse would make all the difference. Governments can finance better public healthcare systems, train, employ and equitably distribute more staff, and build the necessary infrastructure, so that more people will live longer, healthier lives. This blog examines how tax justice can make all the difference in improving health. It draws from a chapter in the Global Health Watch 7.  The authors argue \"Taxes may be society\u2019s superpower. Yet deep historic and structural global injustices mean that governments are often unable or unwilling to generate and allocate taxes in ways that dismantle inequalities effectively\".  The blog presents options to deliver on the five principles of tax justice - revenue, redistribution, repricing, representation, reparations-  that would better finance the features of public sector health systems that promote equity and the national and international reforms that are needed to back this. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Online meeting: Strategies for engaging with the public health impacts of climate change and fossil fuels","field_subtitle":"EQUINET, Global Climate and Health Alliance, Federal University of Rio Grande do Sul: 30th September 12noon -1330pm Southern Africa time","URL":"https://us06web.zoom.us/meeting/register/8YweFlRzTNq8xhS_DceNiw","body":"EQUINET through TARSC in association with colleagues from the Global Climate and Health Alliance and Federal University of Rio Grande do Sul will hold an online meeting on Tuesday 30th September 12noon -1330pm Southern Africa time on 'Strategies for engaging with the public health impacts of climate change and fossil fuels\".  The meeting will hear from two international presenters: Shweta Narayan, Global Climate and Health Alliance  on a Public health strategy to challenge health and climate impacts of the fossil fuel industry, and Carlos Dora, Federal University of Rio Grande do Sul, Brazil, on Health impact assessment to respond to commercial determinants of climate change.  The presentations will be followed by discussion. This will be a unique oppportunity to be part of a dialogue that also aims to inform research, policy engagement and online training in the region.   Register at https://us06web.zoom.us/meeting/register/8YweFlRzTNq8xhS_DceNiw  for further information and to be included in the session. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Out of pocket and catastrophic health expenditure in Tanzania: recent evidence on the incidence, intensity and distribution","field_subtitle":"Massito J; Hinju G: BMC Health Services Research 25 (677), 1-11, doi:   https://doi.org/10.1186/s12913-025-12783-w, 2025 ","URL":"https://tinyurl.com/3dyhj8dk","body":"This paper  investigates the catastrophic impact of out-of-pocket health expenditure by estimating the levels, intensities and distribution of catastrophic health expenditure among households in Tanzania. The study applied the Wagstaff and va-Doorslaer methodology using panel data 2020/2021. The study found that 21.9% of the respondents reported visiting a healthcare facility within four weeks before the survey. Over 50% reported an incidence of illness or injury within the same period. Among those who used health care, about 7.1% experienced catastrophic health expenditures. Poor households are more likely to experience catastrophic health costs than rich households. The authors conclude that out-of-pocket health expenditures expose poor households to more poverty and forcing them to resort to coping mechanisms that compromise their welfare. They propose that this necessitates the development of new and reinforced existing systems to protect impoverished households against out-of-pocket and catastrophic healthcare costs.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Postdoctoral Research Fellow: Global Postdoc In Implementation Science And Primary Care","field_subtitle":"Closing Date: open until filled","URL":"https://tinyurl.com/2en533tt","body":"The University of Botswana is offering a 1-2 year postdoctoral fellowship in the upcoming academic year.  The Postdoctoral Research Fellow will be joining ongoing and planned studies using implementation research to improve primary care in Botswana, focusing on non-communicable diseases, aging, and other relevant health challenges. The Postdoctoral Research Fellow should bring strong qualitative analytical skills (and ability to work with a team of biostatisticians and other experts in behavioural science, clinical medicine and primary care) with experience in health-related research and ideally implementation and primary care research. Other preferred skills include knowledge of health systems strengthening and research, mixed methods, and experience in the field of primary care and chronic diseases research. The Fellow will include working in a strong and supportive multidisciplinary, multi-country team, in person and support from virtual mentoring by research leaders. This is a one-year full-time research post-doctoral fellowship opportunity at University of Botswana. There is a potential for a second year, contingent upon performance and funding. Applications are now being accepted and will be reviewed until the position is filled.\r\n","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Prevalence and factors associated with intimate partner violence among women in Tanzania: evidence from Tanzanian demographic and health survey 2022","field_subtitle":"Luoga P; Abihudi S A; Adam J; et al: BMC Women's Health 25 (235), 1-12, doi:https://doi.org/10.1186/s12905-025-03760-w, 2025 ","URL":"https://tinyurl.com/nhdtwxyv","body":"This study used a nationally representative secondary data from the 2022 Tanzania Demographic and Health Survey for women aged 15\u201349 years in a cross-sectional design to identify factors associated with intimate partner violence (IPV) among women in Tanzania. The results revealed that women who are working and those whose husband/partner drinks alcohol had higher odds of experiencing IPV compared to their counterparts. Conversely, protective factors include women\u2019s secondary and higher education level and residing in the Southern zones. The prevalence of IPV among women in Tanzania at 38.9% remains high compared to the global average of 30%. The authors recommend that the government implement community-based educational programs to raise awareness about IPV and dedicate more efforts like raising the tax on all alcoholic beverages to controlling alcohol consumption among men as a strategy to combat IPV in society.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Regulation of artificial intelligence in Uganda\u2019s healthcare: exploring an appropriate regulatory approach and framework to deliver universal health coverage","field_subtitle":"Mugalula K: International Journal for Equity in Health 24 (158), 1-24, doi: https://doi.org/10.1186/s12939-025-02513-3, 2025 ","URL":"https://tinyurl.com/536a7m2r","body":"This paper analysed the two prominent regulatory approaches to Artificial Intelligence (AI) in Europe that have adopted risk-based and principles-based approaches. It investigates whether these approaches are suitable for regulating AI in Uganda\u2019s healthcare and in achieving Universal Health Coverage (UHC). The strengths and weaknesses of each approach are examined. The paper advocates for considering a human rights-based approach that can be integrated with the principles-based approach. Regulation is argued to have a potential to emancipate ordinary people\u2019s lives so Uganda should leverage the positive aspects of both principles-based and human rights-based approaches to regulation to ensure that AI\u2019s potential to achieve UHC is effective. The hybrid approach to AI regulation is best suited to serve Uganda\u2019s healthcare needs. However, such a  hybrid approach while contributing will not be a silver bullet and the author recommends that Uganda supplement efforts to achieve UHC with other non-regulatory strategies.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Routemap for health impact assessment implementation: scoping review using the consolidated framework for implementation research","field_subtitle":"Kenny T; Harris-Roxas B; McHugh S et al. Health Promotion International, 2025, 40, daaf080 https://doi.org/10.1093/heapro/daaf080, 2025","URL":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12208066/","body":"Health Impact Assessment (HIA) provides a practical set of tools to appraise the potential health effects of a policy, programme, or project prior to implementation. HIA has gained significant attention in recent decades due to its utility in facilitating a broader understanding of health and bringing diverse stakeholders and evidence into decision-making processes. Despite this interest in HIA its implementation remains challenging within governance, decision making, and regulatory contexts. The authors used the Consolidated Framework for Implementation Research (CFIR) 2.0  as a methodological framework to identify potential factors influencing implementation of HIA from an implementation science perspective. The findings suggest that building wider HIA support, awareness, and capacity are essential to progressing HIA, and that this is also dependent on wider public health advocacy.  ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Safeguarding global health security amidst a scramble for Africa's minerals for the clean energy transition","field_subtitle":"Ajumobi O: Globalization and Health 21:24, doi: https://doi.org/10.1186/s12992-025-01102-x, 2025","URL":"https://tinyurl.com/m5f8836w","body":"This commentary addresses the global health security threats posed by increased critical minerals mining in Africa driven by the clean energy transition and 2050 net-zero emissions targets. The Democratic Republic of Congo houses over 55% of global cobalt reserves and produces 75% of global cobalt, while Guinea contains the world's largest bauxite reserves, South Africa holds over 70% of platinum, and Zimbabwe has the largest untapped lithium deposits. The author argues that without appropriate safeguards, expansion of mining operations increases risks of mining-associated infectious disease outbreaks with epidemic and pandemic potential. Several studies report linkages between habitat encroachment from mining activities and outbreaks of emerging/re-emerging infectious diseases, with examples from DRC and Uganda. The recent emergence of a more severe strain of the 2023 Mpox outbreak in DRC has for example been traced to the Kamituga mining area. The author recommends expanding Environmental, Social, and Governance standards to include biosecurity risk analysis under Environmental Impact Assessments; increased stakeholder representation in the Mineral Security Partnership; integration of spill-over/emergence/spread (SES) risk analysis into the draft Pandemic Accord, and leveraging earth observation technologies and pathogen surveillance for early detection and prevention of mining-associated health security threats.\r\n","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Strengthening National Leadership for Sustainable HIV Programs: A Policy Brief for Government Leaders","field_subtitle":"Matanje B; Chunda L; Holmes CB, et al: Blantyre Prevention Strategy/Georgetown University Center for Innovation in Global Health Policy Brief, 2025","URL":"https://tinyurl.com/436arvnn","body":"This policy brief emerges from a Sustainable HIV Prevention Initiative Convening held in Lilongwe, Malawi on February 18-19, 2025, hosted by the Government of Malawi. The brief presents priority recommendations for governments navigating external funding transitions, including strategies for increasing domestic and innovative financing mechanisms, accelerated integration of HIV services into national health systems and primary care, and ensuring continuation of people-centered HIV services including prevention for key and vulnerable populations. Drawing from the successful Blantyre Prevention Strategy model - a district-based approach that strengthens local institutional capacity for HIV prevention through data-driven decision making, quality improvement, and community engagement - the brief advocates for bold government actions to maintain progress toward ending AIDS as a public health threat by 2030 despite declining donor support.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Strengthening the role of community health assistants in delivering primary health care: the case of maternal health services in Zambia","field_subtitle":"Akinola O; Banda N; Silumbwe A; et al: BMC Primary Care 26 (156), 1-12, doi:  https://doi.org/10.1186/s12875-025-02829-7, 2025 ","URL":"https://tinyurl.com/f77t7y6k","body":"This paper explored the role of the community health assistants (CHA) in delivering as maternal and child health (MCH) services in Zambia. Key informant interviews and focus group discussions were held in all 10 provinces of the country with the CHAs, and their supervisors, health workers, neighbourhood health committees and community members. The community health systems strengthening interventions (provision of training manuals, streamlined recruitment and deployment policies, capacity building of CHA supervisors, provision of transport and monthly remuneration) contributed to improved delivery and acceptability of MCH services. The CHAs leveraged community networks, linkages and partnerships when delivering these services, including with traditional and religious leaders, contributing to improved coverage and acceptability of MCH services. Health systems barriers such as limited supplies in some health facilities, shortage of health workers, persistent transportation challenges and failure to fully abide by the CHA recruitment and selection criteria affected delivery and acceptability of the services. The authors emphasize the need to integrate provision of training manuals, enhanced recruitment and deployment policies, capacity building of supervisors, provision of transport and remuneration within the CHA program to enhance the provision and acceptability of health services.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Structural barriers and facilitators to accessing HIV services for marginalized working populations: insights from farm workers in South Africa ","field_subtitle":"Mlangeni N; Lembani M; Adetokunboh; et al: Health Policy and Planning 40(1), 75-84, doi: https://doi.org/10.1093/heapol/czae098 , 2025 ","URL":"https://academic.oup.com/heapol/article/40/1/75/7842825","body":"Farm workers are vulnerable working populations face significant inequalities in accessing health services, including those for human immunodeficiency virus (HIV) prevention, treatment and care. This study explored through in-depth interviews and focus group discussions farm workers\u2019 experiences when accessing HIV services in Limpopo province, South Africa. The results reveal that farm workers report multiple interdependent factors that inhibit or enable their access to HIV healthcare services, including transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities and difficult working conditions. Key facilitators for their HIV healthcare access were reported to include the availability of mobile health services, the presence of community health workers and a supportive work environment. The findings suggest disparities in farm workers\u2019 access to HIV services, with work being the main determinant of access. The authors recommend a review of HIV policies and programmes for the agricultural sector and models of HIV healthcare delivery that address the unique needs of farm workers.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The cost of delivering COVID-19 vaccines in Mozambique: a bottom-up costing study","field_subtitle":"Namalela T; Moi F; Dipuve A; et al: BMC Health Services Research 25 (521), 1-11, doi: https://doi.org/10.1186/s12913-025-12671-3, 2025 ","URL":"https://tinyurl.com/4u8yjv64","body":"This retrospective, bottom-up costing study  in Mozambique estimated the financial and economic costs from a payer perspective of delivering COVID-19 vaccines in 2022 USD, during the first year of introduction. Recurrent costs were collected for the initial rollout period and for a later, higher-volume period. The cost per dose for the first year of implementation was $1.14 for economic costs and $0.50 for financial costs. For the initial rollout period, when the volume delivered was low, the economic cost per dose was $3.56 and decreased considerably to $0.85 when the program delivered at scale and volume delivered increased to 225 doses/vaccination day. Opportunity costs made up a considerable share of the economic cost per dose, 73% and 49% respectively during the initial rollout and when the program delivered at scale. Qualitative interviews found that political prioritization and workers\u2019 commitment made the program possible despite little financial investment. The cost of delivering COVID-19 vaccines in Mozambique was found to be low compared to other countries, due to reliance on existing resources and little additional investment into the program.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Towards a sustainable HIV response: strengthening Zimbabwe's domestic financing for HIV programs amid declining donor support","field_subtitle":"Musuka G; Makoni T; Dzinamarira T: Frontiers in Health Services (2025) 5:1558992, doi: https://doi.org/10.3389/frhs.2025.1558992, 2025","URL":"https://tinyurl.com/33tr8v2j","body":"This paper examines Zimbabwe's transition toward sustainable domestic financing for HIV programs as external funder support declines. With Zimbabwe's economy projected to achieve middle-income status by 2030, driven by mineral exports (gold, platinum, lithium) and diaspora remittances totalling US$1.9 billion in 2024, the country has opportunities to strengthen health system financing. The authors analyse existing domestic revenue mechanisms including the AIDS levy (generating ~US$40 million annually), Health Fund Levy, and sugary drinks tax. Key findings highlight Zimbabwe's achievement of UNAIDS 95-95-95 targets in 2023, but emphasize the critical need to integrate HIV services into mainstream health systems rather than maintaining standalone programs. The paper proposes innovative financing approaches, strengthening local pharmaceutical manufacturing capacity for ARV drugs, improving accountability mechanisms to prevent corruption and mismanagement, engaging informal sector and private sector stakeholders, and addressing regulatory barriers like the Private Voluntary Organisations Amendment Act that restricts NGO participation. ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Transition in care interventions for Refugee, Immigrant and other Migrant (RIM) populations: a health equity-oriented scoping review","field_subtitle":"Liu A; Yazdani Y; Elias M; et al: Globalization and Health 21:25, doi: https://doi.org/10.1186/s12992-025-01114-7, 2025","URL":"https://tinyurl.com/yvf4pype","body":"This health equity-oriented scoping review examines transition in care interventions for refugee, immigrant, and migrant (RIM) populations, analyzing 42 studies evaluating 38 unique interventions from databases including MEDLINE, Embase, and Scopus for studies published from 2000 onward. The systematic search identified interventions delivered across various healthcare sectors and professionals, with some programs enlisting non-medical personnel to provide health-related education and support, with the most promising programs involving health navigation or providing public health education for RIM populations. Results showed that language, education, and cultural background were the most common equity-relevant characteristics targeted. Three types of continuity of care: informational, management, and relational were found, with interventions addressing challenges including linguistic and cultural barriers, unfamiliarity with healthcare systems, and complex health needs such as untreated chronic conditions or trauma-related mental health issues. The authors conclude that future research should target transitions to digital health technologies, public health, hospital-to-home, and paediatric to adult care gaps to ensure smoother transitions for equity-deserving populations navigating new healthcare systems, while emphasizing the need for culturally appropriate and contextually responsive interventions for diverse subgroups within the broader migrant population.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Turning waste into value: Plastics recycling in a circular economy in Kasangati Town Council, Uganda","field_subtitle":"Innovations for Development: EQUINET, Harare, July 2025","URL":"https://tinyurl.com/55ykzeef","body":"EQUINET\u2019s recommendations on integrated urban health in 2024 in Eastern and Southern Africa include measures to BUILD and ENABLE health promoting integrated improvements for urban health, including those that link improved environments to health (EQUINET, 2024). This case study exemplifies the \u2018BUILD\u2019 and \u2018ENABLE\u2019 agenda through a town council and social enterprise support of local income generating plastic waste reduction and recycling. The initiative has built women and young people\u2019s skills in recycling and supported incomes, while also visibly reducing plastic pollution and protecting the environment. The initiative was enabled by strong community engagement and local leadership. Involving community members in its design and implementation built trust and relevance and fostered a sense of ownership that supports sustainability. The collaboration with schools, religious institutions and informal sector workers fostered a community centred circular economy that promotes equity, environmental conservation, and youth empowerment. The use of accessible, low-tech methods minimised the need for expensive infrastructure or specialised skills. Ideas could be adopted and replicated using locally available materials and knowledge. A revenue-generating model producing marketable goods, the contribution of the founder and fees obtained for the training has sustained operations and created income streams that reduce dependency on external funding.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"TWN's Statement on the Pandemic Agreement Adoption","field_subtitle":"Shashikant S: Third World Network, May 2025","URL":"https://tinyurl.com/4s8h9fa5","body":"This Third World Network (TWN) statement on the adoption of the Pandemic Agreement at the 78th World Health Assembly states that \"The adoption of the Pandemic Accord marks the beginning, not the end, of the equity debate.\" The organization views the agreement as a milestone following three years of intense negotiations, deep divides, and difficult compromises, representing an initial multilateral effort to address global inequities and promote international cooperation for pandemic prevention, preparedness and response in a world marked by growing health inequities and geopolitical fragmentation. However, TWN stresses that the real test lies ahead, particularly in the next phases of negotiations beginning with the Pathogen Access and Benefit-Sharing System (PABS). The upcoming PABS discussions offer WHO Members a rare opportunity to build a transparent and accountable system, anchored in legally binding rules for sharing biological materials and sequence data of pathogens with pandemic potential, coupled with enforceable benefit-sharing obligations. The statement warns that if these next steps fail, the world may once again face a pandemic armed only with empty promises, risking a repeat of the devastating failures seen during COVID-19, emphasizing that the agreement's success will be measured by whether it becomes a meaningful tool for equity or remains merely symbolic in ensuring developing countries can access affordable vaccines, treatments, and diagnostics swiftly and fairly during health emergencies.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Untangling Antimicrobial Resistance (AMR): The Legacy of an Unhealthy Development Model","field_subtitle":"Society for International Development (SID): Online Blog, July 2025","URL":"https://www.sidint.org/sid-blogs/unseen-fallout-war-rising-antimicrobial-resistance","body":"This blog post discusses how conflicts in Gaza, Sudan, and Ukraine, affecting 2.4 billion people worldwide, create conditions where bacteria develop immunity to existing drugs through the destruction of infrastructure, forced population movements, and environmental contamination. Heavy metals used in weapons (zinc, lead, mercury, chromium, antimony, and barium) released during bombings are easy inducers of antimicrobial resistance. Examples from Iraq, Afghanistan, Libya, Syria, and Gaza show recurrent outbreaks of multi-resistant bacteria among military personnel and civilians. AMR is said to have already resulted in 5 million deaths in 2019, with projections suggesting humanity could return to a \"pre-penicillin era\" if current trends continue. The author argues that the systemic scope of AMR is underestimated, with hyper-reductionist interpretations dominated by financial interests in food, pharmaceutical, and bio-surveillance industries reluctant to change course. Microorganisms are observed to know no geopolitical borders and to strengthen their ability to spread silently during uncontrolled chaos of war, with spill-over effects in neighbouring countries and regions affected by ongoing conflicts.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Using health impact assessment to lever improvements in urban health in Lilongwe","field_subtitle":"Country Minders for Peoples Development: EQUINET, Harare, July 2025","URL":"https://tinyurl.com/499prtda","body":"EQUINET\u2019s recommendations on integrated urban health in 2024 in Eastern and Southern Africa include measures to ENABLE health promoting integrated improvements for urban health (EQUINET, 2024). This case study provides an example of this \u2018ENABLE\u2019 agenda by institutionalizing health impact assessment (HIA), linking where relevant with environment impact assessment, for policies that have high health impact in urban areas. The case study illustrates implementation of a health impact assessment (HIA) of the 2019 Malawi National Urban Policy was implemented in February to June 2024 in informal settlements in Lilongwe Malawi to show the situation and health impacts relating to the waste management, hygiene, safe water and clean energy services and to recommend improvements in line with the policy. The assessment recommendations, such as on budget resources and services and integration of community representatives in urban planning were tabled with the local authorities and have led to improvements in and commitments to increase funding for these areas. The authorities indicated as feedback that the HIA assists them to interrogate existing problems, their causes and what needs to be done in line with existing policy and legal frameworks. The team saw that the HIA process creates an evidence-backed platform for engagement between residents and authorities to improve service delivery and improve health outcomes in these areas.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Using radio programming to reach young adolescents with gender and sexual health information in a low-income urban setting in Kenya","field_subtitle":"Maina B W; Nyakangi V; Mbuthia M; et al: Reproductive Health 22(Suppl 1) (73), 1-13, doi: https://doi.org/10.1186/s12978-025-01984-5, 2025 ","URL":"https://tinyurl.com/yc8e6nr8","body":"An increasing body of evidence indicates that young individuals need accurate and easily accessible gender and sexual and reproductive health (SRH) information to equip them to make well-informed choices about their SRH. The authors developed an engaging and educative seven-session radio show, which featured skits and guest speakers. A local radio station in Kenya broadcasted the show as a weekly episode over seven consecutive weeks. The authors conducted in-depth interviews with a purposeful sample of 17 parents and 20 adolescents aged 12\u201414 years living in an informal settlement in Nairobi and who had participated in at least three of the sessions; the radio manager and program presenter. Both parents and adolescents indicated that they felt more connected to each other after listening to the program and this enhanced communication, especially on SRH issues. Both adolescents and parents expressed greater awareness of gender and adolescent SRH issues, which were rarely discussed in detail in open forums in their context prior to the radio program. They recommended that such radio programs run regularly as they provide a platform where sensitive issues about adolescent health can be shared and discussed openly, allowing for both adolescent and community participation. Radio programming was perceived as a good platform for knowledge transfer and discussions about gender norms and SRH among young adolescents, if messages are designed to resonate with a diverse audience.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"World Court says countries are legally obligated to curb emissions, protect climate","field_subtitle":"UN: United Nations News, Online, July 2025","URL":"https://news.un.org/en/story/2025/07/1165475","body":"The UN\u2019s principal judicial body, the International Court of Justice, ruled that States have an obligation to protect the environment from greenhouse gas (GHG) emissions and act with due diligence and cooperation to fulfil this obligation.  This includes the obligation under the Paris Agreement on climate change to limit global warming to 1.5\u00b0C above pre-industrial levels.  The Court further ruled that if States breach these obligations, they incur legal responsibility and may be required to cease the wrongful conduct, offer guarantees of non-repetition and make full reparation depending on the circumstances. The Court used Member States\u2019 commitments to both environmental and human rights treaties to justify this decision.  Firstly, Member States are parties to a variety of environmental treaties, including ozone layer treaties, the Biodiversity Convention, the Kyoto Protocol, the Paris Agreement and many more, which oblige them to protect the environment for people worldwide and in future generations.  But, also because \u201ca clean, healthy and sustainable environment is a precondition for the enjoyment of many human rights,\u201d since Member States are parties to numerous human rights treaties, including the  Universal Declaration of Human Rights, they are required to guarantee the enjoyment of such rights by addressing climate change.  ","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"World is facing a health financing emergency, warns WHO","field_subtitle":"Raja K: Third World Network Health Info Service, Hi250605, 2025","URL":"https://www.twn.my/title2/health.info/2025/hi250605.htm","body":"WHO's Director for Health Financing and Economics states that \"the world is faced with a health financing emergency\" due to the US government's decision to freeze or discontinue aid programmes and European governments' announcements to reduce aid, creating significant disruptions in aid ecosystems and national health systems. Health aid is projected to decline by 35-40% in 2025 compared to 2023 baseline, decreasing by approximately US$10 billion from US$25.2 billion in 2023, with eleven OECD countries announcing aid-related budget reductions for 2025. The impact is reported to be particularly severe in sub-Saharan Africa where US Development Assistance for Health represented up to 30% of current health expenditure in countries like Malawi or 25% in Mozambique or Zimbabwe. The crisis occurs against a backdrop where since 2006, per capita external aid in low-income countries (US$12.8 in 2022) has consistently surpassed domestic public spending on health, with poor countries spending around $8 per person per year on health through public financing. WHO reports that out-of-pocket spending accounted for 35% in Sub-Saharan African countries and government spending for 33% in 2022, creating the most inequitable financing system where poor households must sacrifice food and schooling to access health services. The organization is working with countries to identify financing gaps, protect the poorest populations, mobilize new revenue through better taxation including tobacco and sugary drinks taxes, and through enhanced highly concessional lending for cost-effective treatments.","php":"","field_issue_date":"2025-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"10th East African Health and Scientific Conference (EAHSC) ","field_subtitle":"24th - 26th April 2025, Juba South Sudan","URL":"https://conferences.eahealth.org/","body":"The East African Health and Scientific Conference (EAHSC) is an EAC biennial event convened in East Africa by the EAHRC in collaboration with a host EAC Partner State. Hosting of the event is rotational to each of the Partner States and coordinated through the ministries responsible for EAC affairs, ministries responsible for health and others and it is done in close collaboration with regional and international health-related NGO's, civil society, individuals and stakeholders. The EAHSC contributes towards strengthening regional cooperation in health.  ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A case for increasing taxes on cigarettes, vapes and oral nicotine pouches, Kenya","field_subtitle":"Mostert C M; Ayo-Yusuf O A; Kumar M; et al: Bulletin of the World Health Organisation 102, 618\u2013620, doi: http://dx.doi.org/10.2471/BLT.23.290985, 2024 ","URL":"https://tinyurl.com/yn5rajxy","body":"This paper explored Kenya\u2019s current cigarette tax regime which fails to control cigarette consumption efficiently, especially among young people. For example, the 2007 Global Youth Tobacco Survey revealed that 1 out of 10 students aged 13 to 15 years were current smokers, and boys were twice more likely to be using tobacco than girls. In 2013, WHO reported that this prevalence estimate remained relatively unchanged despite the adoption of the Tobacco Control Act. To date, no comparable survey has been published in Kenya, but in 2022, preliminary findings of a study conducted by the Kenya Tobacco Board on the use of tobacco and its products in four counties showed that consumption of e-cigarette and nicotine pouches was increasing among young people in Kenya. These developments underscore the need for reforming tax policies to protect young Kenyans from nicotine- and tobacco-related harms.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"A comparative study of menstrual poverty among urban and rural female learners in government schools of Zambia","field_subtitle":"Bwalya B B; Mwansa A; Amanzi P; et al. BMC Women's Health 25:17, 1-15, doi: https://doi.org/10.1186/s12905-024-03542-w, 2025 ","URL":"https://tinyurl.com/s7v3w832","body":"This mixed-methods study examined menstrual poverty among 447 female learners in Zambian urban and rural schools. Urban students showed better understanding of menstruation than rural peers, though both groups reported similar emotional responses including fear and discomfort. Support-seeking behaviors and cultural practices varied by location, with rural learners often using herbal remedies. Over 50% of all students reported inadequate sanitary facilities, citing problems with cleanliness, privacy, and handwashing. The authoprs indicate that the significant urban-rural disparities in menstrual knowledge and practices highlight the need for comprehensive menstrual health education in public schools and collaboration with the Ministry of Health to ensure access to essential resources and gender-sensitive facilities.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"A novel approach to expedite evidence to impact in pre-eclampsia: co-developed policy labs in Zambia and Sierra Leone","field_subtitle":"Kuhrt K; Mabula-Bwalya C; Boulding H; et al: BMC Global and Public Health 3(3), 1-10, doi: https://doi.org/10.1186/s44263-024-00116-8, 2025 ","URL":"https://tinyurl.com/3s4ps9y6","body":"This study examined pre-eclampsia management in Sierra Leone and Zambia, where the condition contributes significantly to maternal mortality (70% of 30,000 annual deaths occur in Sub-Saharan Africa). The authors implemented policy labs, a user-centric approach bringing together diverse stakeholders to integrate new evidence into care pathways. Working with the Policy Institute and local stakeholders, the labs focused on improving timely detection and early delivery strategies for pre-eclampsia cases. Participants identified lack of awareness as a key barrier and recommended locally co-designed community strategies to increase access to timely management. The policy lab approach proved effective in both settings for translating new knowledge into policy and action.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"A scoping review and expert consensus on digital determinants of health","field_subtitle":"van Kessel R; Seghers L; Anderson M; et al: Bulletin of the World Health Organisation 103(2), 110-125H, doi: 10.2471/BLT.24.292057, 2024","URL":"https://tinyurl.com/p4j2caxc","body":"This systematic review mapped how social, commercial, political, and digital determinants of health have evolved during society's digital transformation. Analyzing 204 studies from 13,804 records (MEDLINE, Embase, Web of Science) published since 2018, supplemented by expert recommendations and recent literature searches, researchers identified 127 related health determinants across four domains: digital (37), social (33), commercial/economic (33), and political (24). Through thematic analysis and a two-round consensus process, 30 determinants (23.6%) were identified as requiring urgent policy attention. The findings provide a comprehensive framework for understanding how digitalization influences health outcomes through policy decisions, individual behaviours, and broader societal factors, offering insights for addressing these complex, interconnected determinants within the modern digital ecosystem. The study highlights the need for targeted policy interventions to address emerging health challenges in an increasingly digitalized society.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"A workplace-based HIV self-testing intervention as a determinant for self-testing knowledge, beliefs, and use among unskilled workers in Wakiso Uganda","field_subtitle":"Nsereko G M; Musanje K; Ayesiga E R; et al. BMC Public Health 25(187), 1-12, doi: https://doi.org/10.1186/s12889-025-21471-7, 2025  ","URL":"https://tinyurl.com/c5x8npyt","body":"This paper examined the effect of a workplace-based HIV self-testing intervention (HIVST) on the use of HIV self-testing among unskilled workers in Wakiso Uganda. A quasi-experimental one-group pretest-posttest design was conducted among 46 participants systematically and randomly selected. A comparison of the mean differences between the pre-post-test scores for the intervention group showed a statistically significant difference for HIVST knowledge, perceived susceptibility, perceived benefits, perceived barriers, and HIVST use. However, perceived barriers increased exponentially than earlier hypothesized amidst the knowledge acquired. Multiple regression showed that HIVST knowledge and individual beliefs predict 37.2% of the variance in HIVST use and that the overall biggest predictor of HIVST use was perceived susceptibility. The authors propose advocacy for frequent knowledge sharing about self-testing among unskilled working populations in Uganda. Organizations, alongside HIV testing implementing partners, should awaken people operating in risky environments and those engaging in risky sexual acts on the threat of succumbing to HIV as this greatly increases HIVST and repeat testing.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study","field_subtitle":"Masengere P; Halbesma N; Ndejjo R; et al. BMC Public Health 25:201, 1-9, doi: https://doi.org/10.1186/s12889-025-21429-9, 2025 ","URL":"https://tinyurl.com/26w4ae7j","body":"This cross-sectional study examined the combined effects of smoking and alcohol consumption on hypertension among 4,372 adults in rural Uganda's Mukono and Buikwe districts. Among participants, 23% had high blood pressure. Results showed smokers had 1.36 times higher risk of hypertension than non-smokers, while moderate drinkers had 1.45 times and heavy drinkers 2.53 times higher risk than non-drinkers. Notably, the combination of smoking and heavy drinking produced an additive effect, with combined users showing 45% higher odds of hypertension than the sum of individual risks. These findings suggest the need for integrated interventions targeting both smoking and heavy drinking to reduce hypertension in rural Uganda.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Africa Healthtech Summit ","field_subtitle":"African Union, 13-15 October, 2025 ","URL":"https://healthtechsummit.africa/","body":"The Africa HealthTech Summit brings together Ministers of Health and ICT, National Public Health Institutes, Regulators, leading Tech Innovators, Healthcare Professionals, Development Partners, Investors and Academia, to explore how emerging technologies can be harnessed to build resilience and improve health systems and individual wellbeing across African communities. The Summit focuses on critical questions such as realizing the potential of technology innovations to tackle Africa\u2019s most pressing health challenges. Further information will be available closer to the date\r\n","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Africa\u2019s leaders must address weaponisation of rape in Sudan\u2019s conflict","field_subtitle":"Noor F: Al Jazeera, February 2025","URL":"https://tinyurl.com/4vz5v8c7","body":"This article highlights the devastating impact of sexual violence on women and girls in Sudan's ongoing conflict, focusing on the humanitarian crisis that has displaced over 11 million people. The author, drawing from a personal visit to a refugee camp in Renk, South Sudan, shares the harrowing story of Afrah, a 15-year-old who was raped by soldiers while protecting her younger siblings, exemplifying the widespread weaponization of sexual violence in the conflict. The narrative underscores the urgent need for African leaders to take concrete action, emphasizing that the systematic rape of women and girls has become a common war tactic with virtually no accountability. By centering the experiences of survivors like Afrah, the article calls for immediate international intervention, humanitarian access, and comprehensive support for victims, arguing that addressing the plight of women and girls is crucial to Sudan's potential path to healing and peace.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Artificial intelligence, recessionary pressures and population health","field_subtitle":"Occhipinti J; Prodan A; Hynes W; et al: Bulletin of the World Health Organisation 103(2), 155-163H, doi: 10.2471/BLT.24.292057, 2024","URL":"https://tinyurl.com/p4j2caxc","body":" Economic and labour policies significantly impact health and well-being through financial and environmental mechanisms. The rapid rise of generative artificial intelligence (AI) presents challenges to economic stability, with the potential to perform non-routine cognitive tasks and create new efficiencies. While offering opportunities for innovation, AI's labour-displacing potential raises serious concerns about economic equity and social health. The authors propose an AI-capital-to-labour ratio threshold that could trigger a self-reinforcing cycle of recessionary pressures beyond market correction. They call for a proactive global response that reorients economic systems towards collective well-being, as outlined in the World Health Assembly resolution Economics of health for all and the United Nations' Global Digital Compact. Integrated strategies combining fiscal policy, regulation, and social policies are critical to ensuring generative AI advances societal health while mitigating potential harm from excessive job displacement.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Assessing feasibility and acceptability of increasing access to sexual and reproductive health and rights through pharmacy outlets and community health volunteers: lessons from pilot study in Kenya","field_subtitle":"Liambila W; Obare F; RamaRao S; et al:  BMC Health Services Research 24(1663), 1-16, doi: https://doi.org/10.1186/s12913-024-12176-5, 2024  ","URL":"https://tinyurl.com/r892jm67","body":"This paper assessed in 2022 the feasibility and acceptability of using pharmacy outlets and community health volunteers to increase women\u2019s and girls\u2019 access to information, medication abortion and other sexual and reproductive health services and rights. The study utilized a single arm pre-test and post-test design that involved implementing a set of interventions and comparing the baseline and endline indicators using simple frequencies considering the number of respondents involved in the study. Data collected from 10 pharmacy staff and 20 community health volunteers, along with pharmacy sales records, showed steady increase in service uptake. Medication abortion clients increased from 15 to 112 monthly, with 527 total clients, of whom 523 also obtained family planning methods. All pharmacy staff and health volunteers reported satisfaction and positive attitudes toward service provision. The intervention demonstrated the feasibility and acceptability of providing medication abortion and reproductive health services through private pharmacies, with community health volunteers effectively increasing awareness and strengthening referral systems. Results suggest potential for addressing unsafe abortion, a leading cause of maternal mortality in Kenya.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Benefits, challenges, and best practices of collaborative partnerships among health supply chain stakeholders in Rwanda: a cross-sectional study","field_subtitle":"Tuyishime A; Hahirwa I; Njunwa K J; et al: BMC Health Services Research 25(75), 1-9, doi: https://doi.org/10.1186/s12913-025-12239-1, 2025 ","URL":"https://tinyurl.com/y3z45u2n","body":"This cross-sectional study examined health supply chain management in Rwanda through surveys of 103 respondents from 54 institutions, including government bodies, medical suppliers, pharmacies, and hospitals. Health commodity availability ranked highest (98.0%) among benefits, alongside improved infrastructure and cost-effectiveness. Major challenges included insufficient financial resources, skilled staff shortages, and limited information sharing. Participants recommended improving collaborative partnerships through political will, supply performance measurement, better financing policies, and increased transparency. Results emphasize the importance of strengthening stakeholder collaboration, staff capacity, and information sharing to enhance supply chain efficiency and client satisfaction.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Brief on climate, land rights and agroecological links to pandemics in East and Southern Africa","field_subtitle":"EQUINET, SEATINI, TARSC, December 2024","URL":"https://tinyurl.com/2r5s7dhm","body":"This brief from the webinar on Climate, land rights and agroecological links to pandemics summarises key issues raised related to: climate links to land and agro-ecology in the region and the impacts on health equity and pandemics; actions proposed to address these issues at local, national, regional and in global level processes; and issues for further research and discussion. The session noted that current agricultural practices in East and Southern Africa are creating significant environmental and health challenges. Industrial agriculture relies heavily on chemical pesticides, which contribute to biodiversity loss, soil and water pollution, and increased zoonotic disease risks, exacerbating climate change impacts and creating conditions that make communities more vulnerable to pandemics. To address these challenges webinar speakers and participants noted that policies need to be re-oriented to support smallholder farmers and provide land security. Trade agreements that undermine seed sovereignty must be rejected and a One Health approach must be implemented to manage zoonotic disease risks. The brief emphasizes the importance of integrating climate adaptation and food security into local and national plans, and ensuring that farmer-led solutions are central to trade, investment, and climate policy discussions. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Building evidences in Public Health Emergency Preparedness (\"BePHEP\" Project)\u2014a systematic review ","field_subtitle":"Mercogliano M; Spatari G; Noviello C; et al: International Journal for Equity in Health 24(41), 1-17, doi: https://doi.org/10.1186/s12939-025-02382-w, 2025 ","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-025-02382-w","body":"This systematic review evaluated strategies and interventions implemented in low- and middle-income countries (LMICs) to prevent and manage infectious disease outbreaks during humanitarian crises from 2018 to 2023. Utilizing a comprehensive literature search across Scopus, PubMed, and Web of Science, the authors identified eleven studies from 1,415 unique articles. The research examined diverse interventions including vaccination campaigns, epidemiologic surveillance, and integrated health services across multiple countries. Case studies from Haiti, Mozambique, Thailand, India, the Philippines, Yemen, Uganda, South Sudan, and Nigeria demonstrated the effectiveness of multimodal, targeted, and collaborative responses to complex health emergencies. The findings highlighted the critical importance of adaptable healthcare systems and international collaboration in addressing infectious disease risks during humanitarian crises. Despite successful interventions, the study noted persistent challenges such as infrastructure limitations, insecurity, and logistic constraints that impede comprehensive public health emergency preparedness.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for abstracts: South African Health Review 2025","field_subtitle":"Deadline 31 March 2025","URL":"http://www.hst.org.za/sahr","body":"The South African Health Review (SAHR) invites submissions for its 2025 edition 'Learning health systems: bridging knowledge and practice'. This edition seeks to explore successful health systems reform experiences within the country and draw from good practices and exemplary implementation across the provinces. The 2025 edition aims to identify practical ways to enhance specific aspects of the health system in the short term, while aligning with the broader reforms needed to achieve universal health coverage. The South African Health Review is a peer-reviewed publication accredited with the Department of Higher Education and Training, and published by Health Systems Trust. The aims of the SAHR are to advance the sharing of the knowledge, feature critical commentary on policy implementation, and offer empirical studies for improving South Africa's health system.\r\n","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for case studies: Scaling up promising practice to promote healthy urban people and ecosystems in east and southern Africa","field_subtitle":"Call closes 5pm April 30th 2025","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/Call%20for%20urban%20health%20case%20studies%202025.pdf","body":"In 2024 the regional community of practice on urban health in EQUINET proposed 10 recommendations on areas of practice and policy to build, enable and amplify climate-responsive integrated healthy urban food, waste and ecosystems in ESA.  A brief (on the EQUINET website) indicates that we already have many examples of practices in these areas. This call is seeking case study examples of promising sustained practice, policy or measures within urban and peri-urban areas in ESA countries or if relevant at regional level relevant to water, energy, green spaces, climate and local economies that show innovation in one or more of the five areas The selected case studies should be drafted in May 2025 and provide evidence showing the learning in a 5-6 page brief with photographs written in an accessible style on the specific practice(s) underway that demonstrate one or more of the five areas.  These five areas are explained in the call with the details requested to be sent by those responding. EQUINET will provide review, copy edit and layout and publishing of the case study in July 2025 for wider dissemination on the EQUINET website and in an updated recommendations brief.   The authors will be integrated into activities and partnerships of the regional community of practice on urban health. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Challenging the myth of women's empowerment: Mining development and commercial sex in a Zambian town","field_subtitle":"Johnston L, Mulenga M, Davison C. et al: Wellbeing, Space and Society, 6,100186,doi.org/10.1016/j.wss.2024.100186, 2024","URL":"https://www.sciencedirect.com/science/article/pii/S2666558124000046","body":"Commercial sex and mining have long been interwoven. With the spread of neoliberal capitalism, social relations around the mine site have become increasingly commodified. This ethnographic study examines the experiences of female sex workers in the mining town of Solwezi, Zambia. Women's stories offer insight into the lives of those excluded from the conventional women's economic empowerment narrative that has been widely adopted by the mining industry and what this means for their wellbeing and health. Despite the rhetoric, economic empowerment is not easily attained and women often remain heavily reliant on mine workers given limited and unequal opportunities within the labour market. In Solwezi, women who have been abandoned by a mine-working husband may find that sex work is the one opportunity available to them. Alternatively, women have migrated from across the country to participate in commercial sex work in Solwezi. Men, especially mine workers with twice-monthly pay cheques, have become a sought-after commodity, by both sex workers and wives. This has increased their power in their relationships, entrenches inequality, and increases the potential for abuse in these relationships. Despite these dynamics, sex working women continue to be neglected in Solwezi and by the broader development community. When they are considered, generally attention is directed towards HIV prevention. The authors note that these interventions fail to consider the complex social, political, and economic context that can affect women's living and working conditions. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"COVID-19 vaccine uptake in Zimbabwe and Sierra Leone: an application of Health Belief Model constructs","field_subtitle":"Ssentongo S; Muhereza A; Mustapha M; et al: BMC Public Health 25:451, 1-8, doi: https://doi.org/10.1186/s12889-025-21610-0, 2025 ","URL":"https://tinyurl.com/p4j2caxc","body":"This cross-sectional study examined vaccine acceptance factors among 2,312 participants in Zimbabwe and Sierra Leone using the Health Belief Model and Theory of Planned Behaviour frameworks. Using adjusted logistic regression models accounting for gender, age, education, and location, researchers found high vaccine uptake correlated with heightened perceived COVID-19 threat, recognized vaccination benefits, stronger perceived behaviour control, and fewer barriers to vaccination. Conversely, low uptake was linked to diminished perceived threats, fewer perceived benefits, weaker perceived behaviour control, and heightened perceptions of barriers. Results underscore the importance of theoretical constructs in understanding vaccine uptake variations and suggest public health campaigns should focus on reshaping risk perceptions, addressing obstacles, emphasizing vaccination benefits, and fostering a sense of self-efficacy within target communities.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Cross-cultural insights into internet addiction and mental health: a network analysis from China and Malawi","field_subtitle":"Li M; Wang Y; Liu B; et al. BMC Public Health 25:320, 1-10, doi: https://doi.org/10.1186/s12889-025-21496-y, 2025 ","URL":"https://tinyurl.com/nwzhkznd","body":"This paper compared, using network analysis, the network structures of Internet addiction and mental health symptoms among university students in China and Malawi, to provide insights into culturally sensitive prevention and intervention strategies. The prevalence of internet addiction and mental health was significantly higher in China than Malawi. In Malawi, the strongest edges were school work, job performance and a sense of worthlessness. The central nodes were daily work, suffering, fantasizing and loss of interest. In China, the strongest edges were neglected household, neglected partner and difficulties with daily work suffering. The central nodes were trouble thinking, unhappiness, and inability to 'play a useful part'. Bridge symptoms varied between the countries, with functional impairments being more prominent in Malawi and emotional disturbances in China. The study highlights significant differences in the network structures of internet addiction and mental health between China and Malawi. This underscores the importance of culturally sensitive mental health interventions. In Malawi, addressing functional impairments related to academic and work performance is crucial, while in China, interventions should focus on emotional and relational aspects.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Cross-sectional analysis of risk factors associated with the coexistence of three undernutrition indicators among children aged 0\u201323 months in Tanzania","field_subtitle":"Pallangyo E E;  Kimaro O J; Mwalupani N R; et al: BMC Nutrition 11(4), 1-11, doi: https://doi.org/10.1186/s40795-024-00980-5, 2025   ","URL":"https://tinyurl.com/4f7bzr6j","body":"This paper investigates demographic, maternal, and child-related factors associated with the coexistence of stunting, wasting, and underweight. Secondary data from 2,158 children aged 0\u201323 months in the 2022 Tanzania Demographic and Health Survey were analyzed. Risk factors assessed included child age, birth weight, size at birth, birth order, and maternal education. Multinomial regression analysis was conducted to determine associations. The risk of coexisting undernutrition was significantly higher among children aged 12\u201317 months and 18\u201323 months. Protective factors included birth weight\u2009","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 241: Uprooting climate-related health inequities in East and Southern Africa","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. \r\n","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Webinar on Climate-Related Migration and Health Equity in East and Southern Africa","field_subtitle":"Thursday 20th March, 2025 12:00-14:00 Southern African time;  13.00-15:00 East African time","URL":"https://us06web.zoom.us/meeting/register/X8XXqITLQDu9bT1_7_aN4w","body":"This webinar discusses the most critical drivers of climate-related migration in the region and how they affect differentials in both opportunities for and threats to improved wellbeing.  We hear from key panellists from community, national and international/global lens and discuss how far current policies and actions address the health risks and benefits of climate-related mobility, and what strategies and integrated approaches can prevent or mitigate the risks and maximise benefits. Register now in advance to receive a confirmation email with further information on the meeting and your link to join.   ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Exploring the hurdles of implementing National School Health Policy in Namibian Schools: insights from stakeholders","field_subtitle":"Katangolo-Nakashwa N; Honest Mfidi F H: BMC Health Services Research (2025) 25(131), 1-7, doi: https://doi.org/10.1186/s12913-024-12197-0, 2025","URL":"https://tinyurl.com/5xmdsj9v","body":"This paper explored stakeholders\u2019 perspectives on the challenges of implementing Namibia's National School Health Policy (NSHP) in schools using a specifically designed interview guide. A total of 20 stakeholders participated, including educators, nurses, principals, and health program administrators from three regions in Namibia. The study identified significant barriers to effectively implementing the school health policy, including staffing shortages, inadequate resources, limited learner awareness of health rights, and insufficient teacher well-being. Additional challenges involve resource constraints, a lack of monitoring and evaluation, and limited coordination between the education and health sectors. The analysis emphasizes the need for increased resource allocation, comprehensive training, collaborative policy development, and initiatives to improve teacher well-being, and highlights the importance of strong leadership, stakeholder involvement, and adequate funding to support the policy goals.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Exploring the inherent resilience of health districts in a context of chronic armed conflict: a case study in Eastern Democratic Republic of the Congo","field_subtitle":"Makali S L; St Louis P; Karemere H; et al:Health Research Policy and Systems 22(175), 1-15, doi: https://doi.org/10.1186/s12961-024-01252-1, 2024","URL":"https://tinyurl.com/ycyhshwa","body":"This mixed-methods study compared health districts with and without armed conflict exposure in South Kivu, DRC, using the Kruk index framework. Through document review, stakeholder interviews, and Likert scale questionnaires, researchers identified essential resilience components including prior knowledge of strengths/weaknesses and crisis risks, plus community and non-health actor involvement. The conflict-affected district implemented additional mechanisms including armed forces involvement, mobile clinics, warning systems, and displaced persons monitoring. Findings emphasize that health districts need better resourcing during stable periods to build capacity for crisis resilience, enabling improved care quality and disturbance management.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Global strategies for implementing health financing equity \u2013 a state-of-the-art review of political declarations","field_subtitle":"Nimubona A; Yandemye I; Nigaba C; et al: International Journal of Equity in Health 24(45), 1-16, doi: https://doi.org/10.1186/s12939-025-02404-7, 2025","URL":"https://tinyurl.com/3wer6djb","body":"This study investigated the global strategies for implementing health financing equity that emerged from political declarations made before 2024. The authors identified the political declarations from a search of United Nations databases and snowball searches and extracted the global strategies of health financing equity implementation that emerged from the political declarations, using the WHO Health Financing Progress Matrix framework. In total, 40 political declarations were included. From these declarations emerged strategies of targeted, selective, contributory, universal, claims, proportionate, experimental, united, and aggregated financing to implement health financing equity in countries. Thirty nine of the 40 political declarations that labelled the global health community from 1944 until 2023 placed more efforts on duplicating the prevailing strategies. The declarations, categorised into nine groups (target, unity, universality, selectivity, contribution, aggregation, claims, experience, and proportionality-oriented political declarations), were used to press countries to implement the strategies, although the strategies could not claim effectiveness nor to be optimal for providing efficient and sustainable UHC in all countries. Authors propose careful management and adaptation of global strategies for the diverse needs of the diverse population.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Going paperless: the strengths and limitations of electronic research ethics information management system in a health training institution in Tanzania","field_subtitle":"Mkumbwa R D; Pancras G; Sirili N S; et al: BMC Health Services Research 25(12), 1-7, doi: https://doi.org/10.1186/s12913-024-12151-0, 2025  ","URL":"https://tinyurl.com/ycku897z","body":"This qualitative pre-post evaluation study examined the transition to an electronic Research Ethics Information Management System at Muhimbili University through interviews with 16 faculty members with experience in both paper-based and electronic systems. Using thematic analysis, researchers identified key strengths including system convenience and improved records management. Limitations centered on demands for reliable information and communication technologies and reduced reviewer-researcher interaction. The findings underscore both benefits and challenges of implementing paperless systems in resource-limited settings, recommending system automation, strengthened institutional capacity, and further studies on system adoptability, particularly in resource-constrained environments.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Investigating inconsistencies regarding health equity in select World Health Organization texts: a critical discourse analysis of health promotion, social determinants of health, and urban health texts, 2008\u20132016","field_subtitle":" Amri M; Enright T; O\u2019Campo P; et al: BMC Global and Public Health 2(81), 1-14, doi: https://doi.org/10.1186/s44263-024-00106-w, 2024 ","URL":"https://tinyurl.com/37ew5bcv","body":"This paper assessed the World Health Organization\u2019s approaches to health equity in select health promotion, social determinants of health, and urban health texts from 2008 to 2016. The authors found that the World Health Organization usually measures health equity by comparing groups, explicitly specifies three approaches to health equity and considers health equity inconsistently both in terms of socioeconomic status and other social determinants of health. Socioeconomic status was given substantially more attention than other social determinants of health. The authors argue that there is misalignment with the World Health Organization\u2019s stated approaches to tackle health inequity and its discourses around health equity. This incongruence, they argue, increases the likelihood of pursuing short-term solutions and not sustainably addressing the root causes of health inequity. They argue that critical discourse analysis\u2019 focus on power allowed for an understanding of why \u2018radical\u2019 approaches are not explicitly expressed so that governments will be agreeable to addressing health inequity.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Measuring the uptake of clinic-based HIV treatment and prevention services following HIV testing and referral at private pharmacies in Kenya","field_subtitle":"Omollo V; Roche S D; Zhang S; et al. BMC Health Services Research (2025) 25:23, 1-9, doi: https://doi.org/10.1186/s12913-024-12165-8, 2025  ","URL":"https://tinyurl.com/mr6sv9vp","body":"This pilot study evaluated HIV service uptake when private pharmacies offered free testing and referrals in Kisumu County, Kenya. Among 1,500 pharmacy clients tested, 1,178 were followed up after three months. Most participants were women (median age 26), testing HIV-negative and receiving pre-exposure prophylaxis (PrEP), or post-exposure prophylaxis (PEP) referrals. While antiretroviral therapy (ART) initiation and PEP uptake was high among those referred, PrEP uptake remained low at 9%, with prior PrEP use being the only significant predictor of initiation. Findings suggest the need for additional interventions to support PrEP referral follow-through or alternative delivery models like same-day pharmacy initiation.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Member States differ on response to US withdrawal from WHO","field_subtitle":"TWN Info Service on Health Issues, February 2025","URL":"https://tinyurl.com/5xmdsj9v","body":"The 156th Session of the WHO Executive Board, held in Geneva, witnessed intense deliberations over the financial repercussions of the United States' withdrawal from the organization. Member States engaged in complex negotiations that revealed deep divisions about how to respond to the significant budget shortfall, with proposals ranging from reducing the base budget from USD 5.3 billion to USD 4.9 billion to potentially increasing assessed contributions by 20%. High income countries largely advocated for postponing new resolutions and prioritizing activities, while low income countries strongly resisted such approaches, arguing for the preservation of the organization's comprehensive mandate. The discussions highlighted the underlying vulnerabilities of the WHO's funding model, which heavily relies on voluntary earmarked contributions, and underscored the challenges of maintaining critical global health functions amid financial uncertainty. Diplomatic exchanges were marked by nuanced debates about prioritization, with countries like Russia, China, and India questioning the sudden financial adjustments and calling for more measured, transparent approaches to budgeting and resource allocation. The session ultimately reflected the complex task of balancing organizational sustainability with the diverse health priorities of Member States in an evolving global health landscape.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Over a decade of HIV infection prevalence and incidence among Mozambican pregnant women: a secondary analysis of prospectively collected data","field_subtitle":"Mendes-Muxlhanga A; Nhacolo A; Figueroa-Romero A; et al: BMC Public Health 25(251), 1-11, doi:  https://doi.org/10.1186/s1288902521467-3, 2025 ","URL":"https://tinyurl.com/yfbmkdrj","body":"This paper describes HIV infection trends over eleven years in women attending selected antenatal care clinics in southern Mozambique. The authors performed a secondary analysis of data registered at the ANC clinic of the Manhi\u00e7a District Hospital and from the Ministry of Health's HIV National Program Registry between 2010 and 2021. HIV incidence was calculated using prevalence estimates. HIV incidence trends over time were obtained by fitting splines regression model. Data from 21,810 pregnant women were included in the analysis. Overall HIV prevalence was 29.3%, with a reduction from 28.2% in 2010 to 21.7%, except for a peak in prevalence in 2016. Over the study period, by maternal age group, the largest reduction in HIV prevalence was in the 15\u201320 year-old group, followed by the 20\u201325 year old group and the 25\u201330 year old group. Incidence of HIV infection increased from 12.75 per 100 person-years in 2010 to 18.65 per 100 person-years in 2018, and then decreased to 11.48 per 100 person-years in 2021. The prevalence of HIV decreased while the overall incidence stayed similar in Mozambican pregnant women, during 2010 to 2021. However, both estimates remain unacceptably high, which authors suggest indicates the need to revise current preventive policies and implement effective ones to improve HIV control among pregnant women.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Socio-economic and demographic determinants of undernutrition among 6\u201359 months old children living in Malawian stunting hotspots: a cross-sectional community study","field_subtitle":"Ndovie P; Nkhata S G; Geresomo N; et al: BMC Nutrition 11(4),  1-8, doi:  https://doi.org/10.1186/s40795-025-01001-9, 2025 ","URL":"https://tinyurl.com/3hdu7wrm","body":"This paper examined socio-economic and demographic determinants of undernutrition among children aged 6\u201359 months, offering insights to guide interventions in these areas. This cross-sectional study of 1,275 caregiver-child pairs from Mzimba, Mchinji, and Mangochi Malawi used multi-stage sampling. Wasting was linked to occupation, marital status, household size, religious affiliation, and vaccination, with protective factors including farming, business, being single, and full vaccination. Underweight was associated with occupation and household type, with higher risks in business and single-parent households, and protection in smaller households. Stunting was related to unemployment and full vaccination. Education and income showed no significant association with stunting. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Socioeconomic disparities in child malnutrition: trends, determinants, and policy implications from the Kenya demographic and health survey (2014 - 2022)","field_subtitle":"Okutse A O; Athiany H: BMC Public Health 25:295, 1-17, doi: https://doi.org/10.1186/s12889-024-21037-z, 2025 ","URL":"https://tinyurl.com/ms6djnxp","body":"This study analyzed child malnutrition trends and determinants using Kenya Demographic Health Survey data (2014-2022), examining stunting, underweight, and wasting in children under five. Analysis showed increased socioeconomic inequality in malnutrition between 2014-2022, particularly affecting the poorest households. Key risk factors for stunting included child's age, household poverty, and sex, while underweight and wasting were associated with mother's age, child's sex, and socioeconomic status. Residence specifically influenced wasting risk. Socioeconomic status proved the strongest predictor of health inequality, though its effectiveness as a screening tool for stunting was moderate (sensitivity 67.4%, specificity 50.6%). Findings highlight the need for interventions that address both immediate health risks and underlying socioeconomic factors to improve child nutrition outcomes equitably.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Solidarity and its decoloniality in global health ethics","field_subtitle":"Fayemi AK; Kirchhoffer DG; Pratt B: International Journal for Equity in Health 24(13), 1-16, doi:https://doi.org/10.1186/s12939-025-02380-y, 2025","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-025-02380-y","body":"Solidarity is one of the emerging values in global health ethics, with some bioethics papers linking it to decoloniality. However, conceptions of solidarity in global health ethics are influenced primarily by Western perspectives, suggesting any inclusion of decolonial ideas need to include non-Western perspectives. This article explores a decolonial interpretation of solidarity. It employs a palaver approach, typical of African (Yor\u00f9b\u00e1) relational culture, developing a conception of solidarity grounded in a beehive metaphor. Through this approach, the authors posit that a beehive metaphor allegorically symbolises solidarity, embedding it in relational virtues and duties that foster harmony, particularly for people with whom one shares similar circumstances for harmonious well-being through concerted efforts. The authors address five potential objections to this account of solidarity in global health ethics and explores what an African account of solidarity means for global health research funding, including for expanding conceptual perspectives on solidarity in global health ethics. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Stigma relating to tuberculosis infection prevention and control implementation in rural health facilities in South Africa \u2014 a qualitative study outlining opportunities for mitigation","field_subtitle":" van der Westhuizen H-M; Ehrlich R; Somdyala N; et al: BMC Global and Public Health 2:66, 1-13, doi: https://doi.org/10.1186/s44263-024-00097-8, 2024 ","URL":"https://tinyurl.com/3j4kfkf7","body":"This qualitative study explored tuberculosis stigma in rural South Africa through interviews with 18 health workers and 15 patients. Using Link and Phelan's theoretical model, researchers found that TB infection prevention and control measures sometimes exacerbated stigma through physical isolation and mask-wearing requirements. Patients and health workers had contrasting perspectives: patients focused on communal benefit while health workers emphasized negative impacts on patient relationships. Recommendations included improving TB education, promoting respectful communication, emphasizing communal safety, and implementing universal precautions rather than targeted measures. The study suggests using ubuntu (an African humanist framework) to guide stigma mitigation interventions and policy changes.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The nature of self-medication in Uganda: a systematic review and meta-analysis","field_subtitle":"Makeri D; Dilli P P; Pius T; et al: BMC Public Health (2025) 25:197, 1-11, doi: https://doi.org/10.1186/s12889-025-21380-9, 2025 ","URL":"https://tinyurl.com/mduux52a","body":"This systematic review and meta-analysis investigated self-medication prevalence in Uganda through 22 eligible studies encompassing 9,113 participants across different demographics and regions. Analysis revealed that at least one in two Ugandans self-medicate, with antibiotics being the most commonly self-medicated drugs. Key contributing factors included ease of access to medications, perceived cost effectiveness, long hospital waiting times, home storage of drugs, and perceptions of minor illnesses. The high prevalence of antibiotic self-medication is particularly concerning in the context of antimicrobial resistance, indicating an urgent need for awareness campaigns about the dangers of self-medication.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Towards an inclusive digital health ecosystem","field_subtitle":"Xie Y; Fadahunsi K; Kelleher C; et al: Bulletin of the World Health Organisation 103(2), 170-173, doi: 10.2471/BLT.24.292020, 2024","URL":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11774217/","body":"Digital inclusion in health technologies remains a critical global challenge, with significant barriers preventing equitable access across diverse populations. The authors argue that achieving meaningful digital health inclusion requires more than technological advancements, demanding a comprehensive, multisectoral approach that addresses complex social and technical interconnections. The authors propose a novel concept of \"universal design for decision-making\" as a strategic framework to overcome existing limitations. This approach emphasizes multilevel collaboration, involving stakeholders from individual users to governments, and focuses on creating an ecosystem where inclusivity is naturally embedded in technological design, policy development, and health interventions. By integrating sociotechnical methods with universal design principles, the approach aims to develop digital health solutions that accommodate the diverse needs of all populations. The research highlights seven critical dimensions for optimizing inclusive digital health, ranging from policy development and technology design to addressing the needs of underserved groups and ensuring secure, trustworthy systems. The authors underscore that achieving true digital health equity is a continuous, transformative process requiring collective efforts, adaptive governance, and a deep understanding of human diversity across technological, social, and policy landscapes.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Trial of an mHealth intervention to improve HIV prophylaxis for female sex workers, United Republic of Tanzania","field_subtitle":"Christopher H Mbotwa C H; Method R Kazaura M R; K\u00e5re Moen K; et al: Bulletin of the World Health Organisation 102, 852\u2013860, doi: http://dx.doi.org/10.2471/BLT.24.291516, 2024 ","URL":"https://tinyurl.com/3jt8zwfc","body":"This paper evaluated the effect of a mobile health (mHealth) intervention on early retention of female sex workers in human immunodeficiency virus (HIV) pre-exposure prophylaxis services in the United Republic of Tanzania. The study involved 783 female sex workers: 470 from Dar es Salaam who were given the Jichunge mHealth application in addition to standard HIV pre-exposure prophylaxis, and 313 from Tanga who received pre-exposure prophylaxis alone. Participants were recruited using respondent-driven sampling and followed up for 12 months. Early retention was defined as attending a pre-exposure prophylaxis follow-up clinic within 28 days of an appointment scheduled for 1 month after starting treatment. To assess if the Jichunge app led to higher retention, the authors conducted intention-to-treat and per-protocol analyses using a regression model adjusted by inverse probability weighting. Early retention in HIV pre-exposure prophylaxis care was observed in 27.6% of participants in the intervention arm and 20.1% in the control arm. In the adjusted, intention-to-treat analysis, early retention was observed in 29.4% in the intervention arm and 17.7% in the control arm. Early retention in HIV pre-exposure prophylaxis care was significantly greater among female sex workers in the United Republic of Tanzania who used the Jichunge app than in those who did not. Nevertheless, more than two thirds of sex workers using the application did not attend follow-up services after 1 month, suggesting that additional interventions are needed.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Tribute to Professor Charles Ngwenya","field_subtitle":"EQUINET Steering committee","URL":"https://www.chr.up.ac.za/latest-news/3936-prof-charles-ngwena-a-stalwart-has-bowed-out","body":"EQUINET extends our collective condolences to the family, friends and colleagues of Charles Ngwena, a tireless and persistent defender of human rights, particularly from an Afrocentric perspective of law. Professor Ngwena, a native of Zimbabwe but a global scholar, did ground-breaking work in the application of Socio-economic rights in a African context, and particularly focused on disability rights and sexual and reproductive health rights, helping EQUINET develop its early thinking about the relationship between Health Equity and Human Rights. He died in South Africa on 1st Feb and will be sorely missed by our community. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Trump orders immediate end to USAID funding for HIV organisations in SA ","field_subtitle":"Malan M: News24, 27 February, 2025","URL":"https://www.news24.com/news24/southafrica/news/trump-orders-immediate-end-to-usaid-funding-for-hiv-organisations-in-sa-20250227","body":"This report outlines how Pepfar-funded HIV organisations in South Africa, who receive their funds through the United States Agency for International Development, USAID, woke up to letters that were sent overnight telling them their grants have been ended - permanently. USAID-funded district health projects, supported outside of Pepfar, but with other US government funds administered by USAID, have also been instructed to close down, including several projects working on fighting HIV within key populations such as LGBTQI+ groups, and also those working with orphans and vulnerable children, to close down their projects immediately. South African organisations say they have also had reports from Pepfar-funded projects in Kenya and Malawi saying they had received similar letters. The article outlines responses from organisations working on HIV. The Treatment Action Campaign chairperson is reported to have said \" It is so painful that these terminations mean death to poor people of the world. Key and vulnerable populations are the most affected\". Many organisations noted that HIV related deaths and infections will increase and called for a more urgent government and global response.   As one public health specialist noted \"\"The people - the patients, the frontline workers, the programme recipients who relied on these services for survival - are now left stranded, abandoned by a system that once promised progress and partnership. Every contract cancelled is not just a number; it represents a life, a community, a future now in jeopardy. The sheer disregard for the impact on millions of vulnerable people is unfathomable, and the ripple effects of these decisions will be felt for generations to come\". ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Uprooting climate-related health inequities in East and Southern Africa","field_subtitle":"EQUINET Steering committee ","body":"\r\n\u201cLand is more than a resource in east and southern Africa. For millions of people it is their home, their culture, and their livelihood. So when we talk of the droughts, floods and unpredictable growing seasons caused by climate change it is not just an \u2018inconvenient truth\u2019 \u2013 it is a catastrophe for all those who live and depend on the land.  When these communities are also losing land to multinational corporations annexing land for industrial mono-cropping, they deprive people of  livelihoods, wellbeing and generations of wisdom, making people more vulnerable to challenges like climate change\u201d. \r\n\r\nThis discussion at the sixth EQUINET webinar on climate and health equity in east and southern Africa pointed out how deep the action needs to be to uproot climate- related inequities that undermine health.  \r\n\r\nThis, and the previous five webinars heard from community, national and regional/international speakers how the roots of climate change intertwine with other drivers of inequities in health, and what that means for action at all these levels. High levels of economic and social inequality in the east and southern Africa region \u2013 and globally- undermine the right to health for many, including for the many young people who make up the majority of the region\u2019s population. \r\n\r\nLooking across rights, laws, health systems, extractive sectors, agroecology, urban food, trade and tax systems, the webinars presented evidence of how climate change and emergencies  are clearly having  wide-ranging health impacts, with extreme weather disrupting environments, food and water access, expanding disease vectors and  increasing injury, mental distress, communicable disease and mortality. The direct health impacts are profound in a region where a large share of the population is reliant on climate-sensitive sectors like agriculture and natural resource-dependent livelihoods and are particularly affected by water scarcity.  Climate impacts have raised demand for health care, but have also damaged health infrastructures, adding to existing barriers to access. While acute disasters attract the most attention, many of these direct health impacts emerge from longstanding deficits, especially for already vulnerable communities. \r\n\r\nAcross all the webinars, climate impacts were reported to not only intersect with existing inequalities in the region, but to also widen them. Whether discussing female reproductive rights, household food security, employment and incomes and other factors affecting health, webinar speakers and participants gave examples of how climate change is exacerbating existing health disparities, widening gender inequalities and depriving already disadvantaged people of the resources for health. The numbers affected are huge: there was constant reference to poor households, women, children, young people, rural and coastal and flood-prone communities and urban informal settlement residents or workers, and others already disadvantaged in the current political economy. \r\n\r\nWhile there was concern that we often lose sight in climate change and policy forums on the lived experience of these local realities, speakers and participants also raised their global drivers. Commercialised agribusiness and food systems clear forests and land and degrade environments. Transnational corporations (TNCs) are extracting and exporting non-renewable minerals, in activities that are leading to water and air pollution, land subsidence, degraded environments and increasing water scarcity. A skewed global trade system compounds these impacts, as trade protectionism and patents held by high-income countries and TNCs limit the technology and resource transfers needed to manage climate change and its impacts. A global tax and financing system and weak public sector tax capacities enables significant transnational financial outflows, including to tax havens, diminishing the public resources for more inclusive, climate adapted economies, social protection or health systems.  In the face of these global drivers, poorly met climate financing promises of only 12% of Africa\u2019s estimated annual financing need of US$300 billion to prevent and mitigate climate impacts, largely provided as unpredictable aid or debt inducing loans, made it clear that global diplomacy processes are neither adequate nor equitable to address these drivers nor mitigate their consequences. \r\n\r\nOur final webinar on March 20th on climate-related migration and health equity in the region closes the first round of our discussions and moves our focus more directly to responses to improve health equity, whether at local, national, or regional level, or in engaging globally. We welcome further evidence, views and collaboration in this next phase!\r\n\r\nThe previous webinars have pointed to options for action. Many build on existing actions to promote health equity, such as:  ensuring health literacy and an informed public able to claim their rights, use laws and demand that states meet duties to implement laws and hold those harming health accountable; integrating local voice in planning integrated economies and public services that meet food, energy, waste management and water needs of the whole population; promoting health and environment impact assessments, and inclusive inter-sectoral processes to ensure longer-term planning and public control over TNCs extracting mineral and biodiversity resources to internalise health costs;  investing in and ensuring equity in primary health care oriented health systems; and strengthening unified African voice and positions in global engagement.\r\n\r\nAt the same time, the way climate exacerbates existing drivers of health inequity was seen to demand additional responses, embedded within these measures for health equity, including:  integrating climate literacy and specific rights and legal protections related to climate impacts across all sectors;. improving monitoring, collection and use of disaggregated evidence on climate impacts and responses; promoting exchange of promising practice; integrating health and climate considerations in democratic planning, using circular economy models that benefit local incomes and wellbeing; improving TNC tax contributions to generate climate-proofed activities, jobs, services and infrastructures; developing early warning systems and promoting climate-resilient health care practices and infrastructures; and demanding predictable and equitably distributed global tax-based climate financing in place of loans that worsen already high debt burdens.\r\n\r\nAs high income countries intensify their fossil fuel explorations and global conflicts absorb resources in military activities rather than the transformations needed to protect the planet, the global context appears to be intensifying risk. Consistently across the webinar discussions participants have observed that inclusion of the voices of affected, vulnerable communities and young people into climate planning and negotiations is essential to ground a more robust, people-driven and locally responsive approach within the region. This is seen as essential to strengthen the just demand from the region for changes in the global political economy that are critical in the face of climate change, not only for health equity, but for human survival.  \r\n\r\nWe welcome your feedback or queries on the issues raised in this oped \u2013 please send them to the EQUINET secretariat. You can watch the different climate webinars and read the breaks and reports on the EQUINET website. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Urban Health Capacity assessment and response kit","field_subtitle":"WHO; Geneva, 2025","URL":"https://www.who.int/teams/social-determinants-of-health/urban-health/urban-health-capacity-assessment-and-response","body":"WHO has developed an Urban health capacities assessment and response resource kit that equips multi-sectoral teams to assess whether a given initiative can meet its goals in a complex urban environment. It helps answer a critical question: Do we have the right capacities in place to achieve our objectives that influence urban health \u2014whether directly or indirectly? The Kit provides a structured framework through its Primer, and a step-by-step process in the Action Guide and Training Videos, helping you evaluate key capacities across four critical areas: Informed decision-making, monitoring, and evaluation; Policies, programmes, innovation, and change; Resource management (human, financial, and infrastructural) and Partnerships, participation, and knowledge sharing. There are also  real-world examples in the City-examples section.","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Urban Health Council: Community-led health justice programmes and living knowledges rooted in science for those living in oppressive urban environments.","field_subtitle":"Urban Health Councils: Centric Lab","URL":"https://www.urbanhealthcouncil.com/","body":"This site has been designed as a self-learning tool for grassroots activists, advocacy organisations, and policy makers looking to centre health justice in their work. Work is organised into a unique narrative arch used to help people learn specific health injustice topics. This Urban Health Council\u2019s role is to summon together people under an autonomous method of governance and practice whereby peer-led programmes determine the direction of production of works that support health justice movements, led by the People for the People, meeting them where they are with what they need. Each programme is supported through a scientific, technical and financial ecosystem where all works produced are made open-access in a Living Encyclopedia. ","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"We invite submissions on Artificial Intelligence and health equity in east and southern Africa","field_subtitle":"Editor, EQUINET News","body":"The expansion and embedding of Artificial Intelligence (AI) in many processes that positively and negatively affect wellbeing will clearly impact on health equity. There are interesting papers on this in this issue that flag some of the issues for this. In this time of challenging political economy changes and influential digital entrepreneurs, actors and platforms we invite and welcome published papers and reports and editorial submissions to the newsletter (email: admin@equinetafrica.org) that help to strengthen informed analysis and debate on AI and health equity from a regional lens. We look forward to hearing from you!","php":"","field_issue_date":"2025-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"A call for applicants for the 2025 online capacity building course on health impact assessment ","field_subtitle":" EQUINET: TARSC; TalkAB[M]R; SATUCC; in association with ECSA HC, C Dora; NIGH","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20HIA%202025%20course%20info%20for%20web_0.pdf","body":"Call for applicants for the 2025 online training in Health Impact Assessment closing 5pm February 4 2025. EQUINET is through TARSC and in association with regional (SATUCC, Talk AB[M]R) ECSA Health Community and international partners (Nossal Institute of Global Health, C Dora) convening online training and mentored case work to build HIA capacities in ESA countries. The course will provide materials and interactive presentations on the policy and legal basis of HIA, the steps, methods, evidence, analysis in and reporting of an HIA, and the monitoring of recommendations. Trainees will plan and implement a mentored case study HIA in teams over the course period. The capacity building will be implemented in ten online (zoom) training sessions in four course blocks, staggered at intervals between April 28 and July 31 2025. After two or three online course sessions of 2 hours each in a block, there will be a month before the next block to give time for 2 online tutorials with mentors to guide teams to work at self-arranged times on the HIA steps covered in the training for their own case studies. There will be four course blocks in the period. Participants satisfactorily completing the course will receive a certificate of completion. This document outlines the information for applicants for the course.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Brief on climate, land rights and agroecological links to pandemics in East and Southern Africa ","field_subtitle":"EQUINET, SEATINI, TARSC: December 2024","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20Climate%2C%20agroecology%20and%20health%20equity%20brief.pdf","body":"Climate justice and equity, is an urgent issue for communities, countries, and the region, and intersects with, impacts on and is intensified by other areas of inequality that the Regional Network for Equity in Health in east and southern Africa (EQUINET) is focused on. Given this, EQUINET is sharing knowledge, experiences and learning on health equity impacts of climate in webinars on various areas of health equity. The sixth webinar and this brief from it focuses on the interplay between land rights, climate agro-ecology, and pandemic risks. The webinar interrogated these relationships at the local, national and global levels and suggested actions to be taken to mitigate the impacts particularly on these drivers of health and well-being of people and natural resources.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Discussion paper 133: Synthesis report: EQUINET online dialogues and reviews on Climate justice and health equity in east and southern Africa","field_subtitle":"EQUINET SC, TARSC: September 2024","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20133%20climate%20and%20health%20equity%20Sep2024.pdf","body":"EQUINET identifies health equity as being affected by conditions and actions across multiple thematic areas. It sought to understand the intersect between climate change and health equity through the outcomes of five webinars and two rapid reviews and an online review meeting organised to explore these intersects. The webinars and briefs focused on selected thematic areas EQUINET has identified as central to health equity in the region, including health rights, food systems, urban health, extractives and health, trade and health, primary health care and tax justice. This synthesis report presents a thematic analysis of the briefs from the webinars and rapid reviews (separately available on the EQUINET website), and from an online review meeting on the findings. It outlines how climate change is intersecting with the various dimensions of health equity, including social inequalities and vulnerabilities in health, and the approaches underway or proposed to address these impacts and to promote health equity in the face of climate change, including for future work in EQUINET. It is shared as an interim product that we will update following EQUINET\u2019s ongoing work in 2025. ","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter usually comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 240: Freedom from hunger and violence, and safe, healthy lives is a fair demand for 2025","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Header"}},{"node":{"title":"European University Institute call for applicants for Policy Leaders Fellowship","field_subtitle":"Call closes 24 January 2025","URL":"https://www.eui.eu/apply?id=policy-leader-fellowship","body":"The Policy Leader Fellowship (PLF) at the EUI's Florence School of Transnational Governance (Florence STG), part of the European University Institute (EUI), is a residential programme designed for professionals who aspire to make a meaningful impact in the world of policymaking. With participants hailing from diverse backgrounds such as politics, civil service, media, and non-governmental organisations, the fellowship offers a unique platform for collaboration, innovation, and lasting change.The fellows spend five to ten months at the school\u2019s headquarters in Florence, Italy developing policy recommendations and practical solutions for the most pressing cross-border policy issues. The fellowships are fully-funded for the duration of the stay.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Freedom from hunger and violence, and safe, healthy lives is a fair demand for 2025. ","field_subtitle":"EQUINET Newsletter editor","body":"\r\nDid we make progress towards equity in 2024? Global inequities in power, wealth and human security persisted. War, occupation and abuse of human rights became the most common feature of daily news. Climate emergencies seemed to intensify. Women, children and already vulnerable and excluded people bore the brunt of these trends, and of the deficit between articulated commitments, conventions and constitutions, and the realities of daily life. \r\n\r\nYet 2024 has also seen inspiring and creative forms of solidarity and innovation, and a flourishing of new ideas and practices. At different levels, sustained resistance to accepting a normalisation of injustice has confronted despondency. We have shared, celebrated and learned from successes at local, national, regional and global level where they have  happened. \r\n\r\nMoving towards inequity or justice in 2025 is entirely within human choice. So in this abbreviated newsletter as 2025 starts we express thanks for the work done in 2024 and wish all advancing equity and wellbeing in 2025 the strength,  confidence and opportunity to raise and realise a fair demand for safe, healthy lives, and freedom from hunger and violence. ","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Identity Crisis Among Clinical Officers at Malawi\u2019s Public Hospitals Amidst the Implementation of Functional Reviews","field_subtitle":"Chinguwo, P: Journal of Health and Human Services Administration, 0(0). https://doi.org/10.1177/10793739241300506","URL":"https://journals.sagepub.com/doi/10.1177/10793739241300506","body":"In Malawi\u2019s healthcare system, a significant doctor shortage compels clinical officers who are mid-level health professionals, to shoulder responsibilities traditionally reserved for medical doctors. This study delves into the unintended consequences of functional reviews within Malawi\u2019s health sector. The research, employing a qualitative case-study approach across five public hospitals, investigated how the functional reviews triggered an identity crisis among clinical officers. The findings revealed that the implemented changes caused an identity crisis among clinical officers. This identity crisis, demonstrably exacerbated occupational stress among clinical officers. To address this unforeseen consequence and safeguard the well-being of clinical officers in particular and healthcare workers in general, this paper proposes the incorporation of psychosocial risk assessments before implementing functional reviews in the health sector. This proactive approach can help identify potential threats to social identity and mitigate the risk of increased stress among healthcare workers. Ultimately, this research contributes to the growing body of knowledge that underscores the intricate link between social identity and the impact of large-scale workplace changes within the healthcare system.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Litigating Reproductive Justice: Experiences and Perspectives from Malawi","field_subtitle":"Afya na Haki: Uganda, December 2024","URL":"https://tinyurl.com/y3jnctzs","body":"Dr. Kangaude, a prominent figure in Malawi's reproductive health landscape, shares insights on the strategies Civil Society Organisations (CSOs) are employing to advance reproductive justice in Malawi. He emphasizes the critical role of advocacy in raising awareness, influencing policy, and challenging discriminatory laws. Collaboration between African countries, he argues, is essential to share experiences, strengthen regional networks, and amplify collective voices. Dr. Kangaude also discusses the numerous challenges CSOs face and the Nyale Institute's implementation of innovative strategies to overcome these obstacles. The episode also highlights the success stories and impactful cases championed by Nyale Institute, demonstrating the power of strategic interventions and unwavering commitment to reproductive justice in Africa.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Scaling up promising practice to promote healthy urban people and ecosystems in east and southern Africa","field_subtitle":"EQUINET Urban health communmity of practice: September 2024","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/UH%20Recommendations%20brief2024.pdf","body":"There are many examples of healthy, equitable, climate-adapted urban food and waste management practices underway in the east and southern Africa region. These practices integrate waste management, clean energy and green urban ecosystems. They demonstrate multi-sector, multi-actor collaborative planning, informed by disaggregated evidence of different forms, building coalitions that share goals, ideas and ownership, and bring diverse resources and skills to processes. They show how a holistic, circular economy links the 3Rs (reduce, recycle, reuse) to reclaim vacant land with waste dumps for gardens that enable urban agriculture; that use bio-waste for energy and that develop and use local technology innovations. These initiatives integrate equity, incomes and food security to bring sustainable benefit and improved health and nutrition for often marginalised groups. They integrate health and climate justice in reduced air and water pollution, reduce emissions from waste burning, reduce flooding from clogged drains, enrich soil through organic fertilisers, and climate proof infrastructures. In iterative steps, they assess, review and improve practice, and in so doing strengthen social respect for healthy ecosystems as a source of economic and social benefit and reduced ill health. An EQUINET community of practice on urban health proposed 10 areas of action for scaling up such practices. The recommendations to build, enable and amplify such practice are shown in the brief. In each there are examples of promising practice, guidance, methods, tools and experience to share, with hyperlinks to read further information on each example. Information is also given on where to submit your own examples, as the brief will be updated over time.","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"World Health Organization at the International Court of Justice on the Intersection of Climate Change & Global Health","field_subtitle":"Patnaik P: Geneva health files, Newsletter 242, December 2024","URL":"https://tinyurl.com/bdfe2auz","body":"The World Health Organisation participated in the recent hearings on the climate crisis at the International Court of Justice earlier this month. This issue of Geneva health files presents WHO\u2019s statements at the hearing. ","php":"","field_issue_date":"2025-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"A case for increasing taxes on cigarettes, vapes and oral nicotine pouches, Kenya","field_subtitle":"Mostert C; Ayo-Yusuf O; Kumar M; et al: Bulletin of the World Health Organisation 102(8), 618-620, doi: 10.2471/BLT.23.290985, 2024 ","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11276150/?report=classic","body":"The current Kenyan cigarette tax regime is reported to fail to control cigarette consumption efficiently, especially among young people. Kenya decentralized the implementation of the Tobacco Control Act to 47 county governments in 2010. However, this decentralization has created a need for more institutional coherence in implementing the act. The tobacco industry exploits these fragmented counties by targeting the young people with tobacco products, particularly in the eastern, central and coast counties, where less resources are available for governance and control of substance use. The central government is thus recommended to enforce measures that ensure homogeneous implementation of tobacco control in all counties. The lobbying power of the tobacco industry blunts the effectiveness of the cigarette excise tax policy. In 2017, the industry lobbied the Kenyan government to adopt a two-tier tax system, which caused differential taxes between cheap and premium cigarettes. Unfortunately, the current Kenyan tax does not help to reduce nicotine pouch consumption and fails to prevent young people from starting. Therefore, a case for reforming the excise tax policy on cigarettes and nicotine products is argued to exist: the government needs to coordinate robust and comprehensive operations to regulate the entire supply chain of the e-liquid market. These measures should be combined with targeted cessation support and awareness campaigns focusing on vulnerable young people. The authors propose that Kenya can do better by replicating Uganda\u2019s approach, which taxes tobacco progressively, as well as to implement aggressive tobacco taxation in line with the WHO FCTC; introduce high taxation of or ban nicotine pouches and regulate e-liquids.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"A Deep Dive into Public-Private Partnerships and the Corporate Takeover of Development","field_subtitle":"CKUT Montreal: 2024","URL":"https://ckut.ca/podcasts/amandla","body":"The Amandla! Radio Podcast presents a deep dive into public-private partnerships and the corporate takeover of development.  This is the inaugural episode of the new podcast series hosted on CKUT McGill Radio and is the successor to a long-running radio show that broadcast for over three decades. The podcast documents discussions held earlier this year with several authors of the book Corporate Capture of Development. The authors discuss the disruptive and negative impacts of public private partnership development models in Kenya, Ghana, Sierra Leone and Mexico. The rich insights cover issues ranging from the role of the state, how to build resistance and what kind of alternatives could be considered. The accounts describe the learning and tell a story that demands action. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"A new era for African health systems: Market shaping and the African Continental Free Trade Area (AfCFTA)","field_subtitle":"Kamara J; Essien U; Labrique A: Public Health Challenges 3(2), 1-10, doi: https://doi.org/10.1002/puh2.172, 2024","URL":"https://onlinelibrary.wiley.com/doi/full/10.1002/puh2.172","body":"The COVID-19 pandemic has forced a reflection on the origins of supplies in African healthcare market and underscored the need for an increase in local manufacturing of medical supplies. Several African countries\u2019 health markets have been heavily reliant on imports. This article demonstrates how the African healthcare market has had a high import dependency and the role that the African Continental Free Trade Area (AfCFTA) could play to reverse this. It is estimated that African countries import between 80% and 94% of medical supplies, 75% of testing kits, between 70% and 95% of pharmaceuticals, and 99% of vaccines. During the COVID-19 pandemic, countries imposed export restrictions which impacted the flow of medical supplies to African countries. This finding highlighted the limited production capabilities on the African continent and reiterated the need to strengthen continental value chains and local manufacturing capacity for public health on the continent. Local innovations sought to minimize the impact of these supply chain disruptions. Using case studies on the local production of COVID-19 testing kits and personal protective equipment, the article highlights progress made toward health market reform. It calls attention to the implementation of the AfCFTA to strengthen the supply, manufacturing, and trade of medical resources. The article highlights countries that have African-made pharmaceuticals and vaccinations and the importance of regional hubs to expand these products in African healthcare markets. The author concludes by discussing investments made to expand local manufacturing of health products.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Acting locally, excluded globally: Confronting broken links for urban economic, social and ecosystem wellbeing ","field_subtitle":"EQUINET Urban health community of practice","body":"\r\nMounting piles of dumped waste; polluted air from traffic, industry and waste burning; regular floods from blocked drains; dark nights due to electricity cuts; and taps that produce no water. \r\nThis is not the image of urban life that we hope for in our region, but it is one that is often experienced, especially for the most disadvantaged residents. Our cities and towns are sites of growing challenge. \r\n\r\nBut they are also sites of growing innovation in response to these challenges. \r\n\r\nIn the EQUINET Regional Meeting on urban health in east and southern Africa (ESA) in Nairobi this year, delegates from eight east and southern African countries shared the many creative ways that local communities, local governments, professionals and other stakeholders are working together to meet these challenges. Even more, these approaches are building constructive linkages across economic, social, health and ecosystem wellbeing, particularly for disadvantaged communities, and as a response to climate change. \r\n\r\nThe initiatives showed the wealth of experiences and ideas that exist at local level in the region.  They reduce, recycle and reuse mounting unmanaged urban waste to produce compost for urban agriculture, bio-energy to light schools, and a range of household products. They yield local incomes for low income groups. The work underway confronts the common aggressively marketed urban shift towards unhealthy ultra-processed foods by producing and marketing nutritious local foods as alternatives. The latter are grown in vertical gardens, hydroponics, community gardens and other forms of urban agriculture, in backyards and public spaces, including those that have been reclaimed from waste dumping. The initiatives stimulate development and use of locally produced technology to process waste and foods. \r\n\r\nThese efforts not only provide incomes and improve health. They generate more liveable urban environments. They reduce polluting waste burning, flooded drains, enrich soils and climate proof infrastructures. The communities and stakeholders working in these initiatives build new capacities and links, including in schoolchildren. Those involved gain benefits that also increase the social respect for healthy ecosystems. The experiences are diverse, and you can read them in the case studies, photojournalism and technical reports on the EQUINET website.\r\n\r\nHowever, the work shared also showed the barriers and challenges that the implementers faced in securing recognition and support from the national level, and for those implementing them to have a seat and meaningful voice in global level dialogue. These barriers prevent scale-up. \r\n\r\nMuch of the work is being implemented in already disadvantaged communities by committed local authority and non-state \u2018brokers of change\u2019, but without sustainable financing. While local technologies play a key role, they lack accessible innovation funding for research and development (R&D) and field testing. There are weak or uncertain policy, legal and incentive frameworks for key areas such as urban agriculture and domestic food processing, or for health impact assessment to embed health in the design of commercial activities. Key state tools like procurement, community contracting, blended and innovation financing and social tendering that would enable these practices are weakly applied, absent or poorly accessed by informal communities.  \r\n\r\nLocal communities and institutions thus need to overcome the gap between resources and needs and between demand and voice. They face a constant pressure to organise ad hoc, unpredictable funding to support what calls for sustained institutional change.  African countries face a similar challenge in global processes, such as on financing for climate adaptation. African leaders have, for example, criticised the huge gap between an annual demand of US$300 billion for climate adaptation and a huge shortfall in real delivery on voluntary pledges and aid. They called in the September 2023 Nairobi Declaration for more predictable, equitable climate financing, through a global tax regime that would apply a carbon tax on the fossil fuel trade, on maritime transport and aviation, and a global financial transaction tax. \r\n\r\nThe current context clearly demands action at local, national, regional and global level. It also calls for less segmentation between these levels, including for voice to be heard from local to global levels and for resources to flow more equitably from global to local levels. \r\n\r\nThe community of practice on urban health in the EQUINET regional meeting thus made 10 recommendations to BUILD, ENABLE and AMPLIFY promising practice and policy on local climate-responsive integrated healthy urban food, waste and ecosystems in ESA, that also link these different levels. \r\n\r\nTo BUILD bottom-up change that has more direct local benefit, the recommendations include measures to expand various forms of innovative urban agriculture to produce quality healthy urban food; linked in a circular economy to widening the practice of 3Rs, - \u2018reduce, recycle, reuse\u2019 - in waste management systems, supported by domestic investment in R&D for the technologies that process waste and local foods.   \r\n\r\nThe recommendations cover national measures to ENABLE such practices, including to generate and use disaggregated, relevant and community evidence and health impact assessment that is brought to inclusive multi-stakeholder forums to design and plan urban systems. This calls for another form of 3Rs- \u2018relooking, realigning and revising\u2019 policies, laws, and guidance at local and national level, harmonised at regional level, to enable, capacitate and fund these key elements of healthy integrated urban systems. \r\n\r\nThe community of practice recommended AMPLIFYING such measures across the region, to better connect local, national and regional voice, and to strengthen the region in engaging globally. Networks that connect local, national, regional and international actors, including south-south- are identified to provide important means to support the exchange of knowledge and ideas from within the region, if also backed by investments in regional knowledge, technology and ideas hubs. \r\n\r\nWe had direct experience of the role of regional networking when the local experiences from the various ESA countries were brought to the regional East Central and Southern African Health Community Best Practices Forum in June 2024. This forum, held annually, provides an important space for dialogue across local, national and regional level on challenges and promising practice.  The ideas and local experiences presented and discussed in the session on climate and urban health in the 2024 forum informed the resolutions of the ECSA Regional Health Ministers Conference (ECSA/HMC73/R8) on mitigating the effects of climate change on health. (The resolutions are included in this newsletter).  \r\n\r\nHaving a regional forum that brings policy actors together with local and national implementers enriches learning and action within the region, and can inform the proposals that are brought to global level, adding weight to options and demands, such as the call for more equitable and predictable global financing for responses to climate change. Currently, however, local voices and perspectives are increasingly attenuated as processes rise from local to global level, relying largely on indirect representation or reporting of lived experience and priorities in global forums. Yet increasingly literate, active and engaged local stakeholders and communities are implementing local change, and expect more direct, sustained ways of being included and heard in global discussions on issues that affect their lives. \r\n\r\nWe welcome your feedback or queries on the issues raised in this oped \u2013 please send them to the EQUINET secretariat. For more information read the urban health publications at https://www.equinetafrica.org/bibliography-search.html and watch the climate webinars on the EQUINET website at https://www.equinetafrica.org/content/meetings.html. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"After The End: Interdisciplinary approaches to lived experiences in the aftermaths of diseases, disasters and drugs in global health","field_subtitle":"Kingori P; Salisbury L; Wurie H; et al: University of Oxford, 2024","URL":"https://aftertheend.squarespace.com/","body":"When global outbreaks of disease are declared \u2018over\u2019, what, when and for whom is an end \u2018the end\u2019 and what happens after? How do declarations of ends shape personal experiences of crises, ongoing access to care, health and obligations?  Global health is defined by narratives of a clearly discernible and singular end. Official announcements of \u2018the end\u2019, however, are often arbitrary and unstable. Furthermore, they can distract from important counter-narratives and undermine social, environmental, political and epistemic justice when those \u2018left behind\u2019 are excluded from discussions of whether the end has been achieved, or is achievable, and if so when and how. Today, uncertain trajectories, the \u2018slow violence\u2019 of environmental degradation, passive attrition of many diseases, and drug resistances question ideas of a singular extinction event and finality. Drawing on an interdisciplinary approach involving historians, sociologists, epidemiologists, psychologists, bioethicists, literary and legal scholars, philosophers and policymakers, this research has two synergistic empirical and normative aims: 1. to explore lived experiences of time and temporality of endings of crises, to capture counter-narratives and their implications for future practices, responses and policies, and 2. to provide an account of the moral and ethical obligations and responsibilities of global health institutions in the aftermaths of crises to health. From detailed comparative research in three countries, including ethnographic, cognitive time-perception and archival methodologies, the authors foreground the people, places, processes and policies to capture everyday experiences of endings and aftermaths in context.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Brief on climate justice, tax and climate financing for health equity","field_subtitle":"EQUINET; TARSC: May 2024","URL":"https://tinyurl.com/y5n5u25m","body":"This brief provides a rapid review of literature and public evidence from various sources on the interface between financing climate justice, tax justice and health equity1. Prior EQUINET webinars on other areas of health equity raised growing concerns on the lack of delivery on commitments made for climate financing in the region. The brief thus complements the work done in previous EQUINET webinars on how climate justice interacts with different facets of health equity, available on the EQUINET website. All briefs from the webinars are being synthesised in a separate discussion document. This brief summarises key issues related to: climate financing in the region and the links to tax and economic justice and health equity; actions proposed to address these issues at local, national and regional level and in international/ global level processes; and issues for further research and discussion.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Call for Fellows: Afya Na Haki & Litigating Reproductive Justice","field_subtitle":"Deadline for Applications: 6 September 2024","URL":"https://www.afyanahaki.org/call-for-fellows/","body":"This call is for vibrant individuals from Anglophone and Francophone Africa to join the next fellowship cohort under the Litigating Reproductive Justice in Africa (LIRA) Programme. The Programme aims to foster an environment where Africa embraces Reproductive Justice through progressive, evidence-based, and collaborative litigation for access to Sexual and Reproductive Health Rights (SRHR). The programme particularly targets building the capacities of African individuals through our renowned fellowship programme. This round of call for fellows will commence in October 2024 and it is a full-time in-person engagement for a period of 6-12 months at Ahaki. The fellowship is designed to support Ahaki\u2019s programmes and provide opportunities for career development in research, litigation and capacity enhancement in reproductive justice. Ahaki encourages researchers, scholars, litigants, activists, and practitioners from across Africa to apply for the fellowship programme.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for papers - Mental health of adolescents","field_subtitle":"BMC Public Health. Closing date: 7 March 2025","URL":"https://www.biomedcentral.com/collections/mehado","body":"BMC Public Health is calling for submissions to a Collection on mental health of adolescents. Adolescence is a critical developmental stage marked by significant physical and emotional changes, with mental health being heavily influenced by societal pressures, academic demands, and technology. Rising rates of anxiety, depression, and other mental health disorders among adolescents pose a global concern, affecting both immediate quality of life and long-term well-being. Addressing these issues is essential for fostering healthy development and preventing future psychosocial challenges. This collection seeks submissions that explore factors influencing adolescent mental health, such as trends in mental health disorders, risk and protective factors, the impact of digital platforms, school environments, family relationships, barriers to accessing mental health services, and effective intervention strategies.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Participation in ICID\u2019s Ubuntu Community Village","field_subtitle":"International Congress on Infectious Diseases (ICID), Johannesburg, 3-6 December 2024","URL":"https://isidcongress.org/icids-ubuntu-community-village/","body":"The ICID Ubuntu Community Village (UCV) will be a lively, interesting space that will bring together youth, community members, midwives and other health professionals, Civil Society Organizations, and others working on and impacted by AMR, HIV, TB, or other infectious diseases within a One Health context to interact, learn, share, make new connections, strengthen existing networks and celebrate successes. The UCV will also act as a bridge between the more technical scientific sessions at the ICID 2024 and the community action, by sharing the issues in a manner that is more lucid, relevant, and easily translatable/applicable at the grassroots. There will be a mix of live performances, documentaries/films, music, art, dance, skills building and best practice sharing workshops, speaker sessions/presentations, debates, and other exciting cultural activities, all based on feedback and applications from the diversity of community-connected individuals, groups, and organizations. Key proceedings from the UCV will also be captured and shared on various ISID platforms. Are you a community-connected individual, group, or organization working on and impacted by AMR, HIV, TB, or other infectious diseases within a One Health context? Apply if you would like to participate or present at the ICID Ubuntu Community Village.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Colonialism in the new digital health agenda ","field_subtitle":"Sekalala S; Chatikobo T: BMJ Global Health 2024;9:e014131, 1-9, doi: 2024;9:e014131. doi:10.1136/ bmjgh-2023-014131, 2024","URL":"https://gh.bmj.com/content/9/2/e014131","body":"The advancement of digital technologies has stimulated immense excitement about the possibilities of transforming healthcare, especially in resource-constrained contexts. For many, this rapid growth presents a \u2018digital health revolution\u2019. While this is true, the authors note that there are also dangers that the proliferation of digital health in the global south reinforces existing colonialities. Underpinned by the rhetoric of modernity, rationality and progress, many countries in the global south are pushing for digital health transformation in ways that ignore robust regulation, increase commercialisation and disregard local contexts, which risks heightened inequalities. The authors propose a decolonial agenda for digital health which shifts the liner and simplistic understanding of digital innovation as the magic wand for health justice. In the proposed approach, they argue for both conceptual and empirical reimagination of digital health agendas in ways that centre indigenous and intersectional theories. This enables the prioritisation of local contexts and foregrounds digital health regulatory infrastructures as a possible site of both struggle and resistance. Their decolonial digital health agenda critically reflects on who is benefitting from digital health systems, centres communities and those with lived experiences and finally introduces robust regulation to counter the social harms of digitisation. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Community perceptions on health risks associated with toxic chemical pollutants in Kwekwe city, Zimbabwe: a qualitative study ","field_subtitle":"Ngwenya S; Mashau N; Mudau A; et al: Environmental Health Insights 18, 1\u201312, doi: https://doi.org/10.1177/11786302241260487, 2024 ","URL":"https://tinyurl.com/yr4dkrcn","body":"This paper aimed to assess community members\u2019 perceptions regarding health risks associated with potentially toxic elements and cyanide pollution in Kwekwe City. An explorative cross-sectional study was conducted with key stakeholders and industrial settlements\u2019 residents. Face-to-face interviews with key informants and focus group discussions with residents and workers were used to gather data. A thematic approach was utilised in data analysis. Study participants, who played a crucial role in the research process, perceived that industrial pollution principally linked to cyanide, mercury and chromium posed significant environmental and health risks. This participatory approach in risk perception assessment is critical in providing insight into the scope of the problem and formulating intervention strategies. However, given that qualitative study results lack generalisability and replicability, quantitative studies need to be undertaken to determine environmental levels of toxic chemical pollutants as a complementary measure.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Determinants of teenage pregnancy in Malawi: a community-based case-control study","field_subtitle":"Kalulu J; Masoambeta J; Stones W: BMC Women's Health 24(335), 1-10, doi: https://doi.org/10.1186/s12905-024-03166-0, 2024 ","URL":"https://tinyurl.com/28nsf56p","body":"This community-based case-control study identified determinants of teenage pregnancy in Malawi. It used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi.  Data on 3435 participants 20-24 years old were analysed. In multivariable analyses: no teenage marriage; secondary education; higher education; richest category of wealth index, use of contraception, domestic violence by father or mother were found to be significant factors in teenage pregnancy. The authors recommend that the government sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Developing comprehensive woman hand-held case notes to improve quality of antenatal care in low-income settings: participatory approach with maternal health stakeholders in Malawi","field_subtitle":"Mndala L; Kondoni C; Gadama L; et al: BMC Health Services Research 24 (628), 1-14, doi: https://doi.org/10.1186/s12913-024-10922-3, 2024","URL":"https://tinyurl.com/h5w47a78","body":"This paper aimed to update a woman hand-held case notes tool reflecting WHO 2016 antenatal care (ANC) guidelines in Malawi. In 2022, the authors applied a co-creative participatory approach in 3 workshops with key stakeholders to compare the current ANC tool contents to the WHO 2016 ANC guidelines, decide on key elements to be changed to improve adherence and change in practice, and to redesign the woman\u2019s health passport tool to reflect the changes. The developed tool was endorsed for implementation within Malawi\u2019s healthcare system by the national safe motherhood technical working group in July 2023. Five themes were identified in the analysis that were missed in the previous tool. Participants further recommended strengthening of already existing policies and investments in health, strengthening public private partnerships, and continued capacity building of healthcare providers to ensure that their skill sets are up to date. The authors' efforts reflect a pioneering attempt in Malawi to improve women\u2019s hand-held case notes to enhance quality of care and improve women\u2019s satisfaction with their healthcare system.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter usually comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising\r\n","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 239: Acting locally, excluded globally: Confronting broken links for urban economic, social and ecosystem wellbeing ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. \r\n","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Equity in family planning policies and programs in Uganda: conceptualization, dimensions and implementation constraints","field_subtitle":"Namuhani N; Wanyenze R; Kiwanuka S; et al: International Journal for Equity in Health 23(50), 1-13, doi: https://doi.org/10.1186/s12939-024-02143-1, 2024  ","URL":"https://tinyurl.com/2xrnv2vk","body":"Equity is at the core and a fundamental principle of achieving the family planning (FP) 2030 Agenda. However, the conceptualization, definition, and measurement of equity remain inconsistent and unclear in many FP programs and policies. This paper documents the conceptualization, dimensions and implementation constraints of equity in FP policies and programs in Uganda, through. a review of literature and key informant interviews with 25 key stakeholders in 2020. A limited number of documents had an explicit definition of equity, which varied across documents and stakeholders. The definitions revolved around universal access to FP information and services, with limited focus on equity. The dimensions most commonly used to assess equity were either geographical location, or socio-demographics, or wealth quintile. Almost all the key informants noted that equity is a very important element, which needs to be part of FP programming. However, implementation, client and policy constraints were observed to continue to hinder its implementation in FP programs in Uganda. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Evaluation of a peer-support, \u2018mentor mother\u2019 program in Gaza, Mozambique; a qualitative study","field_subtitle":"Katirayi L; Ndima S; Farah A; et al: BMC Health Services Research 24 (382), 1-12, doi: https://doi.org/10.1186/s12913-024-10833-3, 2024 ","URL":"https://tinyurl.com/yw9km3p4","body":"Mozambique launched a peer-support program in 2018, in which HIV-positive mothers provide adherence support as mentor mothers (MMs) for HIV-positive pregnant and lactating women and HIV-exposed and infected children. A descriptive qualitative evaluation was conducted in 2020 across nine facilities in Gaza Province to assess the acceptability and barriers to implementation of the mentor mother program (MMP) among those receiving services and providing services. There were initial challenges with acceptability of the MMP, especially regarding confidentiality concerns and MM roles. Sharing additional information about MMs and making small changes during the beginning of the MMP resulted in generally high acceptance of the programme. HIV-positive mothers reported that counseling from MMs improved their understanding of the importance of and how to take the anti-retroviral treatment. HIV-positive mothers reported having reduced guilt and shame about their HIV-status, feeling less alone, and having more control over their health. MMs shared that their work made them feel valued and decreased their self-stigmatization. However, MMs also reported feeling that they had inadequate resources to perform optimal job functions; they listed inadequate transportation, insufficient stipends, and false addresses of clients among their constraints. Overall, health care workers felt that their workload was significantly reduced with MM support and wanted more MMs in the community and health facility. This study found that the MMP was considered a substantive and highly valued support to HIV-positive mothers, resulting in increased anti-retroviral treatment literacy among patients, improved self-reported well-being and sense of community and reduced feelings of isolation. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Examining inequalities in spatial access to national health insurance fund contracted facilities in Kenya","field_subtitle":"Kazungu J; Moturi A; Kuhora S; et al: International Journal for Equity in Health 23(78), 1-10, doi: https://doi.org/10.1186/s12939-024-02171-x, 2024","URL":"https://tinyurl.com/4dvhnh6y","body":"Kenya aims to apply the National Health Insurance Fund (NHIF) as the \u2018vehicle\u2019 to drive universal health coverage (UHC). While there is some progress in moving the country towards UHC, the availability and accessibility to NHIF-contracted facilities may be a barrier to equitable access to care. The authors estimated the spatial access to 3858 NHIF-contracted facilities,  with data on road network, elevation, land use, and travel barriers. Nationally, 81.4% and 89.6% of the population lived within 60- and 120-minute travel time to an NHIF-contracted facility respectively. At the county level, the proportion of the population living within 1-hour of travel time to an NHIF-contracted facility ranged from as low as 28.1% in Wajir county to 100% in Nyamira and Kisii counties. Overall, only four counties had met the target of having 100% of their population living within 1-hour (60 min) travel time to an NHIF-contracted facility. The author argues that this evidence of the spatial access estimates to NHIF-contracted facilities can inform contracting decisions by the social health insurer, especially focussing on marginalised counties where more facilities need to be contracted. particularly if accelerating progress towards achieving UHC uses social health insurance as a key strategy in Kenya.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Financing Africa: Where is the money?","field_subtitle":"Mo Ibrahim Foundation: Forum Report, June 2024","URL":"https://mo.ibrahim.foundation/sites/default/files/2024-06/2024-forum-report.pdf","body":"The World Bank\u2019s 2024 Global Economic Prospects report, indicates that global economic growth will stabilize in 2024 at a pace that is insufficient for progress on development goals.The needs for adaptation, Africa\u2019s priority, remain underestimated, particularly for universal access to energy. To address these daunting challenges, the report asks where is the money? External resources are substantial, but with problematic accessibility, conditionalities and ineffective utilisation.  Debt has become an impossible option, as Africa\u2019s external debt has already tripled since 2009, and is compounded by a complex structure that renders traditional relief mechanisms obsolete. Foreign Direct Investment (FDI) and participation in global financial markets remain disproportionately low. To move forward, the foundation calls for a radical reboot of the current multilateral financial system and more effective organisation and use of domestic resources. According to the African Union, the mobilisation of the continent\u2019s domestic resources is expected to cover up to 90% of the financing required for Agenda 2063. This means drying up illicit financial flows, strengthening tax systems- African states cannot afford tax holidays for foreign companies-, leveraging remittances, sovereign funds, pension funds and private wealth, monetising Africa\u2019s green assets \u2013 biodiversity, critical minerals, carbon-sinking potential. This is argued to demand a paradigm shift that avoids any trade-off between climate and development, that moves beyond the aid and charity model to a cooperative, deal- making one, and that puts ownership in Africa.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Former Gold Mineworkers And Their Families Encourged To Lodge Compensation Claims For Silicosis And TB","field_subtitle":"Tshiamiso Trust: South Africa, 2024","URL":"https://www.tshiamisotrust.com/information/status-check/.","body":"The Tshiamiso Trust is on a drive to ensure that all potentially eligible former gold mineworkers and their families, know about their right to lodge a claim for compensation, and are given the opportunity to do so. The Tshiamiso Trust was established in 2020 to give effect to the settlement agreement reached between six mining companies and claimant attorneys in the historic silicosis and TB class action. The companies are African Rainbow Minerals, Anglo American South Africa, AngloGold Ashanti, Harmony Gold, Sibanye Stillwater and Gold Fields. To date, the Trust has compensated over 18,000 beneficiaries, to the value of South African Rand 1.67 billion. The Trust is committed to ensuring that all eligible ex-mineworkers and their families get the compensation they deserve, and appeals your assistance in reaching potential claimants. To lodge a claim: Mineworkers must have carried out risk work at one of the qualifying gold mines during the qualifying periods between 12 March 1965 and 10 December 2019. Living mineworkers must have permanent lung impairment from silicosis or TB that they contracted while doing risk work at these mines. For deceased mineworkers, there must either be evidence that they died from work-related TB within a year of leaving the mine if it's a TB claim, or evidence that they had silicosis or died from silicosis if it's a silicosis claim. For more information and to check eligibility, contact the Trust.  Claimants are reminded to be careful of people impersonating the Trust or promising to help speed up their claims. Only the Tshiamiso Trust can process claims in a free service. Claimants must only share their documents with the officials at the lodgement offices and should not pay anyone to help them with their claims.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global health initiatives in Africa \u2013 governance, priorities, harmonisation and alignment","field_subtitle":"Mwisongo A; Nabyonga-Orem J: BMC Health Services Research 16 (212) 1-15, doi: https://doi.org/10.1186/s12913-016-1448-9, 2016 ","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1448-9","body":"The advent of global health initiatives (GHIs) has changed the landscape and architecture of health financing in low and middle income countries, particularly in Africa. Alignment and harmonisation of partnerships and GHIs are still difficult in the African countries with inadequate capacity for their effective coordination. Both published and grey literature was reviewed to understand the governance, priorities, harmonisation and alignment of GHIs in the African Region; to synthesise the knowledge and highlight the persistent challenges; and to identify gaps for future research. GHI governance structures are often separate from those of the countries in which they operate. Their divergent funding channels and modalities may have contributed to the failure of governments to track their resources. There is also evidence that GHI earmarking and conditions drive funding allocations regardless of countries\u2019 priorities. GHIs have used several strategies and mechanisms to involve the private sector. These have widened the pool of health service policy-makers and providers with both positive and negative implications. To maximise returns on GHI support, the authors suggest that there is need to ensure that their approaches are comprehensive as opposed to being selective; to improve GHI country level governance and alignment with countries\u2019 changing epidemiologic profiles; and to strengthen their involvement of civil society. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health care workers\u2019 experiences of calling-for-help when taking care of critically ill patients in hospitals in Tanzania and Kenya","field_subtitle":"Mkumbo E; Willows T; Onyango O; et al: BMC Health Services Research 24(821), 1-9, doi: https://doi.org/10.1186/s12913-024-11254-y , 2024 ","URL":"https://tinyurl.com/5xv6dd7p","body":"When caring for critically ill patients, health workers often need to \u2018call-for-help\u2019 to get assistance from colleagues in the hospital. This study aims to describe health workers\u2019 experiences about calling-for-help when taking care of critically ill patients in hospitals in Tanzania and Kenya. Ten hospitals across Kenya and Tanzania were visited and in-depth interviews conducted with 30 health workers who had experience of caring for critically ill patients. The study identified three thematic areas concerning the systems for calling-for-help when taking care of critically ill patients: i. Calling-for-help structures: with a lack of functioning structures for calling-for-help; ii. Calling-for-help processes: with calling-for-help processes noted to be innovative and improvised; and iii. Calling-for-help outcomes: with the help provided not that which was requested. Calling-for-help when taking care of a critically ill patient is a necessary life-saving part of care, but health workers in Tanzanian and Kenyan hospitals experience a range of significant challenges. Hospitals lack functioning structures, processes for calling-for-help are improvised and help that is provided is not as requested. These challenges are observed to be likely to cause delays and to decrease the quality of care, potentially resulting in unnecessary mortality and morbidity.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Health workforce strategies during COVID-19 response: insights from 15 countries in the WHO Africa Region","field_subtitle":"Ahmat A; Okoroafor S; Asamani J; et al: BMC Health Services Research 24 (470), 1-8, doi: https://doi.org/10.1186/s12913-024-10942-z, 2024  ","URL":"https://tinyurl.com/2uphe8nu","body":"This paper examined the health workforce governance strategies applied by 15 countries in the WHO Africa Region in responding to the COVID-19 pandemic. The authors extracted data from country case studies developed from national policy documents, reports and grey literature obtained from the Ministries of Health and other service delivery agencies. This study was conducted from October 2020 to January 2021 in 15 countries - Angola, Burkina Faso, Chad, Eswatini, Ghana, Guinea, Guinea Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal and Togo. All 15 countries had national multi-sectoral bodies to manage the COVID-19 response and a costed national COVID-19 response plan. All the countries also reflected human resources for health activities along the different response pillars. These activities included training for health workers, and budget for the recruitment or mobilization of additional health workers to support the response, and for provision of financial and non-financial incentives for health workers. Nine countries recruited an additional 35 812 health workers either on a permanent or temporary basis to respond to the COVID-19 with an abridged process of recruitment implemented to ensure needed health workers are in place on time. Six countries redeployed 3671 health workers to respond to the COVID-19. The redeployment of existing health workers was reported to have impacted negatively on essential health service provision. The paper raises strengthening multi-sector engagement in the development of public health emergency plans as critical to promote the development of the holistic interventions needed to improve health workforce availability, retention, incentivization, and coordination and to ensure optimized utilization based on competencies, especially for the existing health workers.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"IHR 2005 Amendments: Setting the Legal Framework for Equity","field_subtitle":"Ramakrishnan N: MMS Bulletin 169, 2024","URL":"https://tinyurl.com/3fw6f4jf","body":"After negotiations spanning over 2 years, International Health Regulations (IHR) 2005 was amended by consensus during the 77th Session of World Health Assembly (WHA77) in the first week of June 2024 (WHO, 2024). The amendments set out the legal framework for delivery of equity in health emergency preparedness and response.  One of the drawbacks of the IHR adopted in 2005 was the lack of explicit legal provisions requiring WHO and States Parties to ensure equitable access to health products to prevent disease outbreaks from becoming public health emergencies of international concern (PHEIC). The amendments adopted by WHA77 address this gap. Around 24 Articles out of 66 Articles, and 6 Annexes out of 9 Annexes were amended substantively and 2 new Articles were added. Amendments in Articles 1, 3, 13, 15-18, 44, and Annex 1 and the two new Articles, 44 bis and 54 bis, help in particular addressing the gaps relating to equitable access to health products. Article 3 now recognises equity and solidarity as principles of IHR implementation. The Amended Article 3 now mandates that the implementation of the IHRs needs to \u201cpromote\u201d equity and solidarity. It means there should be demonstrated enhancement in the delivery of equity, in the implementation of IHR.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Institutionalising health impact assessment in East and Southern Africa","field_subtitle":"EQUINET: TARSC, TalkAB[M]R, SATUCC, with C Dora, NIGH, ECSA Health Community: July 2024","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20HIA%20brief%202024.pdf","body":"East and southern African (ESA) countries have achieved many gains in health, but also face many health challenges, including from commercial risks and the challenges of climate change. Poverty and inequality continues to affect opportunities to lead healthy lives. This context, the region\u2019s policy commitment to primary health care and the need for action by many sectors to address the drivers of ill health calls for authorities, approaches and tools that more firmly lever evidence, and multi-sectoral action to protect and improve health. In the same way as environmental impact assessment was institutionalized in the ESA region to play a role in protecting ecosystems, health impact assessment similarly needs to be institutionalized to embed evidence and health promoting changes in wider activities, systems and policies that raise health risks. Policy leaders in Africa recognized this in the WHO AFRO Regional Multi-sectoral Strategy to promote health and well-being, 2023\u20132030, with a target by 2030 to have institutionalized and integrated health impact assessment .","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Knowledge and practice of health workers towards maternal and child health in the Democratic Republic of the Congo: a cross-sectional study","field_subtitle":"Ndela B; N\u2019siala A; Ngwala P; et al: Reproductive Health 21(62), 1-9, doi: https://doi.org/10.1186/s12978-024-01801-5, 2024","URL":"https://tinyurl.com/4f7hwm2m","body":"This paper aimed to assess the knowledge and practice of health workers (HWs) towards maternal and child health (MCH) in Kasai and Maniema, two Democratic Republic of the Congo provinces with very high maternal mortality ratios and under-5 mortality rates. This cross-sectional study was conducted with all HWs in charge of MCH in 96 health facilities of Kasai and Maniema provinces in 2019. Among participating HWs, 43% were A2 nurses, 82% had no up-to-date training in MCH, and 48% had only 1-5 years of experience in MCH. In the two provinces combined, about half of HWs had poor knowledge and poor practice of MCH. Good knowledge and practice scores were significantly associated with high qualification, continuing up-to-date training in MCH, and 6 years of experience or more in MCH. The authors argue that conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Knowledge, and utilization of HIV self-testing, and its associated factors among women in sub\u2013Saharan Africa: evidence from 21 countries demographic and health survey","field_subtitle":"Terefe B; Jembere M; Reda G; et al: BMC Public Health 24(1960), 1-14, doi: https://doi.org/10.1186/s12889-024-19529-z, 2024","URL":"https://tinyurl.com/2ftxdy89","body":"This study aimed to identify women\u2019s HIV Self-Testing (HIVST) knowledge, utilization, and its associated factors in Sub-Saharan Africa (SSA). The data used were gathered from the most recent demographic and health surveys conducted in 21 SSA nations between 2015 and 2022.  The level of knowledge and utilization of HIVST among women in SSA was very low. To improve this situation,  the authors suggest facilitating institutional delivery, promoting access to modern contraception, increasing ANC coverage, empowering women\u2019s associations, creating culturally respectful mass media content, and involving rural and economically disadvantaged women. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Living a private lie: intersectional stigma, depression and suicidal thoughts for selected young key populations living with HIV in Zambia","field_subtitle":"Zulu J; Budhwani H; Wang B; et al: BMC Public Health 24(1937), 1-15, doi: https://doi.org/10.1186/s12889-024-19278-z, 2024 ","URL":"https://tinyurl.com/ykm6cuht","body":"This study conducted in 2022 aimed to elucidate the experiences of these in a small group of young, HIV\u2009+\u2009men who have sex with men and transgender women in Zambia through in-depth interviews and a questionnaire. The authors recruited 56 participants from three sites: Lusaka, Chipata, and Solwezi districts. Participants\u2019 mean age was 23 years. The study found that 36% of all participants had moderate to significant symptoms of depression, 7% had major depression, 30% had moderate signs of anxiety, 11% had high signs of anxiety, 4% had very high signs of anxiety and 36% had contemplated suicide at least once. A greater proportion of transgender women had moderate to significant symptoms of depression or major depression compared to men who have sex with men, at 33% and 6%, respectively. Similarly, more transgender women had contemplated suicide than MSM peers. Overall, having to hide both one\u2019s sexuality and HIV status had a compounding effect and was described as living a private lie. The authors argue that effectively addressing stigma and poor mental health outcomes among young HIV-positive MSM and transgender women requires a socio-ecological approach that focuses on structural interventions, more trauma-informed and identity-supportive care for young people with HIV, as well as strengthening community-informed public health efforts.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Mpox","field_subtitle":"Hesperian health information sheet, 2024","URL":"https://tinyurl.com/bdccrtvy","body":"This resource provides updated information on Mpox, on its mode of spread, who it infects, how it is treated, and vaccine options and vaccine inequality related to Mpox.  It also provides information on how to prevent the spread of mpox. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"People Living With HIV and Non Communicable Diseases Call for Integrated Care","field_subtitle":"Cullinan K: Health Policy Watch, South Africa, 2024","URL":"https://tinyurl.com/kur76uer","body":"A Case for Integration: A Collection of Lived Experiences of People Living with NCDs and HIV has been published as part of the Non Communicable Disease (NCD) Alliance\u2019s \u201cOur Views, Our Voices\u201d initiative, dedicated to promoting the meaningful involvement of people living with NCDs in the NCD response. Many people living with HIV struggle with mental health, yet most are unaware that their HIV status makes them more vulnerable. A number of people with HIV also reported that their other conditions were not promptly diagnosed by healthcare workers at HIV clinics. The NCD Alliance has developed 15 Transformative Solutions, which are recommendations for contextually appropriate, person-centred information about NCDs and their risk factors for people living with HIV.  These include overarching recommendations: that governments \u2013 with the support of WHO, UNAIDS, global health donors, and key constituencies, including civil society, communities and people living with HIV and NCDs, and the private sector \u2013 must coordinate, fund and drive local context- responsive agendas for HIV-NCD integration to achieve the 90% integrated care target, which emphasises person-centred care and considers the whole care cascade (prevent-find-link-treat- retain). The document proposes that government strategies, national policies, and strategic plans for HIV-NCD integration must: take a phased and context-specific approach to linkages and integration of services and systems; promote the transition to UHC; consider the state of development of different national and local systems for health; and include essential HIV and NCD prevention and care services as key priorities in COVID-19 recovery plans and the \u2018building back better\u2019 agenda. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Post-abortion care services in Zambian health facilities: a qualitative study of users\u2019 experiences and perceptions","field_subtitle":"Lubeya M; Munakampe M; M Mwila; et al: BMC Women\u2019s Health 24(414), 1-12, doi: https://doi.org/10.1186/s12905-024-03179-9, 2024 ","URL":"https://tinyurl.com/434hjf4s","body":"This paper explored the experiences and perceptions of women receiving post-abortal care services in Zambia, within a human-rights framework. A qualitative case study was conducted between August and September 2021 in Lusaka and Copperbelt provinces of Zambia. Fifteen women seeking post-abortion care services were` interviewed using audio recorders; transcribed data was analyzed using thematic analysis. Women who experienced spontaneous abortions delayed seeking health care by viewing symptoms as \u2018normal pregnancy symptoms\u2019 and not dangerous. Women also delayed seeking care because they feared the negative attitudes from their communities and the health care providers towards abortion in general, despite it being legal in Zambia. Some services were considered costly, impeding their right to access quality care. Women delayed seeking care compounded by fear of negative attitudes from the community and healthcare providers. To ensure the provision and utilization of quality all abortion-related healthcare services, the authors argue that there is a need to increase awareness of the availability and legality of safe abortion services, the importance of seeking healthcare early for any abortion-related discomfort, and the provision and availability of free services at all levels of care should be emphasized.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Report of the Online capacity building on Health Impact Assessment in east and southern Africa, February to June 2024","field_subtitle":"EQUINET, TARSC, SATUCC, TalkAB[M]R, NIGH, ECSA HC: July 2024","URL":"https://tinyurl.com/yc8avc8t","body":"Assessing the effect of policies, strategies, corporate and economic activities on health is a core capability to protect public health. Health impact assessment (HIA) helps to identify where changes to project design or operation provide health benefits and mitigate health risks, adding economic value and wellbeing. HIA is a structured process that informs decision makers about the potential effects of a project, programme, economic activity or policy on the health and well-being of populations. In 2023, EQUINET and partners initiated work to provide online training and mentored case study work to build HIA capacities in multi-actor teams in ESA countries. The course built understanding of the theoretical basis of HIA, and knowledge of the methods, evidence, analysis in an HIA, of reporting of and engagement on HIA, and implementation and monitoring of proposed actions. It provided mentored guidance of participant HIA practical work, using real HIA case studies. Towards the end of the course there was discussion on issues and strategies for scaling up and integrating HIA in key sectors and in public health law. This report summarises the proceedings and issues raised.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Report of the Online skills session on Participatory Action Research in health and well-being","field_subtitle":"EQUINET Steering committee; TARSC: July 2024","URL":"https://tinyurl.com/38vkkea5","body":"EQUINET has been using participatory action research (PAR) for several decades, reflecting the understanding that the voice, power and self-determination that is inherent for equity should also be integrated in the production of knowledge, and that knowledge and its generation and use is a deeply sociopolitical activity. While some thematic areas of work in EQUINET have applied PAR approaches, not all had, and steering committee (SC) members felt that it would be important to widen understanding of the methods to see how they could be integrated within different areas of work, as a cross cutting process. This online skills session was implemented in June 2024 to give colleagues involved in EQUINET work a brief introduction to PAR and how it can be used in EQUINET\u2019s various thematic areas. The session aimed stimulate interest in and understanding of how PAR can deepen the different areas of research work on health equity. A video of presentations in the session is available at https://youtu.be/OR_lhxoSQuQ ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Resolutions of the 73rd Health Ministers' Conference, Arusha, June 2024","field_subtitle":"ECSA Health Community: Arusha, Tanzania, June 2024","URL":"https://tinyurl.com/y53273au","body":"The East, Central and Southern Africa Health Community 73rd Health Ministers Conference was held in Arusha in the United Republic of Tanzania from June 20 -21, 2024. The Conference was attended by Honourable Ministers, Heads of Delegations, senior officials from ECSA Health Community Member States, partner organizations, research institutions, civil society organizations and other key stakeholders. The Conference was organized under the theme: 50 Years of Leadership and Excellence in Regional Health Collaboration. Deliberations at the Conference proceeded under the following sub-themes: 1. Human Resources for Health 2. Health Financing 3. Emerging and Re-emerging infectious diseases and health emergencies 4. Reproductive, Maternal, Neonatal, Child and Adolescent Health and Nutrition 5. Non-communicable, mental health and Substance use 6. Mitigating the effects of climate change on health 7. Technology and Innovations in health At the end of the conference, the Ministers considered and passed the resolutions presented in each of these areas in this document.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Risk negotiation: a framework for One Health risk analysis","field_subtitle":"Ehling-Schulz M;  Filter M; Zinsstag J; et al: Bulletin of the World Health Organisation 102(6), 453\u2013456, doi: 10.2471/BLT.23.290672, 2024","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11132153/?report=classic","body":"The world faces global health risks that need to be effectively addressed in integrated, participatory efforts. However, risk analysis frameworks do not account for the complex nature of systems that span multiple sectors or disciplines. The authors propose the participatory and interdisciplinary concept of risk negotiation to transform the way global health challenges such as pandemics, physical and mental health inequities, environmental problems and food security are tackled. To allow such risk analysis, there is a need to recognize the value of risks and trade-offs and negotiate them with stakeholder groups representing different disciplines and sectors. This approach becomes feasible through recent technological breakthroughs such as artificial intelligence-assisted multi-agent negotiations or large language models. These models are accessible, hold promise in negotiating agreements and can be used to accommodate the complexity of real-world decision-making.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Scaling up promising practice to promote healthy urban food, waste and ecosystems in east and southern Africa, Report of an EQUINET Regional Workshop","field_subtitle":"EQUINET;: May 2024","URL":"https://tinyurl.com/5d6nsc25","body":"This EQUINET regional meeting gathered people from institutions involved in the work on urban health and health impact assessment (HIA) and related expertise in May 2024 in Nairobi, Kenya, to address issues relating to scaling up promising, climate responsive practice to promote healthy urban food, waste and ecosystems in ESA. It built on work implemented in the region on urban health from 2020 and used a mix of presentation, discussion and participatory processes. The meeting reports on information shared on experience and evidence from both urban health work and HIA in ESA on the laws, policies, systems, features, measures and tools that positively impact on and make linkages across economic, social, health and ecosystem wellbeing, including to respond to climate change. Delegates identified implications for policy and practice at national, regional and global level and a theory of change, strategies and recommendations to advance, support and scale-up the promising policies, practices and tools identified in the meeting. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Social protection as a strategy for HIV prevention, education promotion and child marriage reduction among adolescents: a cross-sectional population-based study in Lesotho","field_subtitle":"Hertzog L; Cluver L; Banougnin B; et al: BMC Public Health 24(1523), 1-12, doi: https://doi.org/10.1186/s12889-024-18903-1, 2024","URL":"https://tinyurl.com/2ftb6m8k","body":"While recent evidence established a positive causal relationship between some social protection programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho. This study used cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey to examine the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people living in poverty. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income.  Among the 3 506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use, educational attainment, and school enrolment. Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females and higher odds of educational attainment and school enrolment among males. The study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. The author recommends implementing and expanding such social protection initiatives to improve the well-being of vulnerable adolescents.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Special Issue: Food, Diet, and Nutrition: Connecting Underlying Determinants of Health in the 21st Century","field_subtitle":"Call for papers. Submission Deadline: 31 January 2025","URL":"https://tinyurl.com/ydsu8pjt","body":"Nutritional well-being is the product of a complex interplay of factors that directly or indirectly affect what people consume and how their bodies break down and utilize it. Equating malnutrition with hunger changed as evidence grew that underweight and obesity could co-exist in individuals and households and the double burden of malnutrition emerged.  This special issue aims to highlight Food, Diet, and Nutrition at the intersection of multiple determinants of health; namely, climate and environmental changes that affect food production and distribution; commercial interests that drive food manufacturing, processing, distribution, and marketing; economic, social, and cultural determinants of households\u2019 and individuals\u2019 consumption choices based on affordability, palatability, and social status perceptions; and the psychosocial realities that influence feeding and dietary habits in the 21st century. It draws contributions and learning from work on how these determinants and environments can be tackled, from interventions on the more immediate conditions that shape food systems to the deeper policy, legal, economic, and other structural interventions that control harmful conditions or that promote healthy food systems. Authors are invited to submit abstracts and full papers as outlined in more detail in the website. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Strengthening Analysis and Use of Routine Facility Data for Maternal, Newborn, Child and Adolescent Health ","field_subtitle":"USAID: MOMENTUM Webinar Series, August- September 2024","URL":"https://jsi.zoom.us/webinar/register/WN_9Dua46gIRaG4cMIp9SyGdA#/registration","body":"Routine health facility data helps decision-makers better understand facilities\u2019 service readiness, utilization, and quality, enabling evidence-based policy and resource decisions. MOMENTUM\u2019s \u201cStrengthening Analysis and Use of Routine Facility Data for Maternal, Newborn, Child and Adolescent Health\u201d webinar series is a \u201ctraining of trainers\u201d for monitoring, evaluation, and learning professionals.  The series covers WHO\u2019s Analysis and Use of Health Facility Data: Guidance for Maternal, Newborn, Child, and Adolescent Health (MNCAH) Program Managers toolkit, which introduces a catalog of indicators for MNCAH that can be monitored through routine health facility data and offers guidance on data quality, analysis, and use. The series will feature real-world examples of how to improve analysis and use of routine health facility data. French interpretation will be available at all sessions. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Strengthening Health Systems in Eastern and Southern Africa: Launch of the HEPRR Programme","field_subtitle":"East, Central, and Southern African Health Community (ECSA-HC): ECSA HC,  Tanzania, 2024","URL":"https://tinyurl.com/3zbkjwa6","body":"The Health Emergency Preparedness Response and Resilience (HEPRR)  programme for Eastern and Southern Africa was officially launched in May 2024. Through the ECSA-HC in collaboration with the Intergovernmental Authority on Development (IGAD), the programme aims to fortify the region\u2019s health systems to ensure robust preparedness and effective responses to health emergencies, including from climate change. The programme adopts a Multi-Phase Programmatic Approach (MPA), starting with Kenya, Ethiopia, and Sao Tome and Principe, with subsequent phases incorporating additional countries. This phased approach allows for flexibility and adaptability, leveraging insights from earlier phases to enhance the programme\u2019s impact. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Taking stock of Kenya's debt","field_subtitle":"Citizen TV: Kenya, July 2024 ","URL":"https://www.youtube.com/watch?v=g5ZAF7b4u-c","body":"This televised discussion about the debt crisis in Kenya comprises a conversation with Kwame Owino of The Institute of Economic Affairs (IEA Kenya), Professor Attiya Waris, the UN Independent Expert on Foreign Debt and Human Rights and Jason Braganza, Executive Director of the Africa Forum on Debt and Development. The discussion touches on budget deficit, whether or not to mobilize domestic revenue or borrow, the operation of the Kenyan Debt Management Office, and structure and transformation of the Kenyan economy. The speakers critique the deference of the global economy to creditors over debtors, and call for debt reorganisation. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The Climate and Health Africa Conference, Harare, 29-31 October 2024 ","field_subtitle":"Registration closes 20 September 2024","URL":"https://www.climatehealthconf.africa/","body":"This conference, hosted by CeSHHAR Zimbabwe in collaboration with the Zimbabwean Ministry of Environment, Climate and Wildlife and the Ministry of Health and Childcare, aims to address the detrimental health impacts of climate change on health and wellbeing in Africa and to share research evidence into understanding climate-health mechanisms, the health impacts, effective adaptation and mitigation intervention strategies, equitable climate research, and to discuss how to effectively translate research into policy.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Understanding the contexts in which female sex workers sell sex in Kampala, Uganda: a qualitative study","field_subtitle":"Katumba K; Haumba M; Mayanja Y; et al: BMC Women's Health 24(371), 1-11, doi: https://doi.org/10.1186/s12905-024-03216-7, 2024 ","URL":"https://tinyurl.com/549efze3","body":"This paper documented the contexts in which women selling sex in Kampala Uganda meet and provide services to their clients, using qualitative data from semi-structured interviews with 20 women 18 years or older, who were self-identified as sex workers. Women met clients in physical and virtual spaces. Physical spaces included venues and outdoor locations, and virtual spaces were online platforms like social media applications and websites. Of the 20 women included, 12 used online platforms to meet clients. Generally, women from a clinic sample were less educated and predominantly unmarried, while those from a snowball sample had more education, had professional jobs, or were university students. Women from both samples reported experiences of stigma, violence from clients and authorities, and challenges accessing health care services due to the illegality of sex work. Even though all participants worked in settings where sex work was illegal and consequently endured harsh treatment, those from the snowball sample faced additional threats of cybersecurity attacks, extortion and high levels of violence from clients. To reduce risk of HIV acquisition among women who sell sex, the authors suggest that researchers and implementers consider these differences in contexts, challenges, and risks to design innovative interventions and programs that reach and include all women. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Unequal exchange of labour in the world economy","field_subtitle":"Hickel J; Lemos M; Barbour F: Nature Communications 6298 (15), 1-10, doi: https://doi.org/10.1038/s41467-024-49687-y, 2024","URL":"https://www.nature.com/articles/s41467-024-49687-y#citeas","body":"Researchers have argued that wealthy nations rely on a large net appropriation of labour and resources from the rest of the world through unequal exchange in international trade and global commodity chains. The authors assess this empirically by measuring flows of embodied labour in the world economy from 1995\u20132021, accounting for skill levels, sectors and wages. They find that, in 2021, the economies of the global North net-appropriated 826 billion hours of embodied labour from the global South, across all skill levels and sectors. The wage value of this net-appropriated labour was equivalent to about USd18 trillion in Northern prices, accounting for skill level. This appropriation roughly doubles the labour that is available for Northern consumption but drains the South of productive capacity that could be used instead for local social needs and development. Unequal exchange is understood to be driven in part by systematic wage inequalities. The authors find that Southern wages are 87\u201395% lower than Northern wages for work of equal skill. The authors argue that this means that while Southern workers contribute 90% of the labour that powers the world economy, they receive only 21% of global income.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Unlocking food safety: a comprehensive review of South Africa\u2019s food control and safety landscape from an environmental health perspective","field_subtitle":"Mphaga K; Moyo D; Rathebe P: BMC Public Health 24 (2040), 1-15, doi: https://doi.org/10.1186/s12889-024-19589-1, 2024","URL":"https://tinyurl.com/y3cxhm79","body":"Food fraud (often called fake food in South Africa) or the deliberate misrepresentation or adulteration of food products for financial gain, is a growing problem in South Africa, with severe public health and financial consequences for consumers and businesses. It has generated a public outcry against food fraud practices especially in communities and reputational damage to food manufacturers. Despite the risks, food fraud often goes undetected, as perpetrators are argued to be becoming increasingly sophisticated. The precise magnitude of food fraud remains obscure, as incidents that do not cause consumer illnesses are frequently unreported and, as a result, are not investigated. Food fraud can occur at any stage of the food supply chain, from production to processing to retailing or distribution. This is due in part to the limitations of current analytical methods, which are not always able to detect food fraud. This review of food fraud in South Africa  looks at several factors that may be contributing to epidemic of food fraud, including inadequate penalties, inadequate government commitment, a complex labelling regulation, emerging threats such as e-commerce, and shortage of inspectors and laboratories. The review recommends establishing a single food control/safety authority, developing more food safety laboratories, and adopting innovative technologies to detect and prevent food fraud. South Africa faces a serious food fraud crises unless decisive action is taken.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Using a priority setting exercise to identify priorities for guidelines on newborn and child health in South Africa, Malawi, and Nigeria ","field_subtitle":"Dur\u00e3o S; Effa E; Mbeye N; et al: Health Research Policy and Systems 22(48), 1-15, doi: https://doi.org/10.1186/s12961-024-01133-7, 2024","URL":"https://tinyurl.com/5n7yste8","body":"Sub-Saharan Africa has the highest under-five mortality rate globally and child healthcare decisions should be based on rigorously developed evidence-informed guidelines. The Global Evidence, Local Adaptation (GELA) project is enhancing capacity to use global research to develop locally relevant guidelines for newborn and child health in South Africa (SA), Malawi, and Nigeria. The first step, described in this paper, identifies national priorities for newborn and child health guideline development. This followed a good practice method for priority setting, including stakeholder engagement, online priority setting surveys and consensus meetings, conducted separately in South Africa, Malawi and Nigeria. The authors established national Steering Groups, comprising 10\u201313 members representing government, academia, and other stakeholders, identified through existing contacts and references, who helped prioritise initial topics identified by research teams and oversaw the process. Various stakeholders were consulted via online surveys to rate the importance of topics, with results informing consensus meetings with Steering Groups where final priority topics were agreed. Through voting and discussion within meetings, and further engagement after the meetings, the top three priority topics were identified in each country. In South Africa, the topics concerned anemia prevention in infants and young children and post-discharge support for caregivers of preterm and low birth weight babies. In Malawi, they focused on nutrition in critically ill children, diagnosis of childhood cancers in the community, and caring for neonates. In Nigeria, the topics focused on identifying pre-eclampsia in the community, hand hygiene compliance to prevent infections, and nutrition for low both weight and preterm infants.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Voices for positive change: South African women tell their stories","field_subtitle":"IDRC: South Africa, July 2024","URL":"https://tinyurl.com/4tnw24hx","body":"How can women in vulnerable circumstances move beyond hopelessness, extreme poverty, and the health and livelihood challenges of a global pandemic? What are the best research approaches to make their experiences count in post-pandemic recovery efforts and future preparedness? Ask them. Two research projects in the provinces of Eastern Cape and KwaZulu-Natal, South Africa, are using experiential methodologies to reveal women\u2019s stories, ideas and solutions to their post-pandemic recovery. By taking two different approaches \u2014 one ethnographic and the other a workshop series combined with trial cash transfers \u2014, these two projects aimed to understand the multidimensionality of the lives and circumstances of economically disadvantaged women and investigated different ways to amplify their voices using inclusive approaches. Common themes have emerged from the oral histories collected to date. Researchers report that the pandemic disproportionately affected women, many of whom lost their jobs. Workplaces, health centres and other services closed, leaving women disconnected from their social networks. Adult children and spouses moved home, causing even greater strain and leading to increases in domestic violence. Greater numbers of youth pregnancies added to women\u2019s already difficult care burden. Many women reported that debt closed in. High inflation further compounded the problem, leaving women\u2019s households in a continuous cycle of economic deficit. They continue to struggle with food insecurity and an almost universal dependence on social grants for survival. Women reported a new normal: living with stress, mental illness, isolation and substance use. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Which government policies to create sustainable food systems have the potential to simultaneously address undernutrition, obesity and environmental sustainability?","field_subtitle":"Burgaz C; Van-Dam I; Garton K; et al: Globalization and Health 20(56), 1-10, doi: https://doi.org/10.1186/s12992-024-01060-w, 2024 ","URL":"https://tinyurl.com/mtcpv7r3","body":"To address this question this study undertook a 4-step approach, including (i) a compilation of international policy recommendations, (ii) an online survey, (iii) four regional workshops with international experts and (iv) a ranking for prioritisation. Policies were identified and prioritised based on their double- or triple-duty potential, synergies and trade-offs. Using participatory and transdisciplinary approaches, policies were identified to have potential if they were effective in tackling two or three of the primary outcomes of interest: (1) undernutrition, (2) obesity/NCDs and (3) environmental degradation. A final list of 44 proposed policies for healthier and more environmentally sustainable food systems created was divided into two main policy domains: \u2018food supply chains\u2019 and \u2018food environments\u2019. Of the top five expert-ranked food supply chain policies, two were perceived to have high potential: (a) incentives for crop diversification; (b) support for start-ups, and small- and medium-sized enterprises. For food environments, three of the top five ranked policies had perceived high potential: (a) affordability of healthier and more sustainable diets; (b) subsidies for healthier and more sustainable foods; (c) restrictions on children's exposure to marketing through all media. ","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"World Congress of Epidemiology ","field_subtitle":"24 \u2013 27 September 2024, Cape Town, South Africa","URL":"https://www.wce2024.org","body":"The World Congress of Epidemiology (WCE) will be held in an in-person format for this edition of the triennial congress of the International Epidemiological Association (IEA). WCE is well-known for bringing epidemiologists and public health experts working in different sectors together in an atmosphere designed to promote dialogue, the interchange of ideas, and state-of-the-art scientific research. The theme of WCE2024 is \u201cEpidemiology and complexity: challenges and responses\u201d which will engage the full depth and breadth of methods and practice in contemporary epidemiology. The meeting will feature speakers presenting plenary lectures, workshops and interactive sessions. The abstract-driven programme will include oral and poster presentations including theory and application from every sub-discipline of epidemiology. With more than 2000 delegates expected, WCE2024 promises to be a unique opportunity to share experiences and expertise \u2013 the opportunities to learn, grow and network within the field will be phenomenal. This is the first time the congress will be hosted on the African continent.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"\u2018We thought supporting was strengthening\u2019: re-examining the role of external assistance for health systems strengthening in Zimbabwe post-COVID-19","field_subtitle":"Mhazo A; Maponga C: Health Policy and Planning 39 (7), 652-660, doi: https://doi.org/10.1093/heapol/czae052, 2024","URL":"https://academic.oup.com/heapol/article/39/7/652/7713358","body":"Zimbabwe has received substantial external assistance for health since the early 2000s, including funding earmarked for, or framed as, health systems strengthening (HSS). This study sought to examine whether external assistance has strengthened the health system (i.e. enabled comprehensive changes to health system performance drivers) or has just supported the health system (by increasing inputs and improving service coverage in the short term). Between August and October 2022, the authors conducted in-depth key informant interviews with 18 individuals and reviewed documents to understand: (1) whether external funding has supported or strengthened Zimbabwe\u2019s health system since the 2000s; (2) whether the experience of COVID-19 fosters a re-examination of what had been considered as HSS during the pre-pandemic era; and (3) areas to be reconsidered for HSS post COVID-19. The findings suggest that external funders have supported Zimbabwe to control major epidemics and avert health system collapse. However, the COVID-19 pandemic showed that supporting the health system is not the same as strengthening it, as it became apparent at that time that the health sector is plagued with several system-wide bottlenecks. The authors analyse external funding to be fragile and highly unsustainable, reinforcing the oft-ignored reality that HSS is a sovereign mandate of country-level authorities, and one that falls outside the core interests of external funders. The key positive lesson from the pandemic was that Zimbabwe is capable of raising domestic resources to fund HSS. However, they note that there is no guarantee that such funding will be maintained, calling for attention to government\u2019s stewardship for HSS, and for external funders to re-examine whether their funding really strengthens the national health system.","php":"","field_issue_date":"2024-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"50th Anniversary Celebration of ECSA-HC: A Milestone of Regional Health and Cooperation","field_subtitle":"ECSA Health Community: Arusha, 2024","URL":"https://ecsahc.org/50th-anniversary-celebration-of-ecsa-hc-a-milestone-of-regional-health-and-cooperation/","body":"As we step into 2024, the East Central and Southern Africa Health Community (ECSA-HC) is celebrating its 50th anniversary. This milestone not only symbolizes a half-century of collaboration with our core member states \u2013 Kenya, Lesotho, Eswatini, Malawi, Mauritius, the United Republic of Tanzania, Uganda, Zambia, and Zimbabwe \u2013 but also reflects our expansive efforts in health advocacy and service beyond these borders. Over the years, ECSA-HC\u2019s endeavors have reached various other African nations, contributing significantly to the advancement of health care standards and services across a wider region. ECSA HC will be sharing details of the anniversary events and activities on the website, in a year of reflection, celebration, and renewed commitment to advancing health care in our region.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A call for proposals for community actions that promote social justice and solidarity","field_subtitle":"Deadline for applications: 3 April 2023","URL":"http://tinyurl.com/ycxurtdp","body":"ACT Ubumbano invites proposals from community and activist organisations, and organisations of faith, for support for social justice action.  These actions may be responses to the impact of environmental, gender and economic injustice on communities, or they may be campaigns to change particular situations that communities are struggling with. The action must be implemented and completed by 30 November 2024. Proposals may be for a maximum of ZAR30,000 (South African Rands). Amounts allocated are likely to be less than this to reach as many applicants as possible.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Addressing health implications of the African Continental Free Trade Agreement in east and southern Africa","field_subtitle":"Machemedeze R, SEATINI: EQUINET Discussion paper 131, EQUINET, Harare 2023","URL":"http://tinyurl.com/3496b54z","body":"This desk review on the health implications of the implementation of the AfCFTA within the ESA region implemented by the Southern and Eastern African Trade Information and Negotiations Institute (SEATINI) outlines the health sector and health-related areas directly or indirectly covered by the ACTFA and the relevant subsidiary instruments. It presents information on these and the AfCTA provisions and their implications for trade liberalisation, which are largely consistent with those under World Trade Organization (WTO) agreements. The paper identifies the AfCTA\u2019s positive and negative actual and potential health sector and health- related impacts, including for health equity. It does this in terms of the products that will be subject to liberalisation, including those with potential benefit for health such as local production of health technologies and pharmaceuticals, as well as those that may be harmful to health such as tobacco and genetically modified and ultra-processed foods. It also explores the health implications of the AfCFTA on financial flows and public revenue and on the movement of people, including health personnel. Given this analysis of impacts, measures are proposed that individual countries and the ESA region as a whole may take to protect health equity goals, including monitoring mechanisms to track and report on those impacts.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Associations between child marriage and food insecurity in Zimbabwe: a participatory mixed methods study","field_subtitle":"Gambir K, Matsika A, Panagiotou A, et al: BMC Public Health 24:13, 1-14,  2024 ","URL":"http://tinyurl.com/ycx2th5j","body":"This study explored how food insecurity influences child marriage practices in Chiredzi, Zimbabwe. It used mixed methods, including participant-led storytelling and key informant interviews. A total of 1,668 community members participated in the story-telling, while 22 staff participated in interviews. The authors found that food insecurity was a primary concern among community members and was among the contextual factors of deprivation that influenced parents\u2019 and adolescent girls\u2019 decisions around child marriage. Parents often forced their daughters into marriage to relieve the household economic burden. At the same time, adolescents were found to be initiating their own marriages due to limited alternative survival opportunities and within the restraints imposed by food insecurity, poverty, abuse in the home, and parental migration. COVID-19 and climate hazards exacerbated food insecurity and child marriage, while education was assessed to be a modifier that reduces girls\u2019 risk of marriage. The authors suggest that child marriage programming in humanitarian settings should be community-led and address the gender inequality that underpins child marriage. They argues that programming must be responsive to the diverse risks and realities that adolescents face to address intersecting levels of deprivation. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Brief and video from EQUINET Webinar 3:Climate justice and primary health care systems","field_subtitle":"EQUINET, REACH Trust, IWGHSS, TARSC: EQUINET, Harare, November 2023","URL":"http://tinyurl.com/pct275uz","body":"This brief reports on the issues raised in the third webinar in the EQUINET series on climate justice and health, with this webinar on health systems and climate. It was convened by the Research for Equity and Community Health (REACH) Trust, and the International Working Group for Health Systems Strengthening (IWGHSS). This brief summarises key points raised by speakers and participants on how climate features are impacting on PHC-oriented health systems; the actions that need to be taken to address these issues at local, national and regional level and in international/ global level processes and forums from a regional lens; issues raised to be further discussed in the other thematic webinars. The brief is shared to draw further comment and input on the issue. The video of the full webinar is also available on the EQUINET website.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Brief and video from EQUINET Webinar 4: Climate Justice and Trade Systems","field_subtitle":"EQUINET, SEATINI, TARSC: December 2023, EQUINET, Harare","URL":"http://tinyurl.com/nknp6xph","body":"In 2023 \u2013 24 EQUINET is organising a series of online dialogues to share knowledge and perspectives from community/local, national and international level on the impact of climate trends, the intersect with the other drivers/ determinants of inequity, the implications for policy and action that links climate to health equity and vice versa, and the . proposals for policy, practice, research, and action. This brief reports on the issues raised in the fourth webinar in the series on climate justice and trade systems, convened by SEATINI-Southern Africa in the EQUINET steering committee. This brief summarises key points raised by speakers and participants on how climate features are impacting on trade and health systems; the actions that need to be taken to address these issues at local, national and regional level and in international/ global level processes and forums from a regional lens; and issues raised to be further discussed in the other thematic webinars. The brief is shared to draw further comment and input on the issue.The  video of the full webinar is available on the EQUINET website.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review","field_subtitle":"Semahegn A, Manyazewal T, Hanlon C, et al: Health Research Policy and Systems 21:131, 1-16, 2023 ","URL":"http://tinyurl.com/5hxamcjp","body":"This paper compiles current evidence on barriers to uptake of research in health policy and practice in low- and middle-income countries using scoping review.  A total of 4291 publications were retrieved in the initial search, of which 142 were included as meeting the eligibility criteria. Overall, research uptake for policy-making and practice in low- and middle-income countries was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms. Important barriers to research uptake were identified, particularly limited contextual understanding and low participation of key stakeholders and ownership. The authors suggest improved understanding of the local research and policy context and participatory evidence production and dissemination to promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation are noted to potentially play critical role in this translation process.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Climate Change and Health Systems in East and Southern Africa: A Rapid Review","field_subtitle":"Musuka G, Dzinamarira T: EQUINET, Harare, December 2023","URL":"http://tinyurl.com/tdhzbk56","body":"This desk review explored how climate change is affecting health systems in east and southern Africa (ESA); how the region\u2019s health systems are adapting to climate change; and to identify the health system advocacy and policy issues raised in climate change negotiations by ESA countries, including in relation to issues of equity. Climate change was found to be associated with increased demand for health care services and reduced access to them. An increased demand for health services was found to arise from malnutrition caused by drought-related food shortages, an increase in food and water-borne infectious diseases because of drought and floods, especially in low-income settings, as well as heat exhaustion and heat strokes due to heat waves, particularly among people living in informal settlements. Provision of health services was found to be reduced by extreme weather events, with flooding disrupting transport and communication networks, affecting laboratory services, staff and patient travel, supplies of medication and ambulance availability, especially in rural areas.  ESA countries have raised a range of advocacy and policy issues related to climate change and health systems in negotiations at the African Ministerial Conference on Environment and the UN Climate Change Conference of Parties (COP). ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Climate risks in urban areas","field_subtitle":"Humphreys G: Bulletin of the World Health Organisation 1:102(2), 90-91, 2024","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835636/?report=classic","body":"Engaging with communities in informal settlements presents opportunities to mitigate the health impacts of climate change, but government investment is also needed.  Around one third of the estimated 4.5 billion urban dwellers worldwide use pit toilets or septic tanks, which are normally the first to be overwhelmed in floods, spreading excrement and the pathogens it carries into the environment.  Climate change is likely to exacerbate the challenges faced in cities. According to UN-Habitat,  \u201ccities are growing faster than governments can build the necessary institutional capacity to better plan and manage urban growth.\" in the absence of progress on urban investment, planning and management, one suggested way of addressing inequitable exposure to climate risk is to engage with the communities most affected. Not only are community members motivated to initiate risk mitigation measures, they also typically have the best understanding of their surroundings, including the makeup of the local population, and areas most likely to flood.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Communities collaborating in the Kariba Integrated Solid Waste Management Programme: From urban litter-jungles into healthy environments","field_subtitle":"Municipality of Kariba, TARSC: EQUINET, Harare, 2024","URL":"http://tinyurl.com/2uac7795","body":"Interventions on urban waste have been integrated into one solid waste management programme in Kariba through multi-actor participation with high literacy, involving existing community structures and different age groups of people, and incorporating their aspirations for a clean town. Different interest groups select their own interventions on urban waste linking to food, energy and other urban needs, and deploy their own innovation, local knowledge systems. These are then integrated into the overall programme. The activities use affordable technologies and locally available materials, creating a demand for local goods. Information and communication technologies used in the programme have been important contributors to successful outcomes. Bringing diverse social groups together contributes to system wide and holistic awareness and links action on urban waste systems to a circular economy and climate justice.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Costing of HIV services, Uganda and United Republic of Tanzania","field_subtitle":"McBain R, Jordan M, Kapologwe N, et al: Bulletin of the World Health Organisation 101(10), 626\u2013636, 2023","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10523817/?report=classic","body":"This study evaluated resource allocation and costs associated with delivery of HIV services in Uganda and the United Republic of Tanzania. Time-driven activity-based costing was used to determine the resources consumed and costs of providing five HIV services: antiretroviral therapy (ART); HIV testing and counseling; prevention of mother-to-child transmission; voluntary male medical circumcision; and pre-exposure prophylaxis. In Uganda, service delivery costs ranged from US$8.18 per visit for HIV testing and counseling to US$43.43 for ART (for clients in whom HIV was suppressed). In the United Republic of Tanzania, these costs ranged from US$3.67 per visit for HIV testing and counseling to US$28.00 for voluntary male medical circumcision. In both countries, consumables were the main cost driver, accounting for more than 60% of expenditure. Process maps showed that in both countries, registration, measurement of vital signs, consultation and medication dispensing were the steps that occurred most frequently for ART clients. The authors state that establishing a rigorous, longitudinal system for tracking investments in HIV services that includes thousands of clients and numerous facilities is achievable in different settings with a high HIV burden. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Developing an agenda for the decolonization of global health","field_subtitle":"McCoy D, Kapilashrami A, Kumar R, et al: Bulletin of the World Health Organization 102:2, 130\u2013136, 2024 ","URL":"http://tinyurl.com/22smdczf","body":"Colonialism, which involves the systemic domination of lands, markets, peoples, assets, cultures or political institutions to exploit, misappropriate and extract wealth and resources, affects health in many ways. In recent years, interest has grown in the decolonization of global health with a focus on correcting power imbalances between high-income and low-income countries and on challenging ideas and values of some wealthy countries that shape the practice of global health. The authors argue that decolonization of global health must also address the relationship between global health actors and contemporary forms of colonialism, in particular the current forms of corporate and financialized colonialism that operate through globalized systems of wealth extraction and profiteering. They present a three-part agenda for action that can be taken to decolonize global health. The first part relates to the power asymmetries that exist between global health actors from high-income and historically privileged countries and their counterparts in low-income and marginalized settings. The second part concerns the colonization of the structures and systems of global health governance itself. The third part addresses how colonialism occurs through the global health system. Addressing all forms of colonialism is argued to call for a political and economic anticolonialism as well as social decolonization aimed at ensuring greater national, racial, cultural and knowledge diversity within the structures of global health.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Don\u2019t waste the waste! A case study of promising approaches in managing organic solid waste in Manandriana Municipality, Antananarivo Avaradrano, Madagascar","field_subtitle":"FARM Madagascar,  TARSC: EQUINET, Harare, 2024","URL":"http://tinyurl.com/478b4f3y","body":"Understanding how waste management systems are linked to and interact with other sub- systems and the influence and moderation effects of contextual factors including climate change is important in informing actions and approaches that promote health and wellbeing. Waste management systems provide a potential entry point for fostering innovations, collaborations and system-wide changes for healthy communities and ecosystems, such as through strengthening their linkages with food systems and promotion of circular economies. This case study showcases experiences from the municipality of Manadriana in Antananarivo, Madagascar. It has been produced within a series on integrated urban health in EQUINET to foster learning on these promising approaches within east and southern Africa.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 238: We find ourselves drawing inspiration from the local, and confronting the global. ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"From a Waste Dumpsite into a Food Basket in Bembeke, Dedza, Malawi","field_subtitle":"Country Minders for Peoples Development, TARSC: EQUINET, Harare 2024","URL":"http://tinyurl.com/mt5jyenc","body":"Bembeke, Dedza has been transformed from one of the worst dumping sites to one of the cleanest urban sites in Malawi. CMPD, in partnership with the Environmental Affairs Department (EAD), and stakeholders in Bembeke Dedza, devised and implemented a waste management initiative to turn waste into manure, reducing waste and improving food security in Bembeke. Bembeke farmers were trained to produce manure from waste and theatre campaigns were held in eight zones to sensitise communities on \u2018waste to wealth\u2019. Urban waste and food security interventions succeed when all key stakeholders, including community members participate from conception to completion. Turning waste into fertiliser for food production contributes to food security, environmental protection, circular urban economies and mitigates the effects of climate change.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Global health inequities: more challenges, some solutions","field_subtitle":"Tangcharoensathien V, Lekagul A, Teo Y-Y: Bulletin of the World Health Organisation 102, 86\u201386A, 2024","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10835631/?report=classic","body":"This theme issue of the Bulletin of the World Health Organization shows how health inequities affect many areas, both at national and global scale. The papers discuss health inequity and its root causes, and offer promising solutions. Challenges include national statistics not capturing health inequity among vulnerable populations such as Indigenous people, refugees and migrant workers, including migrant health workforce. However, good practices exist. For example on paper reports on local Indigenous communities successfully managing primary health-care clinics, that can be scaled up and replicated. Overall, the issue editors observe that rectifying global health inequity requires multidimensional interventions and decisive government leadership at the macro-policy level, collaboration with affected populations at the micro-operational level and accelerating progress towards UHC. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Health expenditure: how much is spent on health and care worker remuneration? An analysis of 33 low- and middle-income African countries","field_subtitle":"Toure H, Garcia M, Izquierdo J, et al: Human Resources for Health 21:96, 1-14, 2023","URL":"http://tinyurl.com/4sbnavms","body":"This paper assessed the amount spent on health and care workforce remuneration in the African countries, its importance as a proportion of country expenditure on health, and government involvement as a funding source. Calculations are based on country-produced disaggregated health accounts data from 33 low- and middle-income African countries, disaggregated wherever possible by income and subregional economic group. Per capita expenditure health and care workforce remuneration averaged US$38, or 29% of country health expenditure, mainly coming from domestic public sources. The contributions from domestic private sources and external aid both measured around one-fifth each\u201423% and 17%, respectively. Spending on health and care workforce remuneration was uneven across the 33 countries, spanning from US$3 per capita in Burundi to US$295 in South Africa. West African countries, particularly members of the West African Economic and Monetary Union, were lower spenders than countries in the Southern African Development Community, both in terms of the share of country health expenditure and in terms of government efforts/participation. By income group, health and care workforce remuneration accounted for a quarter of country health expenditure in low-income countries, compared to a third in middle-income countries. An average 55% of government health expenditure is spent on health and care workforce remuneration, across all countries. The results clearly show that the remuneration of the health and care workforce is an important part of government health spending, with half of government health spending on average devoted to it. Comparing health and care workforce expenditure components allows for identifying stable and volatile sources, and their effects on health and care workforce investments over time. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Health-promoting food and waste management systems in Kwekwe City: Turning waste into assets","field_subtitle":"City of Kwekwe, TARSC: EQUINET, Harare, 2024","URL":"http://tinyurl.com/mt5jyenc","body":"Waste pickers, mostly women collect aluminium cans from shopping centres and homes and sell them to small-scale smelters based in home industries in Mbizo, Amaveni and other suburbs in Kwekwe. The aluminium scrap sells for between 45-50c (US$) per kilogram. The aluminium is moulded into useful traditional pots for local sale. Depending on their sizes, the pots sell for between US$10 to US$90. This is one of the \u2018waste-to-asset\u2019 recycling activities in Kwekwe City described in this brief. Harnessing treated wastewater for crop irrigation recycles nutrients and protects the environment. The food produced, sold and consumed locally in urban agriculture alleviates poverty, and promotes food security and health. Community participation, partnerships and collective decision-making in waste management applies local knowledge and assets for environmental protection and climate justice. Using solar energy protects urban environments, reducing dependence on polluting fossil fuels, and reducing the greenhouse gases that contribute to climate change and its negative impacts. Circular economic activities promote climate-proofing and inclusive economic development","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"How Functional Reviews in the Health Sector Exacerbated Occupational Stress and Burnout Among Clinical Officers at Public Hospitals in Malawi","field_subtitle":"Chinguwo P: Clinical Sociology Review 18(2), 1-37, 2023","URL":"https://journals.uj.ac.za/index.php/csr/article/view/2378","body":"The authors present how the implementation of some functional reviews in the health sector exacerbated occupational stress (OS) and burnout among clinical officers at public hospitals in Malawi through a qualitative case study at four district hospitals and one central hospital, all state-owned. The functional reviews are found to have aggravated occupational stress and burnout among clinical officers at public hospitals, and perpetuated interprofessional conflicts between clinical officers and medical doctors. The  authors recommend that a psychosocial risk assessment should be conducted to avoid or minimise the risks of occupational stress and burnout among clinical officers posed by the implementation of functional reviews in the health sector.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"I still don\u2019t know how someone gets pregnant: determinants of poor reproductive health among young female refugees in South Africa","field_subtitle":"Crankshaw T, Freedman J, Mutambara V, et al: BMC Women's Health 24:10, 1-11, 2024 ","URL":"http://tinyurl.com/567ex26a","body":"This study explored the reproductive health and rights\u2019 needs and challenges amongst young refugee women in South Africa. It was carried out in eThekwini in South Africa in 2021 and 2022 through 35 semi-structured, in person interviews with young refugee women 18 and 24 years old living in the city centre. Eleven of these women had experienced one or more pregnancies while living in South Africa and all of these women had experienced at least one unintended pregnancy. Participants had poor reproductive health knowledge of the role of menstruation and how conception occurs. Economic, social, and legal insecurities intersected in complex ways as determinants of poor reproductive health outcomes. Despite availability, contraceptive use was poor and linked to lack of knowledge, myths and unwanted side effects. There were negative economic and social impacts for young refugee women experiencing early pregnancies irrespective of whether they were intended or not. Desire for confidentiality shaped lack of access to legal termination of pregnancy in the public health sector. Participants experienced specific vulnerabilities resulting from their position as refugees despite length of stay in South Africa. It is important to better understand these specificities in the design of programmes and policies aimed at ensuring positive health outcomes for these young women. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Implementation framework for income generating activities identified by community health volunteers (CHVs): a strategy to reduce attrition rate in Kilifi County, Kenya","field_subtitle":"Riang\u2019a R, Nyanja N, Lusambili A, et al: BMC Health Services Research 24:132, 1-17, 2024","URL":"http://tinyurl.com/ykkb3wuy","body":"This study sought to identify strategies for implementing Income-Generating Activities (IGAs) for Community Health Volunteers (CHVs) in Kilifi County in Kenya to improve their livelihoods, increase motivation, and reduce attrition. Focus group discussions were carried out with CHVs and in-depth interviews among local stakeholder representatives and Ministry of Health officials. A need for stable income was identified as the driving factor for CHVs seeking IGAs, as their health volunteer work does not provide remuneration. Individual savings through table-banking, seeking funding support through loans from government funding agencies, and grants from corporate organizations, politicians, and other donors were proposed as viable options for raising capital for IGAs. Empowering CHVs with entrepreneurial and leadership skills, and connecting them to support agencies were proposed to support implementation and the sustainability of IGAs. Group-owned and managed IGAs were preferred over individual IGAs. The authors propose that agencies seeking to support CHVs\u2019 livelihoods should engage with and be guided by the input from CHVs and local stakeholders.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Malaria vaccine shortfall, heavy cost of Africa\u2019s child deaths all thanks to global complacency","field_subtitle":"Kafuko Z: Daily Maverick, South Africa, 2024","URL":"http://tinyurl.com/d2yscc8t","body":"The RTS,S/AS01 malaria vaccine produced by GSK was recommended by the World Health Organization in 2021. In October 2023, WHO recommended the second malaria vaccine, R21/Matrix-M, developed by Oxford\u2019s Jenner Institute and manufactured by the Serum Institute of India. Both the RTS,S and R21 vaccines have been shown to be effective and safe. Yet for months it was unclear how many doses of R21 would be ordered and delivered; and only recently just 10 million were reported as ordered and delivered at a time when the number of doses available stood at 25 million. The solution to this shortfall is argued to require African action, to prioritise these lifesaving vaccines and push Unicef and GAVI to procure supply. Respective countries aiming to roll out the vaccines also need to authorise R21 through their regulatory authorities, a process that can take about 6 months. So far, only Nigeria, Ghana and Burkina Faso have done so. Applications to GAVI go through the ministries of health and finance and can be submitted only once every three months. The authors propose allowing a rolling window for applications to be submitted as soon as they are ready to save time, but also see the situation as .a wake-up call to Africa to build its own capacity for pioneering research and development of countermeasures against endemic diseases. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Mining-Affected Communities: The Elephant Not in the Room","field_subtitle":"Bailey L: Natural Resource Governance Institute, Blog post: 9 February 2024 ","URL":"https://resourcegovernance.org/articles/mining-affected-communities-indaba","body":"At the Mining Indaba in Cape Town in the week of February 5-9 countless references were made to mining-affected citizens of African countries. However, the author of this blog notes that absent from almost all of the rooms where this word was repeatedly invoked were\u2026members of mining-affected communities. Tengi George-Ikoli shared an African adage: \u201cA man\u2019s head should not be shaved in his absence.\u201d Community voices are observed to be essential in spaces like Indaba to ensure that decision makers account for the social, economic and environmental impacts of mining and minimize them. One place that was replete with community stakeholders was Alternative Mining Indaba, which has operated in distant parallel to the main Indaba for 15 years. However the author argues in this blog that until communities and civil society have a more fixed and prominent seat at the table, and agendas reflect the importance of their voices, progress on challenges such as adding value to raw commodities will be difficult.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Misinformation, knowledge and COVID-19 vaccine acceptance: a cross-sectional study among health care workers and the general population in Kampala, Uganda","field_subtitle":"Atuheirwe M, Otim R, Male K, et al: BMC Public Health 24:203, 1-10, 2024","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-17678-9","body":"This study assessed people\u2019s knowledge of the COVID-19 vaccine and the effect of misinformation on vaccine uptake among healthcare workers (HCWs) and the general population in Uganda. This was a cross-sectional quantitative study conducted in 2022,  including 311 HCWs and 253 from the general population. The study revealed that the proportion of vaccinated HCWs (77.4%) was significantly higher than that of the vaccinated general population (64.4%). The research revealed that a large proportion of the participants (89.7%) encountered rumours regarding unverified adverse effects of the COVID-19 vaccine that significantly contributed to vaccine hesitancy,. The study showed a negative impact of misinformation on vaccine uptake and could be the most significant contributor to vaccine hesitancy in future vaccine programs.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Outer packaging labelling of medicines in Southern African Development Community countries: comparative analysis of requirements and transition terms for harmonisation","field_subtitle":"Narsai K, Masekela F, Leufkens H, et al: BMC Health Services Research 24:111, 1-7, 2024 ","URL":"http://tinyurl.com/rmeheake","body":"The COVID-19 pandemic highlighted an urgent need for harmonised requirements for the regulation of medicines. The authors compared outer packaging labelling requirements and transition terms for harmonization for countries in the Southern African Development Community (SADC) region. Data on legislation and/or regulatory guidelines for medicine outer packaging labelling from National Medicines Regulatory Authorities were obtained for countries in the SADC region by February 2023. A detailed comparative content analysis was conducted to determine alignment with the requirements of the SADC harmonised labelling guidelines to assess readiness levels of each country to transition to the SADC harmonised labelling guideline for outer packaging of medicines. Content analysis showed at least 11 out of 16 countries require national legal reform to transition to the SADC harmonised labelling guideline. In all cases where countries specified labelling requirements for outer packaging of medicines, these were stipulated in national medicines legislation. Even though there is a high level of alignment across the countries in terms of national labelling requirements, most countries in the SADC region would still require national legislative reform to transition to regional harmonised labelling requirements and then ultimately to continental requirements of the African Medicines Agency.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Perceived barriers of access to health and nutrition services under drought and food insecurity emergency in north-east Uganda: a qualitative study","field_subtitle":"Njuguna C, Tola H, Maina B N, et al: BMC Public Health 24:390, 1-9, 2024","URL":"http://tinyurl.com/yyz7nu6z","body":"This study explored barriers to access health and nutrition services in drought and food insecurity emergency affected districts in north-east Uganda. The authors interviewed 30 patients and 20 Village Health Teams from 15 districts and used thematic data analysis on the findings. The majority of respondents reported that difficulties in access to health and nutrition services, with various sociocultural, economic, environmental, health system, and individual barriers. The study identified several modifiable barriers that are addressed in proposals for comprehensive interventions in the paper. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Promoting comprehensive primary health care mental health interventions for young people: A Malawi case study","field_subtitle":"Chikaphupha K, Nanji N, Muhia J: REACH Trust, IWGHSS EQUINET, Harare, 2024","URL":"http://tinyurl.com/2s45wzy9","body":"This study in Malawi aimed to assess the experiences of 15\u201324-year-old youth with regard to mental health problems, to evaluate the management of mental health issues and the responses to the issues they face, as well as to recommend interventions to address young people\u2019s mental health challenges. The study employed a mixed methods approach. The 7% prevalence of depression identified in the study seems low compared to the 11\u201314% in youth in several other studies in Africa. Challenges identified relating to access to mental health services indicate the need for improved availability and accessibility of mental health services for young people faced with mental health problems. The COVID-19 pandemic further impacted youth by increased losses in education, income, employment and food security, as well as increased gender-based violence and sexual abuse. Based on the findings, recommendations are made on areas of primary health care, community, multisectoral, and youth interventions to better support mental health promotion, mental illness prevention, detection, counselling, care and wider responses for young people in Malawi. Although the sample size was small, these may also be relevant across other countries in sub-Saharan Africa.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Promoting the Three R\u2019s -Reduce, Recycle and Reuse- in waste Management in Kadoma, Zimbabwe","field_subtitle":"Abdullah Dzinamarira Foundation Trust, Young Men Christian Association, TARSC: EQUINET, Harare, 2024","URL":"http://tinyurl.com/2mz4y8a2","body":"Waste management is a critical issue facing cities globally, particularly in low-income countries with limited resources. Responding to this challenge, the Abdullah Dzinamarira Foundation (ADF) and Young Men\u2019s Christian Association (YMCA) implemented a comprehensive waste management programme promoting the promote the three Rs - Reduce, Reuse, and Recycle- in Rimuka, a densely populated low-income suburb in Kadoma, Zimbabwe. Waste reduction strategies can be low-cost and high-impact. They call for increased education and awareness on how waste management can create new industries and jobs. This work in Kadoma set up forums and interventions to involve local people and involved stakeholders to build awareness of the opportunities that waste reuse and recycling provides for jobs and inputs to local food and product. The programme generated interventions linking waste recycling to food production, plastic waste collection to incomes and renewal energy to improved urban conditions. Climate change affects health and is creating health inequalities. City efforts to reuse, recycle and reduce contribute to improved health climate change mitigation and adaptation.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Reflections on the process, challenges, and lessons learned conducting remote qualitative research on Violence Against Women during COVID-19 pandemic lockdown in South Africa","field_subtitle":"Mahlangu P, Machisa M, Jewkes R, et al: BMC Public Health 24:33, 1-9, 2024 ","URL":"http://tinyurl.com/pmx2dfyy","body":"The COVID-19 pandemic lockdown and restrictions on movement presented an opportunity to conduct Violence Against Women (VAW) research using remote methods. The authors discuss how they adapted methods, reflect on lessons learned, and make recommendations highlighting key considerations when conducting remote research on a sensitive topic of VAW. An exploratory qualitative study was designed using remote methods with 18 men and 19 women, aged 18 years and older, who lived with their partner or spouse during lockdown in South Africa. Data presented in this paper draws from researchers\u2019 reflections drawn from debriefing sessions during the research process, and from participants\u2019 interview transcripts. Remote recruitment of participants took longer than anticipated, and the authors had to re-advertise the study. The authors could not ensure safety and privacy during interviews. Regardless of all the safety and privacy measures the authors put in place during the research process, some participants had an adult person present in the room during interviews, and the researchers had no control over interruptions. Rapport was difficult to establish without an in-person connection, which limited disclosure about violence experience and perpetration. Given the methodological and ethical challenges which limited disclosure of violence against women remotely, the authors conclude that telephone interviews used in this study impacted on the quality of study data. Therefore, the authors do not recommend violence against women research to be conducted remotely, unless it is essential and participants are already known to the interviewer and trust has been established.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Self-reported cardiovascular disease risk factor screening among people living with HIV vs. members of the general population in Botswana: a community-based study","field_subtitle":"Molefe-Baikai O, Kebotsamang K, Modisawakgomo P, et al: BMC Public Health 24:198, 1-8, 2024 ","URL":"http://tinyurl.com/4rvxua7x","body":"This paper aimed to assess whether people living with HIV (PLWH) were more likely to have previously been screened for cardiovascular disease risk factors (CVDRFs) than people without HIV. A population-based, cross-sectional study was conducted among individuals aged 16 to 68 years across 22 communities in Botswana. Of the 3981 participants enrolled, 2547 were female, and 1196 were PLWH. PLWH were more likely to report previous screening for diabetes, elevated cholesterol and to have had their weight checked than HIV-uninfected participants. PLWH were also more likely to have received counselling on salt intake, smoking cessation, weight control, physical activity and alcohol consumption than their HIV-uninfected counterparts. PLWH were almost two times more likely to have been previously screened for CVDRFs than those without HIV, indicating a need for universal scale-up of integrated management and prevention of CVDs in the HIV-uninfected population.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Socioeconomic inequalities in uptake of HIV testing during antenatal care: evidence from Sub-Saharan Africa","field_subtitle":" Dadzie L, Gebremedhin A, Salihu T, et al: International Journal for Equity in Health 23:4; 1-12, 2024 ","URL":"http://tinyurl.com/bdhnt7uc","body":"This paper assessed the socioeconomic inequalities in HIV testing during antenatal care in sub-Saharan Africa, using Demographic and Health Surveys data spanning from 2015 to 2022. Overall, 73.9% of women in sub-Saharan Africa tested for HIV during antenatal care. Being among the richer and richest wealth quintiles increased the odds of HIV testing during antenatal care. The authors emphasize the necessity for sub-Saharan Africa public health programs to think about concentrating their limited resources on focused initiatives to reach poorer women and should provide women with comprehensive HIV knowledge and decrease the number of lost opportunities for women to get tested for HIV. ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"SOLVE Open Call For Solutions","field_subtitle":"Submissions open until April 18","URL":"https://solve.mit.edu/challenges","body":"Solve\u2019s Global Challenges seek exceptional innovators who are using technology to solve today\u2019s most pressing problems. Those selected become a Solver team and join this nine-month support program, receive access to funding in grants and investments, join a powerful network of impact-minded leaders, receive coaching and strategic advice from experts, and gain exposure in the media, among many other benefits. Since 2016, over 20,000 solutions headquartered in over 180 countries have been submitted in response to Solve\u2019s Global Challenges. The resource supports a diverse group of 299 Solver teams, who have collectively impacted over 190 million lives worldwide. These teams are 62% women-led and headquartered in 59 different countries.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Kampala Declaration on Health, Human Rights and Development","field_subtitle":"The Republic of Uganda Ministry of Health, CEHURD, September 2023, Uganda","URL":"http://tinyurl.com/248zt4a8","body":"This declaration was made by the delegates at the Inaugural Uganda National Conference on Health, Human Rights and Development held in Kampala in September 2023. The declaration makes several commitments, including that the Ministry of Health provide leadership for an integrated and multi-sectoral approach which recognises the intersectionality between SDG 3, human rights and other SDGs. It also commits to strengthen collaboration across all sectors in advancing the right to health; fast-track Government\u2019s process of passing and implementing the National Health Insurance scheme in order to realise Universal Health Coverage; and urges Government through the Parliament to progressively increase financing for health in order to realise the Abuja Declaration of allocating 15% of national budget towards health. The declaration proposes to increase the generation and use of evidence in planning and implementing health interventions, including on social determinants of health; to make more progress on the Right to health in Uganda to realise Sustainable Development Goals.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Nairobi Urban Health and Demographic Surveillance System: Bringing community voice and evidence to urban health in slum communities","field_subtitle":"AB[M]R, TARSC: EQUINET, Harare, 2024","URL":"http://tinyurl.com/5n872w8v","body":"The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first African urban health and demographic site surveillance (HDSS) based in a slum. It seeks to address the health and social needs of urban slum dwellers. NUHDSS has generated the information and evidence needed, to strengthen and inform action and change on healthy food systems and green spaces, promoting equity, poverty reduction and climate justice; facilitating the circular economy through reduced use, reuse, and recycling of waste. The NUHDSS data and nested studies were used to assess the impacts of interventions, to inform local and national policy-making and programmes to improve community health locally, in Kenya and in other African countries. As a tool for community voice and to support governance approaches and collective learning, the NUHDSS platform and process has strengthened the voice and involvement of residents of Viwandhani and Korogocho slums in their health and socioeconomic development bringing community voice in a \u2018whole of society\u2019 approach that recognizes and engages all stakeholders.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"The role of the social sciences and humanities in pandemic preparedness responses: insights gained from COVID-19, HIV and AIDS and related epidemics","field_subtitle":"Govender K, King J, Nyamaruze P, et al: African Journal of AIDS Research, 22(4), 269\u201327,  2023","URL":"https://www.tandfonline.com/doi/abs/10.2989/16085906.2023.2262977","body":"The COVID-19 pandemic, particularly from 2020 to mid-2022, debilitated the management of the HIV epidemic in Africa. The multiple effects included well-documented HIV service interruptions, curtailment of HIV prevention programmes, the associated marked increase in both the risk for HIV infection among key populations and vulnerability of sub-populations. As importantly but less well documented were the diverse negative socio-economic effects that accentuate HIV risk and vulnerability generally (e.g. loss of earnings, gender-based violence, stigma, police harassment of people during lockdowns. The global biomedical response to COVID-19 was necessary and remarkable for mitigating the bio-physical impacts of the pandemic. However,  this article suggests that key lessons learnt during the HIV and AIDS and other pandemics were ignored, at least during the early stages of COVID-19. The authors critique is that better integration of the social sciences and humanities in responses to pandemics can counter the reflex tendency to uncritically adopt a biomedical paradigm and, more importantly, to enable consideration of the social determinants of health in pandemic responses.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Transforming Mbale City\u2019s urban food system in the Good Food for Cities Programme","field_subtitle":"Food Rights Alliance, Rikolto, Global Consumer Centre, TARSC: EQUINET, Harare 2024","URL":"http://tinyurl.com/mr4b59un","body":"Rapid urbanisation in Uganda especially in cities like Kampala and Mbale is reshaping the urban food systems, altering demand and introducing food related challenges. Despite the positive aspects of urban development, there is an increase in unregulated activities that lead to unsafe food practices. The Good Food for Cities programme recognizes these challenges as opportunities to establish more sustainable, fair and healthy food systems in Mbale and Kampala. The programme aims to forge coalitions involving businesses, consumers, local authorities and other food system actors to ensure inclusive, resilient and healthy food environments for all citizens. Two crucial mechanisms of the Good Food Council and the Good Food Parliament serve as platforms for consultation, dialogue, accountability and collective decision making. The programme adopts a three-tier intervention strategy of promoting sustainable production, inclusive urban food markets and an enabling environment. These areas give emphasis to regenerative agriculture, and multi stakeholder participation, addressing climate change, and urban inequalities and food insecurity.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Waste is wealth: Small scale urban farming challenging food insecurity in informal settlements of Kibuye I Parish in Kampala, Uganda","field_subtitle":"ACTogether Uganda, Urban Authority Association of Uganda, TARSC: EQUINET, Harare, 2024","URL":"http://tinyurl.com/2mz4y8a2","body":"Poor waste disposal and management is an overwhelming environmental issue in Kibuye informal settlements. There are no designated communal garbage collection points, as land owners are unwilling to give land for it, citing poor maintenance of the sites. The littered waste clogs the existing drainage channels, gullies and wetlands exposing Kibuye slums to frequent flooding. The small-scale urban farming initiative by SCINE Uganda is providing a foundation for urban food security and sustainable management of the environment in Kibuye I Parish.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"We find ourselves drawing inspiration from the local, and confronting the global. ","field_subtitle":"Editor, EQUINET newsletter","body":"\r\nWe have many new case studies, reports and links to videos in the EQUINET updates and useful resources in this issue, and issued a special editorial on protecting health and health services in conflict in February. In this issue we thus use this editorial space briefly to invite you to read these publications. The February editorial responded to the conflict and violence in different global regions, and particularly the violations against the specific protections provided in international conventions of civilian health, health services and health workers in conflict zones. The extreme situation in Gaza, still continuing, prompted the WHO Director General Dr Tedros Adhanom Ghebreyesus to say \u201cWithout a ceasefire, there is no peace. And without peace, there is no health.\u201d \r\n\r\nAt the same time we present in this newsletter many case studies of inspiring action in different urban sites in our region. They address the rising challenges and health risks posed by urbanisation for unmanaged waste and food insecurity, especially for low income communities. They turn challenge to opportunity, such as by linking waste recycling to incomes and to fertiliser for urban agriculture and food security. They change zones of polluting waste dumping and burning into urban green zones through \u2018whole of society\u2019 approaches. They show concretely the possibility of and measures for taking on issues such as climate justice and inclusive circular economies. For those affected they show that they can produce change.  \r\n\r\nThese local level initiatives yield optimism, even as frustration and social disempowerment is fostered over global and international level actions on key challenges affecting wellbeing, such as climate, conflict and inequity. As another paper in this issue discussing the Africa Continental Free Trade Agreement asks, can we at national and regional level better protect space and support for such initiatives within our countries, rather than reproducing global trade and economic frameworks that block them? We invite you to contribute evidence and publication to the newsletter, and to explore, debate, analyse and share on these and other health equity issues with us in 2024, and wish you a year of peace, health and progress.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"WHO Asks Member States: Join Talks on Global Plastics Treaty, and Climate Action for Health","field_subtitle":"Fletcher E: Health Policy Watch, January 2024","URL":"http://tinyurl.com/3cdz2cwz","body":"A first-ever WHO initiative to join the global negotiations on a plastics treaty, as well as the first WHO decision on climate and health since 2008, are set to come before the World Health Assembly in May 2024. The draft decision on climate change and health, led by eight member states, including Peru, Kenya, the United Arab Emirates and the United Kingdom, reflects new evidence on the linkages between climate and health. The WHO propose to make health-related inputs into the new treaty instrument on plastics, including about particularly hazardous plastics or polymers that should be phased out, and play an active role in a UN science-policy panel on plastics pollution. A range of non-state actors criticised the absence of reference to \u201cfossil fuels\u201d as a driver of climate change in the draft climate and health decision, with one suggesting that WHO should treat fossil fuels like tobacco. The draft document calls upon WHO to clean up its own house by \u201cfirmly integrating climate across the technical work of the WHO at all three levels\u201d and develop a \u201cRoadmap to Net Zero by 2030 for the WHO Secretariat, in line with the UN Global Roadmap.\u201d ","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"World Congress of Epidemiology 2024","field_subtitle":"24-27 September 2024, Cape Town, South Africa","URL":"https://www.wce2024.org/","body":"The theme of World Congress of Epidemiology 2024 is \u201cEpidemiology and complexity: challenges and responses\u201d which will engage the depth and breadth of methods and practice in contemporary epidemiology. The meeting will feature top-calibre invited speakers presenting plenary lectures, workshops and interactive sessions. The abstract-driven programme will include oral and poster presentations including theory and application from every sub-discipline of epidemiology. With more than 2000 delegates expected, WCE2024 promises to be a unique opportunity to share experiences and expertise \u2013 the opportunities to learn, grow and network within the field will be phenomenal. This is the first time the congress will be hosted on the African continent.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"\u201cIt's about our health and our future\u201d: Ensuring sexual and reproductive health support in northern Mozambique","field_subtitle":"UNFPA Press Release: Reliefweb, January 2024","URL":"http://tinyurl.com/mrxybu4r","body":"Since 2017, Niassa and the neighbouring provinces of Cabo Delgado and Nampula in Mozambique have faced mounting attacks by non-state armed groups, with millions of people fleeing their homes in search of safety. This has come alongside repeated climate shocks \u2013 from flooding to drought and powerful cyclones \u2013 and ensuing public health emergencies such as malaria and cholera outbreaks. The ongoing instability and decimated health facilities have rendered pregnancy and childbirth increasingly life threatening, while conflict and displacement are also putting women and girls at greater risk of gender-based violence and trafficking. UNFPA is distributing contraceptives and raising awareness through mobile teams and clinics across northern Mozambique. In Niassa, health providers from all 16 districts have received training on long-term family planning methods, such as the Pill, implants and intrauterine devices. Through the Lichinga centre, community leaders and volunteers have also spoken to around 2,500 adolescents and young people from the region, discussing cultural barriers to sexual health and the stigma surrounding HIV and AIDS. A collaboration with R\u00e1dio Mo\u00e7ambique and Radio Comunit\u00e1ria de Cuamba also produced over 360 broadcasts that discuss sexual and reproductive health services and gender-based violence. Presented in local languages such as Ciyao and Cinyanja and Emakhuwa, the outreach efforts reached around 1.6 million people in Niassa province alone.","php":"","field_issue_date":"2024-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"A special issue on health in conflict","field_subtitle":"Editor, EQUINET newsletter","body":"This special issue of the newsletter includes only a statement from the EQUINET Steering Committee on health in conflict. The next regular newsletter issue will be published on 1 March 2024.","php":"","field_issue_date":"2024-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2024-02-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Special issue newsletter 237: Protecting health and health services in conflict","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. This special issue is produced to share an EQUINET Steering committee statement on health in conflict. The next regular issue will be in 1 March 2024. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2024-02-01","field_equinet":"","category":"Header"}},{"node":{"title":"Protecting health and health services in conflict: Gaza shows a gap we must address between treaties and practice","field_subtitle":"EQUINET Steering Committee ","body":"\r\nThe violent attacks and hostage-taking in Israel on 7 October 2023, and the subsequent and ongoing military onslaught in Gaza, West Bank and military attacks in that region add to conflicts in Ukraine, Yemen, eastern DRC, Sudan, Myanmar and other countries. Yet the intensity in Gaza has been a shock globally, including in our region. For example, WHO reports the number of children killed in the three weeks following 7 October to have surpassed the annual number of children killed in all conflict zones since 2019. As a health network, we focus this statement only on the health dimensions of the situation reported in United Nations evidence, that is the attacks on health personnel, the destruction of health services and the denial of medicines, health technologies, water and food. We write this to raise attention to whether we can better and more rapidly fulfill our duties to protect these health issues in conflict, in Gaza and elsewhere.\r\n\r\nThe major United Nations International Covenants on human rights (the ICCPR ratified by 172 countries and ICESR ratified by 171 countries) protect the right to life and to health. In situations of conflict, the Geneva and Hague Conventions provide further that there should be \u2018no obstacle to humanitarian activities\u2019, and that the wounded and sick should \u2018be respected and protected in all circumstances\u2019. Access to health services are vital to provide this respect and protection, and these conventions state that hospital and medical facilities should not be attacked. The only exception to the latter is if civilian hospitals are actively used to commit \u2018acts harmful to the enemy\u2019. \r\n\r\nThat accessible, well equipped health care and humanitarian relief is needed in Gaza is unquestionable. While attacks have taken place in Israel, Gaza and other areas, the scale of the situation in Gaza is extreme. Between October 7 and 19 January, 24 762 people in Gaza were reported by Reliefweb and UN sources to have been killed, including over 7,729 children, with a further 62 108 injured, and over 7 780 others missing, presumed dead under rubble. Teresa Zakaria, a World Health Organisation (WHO) Health Emergencies official, notes the largest proportion of recorded fatalities to be children (45%) and women (30%). \r\n\r\nUnited Nations (UN) reports provide evidence of the mounting deprivations of the basics for life and health. A UNICEF official warned in January 2024 that \u201csilent, slow deaths caused by hunger and thirst risk surpassing those violent deaths already caused by Israeli bombs and missiles.\u201d In mid-January 2024, WHO reported the entire population of Gaza \u2013 roughly 2.2 million people- to be \u2018in crisis or worse levels of acute food insecurity\u2019, with 1.9 million people displaced from their homes, and over 1.4 million staying in overcrowded shelters. The conflict has damaged or destroyed essential water, sanitation and health infrastructure, with the World Food Programme reporting in December 2023 only 1.5 to 1.8 litres of clean water to be available per person per day, for all uses, below even the daily \u2018survival threshold\u2019 of 3 litres. Beyond the mental ill health impact of military conflict on civilians, WHO report soaring rates of infectious disease, with a 25-fold escalation in case rates of diarrhoea, and rising cases of upper respiratory infection, meningitis, scabies, jaundice and chickenpox. Hunger increases the risk of mortality from these conditions. The effects are not only short-term. UNICEF estimated 1,000 children having lost one or both legs during the conflict and a combination of disease and a 30% rise in wasting that risks survival and their longer-term development. \r\n\r\nWHO stated last December: \u201cThe people of Gaza, who have already suffered enough, now face death from starvation and diseases that could be easily treated with a functioning health system. This must stop\u201d. \r\n\r\nYet access to health services across Gaza has also plummeted with the destruction of health services. As reported by UNICEF by January 2024, there had been 590 direct attacks on healthcare in Gaza and West Bank since the war began, with 291 ambulances damaged, including those marked with the Red Cross or Red Crescent emblem. Missiles have also been fired on health facilities in Israel, with the WHO Surveillance system for attacks on health care reporting on 31 January 2024 that there had been 64 attacks on health facilities in Israel, 18 impacting on facilities, 38 impacting personnel and 13 impacting patients. However, the attacks in Gaza have been significantly more widespread and destructive of health services. By last December, WHO reported more than 238 attacks on healthcare in Gaza alone, damaging or destroying over 61 hospitals and other healthcare facilities. For example, Al-Indonesi hospital was reported by a UN official last December to have been bombed 35 times since 28 October. The military attacks have targeted hospital generators, hospital solar panels, and life-saving equipment, such as oxygen stations and water tanks. As a result, only 13 out of 36 hospitals and 18 out of 72 healthcare centres are reported to still be functioning \u2014 some of them barely \u2014 despite the overwhelming need for these services. In December last year, WHO reported 21of Gaza\u2019s 36 hospitals to be closed, and of the remaining 15, eleven to be only partially functional and four \u2018minimally functional\u2019. Those that are open are operating at multiple times their bed capacity. They lack fuel supplies, food and clean water, which with accumulating medical waste raises a public health risk for patients and the thousands of displaced persons sheltering in hospital grounds. Direct bombing of health services has endangered patients and those sheltering in hospital grounds, with WHO reporting in December 2023 that at least 570 Palestinians have been killed at hospitals and healthcare centres in Gaza, and a further 746 injured by Israeli military strikes or snipers.\r\n\r\nAs noted earlier, international law does not protect health services that are actively used to commit acts of war. In January 2024, Israeli authorities alleged in its case in the International Court of Justice that hospitals in Gaza were used as sites of military action, with militants using some hospitals to retreat to, to hold hostages in, or to fire on Israeli forces. In the same month a WHO official observed that there was no evidence that hospitals in the Gaza Strip were being used for purposes other than providing healthcare. The consequence remains that the wounded and sick are left without respect and protection, in contrast to international norms.  \r\nMany health workers in Gaza did not leave their patients and continued to serve despite the risk to their own lives. In December 2023, UNICEF reported over 311 doctors, nurses and other health workers, including doctors and ambulance drivers killed on duty, while WHO has reported medics and first responders to have been repeatedly detained by Israeli forces, many of these detained incommunicado at unknown locations. Tlaleng Mofokeng, UN Special Rapporteur on the right to health stated, \u201cWe are in the darkest time for the right to health in our lifetimes,\u201d She said. \u201cFor people to have access to quality healthcare, they must have access to healthcare workers, and those healthcare workers must be safe and free to provide care.\u201d \u201cWe bear witness to a shameful war on healthcare workers\u201d. \r\n\r\nThose injured in attacks find insufficient staff and resources for adequate care, raising the risk of infected, necrotic or gangrenous wounds, and deaths from what should be treatable conditions. However, the denial of health care does not only affect those injured in conflict. It affects those needing other forms of care. Patients have to cross long distances in dangerous conditions to find an open facility. Existing triage criteria in emergency departments have to give precedence to war injuries over non-emergency cases, undermining other forms of care. WHO reported in November 2023 an estimated 5,500 Palestinian women in Gaza giving birth each month in unsafe conditions, often with no medical assistance or clean water. UN News report operations, including amputations and caesarean sections, taking place without anaesthetic. \r\n\r\nThere have been efforts to respond. Since the start of the hostilities, WHO, other UN agencies and partners have been supporting the health system and humanitarian relief in Gaza with high-risk missions to deliver medical equipment and supplies, medicines, fuel, coordination of emergency medical teams, and disease surveillance. Agencies have also delivered food and water to people inside Gaza. The UN estimated in November 2023 that the Gaza population required at least 500 humanitarian aid trucks every day, a need that is estimated to have doubled recently, given the prolonged attacks, destruction, and interruption of adequate aid distribution. At the same time, UN OCHA report that the response capacity is hindered by damaged roads, delays at checkpoints \u2018security risks, mobility constraints, delays, denials and a constant risk of distribution in a conflict zone where aid workers have been killed and some convoys shot at.   \r\n\r\nThe current situation worsens a health system already weakened by the 16-year-long blockade of Gaza prior to October 7, with restrictions since 2007 at Israel-controlled crossing points of supplies and services, and on access to medical care outside Gaza. Already by 2020, a UN Special Rapporteur described the impact of this blockade as having turned Gaza \u201cfrom a low-income society with modest but growing export ties to the regional and international economy to an impoverished ghetto with a decimated economy and a collapsing social service system\u201d.\r\n\r\nThe long-term and immediate situation signals that despite the global treaties protecting health, healthcare and human dignity in conflict zones, we do not yet have the measures to operationalise them before significant harm occurs. In December, 2023 WHO\u2019s Executive Board adopted by consensus a draft resolution on \u201cHealth Conditions in the Occupied Palestinian Territory\u201d calling for \u201cimmediate, sustained and unimpeded passage of humanitarian relief, including the access of medical personnel,\u201d and for \u201call parties to armed conflict to comply fully with the obligations applicable to them under international humanitarian law related to the protection of civilians in armed conflict and medical personnel.\u201d The consensus adoption was noted to reflect \u2018the importance of health as a universal priority, in all circumstances, and the role of healthcare and humanitarianism in building bridges to peace, even in the most difficult of situations\u2019.  \r\n\r\nThe efforts of UN and other agency personnel to deliver support and the WHO reports and engagement in various forums have been important and valued, including to document and report violations. The recent South African Case at the International Court of Justice (ICJ) has triggered provisional legal measures to protect access to adequate food and water; medical care; hygiene; sanitation; and other forms of humanitarian relief.  Israel asserted at the ICJ that it is eager to expand humanitarian aid to the fullest extent of its capacity; and to support rather than interfere with the work of medical personnel. However, attacks on and deaths of civilians have continued since the ICJ hearing at a rate of 145 people per day. On 17 January, the Jordanian field hospital in Khan Yunis was targeted during an Israeli bombing, injuring one of the health crews and a person receiving treatment in the intensive care unit; and lighting bombs were dropped over the Nasser Medical Complex in Khan Yunis. \r\n\r\nThe most obvious measure for Gaza\u2019s health system and population is that called for by the UN Secretary General, the WHO and other UN agencies and countries, an immediate \u2018humanitarian\u2019 ceasefire and work to stop the war, safely provide humanitarian relief and rebuild key infrastructure and services. As WHO Director-General Dr Tedros Adhanom Ghebreyesus said on the adoption of the WHO Executive Board resolution \u201cWithout a ceasefire, there is no peace. And without peace, there is no health.\u201d \r\n\r\nHowever, we should not stop there. International norms are now easier to monitor globally, and within regions and countries, so lack of information cannot be a cause of inaction. However, it appears that we may draw little comfort from the specific protection of civilian health, health services and health workers in conflict zones in international conventions, if they can be breached over a sustained period with impunity, and without resolution, including from a paralysed response to human security at the level of the UN Security Council.  Responses are rightly now preoccupied with ending the immediate traumas. But the situation in Gaza also sends a strong signal that, in moving forward, we must proactively strengthen the domestic and regional policy articulation of and preparedness to apply international norms on protection of health and health care in conflict in all regions globally. We need to profile and strengthen the level and speed of response of the national and international systems that ensure compliance with these norms, and where needed penalty and remedy for breaches, when this concerns access to health services, humanitarian activities and protection of the wounded and sick in conflict zones. ","php":"","field_issue_date":"2024-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"2023 Public Health Association of South Africa Conference","field_subtitle":"10 \u2013 13 September in Qheberha, Eastern Cape, South Africa","URL":"https://phasa.samrc.ac.za/about.html","body":"The Public Health Association of South Africa (PHASA) hosts an annual conference, with the aim of engaging public health practitioners from around the country, region and world to share their experiences and research, discuss topical public health issues, and mentor public health students and young researchers. This year it will be from 10 \u2013 13 September in Qheberha, Eastern Cape. The theme is, Transforming Research Translation, Reimagining Public Health Evidence, Policies and Practice. The 2023 conference will engage with the most recent public health research and evidence, rethinking current models of research translation, identifying barriers and opportunities for change, and exploring new strategies for knowledge exchange and dissemination","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A CALL FOR APPLICANTS: Online capacity building on health impact assessment in east and southern Africa","field_subtitle":"Call closes 5pm Southern Africa time October 6 2023","URL":"http://www.equinetafrica.org/content/grants","body":"Health impact assessment (HIA) is a structured process that helps to identify where changes to project design or operation provide health benefits and mitigate health risks, While HIA is being more widely practiced, in ESA countries HIA is sometimes implemented in a more limited manner as a part of environmental impact assessment. The lack of a specific process and legal requirement for HIA leaves the region with inadequate capacities, practice and evidence on health impacts of policies and activities, at a time when new health challenges, changes in trade policy and production systems make it even more necessary. EQUINET is thus, in association with regional and international partners, convening training in 12 online sessions in February to May 2024, including mentored case work to build HIA capacities in different actors in ESA countries. The course is being held free of any fee cost for participants. Applicants for the call should be from an ESA country, should be from state, non- state, labour, professional or academic institutions, and have roles in or an intention to implement HIA. We encourage applicants to apply as a team of up to 4 people from these groups from a country or setting, but will also consider individual applicants and if selected include them  within the teams for their country. Further information is available on the EQUINET website, including the information applicants for the call are asked to provide before the closing date. Applicants will be informed of the outcome of their application before or by 1 November 2023 and be provided with further course information and materials.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"A conceptual framework for healthy urban systems for food and waste management in ESA countries","field_subtitle":"Urban health community of practice: EQUINET, Harare, 2023","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20conceptual%20framework%20for%20UH%20food%20and%20waste%20systems.pdf","body":"Food and waste management systems are key entry points to foster innovation, collaboration, accountability, literacy and system-wide change to support healthy people, healthy ecosystems (including green spaces, energy and water) and an inclusive, productive, regenerative and circular urban economy. This document outlines a conceptual framework and features of key elements for urban systems to achieve this, organised within 5 key areas for such systems to provide affordable, safe, nutritious foods in healthy urban food neighbourhoods and green spaces, in ways that respect and protect ecosystems and provide an inclusive, poverty-reducing and equity oriented circular economy, that reduces, recycles and reuses urban food and other waste to support other needs and benefits, including for water, energy and green spaces. This framework is being applied in ongoing case studies and work in EQUINET.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Africa\u2019s High Cancer Deaths Can Be Addressed by Improved Access to Key Medicines","field_subtitle":"Cullinan K: Health Policy Watch, 2023","URL":"https://tinyurl.com/599a2djc","body":"Africa has one of the highest cancer death rates in the world, yet this could be markedly improved by better access to treatments already widely available in high-income countries for the continent\u2019s biggest killers \u2013 breast, cervical, lung and prostate cancers and Kaposi sarcoma. This is according to a recent study by the Botswana-Rutgers Partnership for Health, which researched which cancer treatments that are effective in other regions could have an impact in sub-Saharan Africa (SSA) \u2013 but are not available or hard to get. The partnership propose a framework for how to improve access to the life-saving and life-altering medications that are proven to work that are available elsewhere but not in Africa. While cost-effectiveness concerns are noted to be important in realistically increasing availability of a broad range of oncology drug therapies in SSA, they propose advancing therapeutics would reduce the significantly high case-fatality rates from cancer in SSA as a global imperative, combined with investment in diagnostic and laboratory infrastructure and in the oncology workforce.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Anti-gay law erodes Uganda\u2019s gains in HIV fight \u00adPEPFAR chief","field_subtitle":"Nantume G: Monitor, Uganda, 2023","URL":"https://tinyurl.com/mpdkud5k","body":"This article summarises points made In July 2023, by Amb Dr. John Nkengasong, the US Global AIDS Coordinator and Special Representative for Global Health Diplomacy, addressing African journalists in Washington DC on the gains of PEPFAR. He noted that the recent signing of the Anti-Homosexuality Act 2023 means that Uganda stands to lose funding of about $400 million from PEPFAR as annual support to HIV/Aids care and treatment.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Artificial intelligence for global health: cautious optimism with safeguards","field_subtitle":"Pujari S, Reis A, Zhao Y, et al: Bulletin of the World Health Organisation 101:6, 364\u2013364A, 2023","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225938/","body":"The United Nations Secretary-General has stated that the safe deployment of new technologies, including artificial intelligence (AI), can help the world to achieve the sustainable development goals. Large language models generate responses that can appear authoritative and plausible to an end-user; however, without adequate controls in place, the veracity and accuracy of responses may be extremely poor. These models may be trained on data for which explicit consent may not have been provided, and they may not protect sensitive data (including health data) that users voluntarily feed into the AI-based tool. AI tools are increasingly being applied to public health priorities, and have the potential to assist with pattern recognition and classification problems in medicine \u2013 for example, early detection of disease, diagnosis and medical decision-making. For any beneficial impact, especially in low- and middle-income countries, ethical considerations, regulations, standards and governance mechanisms must be placed at the centre of the design, development and deployment of AI -based systems, with oversight by governments and their appropriate regulatory agencies. WHO has published guidance on Ethics and governance of AI for health, and has convened an expert group to develop additional guidance. The authors call for a multiagency global initiative on AI for health to improve coordination, leverage collective agency, and ensure that the evolution of AI steers away from a dystopian future towards one that is safe, secure, trustworthy and equitable.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Artificial intelligence in our health systems \u2013 who really needs it?","field_subtitle":"Bona Chitah, University of Zambia, Lusaka","body":"\r\nMedia and discourse is full of statements that artificial intelligence (AI) is here to stay. While less commonly discussed, when AI is linked to health and health care, optimism is expressed that it will be a positive development, offering new diagnostic capabilities and care, helping to organise services, supporting patient adherence to treatment and performing administrative tasks. But is this really the case?  Is this really the technology that will, as it claims, promote healthy lifestyles, prevent disease and support care from primary health care to complex curative care? \r\n\r\nThe total global AI market size was valued at USd454 billion in 2022. In relation to AI in the health sector, the global market value is currently estimated at USd120 million, but is projected to rise to between USd200 billion and USd1.5 trillion by 2030. While still projections to be tested, these estimates suggest AI growth in health care could be one of its fastest growing markets.\r\n\r\nWhile AI is already prevalent and used in many aspects of business and society, its use in health care is already being debated, for a range of reasons. This is a debate that we should be informed and ahead of and not simply reactive to in our region. \r\n\r\nFirstly there is the issue of its relevance and application. Health systems in different parts of the world face different population health challenges, with varying needs and levels and types of resources to meet them. While public health profiles are in transition towards greater chronic disease and ageing populations, there is still diversity in demographic and health conditions.  Health system approaches are thus not homogeneous, including in terms of what is relevant for their design and their integration of technologies and interventions. Using AI may have relevance for precision spotting of malignant tumours in high income countries, but may be viewed as a less relevant technology or use of resources for the common population health profiles and public health needs of low and middle income countries. Even in higher income settings, while AI diagnostic systems have been tested since the 1970s, they have largely not been adopted for clinical practice as they did not outperform human diagnosticians, nor fit well in workflows. \r\n\r\nSecondly, there is a question of who controls the technology innovation and how equitable its diffusion is. While smartphone and information technology innovations are expanding in Africa, as witnessed by the range of innovations produced on the continent during the COVID-19 pandemic, the gap between low and high income countries in AI technology innovation is vast, with challenges in catching up with capacities for local innovation and production of the technology. This may raise the same investment, intellectual property and infrastructure barriers faced with advancing local production of other health technologies. If these barriers are not addressed, integration of AI may raise areas of technology dependency, limiting relevant innovation and use in settings of high health need. \r\n\r\nThirdly, there are ethical issues in applying AI in health systems, including issues of accountability, transparency, permission and privacy. What personal data and processes will AI be applied to, at what cost, and who will access this data? As experiences from COVID-19 showed, technology expanded but social factors played a key role in its uptake. Debates emerged during the pandemic on who controlled the various forms of digital monitoring used to gather and use data, such as for travel or access to services, and what support or benefit was triggered by data collected in these applications. These debates would be equally relevant to the wider use of AI. Who guarantees access and availability, including in contexts of inequity in digital access, and with what measures for permission and privacy? \r\n\r\nFourthly, and related to all of the others, there are emerging pronouncements by experts that the extremely rapid development of AI and expansion of its use should be halted, significantly slowed or better assessed and guided, given concerns on the lack guarantee of the safety of the technology. Most countries, including those in our region, still have limited or no legal provisions ensuring AI safety and ethics in areas where its use may bring public harm, such as in use of false or unexpected outcomes, in amplifying social bias and economic inequality, breaching privacy, displacing jobs or in the loss of human connection. What needs to be put in place first to ensure better guidance and control? \r\n\r\nHealth systems have a duty to provide the functions and services to ensure health outcomes that are socially defined as acceptable, considering population health needs. In our region, priorities are weighted towards conditions and programmes like immunisation, maternal, new-born and child health, adolescent and reproductive health, control of infectious disease and prevention and management of chronic disease. The primary health care (PHC) services for these interventions are under-resourced, but not complex.  \r\n\r\nAI may be argued to play a role in the region in population health; in supporting in person contacts, such as by community health workers; in telemedicine, or in data storage and retrieval systems. However, for its relevance in east and southern Africa, AI needs to have observable benefit for PHC as the entry point into the health system, for frontline health workers who support the systems equitable functioning, and for those communities with highest health need. AI needs to be assessed for and visibly demonstrate whether it can strengthen quality and reduce inequities in our health system. Using it would also need to address the issues noted earlier, including relevance, sustainable operation; data privacy, ethical practice, ownership and control of the technology; trust and regulation, with duties and standards for monitoring and assessing impact, including on equity and the distribution of benefit. \r\n\r\nThese measures call for regulation. But drafting law and policy on AI requires public consultation, which in turn requires significantly greater public and professional literacy on AI-related issues than is currently the case. The issues raised need informed debate. Questions should be asked, including why, when the labour force and social capacities in our region are growing, we shouldn\u2019t rather invest in them than replace them with AI? Who really needs it?\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Batswana say citizens and government must act to protect the environment","field_subtitle":"Amouzou M: Afrobarometer Dispatch No. 669, Botswana, 2023","URL":"https://tinyurl.com/ye259ekk","body":"A special survey module included in the Afrobarometer Round 9 questionnaire explored citizens\u2019 experiences and perceptions of pollution, environmental governance, and natural resource extraction. It showed that a majority of Batswana see pollution as a serious problem in their communities, with inadequate trash disposal as the most serious offender. They believe that ordinary citizens must assume primary responsibility for reducing pollution and keeping their communities clean, but they also expect \u201cmuch more\u201d from the government to protect the environment \u2013 including tighter regulation of natural resource extraction.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Brief from the webinar: Climate justice and the right to health and wellbeing","field_subtitle":"EQUINET, CEHURD, TARSC: August, 2023, EQUINET, Harare","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20CEHURD%20Climate%20and%20rights%20Webinar%202023.pdf","body":"In 2023 \u2013 24 EQUINET is organising a series of online dialogues to share knowledge and perspectives from community/local, national and international level on the impact of climate trends, the intersect with the other drivers/ determinants of inequity, the implications for policy and action that links climate to health equity and vice versa, and the . proposals for policy, practice, research, and action. This brief reports on the issues raised in the first webinar in the series on climate justice and health rights, convened by the Center for Health, Human Rights and Development (CEHURD), and EQUINET steering committee member. The full webinar is available on the EQUINET site. This brief summarises key points raised by speakers and participants on how climate features are impacting on the right to health; the actions that need to be taken to address these issues at local, national and regional level and in international/ global level processes and forums from a regional lens; and issues raised to be further discussed in the other thematic webinars. The brief is shared to draw further comment and input on the issue.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Call for papers on health systems in a new journal","field_subtitle":"Editors: Social Science and Medicine \u2013 Health Systems, 2023","URL":"https://www.sciencedirect.com/journal/ssm-health-systems","body":"SSM - Health Systems is a new open access journal, edited by Sally Theobald (Liverpool School of Tropical Medicine, UK) and John Ataguba (University of Manitoba, Canada). The journal specialises in publishing interdisciplinary social science research that focuses on improving health systems and resources, broadly defined to include health systems and social care and support systems that impact on health and well-being of populations around the world. The journal is inviting submissions and waiving all article publishing charges until 31 December 2023. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Climate change and health risks in Mukuru informal settlement in Nairobi, Kenya \u2013 knowledge, attitudes and practices among residents","field_subtitle":"Andersen J, Kallestrup P, Karekezi C, et al: BMC Public Health 23: 393, 1-12, 2023","URL":"https://tinyurl.com/y4mmaksm","body":"This study investigated how inhabitants of an informal settlement in Sub-Saharan Africa (SSA) experience climate change and its health impacts and related knowledge, attitudes and practices. The study was conducted in Mukuru informal settlement in Nairobi City County, Kenya in September 2021 using a structured questionnaire. Out of 402 study participants, 76% had heard of climate change before the interview, 91% reported that climate change was affecting their community, and 93% were concerned with the health-related impact of climate change. Having lived in Mukuru for more than 10\u2009years and living in a dwelling close to the riverside were factors significantly associated with having heard of climate change before and experiencing a climate change related impact on the community. Chronic respiratory conditions, vector-borne diseases, including diarrhoea, malnutrition and cardiovascular diseases were identified by respondents as climate related health risks. Most respondents were knowledgeable about climate change and were experiencing its impact on their community. This study provides insights for policy makers, planners and researchers to work on locally adapted mitigation and adaption strategies.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Household Poverty"}},{"node":{"title":"Common but Differentiated Responsibilities: The Equity Principle Guiding Climate Change, and the Reforms for Pandemic Prevention, Preparedness & Response ","field_subtitle":"Tcholakov Y: Geneva Health Files, Switzerland, 2023","URL":"https://tinyurl.com/3b3tjbch","body":"While low and middle income countries have called for the principle of Common but Differentiated Responsibilities (CBDR) to be embedded to meet equity objectives in the on-going global health negotiations on climate change and pandemic preparedness, drawing on environmental policies, they face resistance from other countries. The author suggests two possible scenarios ahead: In the first, the CBDR principle is broadly accepted and implemented in a more equitable and effective pandemic response that acknowledges the differentiated capacities of nations and allocates obligations accordingly, through inclusive global health governance. In a second scenario, if the CBDR principle is rejected or adopted in a very diluted form, the author argues that the pandemic accord may struggle to meet its objectives. An uneven distribution of responsibilities could overwhelm less capable nations during health crises, leading to an inefficient and unjust response. Failure to consider the unique needs and vulnerabilities of developing countries could perpetuate existing global health inequities, diminishing the resilience of the global health system in the face of future crises and putting all populations at greater risk.  The author proposes that striving towards equity and inclusion through the careful implementation of the CBDR principle may prove vital in realising a pandemic accord capable of meeting the challenges of global health crises.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Congo\u2019s Forgotten Uranium: How the DRC was used to make the first nuclear bomb ","field_subtitle":"Audu V: The Republic, Nigeria, 2023","URL":"https://tinyurl.com/hh2kby7d","body":"On 06 August 1945, the United States dropped the world\u2019s first atomic bomb on Hiroshima, Japan during the Second World War. A large amount of uranium used in making the first atomic weaponry was sourced from the Shinkolobwe mine in the Katanga province of the DRC, mined by  workers who worked under secret contracts and low wages for the United States national security. To prevent information from leaking, Shinkolobwe was erased from maps. Misinformation was spread to make it appear that uranium was sourced from Canada, whose ores yielded 0.03% uranium while Congolese ores yielded 65% uranium. In a 2004 assessment of the mine, the United Nations found \u2018high risks of mine collapse and potential chronic exposure to ionizing radiation\u2019,  recommending that the mine remain closed, while local Congolese families are reported to believe that their history has been tarnished by the uranium exploitation and use. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Contribution of the one health approach to strengthening health security in Uganda: a case study","field_subtitle":"Bakiika H, Obuku E, Bukirwa J, et al: BMC Public Health 23:1498, 1-11, 2023","URL":"https://tinyurl.com/4pu5wk7c","body":"This study assessed the contribution of the One Health approach to strengthening health security in Uganda. A process evaluation was done between 25th September and 5th October 2020, using a mixed\u2013methods case study. Funding and implementation status from the National Action Plan for Health Security 2019\u20132023 launch in August 2019 to October 2020 was assessed with a One Health lens. Full funding was available for 36.5% of activities while 40.6% were partially funded and 22.9% were not funded at all. The majority of the activities were still in progress, whereas 8.6% were fully implemented and 14.2% were not yet done. In workforce development, several multi-sectoral trainings were conducted including the frontline public health fellowship program, the One Health fellowship and residency program, advanced field epidemiology training program, in-service veterinary trainings and 21 district One Health teams\u2019 trainings. Real Time Surveillance was achieved through incorporating animal health events reporting in the electronic integrated disease surveillance and response platform. The national and ten regional veterinary laboratories were assessed for capacity to conduct zoonotic disease diagnostics, two of which were integrated into the national specimen referral and transportation network. Multi-sectoral planning for emergency response and the actual response to prioritized zoonotic disease outbreaks was done jointly. This study demonstrates the contribution of \u2018One Health\u2019 implementation in strengthening Uganda\u2019s health security. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"COVID-19 crisis interlinkage with past pandemics and their effects on food security","field_subtitle":"Roub\u00edk H, Lo\u0161\u0165\u00e1k M, Ketuama C, et al: Globalisation and Health 19:52; 1-16, 2023","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-023-00952-7#citeas","body":"This paper explores the impacts of COVID-19 and past pandemics on food security and key strategies that could be put in place to manage these impacts on security. The coronavirus pandemic deepened disruptions in the flow of farm workers and farm operations leading to post-harvest food losses, and diets were affected. The authors recommend future responses to prevent and mitigate the effects of pandemics on food security consider inter-connected pro-active policy, program, and institutional actions.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"COVID-19 surveillance in Democratic Republic of Congo, Nigeria, Senegal and Uganda: strengths, weaknesses and key Lessons","field_subtitle":"Fawol O, Bello S, Adebowale A, et al: BMC Public Health 23:835, 1-15, 2023","URL":"https://tinyurl.com/2bu3wykv","body":"Democratic Republic of Congo (DRC), Nigeria, Senegal, and Uganda had variable COVID-19 responses. A mixed-methods observational study was conducted including desk review and key informant interviews, to document best practices, gaps, and innovations in surveillance at the national, sub-national, health facilities, and community levels, with learning synthesized across the countries. Surveillance approaches across countries included case investigation, contact tracing, community-based, laboratory-based sentinel, serological, telephone hotlines, and genomic sequencing surveillance. As the COVID-19 pandemic progressed, the health systems moved from aggressive testing and contact tracing to detect virus and triage individual contacts into quarantine and confirmed cases, isolation and clinical care. Surveillance, including case definitions, changed from contact tracing of all contacts of confirmed cases to only symptomatic contacts and travellers. All countries reported inadequate staffing, staff capacity gaps and lack of full integration of data sources. The authors recommend investments to enhance surveillance approaches and systems including decentralising surveillance to the subnational and community levels, strengthening capabilities for genomic surveillance and use of digital technologies, among others. Investing in health worker capacity, ensuring data quality and availability and improving ability to transmit surveillance data between and across multiple levels of the health care system is also noted to be critical. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Delving into the Cityscape: Transforming the connections between urban environments, social factors, and public health in Nairobi, Kenya","field_subtitle":"Oranga A, Kounkuey Design Initiative: EQUINET Photojournalism brief, Kenya, 2023 ","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/Photojournalism%20UH%20brief%20Kenya%202023.pdf","body":"Kibera, an informal settlement in Nairobi, is situated alongside Ngong River, running along its southern edge. The dam water became hazardous for consumption due to pollutants accumulated during the course of the river, spreading diseases such as malaria, typhoid and cholera, and illnesses caused by chemical effluents pumped into the river from industries. Together with New Nairobi Dam Community, Kounkuey Design Initiative (KDI) conducted a series of workshops with community members and the local administration to identify the challenges, with a series of workshops planning and designing solutions to the pressing issues they had raised, including flood protection, improved sanitation, opportunities for youth, and income generation. Planting, landscaping-driven engineering, solid waste management activities carried out from 2006 to date and improved sanitation services were coupled with community-led site operations and maintenance. The activities changes polluted unhealthy conditions into green, clean environments and improved health for community members living near the river and dam. Beyond these environment and health infrastructures, the community set up childcare services, a school feeding program, and a greenhouse for urban agriculture. The transformation demonstrates the power of co- designing solutions with communities that prioritise a combination of social, ecological, and health benefits.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Devastating harms of criminalisation laid bare by UNAIDS advisory group","field_subtitle":"Phillips H: Be in the Know, Online blog, 2023 ","URL":"https://tinyurl.com/h5mctzrp","body":"An advisory group to UNAIDS has released \u201coverwhelming and undeniable\u201d evidence on the harm that criminalisation is having on public health and the goal of ending AIDS by 2030. Criminalising certain groups, such as sex workers, gay and trans people and people who use drugs was found to be driving HIV infections and violating human rights, as a barrier to achieving the goal of ending AIDS by 2030. Their report shows a clear link between the legal status of groups most affected by HIV and the level of stigma and discrimination they experience.  The UNAIDS Reference Group on HIV and Human Rights is calling on UN member countries to work with community-led organisations to \u201cimmediately repeal or reform\u201d laws that criminalise the following things: consensual same-sex sexual conduct and the expression of gender identity, sex work and related activities, drug use and simple possession of drugs for personal use and HIV transmission and non-disclosure.  ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Effective Waste Management in a Local Food Market: The Longacres experience in Lusaka, Zambia","field_subtitle":"Phiri P, Centre for Primary Care Research: Photojournalism brief, EQUINET, 2023","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/Photojournalism%20UH%20brief%20Zambia%202023.pdf","body":"This brief describes a story of the change at Longacres. Solid waste generated in this food market is sorted at the source, separated by type and placed into designated bins, as receptacles that receive the waste. Stakeholder meetings were organised by BORDA Zambia in collaboration with the Lusaka City Council to train marketeers on how to separate waste at the source and discard it in specific bins for further processing. In 2021 BORDA Zambia met representatives from the Lusaka City Council, school authorities, marketeers and a \u2018Market Advisory Committee\u2019 of those involved and developed a shared framework for the smooth running of the pilot. A decentralised organic solid waste management treatment system and biodigester were locally designed and made, The initiative has installed a functional end-to-end chain for waste disposal and management at the market and Lusaka City Council is now planning to replicate the concept in other markets throughout Lusaka. The story of change is being shared as it could also be applied in food markets in other urban settings in the region.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis","field_subtitle":"Chen A, Waite L, Mocumbi A, et al: The Lancet Global Health 11:8; E1238-E1248, 2023","URL":"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00218-8/fulltext","body":"More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries, but we lack data on the pattern of elevated blood pressure among adolescents aged 10\u201319 years in sub-Saharan Africa. This study aimed to fill this gap, through systematic review and meta-analysis of studies published from Jan 2010, to Dec 2021. 36 studies comprising 37\u2008926 participants aged 10\u201319 years from sub-Saharan African countries were eligible. A pooled sample of 29\u2008696 adolescents informed meta-analyses of elevated blood pressure and 27\u2008155 adolescents informed meta-analyses of mean blood pressure. The reported prevalence of elevated blood pressure ranged from 0\u00b72% to 25\u00b71% of adolescents. with 13\u00b74% of male participants compared with 11\u00b79% of female participants having elevated blood pressure,  Although many low-income countries were not represented in the study, the findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. The authors observe that there is an urgent need to improve preventive heart-health programmes in the region.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Enhancing sustainable access to safe clean water and gender-sensitive sanitation services in Epworth","field_subtitle":"Ndlovu T, Civic Forum on Human Development: EQUINET Photojournalism brief, Harare, 2023 ","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/Photojournalism%20UH%20brief%20Zimbabwe%202023.pdf","body":"Epworth, a peri-urban settlement about 15 kilometres southeast of Zimbabwe's capital, Harare faces water stress and poor santiation. The Civic Forum on Human Development (CFHD) worked with Epworth households and identified with the community a priority to to build better toilets and hygiene facilities. In community-Based planning, information was gathered through a rapid assessment and focus group discussions with community members and organisations, Realising the challenges of water in Epworth, a two litre flush system was introduced as a more appropriate toilet system and pump minders trained. This process combined local technology and social processes to improve water and sanitation in a community with limited infrastructure, and water scarcity.\r\n","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 236: Artificial intelligence in our health systems \u2013 who really needs it?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Future health expenditure in the BRICS countries: a forecasting analysis for 2035","field_subtitle":"Sahoo P, Rout H, Jakovljevic M: Globalization and Health 19:49, 1-17, 2023 ","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-023-00947-4#Abs1","body":"The BRICS nations\u2019 economies are distinguishable from other emerging economies due to their rate of expansion and sheer size. Health spending in the BRICS countries (includes South Africa) has been increasing, but is still below health security needs and with high out-of-pocket spending. This study examined the health expenditure trend among the BRICS from 2000 to 2019 and made predictions with an emphasis on public, pre-paid, and out-of-pocket expenditures to 2035. Health expenditure data for 2000\u20132019 were taken from the OECD iLibrary database. Except for India and Brazil, all of the BRICS countries show a long-term increase in per capita health expenditure, most sharply rising in China, and only India\u2019s health expenditure is expected to decrease as a share of GDP. The authors suggest that BRICS countries have the potential to be important leaders in health policies. Each BRICS country has set a national pledge to the right to health and is working on health system reforms to achieve universal health coverage, and estimations of their future health expenditures may help policymakers decide how to allocate resources to achieve these goals.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Going deeper with health equity measurement: how much more can surveys reveal about inequalities in health intervention coverage and mortality in Zambia?","field_subtitle":"Blanchard A, Jacobs C, Musukuma M, et al: International Journal for Equity in Health 22:109, 1-14, 2023 ","URL":"https://tinyurl.com/52mxtxtc","body":"This study aimed to understand how much more demographic health surveys can reveal about Zambia\u2019s progress in reducing inequalities in under-five mortality rates and reproductive, maternal, newborn and child health intervention coverage, using four nationally-representative Zambia Demographic Health Surveys, comparing wealth quintiles, urban\u2010rural residence and provinces, and further using multi-tier measures including wealth deciles and double disaggregation between wealth and region. Comparing measures of inequalities over time, disaggregation with multiple socio-economic and geographic stratifiers was often valuable and provided additional insights compared to conventional measures. Wealth quintiles were sufficient in revealing mortality inequalities compared to deciles, but comparing composite coverage indices by deciles provided more nuance by showing that the poorest 10% were left behind by 2018. Examining wealth in only urban areas helped reveal closing gaps in under-five mortality and composite coverage indices between the poorest and richest quintiles. Though challenged by lower precision, wealth gaps appeared to close in every province for both mortality and composite coverage indices. Still, inequalities remained higher in provinces with worse outcomes. Multi-tier equity measures provided similarly plausible and precise estimates as conventional measures for most comparisons, except mortality among some wealth deciles, and wealth tertiles by province. This suggests that related research could readily use these multi-tier measures to gain deeper insights on inequality patterns for both health coverage and impact indicators, given sufficient samples. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health-promoting urban food systems in selected local authorities in Zimbabwe","field_subtitle":"Loewenson R, Kadungure A, Machinda T, et al: UCAZ, TARSC, Bulawayo, Chegutu, Harare, Kariba, Kwekwe, Masvingo and Victoria Falls local authorities, MoHCC, EQUINET, 2023","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/UFS%20FINAL%20Synthesis%20Zimbabwe%20May2023.pdf","body":"Evidence suggests that Zimbabwe\u2019s urban households are becoming more food insecure post-2018, including from the impact of COVID-19 and a shift to ultra-processed foods increasing food\u2013related non communicable diseases (NCDs). Case studies from seven urban local authorities (Bulawayo, Chegutu, Harare, Kariba, Kwekwe, Masvingo and Victoria Falls) in Zimbabwe point to range of initiatives underway to support healthy food systems. This synthesis report provides a structured thematic content analysis of and common findings from the seven case study reports, for wider exchange with other urban settings. Urban agriculture (UA) is being actively promoted with innovations to address local water and land constraints, including hydroponics, aquaculture; using available land in hospitals, schools and public spaces; replacing areas of waste dumping with nutrition gardens and recycling bio-waste to fertilise UA. Local technology has been developed and support provided for maize meal fortification, peanut butter processing, fish and livestock farming and vending, supported by solar energy and boreholes for more reliable inputs.These and other activities documented indicate the scope of interventions for urban food systems that could be extended to other local authorities.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Incidence of Coronavirus Disease 2019 (COVID-19) among healthcare workers during the first and second wave in the Democratic Republic of the Congo: a descriptive study","field_subtitle":"Milambo J, Ndirangu J, Mangala S, et al: BMC Infectious Diseases 23:519, 1-7, 2023","URL":"https://tinyurl.com/2p8dtmz7","body":"Healthcare workers (HCWs) are at the frontline of response to the COVID-19 pandemic. This study investigated the burden of COVID-19 among HCWs and infection prevention and control (IPC) gaps during the first to the third wave of the pandemic in a retrospective cohort study in the Democratic Republic of Congo using its National Department of Health database and a WHO questionnaire. The investigation revealed that about 32% of HCWs were infected from household contacts, 11% were infected by health care facilities, 35% were infected in the community and 22% were infected from unknown exposures. IPC performance was moderate, with lower or minimal performance on triage and screening, hand hygiene, PPE availability, waste segregation, waste disposal, sterilization, and training of HCWs. HCWs who tested positive for the COVID-19 virus was higher among frontline healthcare workers from 6 provinces of DRC. The authors recommend strategies to strengthen IPC capacity building and provide HCWs with sufficient PPE stocks and budgets to improve IPC performance and enable adherence to WHO recommendations to minimize COVID-19 transmission in HCFs, communities, and public gatherings.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Kenyan Moderators Behind ChatGPT Want Parliament To Probe OpenAI, Sama Over Exploitation","field_subtitle":"Musau D: Citizen Digital, Kenya, 2023 ","URL":"https://tinyurl.com/2s4j2392","body":"The Kenyan content moderators who built the Artificial Intelligence (AI) chatbot ChatGPT have filed a petition in parliament seeking a probe into the bot\u2019s parent company OpenAI and its local moderation partner Samasource. The Sama employees allege exploitation and underpayment during the creation of the popular chatbot and want the Kenyan government to investigate and regulate the work of tech companies operating in the country. They claim they were not properly informed of the nature of the work they would be undertaking, which involved reading and viewing material that depicted sexual and graphic violence and categorizing it accordingly so that ChatGPT's AI could learn it for purposes of its future interactions with people. All through the ChatGPT training process, the workers say they were not afforded psychosocial support and that due to the exposure to the work, they have developed severe mental illnesses including PTSD, paranoia, depression, anxiety, insomnia and sexual dysfunction. Additionally, the moderators say the contract between OpenAI and Sama was terminated abruptly, sending them home despite already suffering from severe mental illness. The moderators want parliament to enact laws regulating the outsourcing of harmful and dangerous technology work and protecting workers engaged in such work.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"New global indicator for workers\u2019 health: mortality rate from diseases attributable to selected occupational risk factors","field_subtitle":"Pega F, Al-Emam R, Cao B, et al: Bulletin of the World Health Organisation 101:6, 418\u2013430Q, 2023","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10225940/","body":"Through sustainable development goals 3 and 8 and other policies, countries have committed to protect and promote workers\u2019 health by reducing the work-related burden of disease. However, while injuries are well monitored, the World Health Organization and the International Labour Organization estimate that only 363\u2009283 (19%) of 1\u2009879\u2009890 work-related deaths globally in 2016 were due to injuries, whereas 1\u2009516\u2009607 (81%) deaths were due to diseases. To address this gap, the authors present a new global indicator: mortality rate from diseases attributable to selected occupational risk factors, by disease, risk factor, sex and age group. The authors outline the policy rationale of the indicator, describe its data sources and methods of calculation, and report and analyse the official indicator for 183 countries. They also provide examples of the use of the indicator in national workers\u2019 health monitoring systems and highlight the indicator\u2019s strengths and limitations. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"People with HIV remain at higher risk of dying from COVID-19 in the Omicron era","field_subtitle":"Alcorn K: Aidsmap, Australia, 2023","URL":"https://tinyurl.com/28uprx8w","body":"Deaths from COVID-19 have fallen much less sharply in people with HIV compared with the rest of the population since the arrival of the Omicron variant of SARS-CoV-2, the World Health Organization (WHO) reported at the 12th International AIDS Society Conference on HIV Science (IAS 2023). Data from 821331 people admitted to hospital with COVID-19 in 38 countries found that one in five people with HIV admitted to hospital with COVID-19 died during the Omicron wave compared to one in ten people without HIV.  The WHO study team say that the consistent finding that low CD4 counts increase the risk of death from COVID-19 highlights the need for intensified HIV testing and treatment initiation to reduce the risk of severe outcomes, and to give booster vaccine doses for all people living with HIV even during the less severe and low incidence SARS-CoV-2 variant waves.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Productive public space planning and design for inclusive ownership","field_subtitle":"Kounkuey Design Initiative (KDI) Kibera, Kenya, 2023","URL":"https://tinyurl.com/336j3wnf","body":"Kounkuey Design Initiative (KDI) is a non-profit design and community development organisation that partners with under- resourced communities to advance equity and activate the unrealized potential in their neighbourhoods and cities. Involving the community in the development of the Kibera Public Space Project automatically creates a sense of care for the local community, through local ownership and management. During this process, public spaces create opportunities for learning, employment, and activism for the community. That kind of contextual and human centred thinking is transferrable. The process that was developed in Kibera has now been replicated in other parts of the world, including in the USA.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Reclaiming Uganda's food system through a systemic, people-centred transformation ","field_subtitle":"Danny Gotto, Executive Director, Innovations for Development, Uganda","body":"\r\nThe intricate tapestry of Uganda's food system, woven over centuries, underwent a tectonic shift due to colonialism. The reverberations of this historical trauma continue to shape the country's food landscape, underscoring the pressing need to untangle the threads of colonization and breathe new life into an ailing system.\r\n\r\nBefore it was colonised, Uganda's land was a patchwork of kingdoms and chiefdoms, in a communal system where land wasn't just a resource, but a collective heritage. It provided fertile ground for families to cultivate food and other crops for their subsistence and to share with their communities, an arrangement steeped in tradition, reciprocity and co-existence.\r\n\r\nColonial geo-political shifts shattered this communal system. The establishment of the British Protectorate of Uganda in the 1900s changed the relationship between society, land and food. A treaty signed between the British Protectorate government and the Buganda Kingdom in 1900 segregated land into two categories: In one, over 9100 square miles of game reserves, forests, mineral-rich expanses, and water bodies were seized as \u2018Crown Land\u2019, by the Imperial British East Africa Company, and transferred in the 1930s to various private and state landholders. \r\n\r\nIn the other segment, 10000 square miles share of less fertile \u2018mailo land\u2019 was allocated as private land to the king (Kabaka) and his family, chiefs, and religious institutions, making over 1.5 million indigenous residents squatters on the land, requiring permission and having to pay taxes to live on or farm the land. Ordinary Ugandans, once stewards of their land, were thus displaced, marginalised, and impoverished. Forced migration, and violent conflicts with the colonial government intensified displacement, famine, human and livestock disease, poverty and death. \r\n\r\nLandless, indigenous people were compelled to work as poorly paid wage labour for foreign plantation owners, mostly British and Asian, producing cash crops for export, including food, coffee, cotton, tea, and cocoa. Poor wages, substandard conditions, colonial expansion wars and landlessness drove urbanisation. Those migrating to towns and cities often lived in informal settlements, in racially segregated cities, within crowded, substandard living conditions. That situation has evolved into today's unplanned, poorly-serviced areas of towns and cities. The food system also changed. The indigenous food culture, with a diet of nutritious of millet and sorghum slowly yielded to imported influences and local economic pressures. \r\n\r\nBetween 1910 and Uganda\u2019s independence in 1962, smallholder farmers who were the backbone of local food subsistence would sell to exploitative local middlemen. The meagre payments they received drove farmers towards better-paid non-food crops such as cotton, coffee, tea, and tobacco. Low investment and a fall in indigenous food production led to intermittent famines in many regions in the early 1900s. In response, the colonial government introduced fast-growing crops like cabbages and potatoes (locally referred to as \u2018Irish Potatoes\u2019 given their Irish origin) to contain famines. Urban communities increasingly depended on commercial and informal food markets, with poor food hygiene and high levels of additives in imported fast-foods exposing them to communicable and nutritional diseases.\r\n\r\nLandless people joined the struggle for Uganda\u2019s independence, seeking change to these forms of exploitation. Independence brought them political change, but limited socio-economic change. Colonially confiscated \u2018crown land\u2019 became national public land, still producing cash crops, without restoring land to or compensating original inhabitants who were displaced from their land. Despite key new constitutional political freedoms, a priority for development over decolonisation, and adoption of a neoliberal economic model sustained inequalities in wealth and weakened economic self-determination.\r\n\r\nToday\u2019s burgeoning urban population grapples with exorbitant food prices, in commodified food markets. Food prices are affected by international commodity prices, conflicts, emergencies and pandemics like COVID-19 that destabilise food supply chains, particularly as where imported foods such as wheat or rice have supplanted local staples. Climate change compounds this vulnerability, with water-stressed regions facing challenges in producing food from rain-fed agriculture. Under-investment in largely female smallholder farmers constrains their ability to generate livelihoods or to apply technological innovation, at a time when commercial seeds demand increasingly costly synthetic fertilisers and pesticides. \r\n\r\nPolicy deficits related to food systems extend down other policy corridors. Neoliberal economic policies in the last three decades, influenced by international financial institutions, have focused on finance and export sectors, while starving the food sector. The formal private sector, pivotal in shaping the policy landscape, focuses on export-oriented production at the expense of indigenous, locally-consumed food.  Trade liberalisation has promoted a further surge in unhealthy, food imports, further disconnecting people from their indigenous dietary roots. Markets flooded with ultra-processed foods catalyse a rise in food-related non-communicable diseases (NCDs) such as hypertension and diabetes, from 22% of total national deaths a decade ago to 35% today. Kampala contributes to nearly 50% of all cases of NCDs.\r\n\r\nThe urgency to halt this trajectory cannot be overstated. Systemic transformation hinges on a multifaceted, people-centred approach towards food sovereignty. Closing knowledge and resource gaps to facilitate appropriate modern farming techniques, protecting indigenous seed stocks, and implementing inclusive land reforms are pivotal, as is recognising and supporting the role of urban agriculture. Restoring indigenous seeds, practices and foods in ways that prevent local resource depletion can make healthier, affordable foods available and accessible. Legal and tax measures can curb marketing of unhealthy foods, together with promotion of a seismic shift in public awareness to alter consumption patterns.\r\n\r\nReclaiming a healthy and self-determined food system isn't confined to Uganda's borders. \r\nThe trends outlined are found in other African countries, and the Alliance for Food Sovereignty in Africa has engaged on their global corporate drivers. A global forum on food sovereignty is bringing together thousands of indigenous, small-scale farmer, worker and other movements in a \u2018Nyeleni process\u2019 to advance food sovereignty at all levels (https://www.foodsovereignty.org/nyeleni-process/) In east and southern Africa (ESA), as noted elsewhere in this newsletter, we need to and can collaborate regionally to dismantle the colonial and neo-colonial features of our food systems and to strengthen food sovereignty, supported by updated and harmonised food system laws, taxation to discourage harmful foods and by promotion of climate-relevant healthy approaches for farming, producing, processing and promoting consumption of healthy foods. \r\n\r\nUganda stands at a pivotal juncture in its food system trajectory. The path to decolonising its food system and building food sovereignty may raise challenges. It is, however, a path that can and must be traversed, to reach a future where food is not just to survive, but a testament to self-determination.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. You can read further information on EQUINET work on issues raised in this oped on the EQUINET website. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Routine health check-ups for adolescents in Mwanza City, Tanzania: stakeholders\u2019 recommendations on its content, venue, and mode of delivery","field_subtitle":"Sedekia Y, Mshana G, Nsanya M, et al: BMC Public Health 23:1015,1-14, 2023","URL":"https://tinyurl.com/mu429ryy","body":"This study was conducted in 2020 to inform research to define the content and delivery strategies for health check-ups to be performed in young and older adolescents, and to assess whether such services are likely to be acceptable and feasible in Tanzania, using a semi-structured guide with purposively selected stakeholders from government departments, non-governmental and community-based organisations, schools and health facilities. Stakeholders interviewed were supportive of introducing routine health check-ups among adolescents and recommended focusing on non-communicable diseases, physical disabilities, common mental health problems, reproductive health problems, specific communicable diseases, and hygiene-related problems. They also recommended combining counselling and family planning information with these check-ups. Three venues were proposed: schools, community settings, and youth-friendly health facilities. The authors propose further implementation research and cost benefit analysis to help guide policy on this.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Socioeconomic and geographical inequalities in health care coverage in Mozambique: a repeated cross-sectional study of the 2015 and 2018 national surveys","field_subtitle":"Daca CSL, San Sebastian M, Arnaldo C, et al. BMC Public Health. 23:1007 https://doi.org/10.1186/s12889-023-15988-y, 2023","URL":"https://tinyurl.com/yhz3a52h","body":"Over the past years, Mozambique has implemented several initiatives to ensure equitable coverage to health care services. While there have been some achievements in health care coverage at the population level, the effects of these initiatives on social inequalities have not been analysed. This study aimed to assess changes in socioeconomic and geographical inequalities (education, wealth, region, place of residence) in health care coverage between 2015 and 2018 in Mozambique. The study was based on analysis of measures from repeated cross-sectional surveys from nationally representative  sample surveys. The non-use of insecticide-treated nets dropped, whereas the proportion of women with children who were not treated for fever and the prevalence of women who did not take the full Fansidar dose during pregnancy decreased between 2015 and 2018. The authors observed significant reductions of socioeconomic inequalities in insecticide-treated net use, but not in fever treatment of children and Fansidar prophylaxis for pregnant women. They suggest that decision-makers target underserved populations, specifically non-educated, poor people and rural women, to address inequalities in health care coverage.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Solid waste management in Slum Communities of Bwaise III Parish: Transforming Solid Waste into Valuable Resources","field_subtitle":"Gramsen Kizza F, Innovations for Development: EQUINET photojournalism brief, Kampala, 2023  ","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/Photojournalism%20brief%20Uganda2023.pdf","body":"Bwaise is an urban locality in the Kawempe Division, Kampala. The inadequate management of solid waste in Bwaise presents numerous difficulties, including sporadic flooding and outbreaks of diseases. Recognizing the need to address these challenges and the economic struggles faced by the community, the local chairpersons took the initiative to motivate the residents. They initiated training programs, facilitated through saving groups, to promote use of the waste as a resource for energy in the form of briquettes. Under the guidance of the local chairpersons, the community chose members, primarily women and youth, from different community groups. The groups promote waste collection and use the waste for briquettes used for household energy. The groups have also set up plastic waste collection centres to aid the removal of plastic waste in the communities. Fostering collaboration among all stakeholders within the communities has enabled solutions to be designed and implemented to address the challenges encountered.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Taxing for health: taxes on sugar-sweetened beverages in east and southern African countries","field_subtitle":"Kadungure A, Loewenson R: TARSC EQUINET Discussion paper 130, EQUINET, Harare 2023","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20Disss%20130%20SSB%20taxation%20July2023_0.pdf","body":"This paper explores sugar-sweetened beverage (SSB) taxes and their role in a public health response to the challenges of rising consumption of SSBs. The paper outlines the global and regional standards, guidance and areas of legal or policy debate on the control of SSB health risks, particularly through taxation; it provides evidence on the design, taxation levels and products covered in SSB taxation in different regions globally and in east and southern Africa (ESA) countries. It also discusses experiences of and issues around using SSB-related taxation for health in ESA countries. Drawing on the evidence identified, it proposes actions and issues for policy dialogue in ESA countries and in the region. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"The Economic Burden of COVID-19 Infections amongst Health Care Workers","field_subtitle":"World Bank, Resolve to Save Lives : World Bank, New York, 2023","URL":"https://www.worldbank.org/en/topic/health/publication/economic-cost-covid-health-care-workers","body":"This report  estimates the economic burden of health care worker infection and death during COVID-19 to understand the direct and indirect cost of health care worker (HCW) infections, their contributions to wider community transmissions and the economic toll of disrupted health services. The economic burden of HCW infection was heaviest in the countries that had low HCW density and were most severely affected by staff shortages. The heaviest costs were associated with secondary infections and excess maternal and child deaths. The costs of onward viral transmission outweighed those associated with direct HCW infections, ranging from 13% of total economic costs linked to HCW infections in Kenya to 70% in KwaZulu-Natal, South Africa. The burden in Kenya was estimated at almost $34,000 or 18 x GDP per capita and in Eswatini at almost $36,000 or 9 x GDP per capita. As a percentage of annual health expenditure, the total burden associated with HCW infection and death was highest in Western Cape, South Africa, at 8.4. The report demonstrates the importance of prioritizing the protection of health care workers.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The Oliver Tambo Fellowship Programme (OTFP), Faculty of Health Sciences, University of Cape Town","field_subtitle":"Registration open until 9 December 2023","URL":"https://publicaccess.uct.ac.za/psc/public/?cmd=login&errorPg=ckreq&languageCd=ENG","body":"This health leadership programme directly relates to the manager's workplace within the health system. Nominating people from the same team offers the possibility of greater impact, including across successive cohorts. The Fellowship is affiliated to the University of Cape Town and offers a unique perspective on leadership, rooted in systems thinking & policy analysis, tailored to the complex challenges of our health system. The Programme entails four sequenced and interrelated 6-day learning blocks, covering: the complex nature of health systems and their challenges, leading everyday health system strengthening, engaging health system hard- and software resources for implementing improvement, sustaining workplace-based interventions for system improvement, and mentorship during and after the course. The Programme offers direct engagement with senior health leaders, other experts with national and international insights, as well as peer leaders","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Uganda National Conference on Health, Human Rights and Development ","field_subtitle":"26th \u2013 29th September 2023 at Mestil Hotel, Kampala, Uganda","URL":"https://www.cehurd.org/healthconference23/","body":"The Ministry of Health - Uganda (MoH) and the Center for Health, Human Rights and Development (CEHURD) are organising the Uganda National Conference on Health, Human Rights and Development,  scheduled for 26th \u2013 29th September 2023 under the theme; ''The Right to Health; A vital Component in achieving SDGs''.  The conference aims to facilitate an understanding of the trends and progress made on the Right to Health in Uganda in an effort to realise SDGs and accelerate further action. The conference tracks include: Health systems strengthening, Sexual and Reproductive Health and Rights (SRHR), Health, policy and the law, Mental Health, Harm reduction and Wellness, Multi-sectoral Collaborations, and Strategic Partnerships, coalitions and Movements.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Webinar on Climate Justice and Comprehensive PHC systems in East and Southern Africa","field_subtitle":"EQUINET, REACH Trust, IWG: Online October 25th 2023 2-4pm Southern Africa time  ","URL":"https://us06web.zoom.us/meeting/register/tZcudu-ppzkpE9XyKei-9k9TS6NvVUKjIiKH","body":"Climate-related challenges affect every experience and dimension of health equity in the region. EQUINET invites you to explore this with us in a series of cross-cutting webinars in the coming months. Following webinars held on health rights and climate Justice in July and on urban health and climate justice in August the next webinar will explore the intersect between climate justice and comprehensive PHC oriented health systems in east and southern Africa on October 25th 2023 2-4pm Southern Africa time (3-5pm East Africa time).   We will hear from speakers with experience on these issues at community/local level, at national level and at global level, and provide time for participant discussions and proposals for engaging on the issues raised for the region.  Visit the link to register in advance for the meeting, providing your name, institution and contact email. ","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"What SA\u2019s dirty water does to your health","field_subtitle":"Malan M, Mdzeke Y, Moloi M: Health Beat #10,|Bhekisisa, South Africa, 2023","URL":"https://tinyurl.com/4zfec5h9","body":"A broken sewerage system in Bophelong near the Vaal River in Gauteng, forces people to live \u201clike pigs\u201d, says environmental activist Lawrence Majoro. The department of water and sanitation acknowledges the Vaal is \u201cone of the worst polluted rivers in South Africa\u201d, leaving residents exposed to diseases like cholera. In this episode of Bhekisisa\u2019s monthly television show, Health Beat, viewers are taken to see the Emfuleni municipality in Vanderbijlpark\u2019s rundown sewers, with input from an infectious diseases expert and a water scientist on the implications if water treatment services don\u2019t improve.","php":"","field_issue_date":"2023-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":" Equity dimensions in initiatives promoting urban health and wellbeing in east and southern Africa ","field_subtitle":"Loewenson R, Mhlanga G, Gotto D, et al: Frontiers in Public Health, section Public Health Policy, 11: 1-18, 2023","URL":"https://tinyurl.com/y8w63xxj","body":"Urbanisation in east and southern Africa (ESA) has brought opportunity and wealth together with multiple dimensions of deprivation. Less well documented in published literature on the ESA region are features of urban practice that promote health equity. This work thus aimed to explore features of urban initiatives aimed at improving health and wellbeing in ESA countries and their contribution to different dimensions of health equity. The paper discusses learning on local process and design features to strengthen to promote the different dimensions of equity found, and issues to address beyond the local level to support such equity-oriented urban initiatives.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"22nd edition of the International Conference on AIDS and STIs in Africa, ICASA 2023","field_subtitle":"Deadline for abstract submissions: 31 July 2023","URL":"http://icasa2023.saafrica.org/registration/key-dates.php","body":"The 22nd edition of the International Conference on AIDS and STIs in Africa (ICASA 2023) offers a space for exchange of ideas and experiences among delegates in general and key actors, in particular, to respond to the AIDS epidemic, to advocate and implement effective, evidence-based AIDS and STIs, Tuberculosis (TB), Malaria and emerging diseases interventions as well as health systems strengthening in their communities, countries and regions. ICASA 2023, through the Community Village, avails a platform for PLHIV, key populations, community leaders, and their partners to showcase their programmes, services, best practices and share experiences and network to scale-up and sustain the response towards the end of AIDS. It further creates a a forum to appreciate and exchange African arts and traditions in relation to HIV, STIs, TB and Malaria. The Community Village Programme will be released on 30th September 2023.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A closer look at urban health equity and other EQUINET developments","field_subtitle":"Editor, EQUINET newsletter","body":"Over the past few months we have begun to develop work in prioritised  areas arising from a strategic review of the drivers of health equity in our region, drawing also on the diverse and rich inputs to and resolutions from the 2022 EQUINET conference (you will find the recordings on sessions and the resolutions on our website). We welcome new institutions and individuals to the EQUINET steering committee on areas such as tax justice, addressing the health needs of young people and climate justice and thank those who are  continuing in the steering committee to lead work in areas that remain persistently relevant.  We also thank those who have steered EQUINET work over many past years who join our policy and strategy reference group. \r\n\r\nOne of the areas that is engaging diverse new constituencies is that of integrated, holistic approaches to urban health, including urban food systems. We include publications from work in this issue of the newsletter, welcome links with those working in this area and will be giving focus to it in future grant calls, so keep an eye on our website! We will also be holding a series of webinars on climate justice and health equity, integrating climate justice as an intersecting issue in the various areas of thematic work on health equity. The first webinar will be on 11th July focusing on climate justice and the right to health, hosted by CEHURD Uganda. Find more information and the registration link in the 'Latest EQUINET Updates' section in this newsletter and visit the EQUINET website for details of further forthcoming webinars and discussions!\r\n","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"A review of public health-related food laws in east and southern Africa","field_subtitle":"Kasapila W: EQUINET Discussion paper 129, EQUINET, with ECSA HC, MoHCC Zimbabwe, TARSC, Harare, 2023","URL":"https://tinyurl.com/m438k7pw","body":"Food systems have a key role in promoting health and nutrition. National constitutions in many East and southern Africa (ESA) countries provide for a right to food or adequate nutrition, and food law is increasingly important, given expanding food products, trade and risks to health. This report presents findings from a desk review of current food-related laws of 17 countries in the ESA region and international and regional standards.  In terms of key areas of food safety and risks covered, most countries include provisions for food labelling, standards for premises used for food production, storage and processing, as well as provisions prohibiting the sale of unwholesome, poisonous or adulterated food; food preparation under unsanitary conditions, inspection of food establishments, testing and recall.The laws generally include provisions for setting of standards, monitoring, inspection, food-testing and disposal of unsafe foods, and for food labelling and consumer information. Few countries have provisions for risk assessment, scientific research, testing, and labelling of novel and GMO foods. The report identifies specific legal clauses in ESA laws that may serve as useful text for law reform. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Albertina Sisulu Executive Leadership Programme in Health Fellowship, University of Pretoria","field_subtitle":"Deadline for applications: 16 October 2023","URL":"https://tinyurl.com/2zkcz2ab","body":"The Albertina Sisulu Executive Leadership Program in Health (ASELPH) is a unique collaborative program through the University of Pretoria jointly developed and initially implemented with contributions from the Harvard TH Chan School of Public Health, and the National and Provincial Departments of Health in South Africa. The Program is focussed on developing middle and senior health system managers or clinicians for the challenges of the South African health system. It covers modules in Leadership, Ethics, Strategic Planning, Health sector Transformation, Decentralization & health service re-engineering; Complex Problem Solving, Financial Management, Human Resources For Health, Quality Improvement, Strategic Marketing and Communication and Monitoring and Evaluation. Innovative teaching and learning approaches include peer learning, case study methodology, reflective learning and mentorship. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"An invitation to a webinar on Climate justice and the right to health and wellbeing","field_subtitle":"Tuesday 11 July, 2023 11:00-1300 East African time 10.00-12.00 Southern African time","URL":"https://us06web.zoom.us/meeting/register/tZcuc-mgrzoqGtySu4EZkNZRqKfNH0_Uirkt","body":"Climate-related challenges affect every experience and dimension of health equity in the region. EQUINET invites you to explore this with us in a series of cross-cutting webinars in the coming months. In the first we ask, how do issues of climate justice intersect with constitutional and legal protection of health rights? What issues, advocacy and actions does this raise for the region? The Center for Health, Human Rights and Development (CEHURD), lead for the work on legal protection of the right to health in EQUINET is convening this first webinar with speakers from community, national and international level. The webinar will invite participant input and discussion during the webinar. Register now in advance to receive a confirmation email with further information on the meeting and your link to join.  And watch the EQUINET website for the forthcoming webinars in the series!\r\n","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Case study on health-promoting urban food systems in Bulawayo","field_subtitle":"City of Bulawayo, Urban Councils Association of Zimbabwe (UCAZ), Training and Research Support Centre (TARSC): EQUINET, 2023","URL":"https://tinyurl.com/499hprv8","body":"UCAZ and TARSC in EQUINET with review input from Ministry of Health and Child Care (implemented work in 2022-23 to gather and share evidence on initiatives underway in Zimbabwean cities/ towns to promote healthy food systems, to share and promote uptake of promising practice. Bulawayo is one of the urban case studies, using a collectively developed shared framework. Dietary diversity in Bulawayo was higher than the national average in 2018. The major foods consumed, as for the rest of the country, are maize and vegetables, with access to food dependent on household socio-economic features. Bulawayo residents engage in peri-urban and urban agriculture in residential stands, in peri-urban plots and on available vacant land.  Modernisation has, however, changed diets in the city, with a shift towards processed foods. The lack of legislation controlling production and marketing of these foods hampers efforts to promote healthy diets. Various interventions are underway to promote health in the city\u2019s food system, including providing an enabling environment for urban agriculture; promoting consumption of unprocessed foods and healthy diets; fortifying staple foods to provide micro nutrients to under-five year old children and their mothers, and inspecting foods to prevent falsification and adulteration. These and other areas of practice are described in the case study. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Case study on health-promoting urban food systems in Chegutu","field_subtitle":"Chegutu Municipality, Urban Councils Association of Zimbabwe (UCAZ), Training and Research Support Centre (TARSC): EQUINET, 2023","URL":"https://tinyurl.com/mr3h3mns","body":"UCAZ and TARSC in EQUINET with review input from Ministry of Health and Child Care (implemented work in 2022-23 to gather and share evidence on initiatives underway in Zimbabwean cities/ towns to promote healthy food systems, to share and promote uptake of promising practice. Chegutu is one of the urban case studies, using a collectively developed shared framework. In 2018, nearly half (49%) of Chegutu\u2019s urban population was food insecure, compared to the national urban average of 37%, and compared to 31% in 2016. The situation was worsened by the impact of COVID-19, with lockdowns and interrupted economic activities undermining urban household access food and basic services. The local authority with partners has implemented an Urban Resilience Building Program, where community members were capacitated with startup and skills training in sustainable livelihood value chains in agriculture and nutrition, water and sanitation, and in financial literacy and social protection. Two areas of food systems, poultry production and peanut butter processing, implemented by the Shasha Community Group are detailed in this case study, with other initiatives on the food system. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Case study on health-promoting urban food systems in Harare","field_subtitle":"Harare City Council, Urban Councils Association of Zimbabwe (UCAZ), Training and Research Support Centre (TARSC): EQUINET, 2023","URL":"https://tinyurl.com/ycknevxc","body":"UCAZ and TARSC in EQUINET with review input from Ministry of Health and Child Care (implemented work in 2022-23 to gather and share evidence on initiatives underway in Zimbabwean cities/ towns to promote healthy food systems, to share and promote uptake of promising practice. Harare is one of the urban case studies, using a collectively developed shared framework. In Harare city 13.7 % of children under 18 years are poor, and 2,2% food poor, living in households that are below the poverty datum line  The city\u2019s food supply comes from food industries located in the city and other urban areas of Zimbabwe, and food imported from other countries. Fresh fruits and vegetables are mostly obtained from the people\u2019s markets, shops, hawkers, unlicensed vendors and from production in resident\u2019s back yards for home consumption and sometimes for sale to supplement incomes. The City Health Department\u2019s Environmental Health Division conducts regular monitoring to ensure the food sold to the Harare public is safe,  from the planning stage of buildings where food will be handled, through to food handlers, informal food vendors and food business operators. Community Services officers and agricultural extension (Agritex) officers train women groups in high density areas of the city on food-related skills, including cooking, baking, fish farming and mushroom growing. The city convenes competitions involving preparation and cooking of traditional foods by women from the community groups. A range of traditional foods and dishes are showcased, including boiled roundnuts, peanuts, cowpeas, whole maize grain (mutakura in Shona), and dried vegetables (mufushwa) with peanut butter.   The case study outlines these and other practices in the city.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Case study on health-promoting urban food systems in Kariba","field_subtitle":"Kariba Municipality, Urban Councils Association of Zimbabwe (UCAZ), Training and Research Support Centre (TARSC): EQUINET 2023","URL":"https://tinyurl.com/2p9ca8rp","body":"UCAZ, TARSC in EQUINET, with review input from Ministry of Health and Child Care (MoHCC) implemented work in 2022-23 to gather and share evidence on initiatives underway in Zimbabwean cities/ towns to promote healthy food systems. Kariba is one of the urban case studies, using a collectively developed shared framework. Kariba is a small tourist resort town in north-eastern Zimbabwe near the border with Zambia and is located in a National Parks area. The town was initially developed to house workers involved in the construction of Lake Kariba on the Zambezi River for hydro-electricity generation. Most of the food consumed in Kariba town is sourced from far away as farming around the town is not viable because of wildlife. Kariba town is located on a border, raising the challenge of managing cross-border trade and food imports. While there are challenges to urban agriculture and local food processing in Kariba, noted earlier, there are also a number of initiatives to promote health food options in the town, including aquaculture, hydroponics, and recycling of bio-waste to support urban agriculture. The Municipality is also represented in cross-border dialogue mechanisms, such as a Technical Committee between Zimbabwe and Zambia on Kapenta fishing in Lake Kariba. This case study outlines the various processes underway.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Case study on health-promoting urban food systems in Kwekwe","field_subtitle":"Kwekwe City Council, Urban Councils Association of Zimbabwe (UCAZ), Training and Research Support Centre (TARSC): EQUINET, 2023","URL":"https://tinyurl.com/2uzry3pu","body":"UCAZ and TARSC in EQUINET with review input from Ministry of Health and Child Care (implemented work in 2022-23 to gather and share evidence on initiatives underway in Zimbabwean cities/ towns to promote healthy food systems, to share and promote uptake of promising practice. Kwekwe is one of the urban case studies, using a collectively developed shared framework. Kwekwe city in Zimbabwe\u2019s Midlands region is in a mining and industrial area. Over half of the city population are self-employed in the informal economy, with activities including open food preparation and sale, vending farm produce, and grocery tuck shops. Kwekwe City Council has made several urban food system interventions described in this case study, including constructing farm produce/vegetable markets in over 15 locations in the city. In 2010, Council entered into a public-private \u2018build-own-operate-transfer\u2019 (BOOT) partnership with a local company to build shops to accommodate small to medium businesses, including for food vending and processing. The city health department established an environmental health post in 2021 to monitor and ensure food hygiene and health standards, and has set enabling legislation for this.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Case study on health-promoting urban food systems in Masvingo","field_subtitle":"City of Masvingo, Urban Councils Association of Zimbabwe (UCAZ), Training and Research Support Centre (TARSC): EQUINET, 2023","URL":"https://tinyurl.com/ws8cp266","body":"UCAZ and TARSC in EQUINET with review input from Ministry of Health and Child Care  implemented work in 2022-23 to gather and share evidence on initiatives underway in Zimbabwean cities/ towns to promote healthy food systems, to share and promote uptake of promising practice. Masvingo is one of the urban case studies, using a collectively developed shared framework. Masvingo is one of the oldest cities in Zimbabwe. Food security in Masvingo city, as for the wider country, has been affected by drought, economic challenges and household poverty, with the COVID-19 pandemic adding to this. Ultra-processed foods such as sweetened drinks, crisps, sweets, and other foods containing high levels of sugar, fats, salt and additives are mainly imported into the city.  The city identifies urban agriculture as one of the important livelihood strategies for many urban residents and a method for alleviating poverty and improving household food security.  To facilitate multi-sectoral broad-based collaborative approaches, the local authority identified open spaces to be used for agricultural purposes, and set aside land for this within the city.  The council is implementing the various activities outlined in this case study brief, making resources such as land available for urban agriculture, engaging non-state agencies to collaborate on infrastructure for initiatives, and community members to collaborate on interventions. Having a Council policy helps to align different actors and personnel.  ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Climate change and health risks in Mukuru informal settlement in Nairobi, Kenya knowledge, attitudes and practices among residents","field_subtitle":"Andersen JG, Kallestrup P, Karekezi C  et al. BMC Public Health 23:393;1-12, 2023 ","URL":"https://tinyurl.com/4huhb2ej","body":"This study investigated how inhabitants of Mukuru informal settlement in Nairobi, Kenya in 2021 experienced climate change and its health impacts, and assessed related knowledge, attitudes and practices, using a cross-sectional study. Out of 402 study participants, 76% had heard of climate change before the interview, 91% reported that climate change was affecting their community, and 93% were concerned with the health-related impact of climate change. Having lived in Mukuru for more than 10\u2009years and living in a dwelling close to the riverside were factors significantly associated with experiencing a climate change related impact, including chronic respiratory conditions, vector-borne diseases, infectious diarrhoea, malnutrition and cardiovascular disease. With most respondents knowledgeable about climate change and experiencing its impact, the authors propose that policy makers, planners and researchers to work locally with affected communities on mitigation and adaption strategies.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Concurrence of water and food insecurities, 25 low- and middle-income countries","field_subtitle":"Young SL, Bethancourt HJ, Frongillo EA et al: Bulletin of the World Health Organisation 101:2;90\u2013101, 2023 ","URL":"https://tinyurl.com/bdee2rm9","body":"This study investigated how water and food insecurity were associated in nationally representative samples of individuals from 25 low- and middle-income countries, using data from the Individual Water Insecurity Experiences Scale and the Food Insecurity Experience Scale administered to 31\u2009755 respondents, measuring insecurity in the previous 12 months.  The likelihood of experiencing moderate-to-severe food insecurity was higher among respondents also experiencing water insecurity, including in sub-Saharan Africa. The results suggest that water insecurity should be considered when developing food and nutrition policies and interventions and the authors propose research to understand the paths between these insecurities.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Conflict of Interest in health research \u2013 how do we find the green light for ethical practice?","field_subtitle":"Leslie London, University of Cape Town, South Africa","body":"\r\nResearch is key to promoting and health and preventing disease to the extent that international human rights law recognises the right of everyone to benefit from scientific progress. But what if health research is subverted from its aim by the presence of conflict of interest? \r\n\r\nWe have already seen this, such as in how some researchers failed to disclose their conflicts of interest when producing research that downplayed the health hazards of chrysotile asbestos (https://tinyurl.com/52hpah2p), findings that allowed this toxin and the asbestos industry an extended shelf-life at the expense of human lives. \r\n\r\nThe gatekeepers of ethical research are institutions \u2013 typically, science granting councils which allocate research funding and shape science policy at country level, and Research Ethics Committees (RECs), which provide oversight to ensure that health research is implemented in line with generally accepted ethical standards.\r\n\r\nBut in a context of scarce resources for health research, even these institutions can fail, when research funding provided by corporations, or sometimes even governments, with vested interests compromises the independence of the research process, producing research findings that undermine evidence-based policy. A 2020 study of the willingness of Schools of Public Health in the African, Eastern Mediterranean, European and US regions found widespread openness amongst respondents to the idea of accepting funding from corporate sources with vested interests in research on non-communicable diseases (https://tinyurl.com/nmpxcxwd). This is not surprising, given the pressures under which low-income country researchers operate, often with little or no research funding, in contrast to the immense power and financial resources available to corporates wishing to influence health policy to protect their profits. \r\n\r\nEven the most powerful Science Councils can fall prey to conflict of interest. This was illustrated, for example, when the collusion was exposed between officials of the US National Institute of Health, contrary to NIH policy, and representatives of the alcohol beverage industry, in setting up a huge study of moderate alcohol consumption, called the MACH study. The study was plagued by questionable design and by a clear vested interest in choosing a research question that was likely to benefit industry sales, rather than generating evidence pertinent for health policy (https://tinyurl.com/ak57wdj2). \r\n\r\nEmpowering Science Council staff and REC members with the skills to identify, obviate and manage conflict of interest effectively is thus essential if health research is to realise the benefits of scientific progress for people most in need. This is particularly the case in sub-Saharan Africa, where research systems are fragile and starved of the resources needed to ensure researcher independence. \r\n\r\nConflict of interest (COI) is defined as circumstances in which professional judgment concerning a primary interest (such the validity of research) tend to be unduly influenced by a secondary interest (such as financial gain). It can be effectively addressed if systems are designed to insulate decision-making processes from vested interests, and to protect researcher independence, objectivity and impartiality. This is possible if the people in those systems can gain skills to manage COI better. This applies as much to research as to broader policy making, which may also be heavily influenced by corporate activities and strategies.\r\n\r\nA collaborative initiative, funded by the IDRC, and involving researchers from South Africa, Kenya, Cameroon and Lebanon, developed over two years, an online course (https://tinyurl.com/dp9madje) and a toolkit (https://tinyurl.com/c742bb63) that aimed to empower REC members and Science Council staff to better manage COI in the research process. These resources are open access and available to all interested in improving the integrity of evidence used in health policy decisions. \r\n\r\nThe toolkit offers examples of how to identify and manage COI, ranging from prohibition and disclosure through to mitigation or resolution. It emphasizes that reliance on disclosure alone is insufficient. It may be counter-productive if it legitimises any kind of COI, including COIs that, in a traffic light analogy, should trigger red lights.  \r\n\r\nThe toolkit outlines three scenarios. The first is where \u2018moral certainty\u2019 exists that that the research should not proceed, such as when the funding source is an organisation whose products are harmful and where the organisation holds a direct interest in the outcome of the research, as in the example of tobacco industry funding for tobacco-related research. In the second scenario, such as when the funding source has no interest in the study outcome and does not produce commodities harmful to health, it is also easy to conclude the study should proceed. \r\n\r\nBut usually, it is a third scenario where there is uncertainty on the interests. \r\n\r\nIn this situation, the toolkit proposes a series of key questions that could be used to identify COI and characterise its scope. Such questions include whether anyone on the REC or science council will benefit financially from the research, whether a financial loss will be avoided if the research is approved, or whether the research serves a marketing purpose for the funder. Depending on the case, different strategies may be applied. The strategies include recusal of a committee member or science council employee who has direct interest in the outcome of the decision, barring a funder from any say in publication decisions, or mandating an independent oversight committee to monitor study implementation. The toolkit also maps the elements of policy that institutions might adopt to manage COI more effectively. Coupled with skills development, such initiatives are important to finding the right balance between diversifying funding and retaining independence of the research process.\r\n\r\nTo continue the traffic light analogy, finding the green light for health research is the ultimate goal. But much of what we encounter in practice is amber. It is located in that space where careful reasoning, drawing on ethical principles is needed to ensure that health research findings can provide the necessary unbiased evidence, free from vested interests, to advance health in our region.\r\n\r\nFor further information on the Toolkit and online course visit the Conflict of Interest in Health Research website at the University of Cape Town, https://tinyurl.com/5bp4k8b7. Feedback to the team would be very welcome.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"COVID-19 surveillance in Democratic Republic of Congo, Nigeria, Senegal and Uganda: strengths, weaknesses and key lessons","field_subtitle":"Fawole O, Bello S, Adebowale A, et al: BMC Public Health 23:835;1-15, 2023 ","URL":"https://tinyurl.com/2p86wann","body":"The four countries in this mixed-methods observational and desk review study were selected based on their variability in COVID-19 response and representation of Francophone and Anglophone countries. The research documented best practices, gaps, and innovations in surveillance at the national, sub-national, health facilities, and community levels, and these learnings were synthesized across the countries. As the pandemic progressed, the health systems moved from aggressive testing and contact tracing to detect virus and triage individual contacts into quarantine and confirmed cases, isolation and clinical care. Surveillance, including case definitions, changed from contact tracing of all contacts of confirmed cases to only symptomatic contacts and travellers. All countries reported inadequate staffing, staff capacity gaps and lack of full integration of data sources, and  improved surveillance capacity by training health workers and increasing resources for laboratories, but the disease burden was still under-detected, due to limited decentralization of surveillance  at the subnational level and gaps in genomic and post-mortem surveillance, community level sero-prevalence studies, and in digital technologies to provide more timely and accurate surveillance data.  The authors call for investments to enhance surveillance approaches and systems including decentralizing surveillance to the subnational and community levels, strengthening capabilities for genomic surveillance and use of digital technologies, investing in health worker capacity, ensuring data quality and availability and improving ability to transmit surveillance data between and across multiple levels of the health care system. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Developing countries defend principle of \u2018common but differentiated responsibilities\u2019","field_subtitle":"Bozman P: Third World Resurgence 354: 19-22, 2023","URL":"https://twn.my/title2/resurgence/2023/354/cover04.htm","body":"The need to uphold the principle of \u2018common but differentiated responsibilities\u2019  (CBD) between developed and developing countries in global actions to address biodiversity and climate change was a major bone of contention at COP 15. The deadlock at COP 15 on whether or not to retain the CBD principle, which was placed in square brackets (indicating lack of consensus) throughout the evolution of the negotiating texts, stemmed from extremely divergent views between developed and developing countries, with the former refusing to accept it as a principle. The latter pointed out that it is an overarching principle enshrined in Principle 7 of the 1992 Rio Declaration on Environment and Development.  ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Drivers of child marriage in specific settings of Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia \u2013 findings from the Yes I Do baseline study","field_subtitle":"Kok M C, Kakal T, Kassegne AB, et al: BMC Public Health 23:794; 1-16, 2023","URL":"https://tinyurl.com/35vj465h","body":"This study explored the drivers of child marriage in specific contexts in Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia, combining a household survey among youth with focus group discussions and interviews conducted with youth, parents and community stakeholders. A lack of education was associated with the occurrence of child marriage in Ethiopia, Kenya and Zambia. In all countries, teenage pregnancy was associated with child marriage. In Ethiopia, Kenya and Mozambique, fathers\u2019 education seemed a protective factor for child marriage. In all countries, child marriage was driven by difficult economic circumstances, which were often intertwined with disapproved social circumstances, in particular teenage pregnancy, in case of Kenya, Malawi, Mozambique and Zambia. These circumstances made child marriage an \u2018acceptable practice\u2019. The authors found that child marriage is a manifestation of social norms, particularly related to girls\u2019 sexuality, which are intersecting with other factors at individual, social, material, and institutional level \u2013 most prominently poverty or economic constraints. The authors argue that efforts to prevent child marriage need to take these realities of girls and their families into account.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 235: Conflict of Interest in health research \u2013 how do we find the green light for ethical practice?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Expanding promising practice for sustained urban and peri-urban wellbeing in east and southern Africa","field_subtitle":"EQUINET, TARSC: Regional Workshop Report, Nairobi, Kenya, March 2023","URL":"https://tinyurl.com/4b48r8df","body":"Delegates at the EQUINET Regional Meeting on urban health in east and southern Africa noted that rising urbanization, including around extractives, with increasing commercial and climate impacts calls for us to move from single issue interventions to comprehensive, integrated, area-based approaches for urban health; and to shift from project- to process-thinking, designing for sustainability from the onset. Promising practices are taking place locally, but need to be scaled up. Scale-up is enabled when practices link social and economic benefit; when they mobilise public and institutional resources, including collective savings and innovation funds, and facilitate local technology development. Inequity in the burdens of climate change makes these multi-actor, holistic approaches even more critical, for our eyes to shift from effects to root causes, from a focus on technocrats to communities, and from reactive emergency responses to climate to sustained, integrated long term approaches.  The meeting report outlines the experiences and proposals for action raised by delegates from diverse ESA countries, levels, institutions, disciplines, skills to improve urban health in ESA countries.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Experiences of teachers and community-based health workers in addressing adolescents\u2019 sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia","field_subtitle":"Chilambe K, Mulubwa C, Zulu J, et al.: BMC Public Health 23:335:1-10, 2023","URL":"https://tinyurl.com/5as8js8d","body":"This paper explored teacher and community-based health worker experiences in addressing adolescent sexual, reproductive, health and rights (SRHR) in rural health systems in Zambia through 21 qualitative in-depth interviews. Teachers and community-based health workers mobilise the community for meetings, provide SRHR counselling services to both adolescents and guardians, and strengthen referrals to SRHR services if needed. The challenges experienced included stigmatization associated with difficult experiences such as sexual abuse and pregnancy, shyness among girls to participate when discussing SRHR in the presence of boys and myths about contraception. The suggested strategies for addressing the challenges included creating safe spaces for adolescents to discuss SRHR issues and engaging adolescents in coming up with the solution. The study emphasizes the need to fully engage adolescents in addressing adolescent SRHR problems.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"How gender is socially constructed in policy making processes: a case study of the Adolescent and Youth Health Policy in South Africa","field_subtitle":"Jacobs T, George AS: International Journal for Equity in Health 22:36;1-15, 2023 ","URL":"https://tinyurl.com/msrmaes8","body":"This paper explores the range of policy actors, narratives and different framings of gender, through Adolescent Youth Health Policy (AYHP), using a case study design and analysis of reporting of  government, academia, youth and other members of the Adolescent Youth Health Policy Advisory Panel, and civil society. Gender power relations and more gender-transformative approaches discussed during the policy making process were not reflected in the final policy. Diverse gender narratives were juxtaposed, some becoming dominant in the policy-making process and consequently included in the final policy document. The constellation of actors\u2019 gender narratives reveals overlapping and contested framings of gender and what is required to advance gender equality. The authors note that understanding actor narratives in policy processes contributes to bridging the disconnect between policy commitments and reality in advancing the gender equality agenda.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Important Lessons from the African Vaccine Manufacturer That Could Not Sell a Single Dose","field_subtitle":"Cullinan K: Health Policy Watch, 11 May 2023","URL":"https://tinyurl.com/yw8x46ch","body":"Regional vaccine production features in the draft pandemic accord, but there is still a long road before this becomes a reality. Aspen Pharmacare invested millions of dollars in scaling up its South African production plant to make COVID-19 vaccines \u2013 yet it never sold a single vial. Three key factors combined to undermine Aspen\u2019s vaccines. First, despite the hype about the need for African-produced vaccines, African governments failed to buy the locally-made vaccines.  While the pandemic accord currently being negotiated is almost certain to support regional vaccine production, setting this up is complex and the COVID-era failures offer a number of sobering and cautionary lessons. Then Aspen became caught in a political stand-off between Africa and Europe about the fate of African-produced vaccines which delayed production by months. When that was eventually resolved, the world had fallen for mRNA vaccines and no longer wanted the viral vector vaccine that Aspen had been licensed to produce by Johnson & Johnson. With the waning of COVID-19, maintaining countries\u2019 and companies\u2019 interest in building regional vaccine manufacturing ability is a challenge and the authors suggest that Aspen\u2019s difficulties should be well noted.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Individual and area-level socioeconomic correlates of hypertension prevalence, awareness, treatment, and control in uMgungundlovu, KwaZulu-Natal, South Africa","field_subtitle":"Madela S L M, Harriman N W, Sewpaul R et al. BMC Public Health 23:417; 1-15, 2023","URL":"https://tinyurl.com/mpj4nm6z","body":"This analysis explores the relationship between individual and area-level socioeconomic status and hypertension prevalence, awareness, treatment, and control within a sample of 7,303 Black South Africans in three municipalities of the uMgungundlovu district in KwaZulu-Natal province. The prevalence of hypertension in the sample was 44% (n = 3,240). Of those, 2,324 were aware of their diagnosis, 1,928 were receiving treatment, and 1,051 had their hypertension controlled. Educational attainment was negatively associated with hypertension prevalence and positively associated with its control. Employment status was negatively associated with hypertension control. Black South Africans living in more deprived wards had higher odds of being hypertensive and lower odds of having their hypertension controlled. Potential interventions proposed by the authors include community-based programs that deliver medication to households, workplaces, or community centers.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Inequality and private health insurance in Zimbabwe: history, politics and performance","field_subtitle":"Mhazo T; Maponga C; Mossialos E: International Journal for Equity in Health 22:54;1-13, 2023","URL":"https://tinyurl.com/2ebud4k5","body":"Zimbabwe has one of the highest rates of private health insurance (PHI) expenditures as a share of total health expenditures in the world, through medical aid societies. This study considers the roles of history and politics in shaping PHI and determining its impact on health system performance in Zimbabwe. The authors reviewed 50 sources of information using a conceptual framework that integrates economic theory with political and historical aspects and present a timeline from the 1930s to present. The authors observe that Zimbabwe's current PHI coverage is segmented along socio-economic lines due to a long history of elitist and exclusionary politics in coverage patterns. While PHI was considered to perform relatively well up to the mid-1990s, the economic crisis of the 2000s eroded trust among insurers, providers, and patients. That culminated in agency problems which severely lessened PHI coverage quality with concurrent deterioration in efficiency and equity-related performance dimensions. The present design and performance of PHI in Zimbabwe is thus argued to be primarily a function of history and politics rather than informed choice. The authors propose that reform efforts to expand PHI coverage or improve PHI performance explicitly consider the relevant historical, political and economic aspects for successful reform. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Non-communicable disease burden among inpatients at a rural district hospital in Malawi","field_subtitle":"Olds P, Kachimanga C, Talama G,et al: Global Health Research and Policy 8:4;1-10, 2023","URL":"https://tinyurl.com/mwsay5fb","body":"The authors sought to understand the burden of non communicable diseases (NCDs) among inpatients in a rural district hospital in Malawi between 2017 and 2018. The definition of NCDs was broadened beyond the traditional 4 \u00d7 4 set of NCDs, and included neurological disease, psychiatric illness, sickle cell disease, and trauma. A retrospective chart review was conducted of all inpatients who were admitted to the Neno District Hospital between January 2017 and October 2018. Of 2239 total visits at the hospital, 28% were patients with NCDs, making up 40% of total hospital time. Two distinct populations of NCD patients were identified. The first were patients 40 years and older with primary diagnoses of hypertension, heart failure, cancer, and stroke. The second were patients under 40 years old with primary diagnoses of mental health conditions, burns, epilepsy, and asthma. High rates of NCDs in the younger population were noted. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Push for African vaccine independence","field_subtitle":"Musoke R: The Independent, Uganda, March 2023","URL":"https://www.independent.co.ug/push-for-african-vaccine-independence/","body":"A consortium of African civil society organisations has kick-started a campaign to change the continent\u2019s situation regarding vaccines and other essential pharmaceutical products. Afya Na Haki, a Kampala-based health policy thinktank is working with partners from Uganda, Nigeria, Rwanda, Tanzania, South Africa, Kenya, Senegal and Zimbabwe in a programme called \u201cAdvancing Regional Vaccine Manufacturing and Access in Africa (ARMA). ARMA programme\u2019s objective is \u201cadvancing African advocacy and research approaches that strategically enhance vaccine manufacturing and access in Africa,\u201d T to ensure that commitments and resolutions made by the African Union and individual African countries are actually implemented.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"R8bn and counting: That\u2019s the cost of Covid-related corruption, says updated SIU report","field_subtitle":"Heywood M: Daily Maverick, South Africa, May 2023","URL":"https://www.dailymaverick.co.za/article/2023-05-04-r8bn-and-counting-thats-the-cost-of-covid-related-corruption-says-updated-siu-report/","body":"The South African Presidency released the \u2018Third Final Report\u2019 of its investigations into Covid-related corruption in December 2022, probing 5,513 contracts given to 3,058 service providers. Irregularities were identified in 2,965 contracts to the tune of R8.8bn. Although the Special Tribunal has played a pioneering role since it was established, its work has often been hampered by legal challenges to its authority, although now empowered by an important decision in its favour by the Constitutional Court. The authors note that although irregularities to the value of R8.8-billion have so far been found by the SIU, the value of matters enrolled at the Tribunal is less than R2.5-billion and the rand value of cash and/or assets actually recovered so far is a mere R36-million. This is noted to be a vast disjuncture, amounting to less than half a percent, and that there is a lot of work to be done.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Recovering from COVID lockdowns: Routine public sector PHC services in South Africa, 2019 - 2021","field_subtitle":"Pillay Y;  Museriri H;  Barron P; et al: South African Medical Journal 13:1;17-23. 2023","URL":"https://tinyurl.com/yc3ada84","body":"In this article the authors explore the extent to which the third and fourth waves of the COVID-19 pandemic in South Africa affected routine public sector services, drawing on 2019, 2020, and 2021 DHIS data. While there was recovery in some indicators, such as number of children immunised and HIV tests, in many other areas, including primary healthcare visits, the 2019 numbers have yet to be reached - suggesting a slow recovery and continuing impact of the pandemic. Impact indicators of maternal and neonatal mortality continued to worsen in 2021. The authors note that if interventions are not urgently implemented, the country is unlikely to meet the Sustainable Development Goal targets.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Stricter rules: Why better food regulations will help us fight obesity","field_subtitle":"Moloi M, Pretorius L: Bhekisisa, 16 May 2023","URL":"https://tinyurl.com/3arfvvda","body":"About one in four South Africans are reported to be obese, and almost as many are overweight. Obesity is a massive public health problem \u2014 affecting more than 650-million people worldwide \u2014 because it also leads to other health problems, such as diabetes, high blood pressure (also called hypertension) and heart disease. Often eating highly processed foods with lots of sugar, salt or fat, and fast food generally being cheaper than healthier options add to the country\u2019s obesity problem. In the latest episode of Health Beat, Bhekisisa\u2019s monthly TV show, Mia Malan speaks to public health researcher Susan Goldstein about what policymakers can do to help make South Africans healthier. Goldstein discusses the burden on the healthcare system, the need to ban advertising of ultra-processed foods to children, dismantling a food system that\u2019s dominated by big, multinational companies and rethinking food systems towards healthier, more local and equitable alternatives. She explains why regulating the sale and advertising of highly processed foods (which can make us fat) and making it easier for people to buy healthy food at low prices are as crucial as finding medicines to fight obesity.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The lived experience of stigma and Parkinson\u2019s disease in Kenya: a public health challenge","field_subtitle":"Fothergill-Misbah N: BMC Public Health 23: 364;1-12, 2023","URL":"https://tinyurl.com/5ccdekzf","body":"Stigma is a recognised barrier to health-seeking behaviour and a social determinant of population health. This study draws on qualitative data collected from 55 people diagnosed with Parkinson\u2019s and 23 caregivers as part of a wider ethnographic study to explore the lived experience of Parkinson\u2019s disease in Kenya, using the Health Stigma and Discrimination Framework as a tool to understand stigma as a process. Participants reported their lived realities of stigma, and experiences of stigma practices, which had significant negative health and social outcomes, including social isolation and difficulty accessing treatment. Ultimately, stigma had a negative and corrosive effect on the health and wellbeing of patients, highlighting the interplay of structural constraints and the negative consequences of stigma experienced by people living with Parkinson\u2019s in Kenya. Targeted and nuanced ways of tackling stigma are suggested, including educational and awareness campaigns, training, and the development of support groups. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Toolkit and Free Online Course: Conflict of Interest in Health Research","field_subtitle":"School of Public Health: University of Cape Town, South Africa, 2023","URL":"https://health.uct.ac.za/school-public-health/conflict-interest-health-research","body":"Resource-poor areas  in sub-Saharan Africa benefit from collaborative research partnerships between clinicians/researchers and industry, but the scientific rigour and research integrity of such collaborations need to be preserved, and research partnerships protected from threats such as conflicts of interest. Science Councils, and Research Ethics Committees (RECs) play key roles in sustaining science and health research, and are eminently positioned to identify, prevent or manage conflicts of interest. UCT, in partnership with researchers in Kenya, Cameroon, Lebanon and elsewhere in South Africa, is providing a free online course aimed at Research Ethics Committee members and Science Granting Council staff to enhance skills to identify, manage and prevent conflict of interest in the health research process.  The project also includes an open access toolkit which is a resource for Research Ethics Committee members, Science Granting Council staff, researchers, managers and administrators involved in the research process. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Towards a bottom-up approach for localising SDGS in African cities: findings from Cairo and Dar es Salaam","field_subtitle":"Nagati O, Gad H, El-Didi A, et al: Africa Development XLVIII:1;79-111, 2023","URL":"https://tinyurl.com/veam68rc","body":"The authors applied a localisation methodology to analyse the current status of the implementation and monitoring of Sustainable Development Goals (SDGs) 6 and 11.2 in Cairo and Dar es Salaam. It uses comparative, top-down and grounded bottom-up analyses to identify gaps in the existing SDG framework and ultimately proposes a set of evaluation criteria to replace the global indicators with new localised and quantifiable indicators in the two cities. In doing so, it responds to prevalent critiques of SDGs specific to their application in the global South, including difficulties in measuring and monitoring urban conditions, misrepresentation due to the reduction of complex local conditions to abstracted data, and the inadequate capacity of the agenda to consider and assess informal activity. The proposed revisions to targets and indicators for SDG 6.1, 6.2 and 6.b, and SDG 11.2, were discussed with community organisers and residents to bolster their validity, and to negotiate better sustainable-development paradigms policy-makers. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Uganda National Conference on Health, Human Rights and Development (UCHD) ","field_subtitle":"Center for Health, Human Rights and Development (CEHURD): 26th \u2013 29th September 2023, Kampala, Uganda","URL":"https://www.cehurd.org/","body":"CEHURD will hold the Uganda National Conference on Health, Human Rights and Development together with the Ministry of Health in Kampala, Uganda  for 3-days in September, 2023. This conference is the first of its kind in Uganda and will focus on the country\u2019s advancement on realizing the right to health within the context of sustainable development goals. The right to health is a fundamental part of our human rights and human dignity. It is a development issue, which is incorporated in international and regional human rights treaties and in national laws, policies and strategies.  A call for abstracts will be designed and sent out to all partners and potential networks to share papers based on the different conference tracks. Conference registration information will be available on the conference website at CEHURD in due course. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Ultra-processed food for infants and toddlers; dynamics of supply and demand","field_subtitle":"Dunford E, Popkin B: Bulletin of the World Health Organisation 101:5;358\u2013360, 2023","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140693/","body":"he global baby food market has grown from\u2009US$ 9.6 billion in 2010 to US$ 17.9 billion in 2022. Emerging economies offer opportunities for baby food manufacturers and now represent half of all global baby food sales. The authors used data from Euromonitor International to assess sales trends of milk formula, growing-up formula and baby foods during the past decade as well as the level of sugar sold in the infant and toddler feeding sector. The consumption of commercially prepared baby foods in many cases may exceed consumption of homemade foods for infants and toddlers, with concerns about the nutritional composition, sweet taste and long-term health effects of these products. The data raise major questions about the role infant and toddler food companies play in rising global obesity levels and the double burden of malnutrition in low- and middle-income countries. The diets of infants and young children worldwide are undoubtedly becoming increasingly highly processed, a trend mirrored by increased global consumption of ultra-processed foods. The five largest global formula companies are Nestl\u00e9, Danone, Abbott, RFC and RBMJ with four out of these five companies present in more than 100 countries. The authors observe that policy-makers need to ensure these products and the companies who manufacture them are more closely monitored and their marketing more tightly regulated.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Understanding the effect of gender-based violence on uptake and utilisation of HIV prevention, treatment, and care services among transgender women: a qualitative study in the greater Kampala metropolitan area, Uganda","field_subtitle":"Muyanga N, Isunju J B, Ssekamatte T, et al: BMC Women's Health 23:250;1-13, 2023","URL":"https://tinyurl.com/2tawrtpj","body":"This participatory qualitative study using  in-depth interviews and focus group discussions explored how gender-based violence affects uptake and utilisation of HIV prevention, treatment, and care services among transwomen in the Greater Kampala Metropolitan Area, Uganda. At the individual level, emotional violence suffered by transwomen led to fear of disclosing their HIV status and other health conditions to intimate partners and healthcare providers respectively; inability to negotiate condom use; and non-adherence to antiretroviral therapy. Sexual violence compromised the ability of transwomen to negotiate condom use with intimate partners, clients, and employers. Physical and emotional violence at the community level and in services led to fear among transwomen traveling to healthcare facilities, and limited use of pre-exposure prophylaxis and HIV testing services, denial of healthcare services, and delays in receiving appropriate care. Given its effects on HIV transmission, the authors argue for strategies/ interventions targeting a reduction in gender-based violence and to sensitize communities to accept transwomen, including in healthcare settings. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Urban Studies Foundation International Fellowships for urban scholars from the Global South","field_subtitle":"Deadline for applications: 20 June 2023","URL":"https://www.urbanstudiesfoundation.org/funding/international-fellowships/","body":"Applications are invited to the USF\u2019s International Fellowships for urban scholars from the Global South. Each award will cover the cost of a sabbatical period at a university of the candidate\u2019s choice, worldwide, for the purpose of writing-up the candidate\u2019s existing research findings in the form of publishable articles and/or a book. The proposed work should be completed under the guidance of a chosen mentor in the candidate\u2019s field of study. Funding is available for a period ranging between 3-9 months, and eligible research may cover any theme pertinent to a better understanding of urban realities in the Global South.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Urban Studies Foundation International Fellowships for urban scholars from the Global South","field_subtitle":"Deadline for applications: 20 June 2023","URL":"https://www.urbanstudiesfoundation.org/funding/international-fellowships/","body":"Applications are invited to the USF\u2019s International Fellowships for urban scholars from the Global South. Each award will cover the cost of a sabbatical period at a university of the candidate\u2019s choice, worldwide, for the purpose of writing-up the candidate\u2019s existing research findings in the form of publishable articles and/or a book. The proposed work should be completed under the guidance of a chosen mentor in the candidate\u2019s field of study. Funding is available for a period ranging between 3-9 months, and eligible research may cover any theme pertinent to a better understanding of urban realities in the Global South.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"What values drive communities\u2019 nutrition priorities in a resource constrained urban area in South Africa?","field_subtitle":"Erzse A; Rwafa-Ponela T; Goldstein S et al: BMC Public Health 23:873;1-15, 2023 ","URL":"https://tinyurl.com/3mpmndn6","body":"This study sought through focus group discussions to identify the priorities of community members of a South African township, Soweto, and describe the underlying values driving their prioritisation process, to improve nutrition in the first 1000 days of life. The authors used a modified public engagement tool: Choosing All Together which presented 14 nutrition intervention options and their respective costs. Participants deliberated and collectively determined their nutritional priorities. All groups demonstrated a preference to allocate scarce resources towards three priority interventions school breakfast provisioning, six months paid maternity leave, and improved food safety. All but one group selected community gardens and clubs, and five groups prioritised decreasing the price of healthy food and receiving job search assistance. Participants\u2019 allocative decisions were guided by several values implicit in their choices, such as fairness and equity, efficiency, social justice, financial resilience, relational solidarity, and human development, with a strong focus on children.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"WHO's health inequality data repository","field_subtitle":"Hosseinpoor A, Bergen N, Kirkby K, et al: Bulletin of the World Health Organisation 101:5;298\u2013298A, 2023","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140685/","body":"Launched in April 2023 by WHO, the health inequality data repository aims to make disaggregated data more accessible to diverse global audiences, including policy-makers, analysts, researchers, health professionals and others.6 The repository contains the largest collection of publicly available disaggregated data on health and health-relevant topics, with about 11 million data points. The repository includes over 2000 indicators related to the SDGs; coronavirus disease 2019 (COVID-19); reproductive, maternal, newborn and child health; immunization; HIV, tuberculosis and malaria; adult health; health care; burden of disease; disability; environmental health; WHO Thirteenth General Programme of Work; and other health determinants. A key feature of the repository is its user-friendly interface, which makes it accessible to audiences with a range of technical skills. The repository allows users to explore data through an interactive data visualization software that was specifically developed for health inequality analyses, the health equity assessment toolkit. The repository also opens new opportunities for expanded inequality monitoring. ","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"WHO: Zero Draft of the pandemic instrument creates an \u201cillusion\u201d of equity","field_subtitle":"Ramakrishnan N, Gopakumar K: Third World Network, February 2023","URL":"https://www.twn.my/title2/health.info/2023/hi230207.htm","body":"The zero draft of the proposed pandemic instrument being negotiated at the World Health Organization is argued by the authors to create an illusion of equity. Most of the inputs given by developing countries are observed to have been ignored. The authors are that proposed structure neglects two demands from developing countries. First, a different chapter scheme should be used which would reflect the logical order of the pandemic prevention, preparedness, response and recovery processes on the ground. Secondly, the broader phrase of \u201cpandemic prevention, preparedness, response and recovery\u201d should be used instead of \u201cpandemic and recovery of health systems\u201d. The zero draft continues to be silent on the determination of the pandemic status of a public health event and WHO\u2019s role in determining the same. In effect, the text is viewed as simply seeking to generate \u201cpolitical will and commitment\u201d on equity.","php":"","field_issue_date":"2023-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":" RECLAIM 2022!","field_subtitle":" Desire Moyo, Moyoxide, Novembe, 2022","URL":"https://youtu.be/U7IEiKzaNPk","body":" This video of a poem by Desire Moyo presented on the last day of the EQUINET conference captured some of the aspirations and ideas covered in the three days of the conference and in the resolutions for action. Halala! ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"'Historic Win': UN Members to Start Talks on 'Inclusive and Effective' Global Tax Standards","field_subtitle":"Corbett J: Common dreams, online, November 24, 2022 ","URL":"https://tinyurl.com/4pj9dbkz","body":"Tax justice advocates around the world on Wednesday celebrated the unanimous adoption of a resolution to begin intergovernmental discussions in New York at United Nations Headquarters on ways to strengthen the inclusiveness and effectiveness of international tax cooperation. \"African countries stood together and made historic strides, breaking through the long-standing blockade by the OECD countries,\" said Global Alliance for Tax Justice executive coordinator Dereje Alemayehu. The U.N. General Assembly (UNGA) resolution on the \"promotion of inclusive and effective international tax cooperation at the United Nations\" was spearheaded by the African Group\u2014which is composed of the continent's 54 member states\u2014and comes after about a decade of delays on the topic at the Organization for Economic Cooperation and Development (OECD). \"We note that the OECD has played a role in these areas,\" a representative of the Nigerian delegation to the U.N. reportedly said Wednesday. \"It is clear after 10 years of attempting to reform international tax rules that there is no substitute for the global, inclusive, transparent forum provided by the United Nations.\"","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"A Snapshot Of Wealth In Africa","field_subtitle":"Durden T: Zerohedge, Online, 2022","URL":"https://www.zerohedge.com/geopolitical/snapshot-wealth-africa","body":"The continent of Africa contains more than 50 countries, but, as Visual Capitalist details, just five countries account for more than half of total wealth on the continent: South Africa, Egypt, Nigeria, Morocco, and Kenya. Despite recent setbacks in Africa\u2019s largest economies, wealth creation has been strong in a number of areas, and total private wealth is now estimated to be US$2.1 trillion. There are an estimated 21 billionaires in Africa today. Drawing from the latest Africa Wealth Report, this article looks at where all that wealth is concentrated around the continent.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Amendments to the IHR Come to the Fore. Will the Pandemic Accord Lose Traction?","field_subtitle":"Patnaik P: Geneva Health Files, Online, November 2022","URL":"https://tinyurl.com/2s3kucbp","body":"In 2021, when the negotiations towards a Pandemic Accord was not yet a reality, a number of member states were advocating for restoring the centrality of the International Health Regulations (IHR) (2005), and for amending these rules that already exist. This article covers the dynamics between the two parallel, somewhat competing processes: on the one hand, efforts to amend the International Health Regulations (IHR, 2005), and on the other, the process to arrive at a new Pandemic Accord. The authors argue that the IHR are back to the fore. The update outlines the changing contours of how countries are lining up along these two processes. Much of what countries aspire for, is noted to already exist. But the \u201ctargeted\u201d amendments is where the politics lie. Who articulates what needs to be amended and why? Over the next 17 months when both these processes are expected to conclude, calling for attention to the evolution of these historic negotiations.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"As 2022 ends, thanks for joint actions and wishing you a heathy start to 2023   ","field_subtitle":"EQUINET Steering Committee","body":"We appreciate the ideas, actions, initiatives on health equity we've shared in 2022.  The context is challenging, but our conference in 2022, profiled in this issue, showed the rich perspectives, evidence, experiences and creativity people in the region bring to our struggles for social justice in health. We wish you wellbeing and progress in 2023! In 2022 our EQUINET Conference and various steering committee meetings identified key areas of work on health equity within our three strategic directions - Reclaiming the resources; Reclaiming the state; Reclaiming collective agency and solidarity. We are building on past work and alliances, renewing network leadership and developing a programe of research, work, dialogue, and engagement to put the resolutions of our Conference into action.  To give time for this we will not have the quarterly newsletter in March 1 2023. Watch out for our next newsletter on June 1 2023- it will be a bumper issue! ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Call for Applications: Preparing Outstanding Social Science Investigators to Benefit Lives and Environments in Africa Programme ","field_subtitle":"Deadline for submissions: 11 December 2022","URL":"https://scienceforafrica.foundation/funding/possible-africa-call-for-applications","body":"The POSSIBLE- Africa Fellowship Programme is a 24-month early postdoctoral (graduated within the last 5-10 years) fellowship opportunity for outstanding African scholars in the Social Sciences & Humanities, who propose research that aims to create evidence to inform sustainable development within the African continent. The fellowship aims to build a critical mass of independent African research leaders in the SS&H to lead science programmes at local and international levels. These leaders will have the capacity to engage successfully with funders, policy makers, communities, and other stakeholders, and to serve as mentors and supervisors for the next generation of researchers in Africa.  ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers: From COVID-19 to stronger people-centred and equitable health systems ","field_subtitle":"Health policy and systems research from low- and middle-income countries, no deadline","URL":"https://academic.oup.com/heapol/pages/call-for-papers-from-covid-19-to-stronger-health-systems","body":"Health Policy and Planning has launched a call for papers to take stock of what happened during the COVID years in terms of health system governance, transformation and innovation. Submissions are invited by researchers, policymakers, providers, health system managers and programme managers. Papers can focus on regional, national, sub-national and \u2018district\u2019-level impact and responses. Of particularly interest are papers that critically review the response to the pandemic at country-level in low- and middle-income countries.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for proposals: Health policy analysis for health taxes: Lessons from countries ","field_subtitle":"AHPSR: Deadline for applications: 23 December 2022","URL":"https://tinyurl.com/yc47n6zn","body":"This research programme aims to generate knowledge and advocate for greater attention for health policy analysis on health taxes. It aims to develop cross-national learning based on this knowledge to inform civil society advocacy and government and funder policy-making. Country teams are expected to use a mixed-method approach, combining semi-structured interviews, literature reviews and situational analysis to analyze how a health tax is being advanced and implemented. These studies will consider how political economy factors influenced the design, adoption and implementation of health taxes, and how analysis can be used to further health taxes in country contexts. There is a requirement for research teams to engage and work closely with policy-makers (including WHO and other international partners working in the country), and civil society groups (this will be coordinated with WHO and external partners). A common conceptual framework will be developed to ensure that findings are comparable across countries.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Catalysing change for equity and social justice in health: Resolutions for action ","field_subtitle":"EQUINET Conference 2022: Headline resolutions, November 2022 ","body":"\r\nDelegates at the EQUINET Conference 2022 comprised representatives of civil society organisations, community members, parliament, central and local government leaders and officials, trade unions, media, academia, researchers, and personnel from regional and international organisations. We came together virtually under the umbrella of the Regional Network for Equity in Health in East and Southern Africa (EQUINET) to deliberate the actions needed to Catalyse change for health and social justice in this region. \r\n\r\nOur deliberations took place at a time of deep-seated and multiple crises that have decimated the basic foundations for provision of public goods (the state, resources and collective agency) in our region, with the poor and marginalised communities left behind to shoulder the burden. \r\nWe: \r\n\u2022\tAre alarmed by the: deepening resource extraction from our region that harms our environment and depletes resources for current and future generations; by inequalities in health, wellbeing and access to services, especially in urban areas and with particular consequences for young people, that are exacerbated by harmful commercial practices; underfunding, privatisation and commodification of  public sector services; and by local to global political and economic systems that promote profit over people, disempower people and disrupt collective agency, dignity and social solidarity.\r\n\u2022\tAre greatly concerned with the limit and slow pace of action to address these challenges and make the change needed to promote equity in health and wellbeing at local, national and regional levels. \r\n\u2022\tRecognise that public sector-led health systems and comprehensive primary health care are central elements of the robust, redistributive and participatory states that are essential to meet our challenges, including from pandemic, conflict and climate injustice and address global drivers of injustice and inequity.\r\n\u2022\tUnequivocally identify the pivotal contribution that human rights, solidarity values, collective organisation and social power make in supporting self-determined action towards social, economic and ecological justice.\r\n\r\nCommitting to reclaim our resources, our states and our collective agency and solidarity for health and social justice, and as a catalyst for a political economy and systems that are rooted in values of equity, social justice, collective wellbeing and protection of nature, we propose a set of inter-linked areas of action to address our most critical challenges and tap our assets for health. \r\n\r\nBuilding on our past 25 years, we understand that equity demands sustained, longer-term action. Over the next five years, we will: \r\n\r\n1.   Take action to: \r\na.\tBuild and amplify a clear and affirmative pro-equity, pro-public discourse to affirm values, claim rights, resist inequity and demand action.\r\nb.\tTrack, generate evidence and knowledge on inequities and rights violations in health and wellbeing, and on the opportunities for and feasibility of social justice change that promotes both sustained human and ecosystem wellbeing.   \r\nc.\tPromote, demonstrate, advocate for and contribute to the implementation of specific equity-promoting laws, policies, practices and reforms for equity in health and wellbeing. \r\nd.\tBuild the capacities, leadership and activism needed to promote active participation and communities as agents of change; and to engage in participatory democracy around the policies, laws and systems that are critical in catalysing equity-oriented change. \r\ne.\tDevelop, sustain and work with pro-equity networks and alliances for action within and across countries in the east and southern Africa (ESA) region, in exchanges and engagement with other regions, with global actors and in global processes. \r\n\r\n2. With a particular focus on the following issues: \r\n\u2022\tDevelopment and implementation of constitutional and legal provisions that protect the right to health and enable action on equity in health and wellbeing.\r\n\u2022\tHealthy living, working and ecological conditions and food sovereignty, including specific concern on the extractive sectors, corporate practices, climate and eco-social justice, and for youth health and urban wellbeing. \r\n\u2022\tAdequate and progressive public sector resourcing (financial, health worker, commodities, infrastructures) and fair allocation for comprehensive primary health care oriented, universal, equitable, socially accountable public sector health, social and essential services, including in pandemics, and on disaggregated and publicly accessible information, monitoring and public health surveillance systems that integrate community evidence.\r\n\u2022\tInvestment in local production of essential health products and tax justice, and the rule systems, measures and institutional reforms for this within the region and at global level.\r\n\u2022\tRegional counterproposals to paradigms, narratives, and local to global economic, political and procedural drivers of policies and practices that harm equity health and wellbeing and participatory democracy in health systems and services.\r\n\r\nThese headline resolutions were adopted by the conference on its final day. Further detail on the issues and areas of action is shown at https://www.equinetafrica.org/conference/resolutions.html.    ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"East, Central and Southern Africa Health Community 13th Best Practices Forum (BPF) and 28th Directors Joint Consultative Conference (DJCC) Meeting","field_subtitle":"5-7 February 2023, Maseru, Kingdom of Lesotho","URL":"https://tinyurl.com/3ckw4z53","body":"The 13th BPF and 29th DJCC will now be held in Maseru, Kingdom of Lesotho, from 5-7 Feb 2023, immediately be followed by the 71st Health Ministers' Conference starting from 8-9 Feb 2023. ECSA-HC in collaboration with Member States and Partners hosts a regional platform to identify and build consensus on regional health priorities known as the \u201cBest Practices Forum (BPF)\u201d. Promising practices and key policy issues and approaches emanating from the BPF are then motioned on to be recommendations to the Health Ministers during their annual conference. ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Emigration as a social and economic determinant of health in low-income urban Zimbabwe","field_subtitle":"Chigariro, TC and Mhloyi, MM:. Journal of Health, Population and Nutrition 41(49), 1-10, 2022","URL":"https://tinyurl.com/2j9e4cfz","body":"This study compared socio-economic characteristics, including health, of emigrants\u2019 households with those of non-emigrants\u2019 households in an urban setting in Harare, Zimbabwe. A cross-sectional survey and focus group discussions were used to collect quantitative and qualitative data, respectively. Concurrent and retrospective data were collected using an interviewer-administered questionnaire with 268 de facto heads of the respective households, the. majority of whom were female. Emigrants\u2019 households were more likely to access private compared to government health care facilities, than non-emigrants\u2019 households. Emigrants' households were also more likely to report higher incomes than non-emigrants\u2019 households and were having more meals per day and better access to education. Emigrants' households were also more likely to report positive lifestyles than non-emigrants\u2019 households. Only 13.8% of emigrants' households reported a negative shift in lifestyle, compared to 25.2% non-emigrants' households. Emigration was found to have a positive relationship with health seeking, income, education, and number of meals a household had. The authors argue that it is clear from the findings that emigration during the hard economic times in Zimbabwe is beneficial; it cushions households from the ravages of poverty. Yet emigration robs the nation of its professional able-bodied people. They recommend that government optimise the reported positive effects, whilst improving the economy to reverse out-migration.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET Conference 2022: Videos of Day 1-4 Conference sessions","field_subtitle":"EQUINET, November 2022","URL":"https://www.equinetafrica.org/conference/resources.html","body":"EQUINET conferences have provided an opportunity for different communities and areas of focus to interact, and have given guidance to our work, organisation and networking on health equity in East and Southern Africa. In 2022 EQUINET held a regional conference. Challenging a neoliberal mantra that there are no alternatives to policies that create social deficits and injustice, and sharing the ideas and creativity of our region, the 2022 conference shared and discussed experiences, evidence, analysis, successes and struggles from local to regional level and engagement globally to advance health and wellbeing in East and Southern Africa. Through the exchanges, delegates framed propositions to advance health equity and social justice in our region. The EQUINET Conference was held online in three and a half days, each day a month apart, with each of the three full days covering one of the EQUINET strategic directions - Reclaiming the resources for Health, Reclaiming the state, and Reclaiming collective agency and solidarity in health - with a final half-day - Organising regionally for health equity - on how EQUINET organises and what it does to take the strategic directions forward. You can now watch the videos of the presentations on each of the 4 conference days, from opening speeches from diverse leaders in and beyond the region, EQUINET, regional and international presenters, musicians and artists, reports of discussions and finally a closing speech from WHO AFRO.  ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 234: Catalysing change for equity and social justice in health","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET: the road travelled over 25 years","field_subtitle":"TARSC, EQUINET Steering committee","URL":"https://youtu.be/VbVqMBQzgf4","body":"This video pechakucha of photographic images tells the story of EQUINET's journey from its formation in 1998 to the current date. It shows the many places, people, areas and forms of work EQUINET has been involved in. ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Health taxes: a call for papers","field_subtitle":"BMJ Global Health: Deadline for submissions: 17 February 2023","URL":"https://gh.bmj.com/content/7/10/e010709","body":"The editors invite papers that focus on political economy and policy analysis as well as consider how framing can be used to advance health taxes; and in health taxes on products including, but not limited to, tobacco, alcohol, sugar, fossil fuels, meat and salt. The special issue welcomes a variety of different types of articles, including those focused on exploring new theoretical and methodological terrain, in addition to papers that present empirical research findings considering how countries can accelerate, develop, deepen, expand and sustain health taxes, with a special interest on low-income and middle-income countries. This is a call for submissions across article types, including original research, analysis and practice articles.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health worker perceptions of stigma towards Zambian adolescent girls and young women: a qualitative study","field_subtitle":"Meek C; Mulenga D M; Edwards P; et al: BMC Health Services Research 22(1253), 1-11, 2022 ","URL":"https://tinyurl.com/5n7eprtt","body":"This study explored health workers\u2019 perceptions of clinic- and community-level stigma against adolescent girls and young women seeking HIV and sexual and reproductive health services in Lusaka, Zambia. The authors conducted 18 in-depth interviews in August 2020 with clinical and non-clinical health workers across six health facilities in urban and peri-urban Lusaka. Health workers reported observing stigma driven by attitudes, awareness, and institutional environment. Clinic-level stigma often mirrored community-level stigma. Health workers described the negative impacts of stigma for adolescent girls and young women and expressed a desire to avoid stigmatization. Despite this lack of intent to stigmatize, results suggest that community influence perpetuates stigma, although often unrecognized and unintended, in health workers and clinics. These findings demonstrate the overlap in health workers\u2019 clinic and community roles and suggest the need for multi-level stigma-reduction approaches that address the influence of community norms on health facility stigma. The authors propose that stigma-reduction interventions should aim to move beyond fostering basic knowledge to encouraging critical thinking about internal beliefs and community influence and how these may manifest in service delivery to adolescent girls and young women.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Human Climate Horizons","field_subtitle":"Climate Impact Lab, United Nations Development Programme, 2022","URL":"https://horizons.hdr.undp.org","body":"Built upon frontier scientific work, this platform visualises hyperlocal human impacts of climate change and its effects on human security for more than 24,000 regions across the world. It shows the effects we face today, on our health, our livelihoods, and the infrastructure we need. It shows how they are projected to evolve over the next century, bringing into focus which regions and locations are most at risk. \r\n","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Labour protests during the pandemic : The case of hospital and retail workers in 90 countries","field_subtitle":"International Labour Organisation: Working paper 83, ILO, November 2022","URL":"https://www.ilo.org/global/publications/working-papers/WCMS_860587/lang--en/index.htm","body":"The report offers the first global dataset of labour protests of key workers during the pandemic. It focusses on two sectors, healthcare and retail. The results show that, overall, despite large volumes of protest over acute COVID-related problems such as the provision of Personal Protective Equipment (PPE), the main concern of protesting workers during the pandemic was their pay. Collective action accompanying demands for pay rises involved not only the withdrawal of labour, but also demonstrations and leverage tactics. Health and safety was the second most important concern, and protests linked to these demands did not cease when the pandemic became less deadly. Protest spiked during the initial March 2020 lockdowns, before continuing at a lower level throughout the pandemic. The report identifies important variation between countries and sectors, and highlights specific local contingencies, and strategic decisions taken by workers and their unions. ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Learning from initiatives on equitable urban health and wellbeing in east and southern Africa","field_subtitle":"Loewenson R; Mhlanga G; Gotto D; et al: EQUINET discussion paper 127, September 2022","URL":"https://tinyurl.com/yknfz8mb","body":"Work was implemented in 2022 in EQUINET to gather evidence on promising practice aimed at addressing urban health equity and wellbeing in east and southern Africa (ESA to contribute to learning within the ESA region and to share and exchange with other regions. This report presents the work carried out in the ESA region through a desk review of online documents and case studies from selected cities, of areas of promising practice. It shares insights and learning from the findings on practices that promote urban wellbeing and health equity. Collectively, the initiatives have yielded a range of outcomes and changes. In terms of processes for equity-oriented change in urban wellbeing, the report outlines a mix of interventions and tools that promote both participatory and recognitional equity as pivotal to change. Many of the insights generated relate to the design of initiatives and the efforts made to stimulate cross sectoral, multi-stakeholder inputs as a response to the multi-dimensional nature of the drivers of inequality and deprivation. The report notes, however, that initiatives need to connect beyond the local level if they are to have more impact on the structural dimensions of equity, and points to national level inputs that appear to be important to sustain and support such local level practice.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Limited handwashing facility and associated factors in sub-Saharan Africa: pooled prevalence and multilevel analysis of 29 sub-Saharan Africa countries from demographic health survey data","field_subtitle":"Endalew M; Belay D G; Tsega N T; et al: BMC Public Health 22(1969), 1-12, 2022","URL":"https://tinyurl.com/ms2u2922","body":"This study determined the prevalence of limited handwashing facility and its associated factors in sub-Saharan Africa. Data was obtained from the Demographic and Health Surveys in 29 sub-Saharan African countries since January 1, 2010. The pooled prevalence of limited handwashing facilities was found to be 66%. Having a limited handwashing facility was associated with having a household head aged between 35 and 60, having a mobile type of hand washing facility, unimproved sanitation facility, water access requiring more than a 30 min round trip, living in an urban residential area, having low media exposure, low educational level, low income level and being in a lower middle-income level and having more than three children.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Living with COVID-19 and preparing for future pandemics: revisiting lessons from the HIV pandemic","field_subtitle":"Auerbach J; Forsyth A; Davey C; et al:The Lancet HIV, 1-7, doi: https://doi.org/10.1016/S2352-3018(22)00301-0, 2022","URL":"https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(22)00301-0/fulltext","body":"In April, 2020, just months into the COVID-19 pandemic, an international group of public health researchers published three lessons learned from the HIV pandemic for the response to COVID-19, which were to: anticipate health inequalities, create an enabling environment to support behavioural change, and engage a multidisciplinary effort. The authors revisit these lessons in light of more than 2 years' experience with the COVID-19 pandemic. With specific examples, the article details how inequalities have played out within and between countries, highlight factors that support or impede the creation of enabling environments, and note ongoing issues with the scarcity of integrated science and health system approaches. The authors argue that to better apply lessons learned as the COVID-19 pandemic matures and other infectious disease outbreaks emerge, it will be imperative to create dialogue among polarised perspectives, identify shared priorities, and draw on multidisciplinary evidence.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Mapping urban physical distancing constraints, sub-Saharan Africa: a case study from Kenya","field_subtitle":"Chamberlain HR,  Macharia PM, Tatem AJ: Bull World Health Organ 2022;100(9):562\u2013569  ","URL":"https://tinyurl.com/55stmrtm","body":"With the onset of the coronavirus disease 2019 (COVID-19) pandemic, public health measures such as physical distancing were recommended to reduce transmission of the virus causing the disease. However, the same approach in all areas, regardless of context, may lead to measures being of limited effectiveness and having unforeseen negative consequences, such as loss of livelihoods and food insecurity. Focusing on sub-Saharan Africa, the authors outline and discuss challenges that are faced by residents of urban informal settlements in the ongoing COVID-19 pandemic. The authors describe how new geospatial data sets can be integrated to provide more detailed information about local constraints on physical distancing and can inform planning of alternative ways to reduce transmission of COVID-19 between people. A case study of Nairobi County, Kenya, is included with mapped outputs which illustrate the intra-urban variation in the feasibility of physical distancing and the expected difficulty for residents of many informal settlement areas. These examples demonstrate the potential of new geospatial data sets to provide insights and support to policy-making for public health measures, including COVID-19.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Multi-level change strategies for health: learning from people-centered advocacy in Uganda","field_subtitle":"Bailey A; Mujune V: International Journal for Equity in Health 21(143), 1-15, 2022 ","URL":"https://tinyurl.com/bdcpd4ku","body":"This paper is based on a comparative, inductive, practitioner-led analysis of program monitoring data from 18 multi-level health advocacy campaigns. The findings emerge from analysis of a \u201cHeat Map,\u201d capturing grounded accounts of government responses to community-led advocacy. Officials in eight out of 18 districts were noted to have fulfilled or surpassed commitments made to community advocates. Government responses included: increased monitoring, more downward accountability, countering backlash against advocates, applying sanctions for absent health workers, and increased budget allocations. Advocates\u2019 bottom-up advocacy worked in part through triggering top-down responses and activating governmental checks and balances. Methodologically, this article demonstrates the value of analyzing process monitoring and program data to understand outcomes from direct engagement between citizens and the state to improve health services. Survey-based research methods and quantitative analysis may fail to capture signs of government responsiveness and relational outcomes many hope to see from citizen-led accountability efforts. Practitioners\u2019 perspectives on how accountability for health emerges in practice are argued to be important correctives to much positivist research on accountability, which has a tendency to ignore the complex dynamics and processes of building citizen power.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Multimorbidity and its socio-economic associations in community-dwelling older adults in rural Tanzania; a cross-sectional study","field_subtitle":"Lewis E G; Gray W L; Walker R; et al: BMC Public Health 22(1918), 1-12, 2022  ","URL":"https://tinyurl.com/dkztrpjs","body":"The authors describe the prevalence and socio-economic conditions associated with multimorbidity in 235 community-dwelling older people (\u2009\u2265\u200960 years) living in rural Tanzania, using a history and focused clinical examination. Multimorbidity was defined as having two or more conditions. The median age was 74 years and 136 were women. Adjusting for frailty-weighting, the prevalence of self-reported multimorbidity was 26%, and by clinical assessment/screening was 67%. Adjusting for age, sex, education and frailty status, multimorbidity by self-report increased the odds of being financially dependent on others threefold, and of a household member reducing their paid employment nearly fourfold. Multimorbidity is prevalent in this rural lower-income African setting and is associated with evidence of household financial strain. Multimorbidity prevalence is higher when not reliant on self-reported methods, revealing that many conditions are underdiagnosed and undertreated.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Open call for short films: 4th edition Health for All Film Festival","field_subtitle":"Deadline for submissions: 31 January 2023","URL":"https://tinyurl.com/yxmavarv","body":"The Health for All Film Festival aims to recruit a new generation of film and video innovators to champion global health issues, launching its 4th edition, the festival is opening an invitation to independent film-makers, production companies, NGOs, communities, students, and film schools from around the world to submit their original short films about health.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Open Letter Sets Bill Gates Right About Global Food Insecurity","field_subtitle":"TWN: Info Service on Sustainable Agriculture, TWN, November 2022","URL":"https://www.twn.my/title2/susagri/2022/sa1030.htm","body":"An open letter to Bill Gates from the Community Alliance for Global Justice and co-signed by 50 other organisations warns that Gates fundamentally misdiagnoses the problem of food insecurity as relating to low productivity, leading him to recommend the replication of Green Revolution technologies, including more fertilizer. However, the letter points out that the world does not need to increase production as much as to assure more equitable access to food. Moreover, the authors assert that the Green Revolution did very little to reduce the number of hungry people in the world and caused long-term soil degradation, and increased inequality and indebtedness. The letter points to the many tangible, ongoing proposals and projects that work to boost productivity and food security such as agro-ecological programs, and invites Gates to step back and learn from those on the ground.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Opportunities and considerations for the design of decentralized delivery of antiretroviral therapy for female sex workers living with HIV in South Africa ","field_subtitle":"Comins C A; Guddera V; Parmley L E; et al: BMC Health Services Research 22(1166), 1-10, 2022  ","URL":"https://tinyurl.com/3npd8243","body":"In South Africa, 60% of female sex workers (FSWs) are living with HIV, many of whom experience structural and individual barriers to antiretroviral therapy initiation and adherence. Community-based decentralized treatment provision (DTP) may mitigate these barriers. To characterize optimal implementation strategies, the authors explored preferences for DTP among FSWs living with HIV in Durban, South Africa, using 39 semi-structured in-depth interviews. Respondents suggested that decentralized treatment provision should be venue-based, scheduled during less busy times and days, and integrate comprehensive health services including psychological, reproductive, and non-communicable disease services. Antiretroviral therapy packaging and storage were important for community-based delivery, and participants suggested decentralized treatment provision should be implemented by sex work sensitized staff with discrete uniform and vehicle branding. The authors suggest the potential utility of decentralized treatment provision for female sex workers as a strategy to address those most marginalized from current antiretroviral therapy programs in South Africa.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Reading Marx\u2019s Grundrisse ","field_subtitle":"David Harvey: Online Political Economy Course, 2022","URL":"http://davidharvey.org/2020/01/reading-marxs-grundrisse/","body":"A new course featuring David Harvey teaching Karl Marx\u2019s Grundrisse: Foundations of the Critique of Political Economy. Recorded live in 2020 first at The People\u2019s Forum and then in quarantine, these 12 accessible lectures guide the reader through the major themes of Marx\u2019s seminal text on political economy, and feature commentary relating the text to the pandemic and economic crisis.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Saying \u2018no\u2019 in science isn\u2019t enough","field_subtitle":"Babcock L; Peyser B; Vesterlund L; et al: Nature, November 2022","URL":"https://www.nature.com/articles/d41586-022-03677-6","body":"In August 2022, a group of female scholars wrote \u2018Why four scientists spent a year saying no\u2019: an article about what they had gained by saying no to 100 work-related requests over the course of year. That led the authors, four female professors, to form the No Club. Over the past decade, the authors have researched work that doesn\u2019t help to advance careers \u2014 an attempt to understand why they, along with many others, were doing so much of it. They gave this work a name: non-promotable tasks (NPTs). Studies show that women, regardless of occupation, take on the bulk of NPTs. So, what can organizations do? The authors argue that women are more likely than men to volunteer for an NPT, so asking for volunteers exacerbates the inequity in allocation. Everyone in organizations should be enabled to understand which tasks will move their careers forward (the promotable work) and which ones won\u2019t, and tasks defined as promotable or non-promotable. Knowing where to focus time is argued to help both employees and the organization. If tasks are assigned strategically to take advantage of specialized skill sets, given that an NPT for one position might be promotable for someone at a lower level, the authors propose that tasks be allocated to create equitable portfolios of work and rewards provided for some NPTs. ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"South African Health Review 2021","field_subtitle":"Health Systems Trust, South Africa, 2022","URL":"https://www.hst.org.za/publications/Pages/South-African-Health-Review-2021.aspx","body":"When it comes to service delivery and access in both the public and private health sectors, COVID-19 has put everything to the test. It has demonstrated how central public health security is to health and livelihoods, and how pandemic health emergencies expose the weaknesses and vulnerabilities of health systems, costing lives and causing immeasurable damage to economies. This edition of the South African Health Review considers the government's and broader health sector's response to COVID-19, explores the current challenges facing the health system at this unprecedented time, and reflects on lessons learnt for future for public health emergencies. The chapters offer information on the challenges of balancing lives with livelihoods, and the impact of COVID-19 on different healthcare workers, especially Community Health Workers who found themselves at the forefront of the COVID-19 response. Other areas covered include the impact of COVID-19 on vulnerable populations.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The Africa Care Economy Index","field_subtitle":"Femnet: African Womens development and communication Network, 2022","URL":"https://femnet.org/2022/08/the-africa-care-economy-index/","body":"In Africa, the Care Economy has long been unrecognised. At least since the last pandemic \u2014 HIV-AIDS \u2014 caring work has been severely undervalued in the continent, and the redistribution of caring work, from females in the home and communities, next to non-existent. The COVID-19 pandemic has renewed attention to the care economy globally. The Africa Care Economy Index offers a concrete evaluation of African state performance in the recognition, support and redistribution of caring work. Based on a definition of care economy and related concepts relevant in Africa, the Index uses ten metrics to evaluate the 54 states of the continent. Demonstrating longstanding neglect of the care economy by all states in Africa, recommendations are made around broad policy and in depth research required to begin supporting and redistributing caring work. Social recognition and state support for caring work are shown to be central to building holistic development that benefits the majority in Africa.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Trends in inequality in maternal and child health and health care in Uganda: Analysis of the Uganda demographic and health surveys","field_subtitle":"Kakama A K; Basaza R: BMC Health Services Research 22(1269), 1-12, 2022 ","URL":"https://tinyurl.com/4h94prkw","body":"This study analyses data from Demographic and Health Surveys conducted in 2006, 2011, and 2016 in Uganda, to assess trends in inequality for a variety of mother and child health and health care indicators. The indicators included infant and child mortality, underweight status, stunting, and prevalence of diarrhoea. Antenatal care, skilled birth attendance, delivery in health facilities, contraception prevalence, full immunization coverage, and medical treatment for child diarrhoea and Acute Respiratory tract infections were health care indicators. Two metrics of inequity were used: the quintile ratio, which evaluates discrepancies between the wealthiest and poorest quintiles, and the concentration index, which utilizes data from all five quintiles. The study found universal improvement in population averages in most of the indices, ranging from the poorest to the wealthiest groups, between rural and urban areas. However, significant socioeconomic and rural-urban disparities persist. Under-five mortality, malnutrition in children, the prevalence of anaemia, mothers with low Body Mass Index, and the prevalence of acute respiratory tract infections were found to have worsening inequities. Healthcare utilization measures such as skilled birth attendants, facility delivery, contraceptive prevalence rate, child immunization, and Insecticide Treated Mosquito Net usage were found to show significantly lower disparity levels. Three healthcare utilization indicators, namely medical treatment for diarrhoea, for acute respiratory tract infections, and for fever, demonstrated perfect equity. Increased use of health services among poor and rural populations was found to leads to improved health status and the elimination of income and residential disparities.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"UN vote on new tax leadership role","field_subtitle":"Tax Justice Network: Live Blog, online, 24 November 2022","URL":"https://taxjustice.net/2022/11/22/%F0%9F%94%B4-live-blog-un-vote-on-new-tax-leadership-role/","body":"The UN General Assembly adopted on Wednesday 23 November 2022 by unanimous consensus a resolution that mandates the UN to set course for a global tax leadership role. The historic decision is likely to mark the beginning of the end of the OECD\u2019s sixty-year reign as the world\u2019s leading rule maker on global tax, and will now kick off a power struggle between the two institutions with implications for global and local economies, businesses and people everywhere for decades to come. The adopted resolution will now open the way for intergovernmental discussions on the negotiation of a UN tax convention and a global tax body.  This blog captures information on the resolution, on policy analysis commentary on its passing, and on evidence supporting moving tax rule-making to a globally inclusive and transparent forum at the United Nations.","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"What happened to HIV activist Zackie Achmat?","field_subtitle":"Christie S: Bhekisisa, South Africa, November 2022","URL":"https://bhekisisa.org/features/2022-11-08-what-happened-to-hiv-activist-zackie-achmat/","body":"Zackie Achmat was one of the most vociferous voices against former president Thabo Mbeki\u2019s HIV denialism in the late 1990s and early 2000s. In 1998, Zackie and a handful of others had launched what would rapidly become one of the most prominent HIV-advocacy movements in the world, the Treatment Action Campaign (TAC). This article follows what the authors call \"arguably his generation\u2019s most prominent social justice advocate\"  to his current work on other areas of engaging the state, and report Achmat's analysis of local movements. It also covers his understanding of the COVID-19 pandemic as a harbinger of a new normal \u2014 \u201ca condition where emergencies such as pandemics and climate change disasters are not exotic happenings but things occurring at home on an ongoing basis, requiring a complete reorientation of emergency healthcare, and a corresponding reorientation of activism.\u201d ","php":"","field_issue_date":"2022-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A qualitative assessment of gender roles in child nutrition in Central Malawi","field_subtitle":"Mkandawire E; Bisai C; Dyke E; Dressel A; et al: BMC Public Health 22(1392), 1-13, doi: https://doi.org/10.1186/s12889-022-13749-x, 2022","URL":"https://tinyurl.com/227bvu5z","body":"This study was implemented in central Malawi in 2017 to understand the different roles that Malawian men and women play in child nutrition. It involved interviews (76), focus group discussions and in-depth interviews. The authors found that women carried a disproportionate workload in supporting child nutrition compared to men, and that their heavier workloads in other areas often prevented them from being able to meet children\u2019s food needs. There were some shifts in gender roles with men taking up responsibilities typically associated with women, but this did not necessarily increase women\u2019s power within the household. Women continued to be primarily responsible for the food, care, and health of the household. The authors suggest that improving gender equality and child nutrition will require efforts to redistribute gendered work and encourage men to move towards shared power with women over household decision-making and control over income.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"An update on Wellcome\u2019s anti-racism programme","field_subtitle":"Farrar J: Wellcome, August 2022","URL":"https://wellcome.org/news/update-wellcomes-anti-racism-programme","body":"In this statement the Director of Wellcome Jeremy Farrar reports that two years ago, Wellcome made a commitment to developing anti-racist principles and an anti-racist programme, and to an external evaluation of progress at the institution.  An evaluation has now been reported. While it found some progress, such as improvements in the racial diversity of the workforce and some positive behavioural and practice shifts, it reached a clear conclusion that Wellcome continues to fall short of the commitment to anti-racism, both as a funder and as an employer. Farrar accepted and apologised for this and announced two measures to addressing inequity in Wellcome research funding in 2023, including a set of positive action principles applied to funding decision-making processes and the establishment of a dedicated stream of funding available exclusively to researchers who are Black and people of colour, targeted at the career stages where this will have the greatest benefits for diversity. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Asserting public health interest in acting on commercial determinants of health in sub-Saharan Africa: insights from a discourse analysis","field_subtitle":"Loewenson R; Godt S; Chanda-Kapata P: BMJ Global Health 7:e009271, doi: http://dx.doi.org/10.1136/bmjgh-2022-009271,  2022","URL":"https://gh.bmj.com/content/7/7/e009271.full","body":"While not always labelled commercial determinants of health (CDOH), some policy attention has been given in sub-Saharan Africa (SSA) to both harms and benefits of commercial impacts on health, particularly from harmful products and processes, and noting rising non-communicable diseases. This discourse analysis highlights differing interests and lenses among the multiple policy actors involved; the forms of narrative, agential and structural power used to advance and contest commercial policy interests in the health sector; and how this has been intensified by COVID-19. The evidence is used to propose actions to advance public health interests. Public health actors and \u2018one health\u2019 actions need to build on current efforts to strengthen own discursive power, challenging narratives with evidence; to strengthen their agential power through institutionalising health impact assessment, regulation and control measures; and to deepen initiatives to engage with structural power through support for local producers, harmonised regional standards and engagement on global rules that constrain health promoting activity, as was done in the Trade Related Aspect of Intellectual Property Rights (TRIPS) Waiver. Subregional and continental level organisations play a key role in enabling such actions, as does investment in SSA leadership in locally relevant innovation and production, and in links between state, academic and civil society actors to support evidence and to ensure public interests, transparency and accountability in policy decisions on CDOH. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Assessing the scalability of a health management-strengthening intervention at the district level: a qualitative study in Ghana, Malawi and Uganda","field_subtitle":"Bulthuis S; Kok M; Onvlee O; et al: Health Research Policy and Systems 20(85), 1-14, 2022","URL":"https://tinyurl.com/3ykj4at9","body":"The scale-up of successfully tested public health interventions is critical to achieving universal health coverage.  This study assessed the scalability of a tested health management-strengthening intervention (MSI) at the district level in Ghana, Malawi and Uganda. The MSI was seen as credible, as regional- and national-level Ministry of Health officials championed it and district- and national-level stakeholders seemed to be convinced of its value, due to observed positive results regarding management competencies, teamwork and specific aspects of health workforce performance and service delivery. While the relative advantages of the intervention were its participatory and sustainable nature, turnover within the district health management teams and limited (initial) management capacity complicated implementation. The authors propose from the findings that improved documentation of results of the intervention can facilitate scale-up, while embedding continuous assessment with all stakeholders involved can help to adapt to changing conditions.. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Burnout among primary health-care professionals in low- and middle-income countries: systematic review and meta-analysis","field_subtitle":"Wright T; Mughal F; Babatunde O; et al: Bulletin of the World Health Organisation 100(6), 385\u2013401A, 2022 ","URL":"https://tinyurl.com/2c2ax43z","body":"This study estimated the prevalence of burnout among primary health-care professionals in low- and middle-income countries and factors associated with burnout. The authors systematically searched nine databases up to February 2022 to identify studies investigating burnout in primary health-care professionals in low- and middle-income countries.  Three studies collected data during the coronavirus disease 2019 pandemic but provided limited evidence on the impact of the disease on burnout. The overall single-point prevalence of burnout ranged from 2.5% to 87.9%, the pooled prevalence of a high level of emotional exhaustion was 28.1%, and a high level of reduced personal accomplishment was 31.9%. The authors note that a high prevalence of burnout among primary health-care professionals in low- and middle-income countries, particularly in Africa,  has implications for patient safety, care quality and workforce planning and call for further evidence-based assessment to inform solutions..","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Call for applicants: Desk review of health-related food standards in east and southern Africa","field_subtitle":"Deadline for applications: September 15, 2022, 5pm Southern Africa time ","URL":"https://www.equinetafrica.org/content/grants.html","body":"EQUINET is calling for applicants for a desk review of domestic legal and statutory provisions in 16 ESA countries (Angola, Botswana, DRC, Kenya, Lesotho, Madagascar, Malawi, Mozambique, Mauritius, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zimbabwe, Zambia) taking note of key international and regional standards, and guidance.  The review will use online information from international agency websites and African and ESA regional organisations, and online legal databases for the above 16 countries to identify the most recent laws and specific standards in force for: International and regional standards and guidance relevant to food risks, safety and standards relating to the principles, rights, duties and authorities included, the key areas of food safety, risk, standards covered; and provisions/guidance on functions, governance and financing. Domestic law in relation to food and health in relation to scope, objectives and mission; principles, rights and duties; key areas of food safety, risks and standards; key functions; mechanisms  and administration; governance and financing. Applicants for the call are asked to outline their key experience, capacities and availability for the task, institutional and individual country location and contact information for follow up; their CV and the pdfs of at least two publications related to this field that they have authored. Applicants will be informed of the outcome of their application before or by September 21 2022. For further information on the grant and application see the website.  ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Childhood immunization services accessibility and utilization during the COVID-19 pandemic in Africa","field_subtitle":"Dzinamarira T; Moyo E; Moyo P; et al: Journal of Infection, doi: https://doi.org/10.1016/j.jinf.2022.07.020, 2022 ","URL":"https://tinyurl.com/ybbbncd8","body":"The authors present findings of a synthesis of available evidence on the accessibility and utilization of child immunization services (CIS) in Africa during the COVID-19 pandemic period. Data were independently extracted from eligible studies from online journals. The review revealed that CIS was disrupted in some countries and that uptake fell in most sub-Saharan African countries during the pandemic. In some CIS completely ceased during the lockdowns, yet in others, there were no significant changes. The authors propose strengthened monitoring of childhood immunization during pandemics to plan early catch-up vaccination activities.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"City\u2019s Scenes Sounds Actions: Call for Submissions","field_subtitle":"Open Deadline","URL":"https://drive.google.com/file/d/1hJ9_20b-5KX-_MGJtjtbMld2FY9-jjAM/view","body":"The City journal editors are looking for short, innovative and accessible submissions from a diversity of authors, campaigns, practitioners, artists, photographers and activists. These pieces will not follow the standard academic article format and process (i.e. no double blind peer review) as they are aimed at encouraging greater creative freedom, including a wider diversity of voices and reaching beyond academic audiences. These submissions will be shorter than the usual journal length, can include or be led by images and be of varied format, such as opinion pieces, campaign reports etc. Submissions received from campaigns, community organisations, artists, activists and precarious workers will receive a payment of \u00a3200. In some cases support is available for pieces being published in, or translated from, a non-English language. Images will be reproduced in colour online and black and white in the printed journal.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Combining photo-elicitation and discourse analysis to examine adolescents\u2019 sexuality in rural Zambia","field_subtitle":"Mulubwa C; Hurtig A; Zulu J M; et al: International Journal for Equity in Health 21(60), 1-13, 2022","URL":"https://tinyurl.com/2ku9bhym","body":"This article analysed constructions of adolescents\u2019 sexualities and sexual health and the consequences for adolescent exercise of their sexual reproductive health and rights in rural Zambia, using discourse analysis in interviews and focus group discussions. The authors identified three interpretative repertories that influenced youth sexual health, linked to  adolescent 'immaturity'; and what was respectful behaviours for girls and for boys, that shape how adolescents negotiate, adopt and resist sexual reproductive health and rights interventions. Adolescents were conflicted between having and applying sexual reproductive health and rights knowledge. The authors suggest that interventions that target adolescents\u2019 sexual reproductive health and rights must aim to address these perceptions and discourses that erect barriers against positive sexual behaviours, including access to services that promote safer sex.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Conceptualization, detection, and management of psychological distress and mental health conditions among people with tuberculosis in Zambia: a qualitative study with stakeholders\u2019 and TB health workers","field_subtitle":"Mainga T; Gondwe M; Stewart R C; et al: International Journal of Mental Health Systems 16(34), 1-12, 2022","URL":"https://tinyurl.com/3knhhdsu","body":"In this qualitative study, the authors aimed to understand how tuberculosis (TB) health workers and other stakeholders viewed mental health conditions linked to TB and how they screened and treated these in their patients. It was conducted in eight urban communities in Zambia through focus group discussions with local health committee members and TB stakeholders and in-depth interviews with key TB health workers. TB stakeholders and health workers were reported to have an inadequate understanding of mental health and commonly described mental health conditions among TB patients by using stigmatizing terminology and overtones, using for example \u201cmadness\u201d to imply a character  flaw rather than illness, or describing psychological distress as \u201coverthinking\", and not a condition that would benefit from mental health intervention. There were no standard screening and treatment options for mental health conditions in TB patients and most TB health workers had no mental health training, but TB Stakeholders and health workers understood the negative implications of mental health conditions on TB treatment adherence and overall wellbeing for TB patients. The authors propose integrating mental health training in TB services and screening TB patients for mental health conditions followed by care and treatment for those identified with mental health disorders.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"COVID- 19 and human right to food: lived experiences of the urban poor in Kenya with the impacts of government\u2019s response measures, a participatory qualitative study","field_subtitle":"Kimani-Murage E W; Osogo D; Nyamasege C K; et al: BMC Public Health 22(1399), 1-15, 2022  ","URL":"https://tinyurl.com/yckwbrnn","body":"This paper explored the lived experiences of the urban poor people in Kenya in the context of government\u2019s COVID-19 response measures and its impact on the right to food, using focus group discussions, interviews, photovoice and digital storytelling in two informal settlements in Nairobi between January and March 2021. The human right to food was affected in various ways. Many people lost their livelihoods, affecting affordability of food, due to response measures such as social distancing, curfew, and lockdown. The food supply chain was disrupted causing limited availability and access to affordable, safe, adequate, and nutritious food. Consequently, hunger and an increased consumption of low-quality food was reported. Social protection measures were instituted. However, these were inadequate and marred by irregularities. Some households resorted to scavenging food from dumpsites, skipping meals, sex-work, urban-rural migration and depending on food donations to survive. On the positive side, some households resorted to progressive measures such as urban farming and food sharing in the community. Generally, the response measures could have been more sensitive to the human rights of urban poor people. The authors conclude that COVID-19 restrictive measures exacerbated the already existing urban vulnerability to food insecurity and violated food rights and that future response measures be executed in ways that respect the right to food and protect marginalized people from resultant vulnerabilities.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Deconstructing the TRIPS Waiver Discussions: The Susan Sell Interview","field_subtitle":"Patnaik P: Geneva Health Files, Newsletter Edition #150, August 2022","URL":"https://tinyurl.com/ytsh3x9z","body":" In June 2022, the World Trade Organization adopted a decision at its 12th Ministerial Conference, as the outcome of a 20-month long discussion on the TRIPS Waiver. Ultimately what resulted was a rather narrow legal mechanism, essentially clarifying existing rules in the WTO TRIPS Agreement. In this interview, Susan K Sell from the Australian National University explains why words matter and how the Waiver discussions, though disappointing, have broadened and shifted the conversation on intellectual property and public health forever. . ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Determinants of COVID-19 vaccine behaviour intentions among the youth in Kenya: a cross-sectional study","field_subtitle":"Osur J O; Chengo R; Muinga E; et al: Archives of Public Health 80(159), 1-13, 2022","URL":"https://tinyurl.com/bddbcdbw","body":"This study assessed COVID-19 vaccine youth behaviour intentions and their determinants in Kenya using a cross-sectional survey and focus group discussions across 47 urban, peri-urban ad rural counties. The findings indicated that only 42% of the youth were ready to be vaccinated, with 52% adopting a wait and see approach to what happens to those who had received the vaccine and 6% totally unwilling to be vaccinated. Hesitancy was higher among females, some religious groups and those with post-secondary education. Lack of information and concerns around vaccine safety and effectiveness were main cause of vaccine hesitancy. Social media was the major information source in hesitancy. Other contributors to hesitancy included low trust in the health ministry, and belief that mass vaccination is not helpful. The authors raise that these causes of vaccine hesitancy are modifiable and suggest that health systems engage with young people to reduce vaccine hesitancy.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET Information sheet 8 on COVID-19: Experience of the pandemic from a youth lens","field_subtitle":"Training and Research Support Centre for EQUINET, July 2022","URL":"https://tinyurl.com/5brfzwau","body":"What does looking at the pandemic from a youth lens tell us about what we need to address now in our region? This brief focuses on this. EQUINET information sheets on COVID-19 summarise information from and provide links to official, scientific and other resources on east and southern Africa (ESA) covering selected themes related to equity in the pandemic. This brief covers: recent data on COVID-19 in ESA countries and in youth; youth health and wellbeing during the pandemic; services and responses to youth needs during the pandemic; youth led responses and initiatives and equity issues and actions exposed by the pandemic for young people.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET is looking for a creative writer ","field_subtitle":"Call for talent, for response by 15 September","URL":"https://www.equinetafrica.org/content/meetings.html","body":"EQUINET is looking for a creative writer to help us prepare the EQUINET Conference 2022 report linking to visuals and online presentations. If you have skills in preparing reports,  and particularly multimedia reports that use visuals and links to make them accessible to a wide variety of readers and are available in October- December 2022 to work with us on preparing the conference report please send your indication of interest, CV and daily rate to the EQUINET secretariat.  ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org\r\nWebsite: http://www.equinetafrica.org/newsletter\r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others.\r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe\r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 233: Share your stories of change in promoting health and social justice in the region","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Join the EQUINET conference on Reclaiming the State, Online, Next session 15 September ","field_subtitle":"Register before 5 September  ","URL":"https://www.equinetafrica.org/conference/home.html","body":"The 2022 EQUINET regional conference 'Catalysing change for health and social justice' is sharing and discussing experiences,  evidence, analysis, successes and struggles from local to regional level and engagement globally to advance health and wellbeing in  East and Southern Africa. Through the exchanges we are framing propositions to advance health equity and social justice in our region that will inform policy engagement and future work.  The conference includes statements from key institutional representatives in the region and internationally, research papers, photojournalism, art and music and group discussions. The first day has been held, but you can still register for the second and third days on the conference website.  The programme for the second day \"Reclaiming the State 2\" on September 15th is now available online covering issues relating to urban health, youth health, equitable health financing, promoting primary health care in pandemics and more.      ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Kenyan tea pickers on Scottish-run farm to pursue health issues in UK court","field_subtitle":"Bricks L: The Guardian, August 24, 2022","URL":"https://tinyurl.com/2fvap65r","body":"More than a 1,000 Kenyan tea pickers who say that harsh and exploitative working conditions on a Scottish-run tea farm have caused them crippling health complaints can now pursue their class action in an Edinburgh court. Prolonged bending to gather tea for James Finlay Kenya is argued to accelerate ageing of pickers\u2019 backs by up to 20 years. Lawyers acting for the tea pickers have won an order from the court of session, Scotland\u2019s highest civil court, telling James Finlay Kenya Ltd (JFK) to abandon attempts to block the suit through the Kenyan courts. Finlays, an Aberdeen-registered multinational whose estates in Kericho, Kenya, stretch across 10,117 hectares (25,000 acres), is one of the largest suppliers of tea and coffee in the world. The company has defended its health and safety record, and carries the Fairtrade mark on its products, as well as certifications from the Soil Association and the Rainforest Alliance. But in previous testimony, the article reports that workers claimed that oppressive working conditions caused them significant and permanent musculoskeletal damage. They said they had to work up to 12 hours a day in a six-day week, carry up to 26lb of the tea leaf pickings on their back over rough slopes, and in some cases meet a weight target of 66lb of tea a day or not get paid. The article reports that the lawyers hope that the case will impact more broadly on practices in the industry. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Motion to setup Parliamentary Caucus on the Rights of Persons with Disabilities adopted","field_subtitle":"Mwale I: Deaf Zimbabwe Trust, Harare, 2022","URL":"http://deafzimbabwetrust.org/disability-observer-2022-issue-3/","body":"Since 2020, Deaf Zimbabwe Trust has been advocating with the Parliament of Zimbabwe for the establishment of a Parliamentary Disability Caucus. In April this year Parliament approved a motion to establish a Parliamentary Disability Caucus that will ensure that Persons with Disabilities have a voice during the formulation of laws and policies. Currently, disability issues fall under the Parliamentary Portfolio Committee on Public Service and Social Welfare. The caucus will enhance the visibility of persons with disabilities and their access to socio-economic rights. Deaf Zimbabwe Trust working with the Victim friendly Unit and the Judiciary Service Commission is working on the development of Disability Identity Stickers on dockets to foster readiness of the Justice System in dealing with persons with disabilities and better accommodate persons with disabilities in court proceedings. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"New WHO eLearning course series on Health Inequality Monitoring","field_subtitle":"Free online course, World Health Organisation, Geneva","URL":"https://openwho.org/channels/inequality-monitoring","body":"A new WHO eLearning course series, \u2018Health Inequality Monitoring Foundations\u2019 delivers a self-directed learning environment, designed to meet the immediate learning needs of users. It is primarily targeted to monitoring and evaluation officers, researchers, analysts, and others with a general interest in health data and inequality monitoring. The Overview course gives a general introduction to the monitoring process and key terminology and concepts. The Data sources course examines the strengths, limitations and opportunities to improve common data sources for health inequality monitoring, as well as the processes of data source mapping and data linking. The Health data disaggregation course explores how disaggregated health data are integral across the steps of monitoring, and builds skills in assessing and reporting disaggregated data. The Summary measures of health inequality course discusses the general characteristics of simple and complex summary measures, and guides learners through the selection, calculation, interpretation and reporting of a range of measures. The Reporting course demonstrates the components of high-quality health inequality reporting, emphasizing purpose-driven, audience-centred, and technically rigorous approaches. These courses are available for free on the Health Inequality Monitoring channel of OpenWHO.  ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"PHASA (Public Health Association of South Africa) 17th annual public health conference","field_subtitle":", 11 \u2013 14 September, Durban, South Africa","URL":"https://phasa.samrc.ac.za/","body":"The Public Health Association of South (PHASA) is holding their annual conference in Durban (eThekwini), on the east coast of South Africa. PHASA hosts an annual conferences, with the aim of engaging public health practitioners and interested people from around the country and world to share their experiences and research, discuss topical public health issues, and mentor public health students and young researchers. Hosting the national PHASA conference in Durban aims to add stimulus to the local economy, and contribute to enhanced awareness and widespread advocacy, for health, the social determinants of health, and healthcare in the region.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Private sector engagement in the COVID-19 response: experiences and lessons from the Democratic Republic of Congo, Nigeria, Senegal and Uganda","field_subtitle":"Kabwama S N; Kiwanuka S N; Mapatano M A; et al: Globalization and Health 18(60), 1-10, 2022","URL":"https://tinyurl.com/4tx3enpx","body":"This paper documented public and private sector partnerships in the Democratic Republic of Congo, Nigeria, Senegal and Uganda between November 2020 and March 2021 in responses to the COVID-19 pandemic, using literature review and key informant interviews. Across the 4 countries, private sector strengthened laboratory systems, COVID-19 case management, risk communication and health service continuity.  Across the 4 countries, the private sector supported expansion of access to COVID-19 testing services through establishing partnerships with the public health sector albeit at unregulated fees. In Senegal and Uganda, governments established partnerships with private sector to manufacture COVID-19 rapid diagnostic tests. In addition, private entities provided personal protective equipment, conducted risk communication to promote adherence to safety procedures and health promotion for health service continuity. However, there were concerns related to reporting, quality and cost of services, calling for quality and price regulation in service provision. The authors indicate that regulatory frameworks are needed in public\u2013private engagements in pandemics, including of pricing, quality assurance and alignment with national plans and priorities.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Samir Amin internationaliste organique/organic internationalist","field_subtitle":"GRILA pr\u00e9sente, 2019","URL":"https://www.youtube.com/watch?v=mKBJNpTU1Jw","body":" \u201cIn our era, when we consider the destructive (ecological and military) might at the disposal of the powers-that-be, the risk.. that war will end up destroying all the opposing camps, is real. On the other hand, there is a second path that demands the lucid and organized intervention of the internationalist front of workers and peoples.\u201d Taking as its point of departure this observation by Samir Amin, this film depicts the audacious struggles of, as well as interviews with, addresses by and special moments involving this outstanding intellectual of the South. In the film Samir Amin discusses the political economy of development, capitalism and imperialism, as well as the resistance of workers and peoples. The film includes testimonies from other key thinkers of the region and images from the film The Dispossessed by Mathieu Roy, and also by several other sequences from throughout the world.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Share your stories of change in promoting health and social justice in the region","field_subtitle":"Editor, EQUINET newsletter","body":"In exchanges and work in the region and in the 2022 EQUINET conference 'Catalysing change for health and social justice' we have heard and shared creative, committed and often sustained experiences that promote health equity and social justice at local, national and regional level, and in engaging in global processes.  In future newsletters we thus plan to share these stories of change together with our usual editorials. Please contribute and share your work! We invite submissions of about 1000 words that tell the story with links where available to further information that we can feature in future issues. If you need edit support to write it we can assist. Please email your submission to the EQUINET secretariat (email address on the website) with 'Story of Change' in the subject line. If you haven't yet joined the online EQUINET conference you are still in time to register for and join the remaining days. Details are on the EQUINET website.  ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"STORIES OF CHANGE: Opening doors for young people through affordable e-learning in South Africa","field_subtitle":"Nadine Nanji, Public Health Researcher, University of Cape Town, South Africa","body":"South Africa has high levels of socio-economic inequality and youth unemployment. The COVID-19 pandemic has created many economic challenges, especially for those who are already insecure or who live and work in precarious conditions, many of whom are young people.  Poverty and lack of opportunity in a country where there is a visible display of wealth has led to frustration and social unrest. Unemployed youth and those in precarious employment and in lowest income communities are vulnerable to many risks, including mental stress, gender-based violence, sexual abuse, teenage pregnancies, and use of harmful substances.\r\n\r\nDigital courses are available, but are often unaffordable for the lowest income youth, as are university courses and other formal training programmes. Digital skills have high value, but how do unemployed, underserved or economically disadvantaged South African youth access these skills? This generates new forms of digital inequity that add to the country\u2019s other dimensions of inequality. While young people have many interests, they want to follow learning tracks that improve their incomes, working lives and wellbeing. They also don\u2019t want to have to high jump over huge demands for formal educational qualifications to have the chance to learn new skills. \r\n\r\nIn 2021, an initiative was launched to tackle these issues facing the disadvantaged young people, triggered also by the increased demand for online interaction during the COVID-19 pandemic. Afrika Tikkun, a South African non-profit organisation, aims to improve the lives of young people, leveraging solidarity partnerships with other organisations. Afrika Tikkun saw an opportunity to tackle inequities in youth unemployment through education, skills development and placement programmes. They found a partner in Nedbank, who, having done an assessment in 2020 on social issues that could be rectified through financial investment, identified a huge gap in the digital job market in South Africa, with an unmet demand due to a shortfall in skills. Any programme aimed the lowest income young people tapping this opportunity would need to address the multiple barriers they face in access to and the costs of online platforms, to avoid entry barriers from a demand for high formal education levels, and to encourage and guide learning through mentoring and peer support. Afrika Tikkun  and Nedbank partnered with Microsoft to draw on their experience in digital skills building, in a collaboration that brought different capacities and roles towards a shared goal. \r\n\r\nThese partners established an e-learning platform called DigiSkills, with an explicit goal of supporting  digital equity for young people. No formal education was needed to join the programme, the program provides in a low bandwidth five free online short courses on professional digital skills with constant support through facilitators, mentors and peer groups to encourage and support participation. The app provides free access to online learning, although data charges to get online still need to be met. The equity test and sustainability of the initiative lies, however, not so much in the resources of the launching partners, but in the reach to and social and economic value it has for the participating young people, particularly those normally excluded from such skills programmes. \r\n\r\nBy the end of 2021, 1000 students had completed the online digital skills training, with prior screening ensuring that there were drawn from disadvantaged, unemployed or displaced youth. Over 400 of these young people found job opportunities. In 2022, a further 4000 young South Africans are undergoing the training. The DigiSKills program is supporting students to link learning pathways to job creation and entrepreneurial opportunities, and to solidarity with other young people. 26-year-old David, previously unemployed, who took the course and now works as a developer at MLab, commented that the opportunity has given him a power he did not have before to sustain himself and his family. 31-year old Thabani, also a graduate courses, is now assisting other young people to sign up and intends to start his own IT training company to help more youth in South Africa. \r\n\r\nThere are no magic bullets however. These programmes don\u2019t intend to substitute pathways to higher levels of skills, research and development and on their own don\u2019t stop the brain drain from South Africa. They don\u2019t replace more significant levels of investment in self-determined research and innovation in the country. They don\u2019t yet address the wider cost barriers to internet and data and to capital for young people to create new enterprises. All these areas need state and political attention and a wider level of change on the multiple institutions involved in the systems for skills development, research, innovation and entrepreneurship, including from early child development and in schools. \r\n\r\nHowever, there are some lessons from the story of change on how partnerships can bring together actors with different background and capabilities, based on evidence and embedding clear values, towards a shared vision and implementation. The initiative is perhaps not perfect, not adequate for the significant inequities faced and still to be tested in the longer term. It suggests, however, that individually the young people and each of the institutions involved are not drivers of transformation. It is perhaps in their convergence, and their mindfulness and consistency in addressing an equity goal, that there is a possibility for producing change or shifting power in this key area of inequity for young people in South Africa. \r\n\r\nEQUINET, through its Equity Watch Cluster invites your stories of change on any areas that reflect change in health equity and social justice, locally, within countries and regionally in east and southern Africa.  In about 1000 words they tell the story of how a change came about, and who made it happen. To send feedback on the issues raised in this oped or to send a story please email the EQUINET secretariat: admin@equinetafrica.org. Further information on Digiskills can be found at the Africa Tikkun website (https://afrikatikkun.org/ ) and at https://www.digiskills.careers/.\r\n","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Tax justice for universal public sector health systems in East and Southern Africa","field_subtitle":"Loewenson R; Mukumba C: Training and Research Support Centre, Tax Justice Network Africa, EQUINET Discussion paper 126, EQUINET, Harare, 2022","URL":"https://tinyurl.com/5brfzwau","body":"This paper outlines performance on key dimensions of public sector health financing: the size of the funding \u2018gap\u2019 in relation to basic health service needs; population entitlements; and state duties to health care; with brief discussion on the negative implications for equity of meeting this gap through out of pocket spending and privatisation of health services. With tax revenues the most progressive source of health financing for universal health coverage, it examines the level, sources and drivers of lost tax revenue in ESA countries, and relates the public sector health system funding gap to the sources of lost tax revenue. The paper points to how the current global tax framework and its unfair allocation of taxing rights benefits high income countries to the significant detriment of low- and middle-income countries. Despite promises of reforms by some larger high income countries, those that have been proposed fail to address this tax injustice. This evidence indicates that it is possible to meet the health financing gap for public sector health systems in the region through adequate funding from progressive taxation. With the public health and economic implications of COVID-19 having drawn socio-political attention to the need for investment in public sector health systems, the authors argue that there is an opportunity for a more ambitious alliance between the health and finance sectors to demonstrate the public health value of addressing these critical tax losses to increase public revenues for health.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Test to protect: equal access to diagnostics for all","field_subtitle":"Aslanyan G; Rodriguez B; Moyo S: Global Health Matters Podcast, Episode 14, 2022","URL":"https://tinyurl.com/ehxuwedu","body":"The COVID-19 pandemic has brought a new global awareness of the accessibility of diagnostics and the need to test to protect with equal access for all. This episode of Global Health Matters, answers key questions including the availability of essential diagnostics in low- and middle-income countries (LMICs).   Host Garry Aslanyan interviews guests who have a deep understanding of diagnostics and their application worldwide: Bill Rodriguez is CEO of FIND, the global alliance for diagnostics, and is also founder of his own diagnostics company, Daktari Diagnostics; and Sikhulile Moyo who led the team that helped discover the Omicron variant in Botswana through careful cross-examination of COVID-19 tests.  Join Global Health Matters in this podcast episode to understand the state of diagnostic testing in LMICs and how to achieve equity in access to testing in all countries.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review","field_subtitle":"Gnugesser E; Chwila C; Brenner S; et al: BMC Public Health 22(1507), 1-20, 2022 ","URL":"https://tinyurl.com/455mbye7","body":"This paper identified costs and major cost drivers across countries in Sub-Saharan Africa, drawing on published literature. The costs are in US$. Medication costs were accountable for most of the expenditures and varied across countries, with a range from $1.70 to $97.06 from a patient perspective and $0.09 to $193.55 from a provider perspective per patient per month. Major cost drivers were multidrug treatment, inpatient or hospital care and having a comorbidity like diabetes. Hypertension is argued from the findings to pose a significant economic burden for patients and governments in SSA, with medication costs one of the biggest cost contributors. The authors suggest that addressing the economic burden of hypertension implies reducing medication costs, including in the form of subsidies for patients. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Good Food Festival, Zimbabwe","field_subtitle":"24 September, Harare Botanical Gardens, Harare, Zimbabwe","URL":"http://www.naturallyzimbabwean.com","body":"The Good Food Festival, organised by the Zimbabwe Traditional and Organic Food Forum, is celebrating its 10th anniversary in 2022, hosted on Saturday 24 September at the Harare Botanical Gardens. There will be music all day, a wide range of local produce, products and seeds for sale, a delicious selection of dishes at the food court, chefs\u2019 battles and cooking demos. The event includes a special kids\u2019 zone for children.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Pandemic Plot: Conjuring a literary epidemic reading list","field_subtitle":"Bonhomme E: Mobile Fragments Substack, 2022 ","URL":"https://tinyurl.com/359zybkt","body":"Bonhomme argues that some seminal writing during and on pandemics are worth revisiting, mostly because they provide room for ingenuity, strangeness and insight into another world. This short reading list explores how novels \u2014 past and present \u2014 have not only tackled epidemics but also provided acute and thought-provoking insight into humanity's tenacity.  Given these texts' range in time, scope, and region, the novels are presented to offer a new crop of texts to flourish and overcome the corrosive effects of pandemic disillusionment and despair. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"There is nowhere to take the child: a qualitative study of community members\u2019 views on managing early childhood substance use in Mbale, Uganda","field_subtitle":"Skylstad V; Engebretsen I M S; Nalugya S J; et al: BMC Public Health 22(1192), 1-13, 2022 ","URL":"https://tinyurl.com/2p9e9k9u","body":"This study explores the experiences and perceptions of community members regarding how childhood substance use (before age 10) is managed in in Mbale District, Uganda.  this area.  Three main themes were identified: \u2018We don\u2019t talk about it\u2019: Despite concern, childhood substance use was not addressed in the community. Participants attributed this to a lack of leadership in addressing it, changing acceptability for peer parental interference, and uncertainty about repercussions related to children\u2019s rights. \u2018There is nowhere to take the child\u2019: Since substance use was not considered a medical problem, help from the health sector was only sought for adverse consequences, such as injury. This left the participants with the experience that there was in effect nowhere to take the child. \u2018The government has not done so much\u2019: The participants called for government action and clear laws that would regulate the availability of alcohol and other substances to children, but they had limited trust in the capacity and commitment of the government to act. Despite concern about childhood alcohol and substance use, the complexity and magnitude of the problem left community members feeling incapacitated in responding. The authors propose measures that address leadership, service, and legal deficits and that support collective agency to act on the issue in communities. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Transforming Africa's health system in wake of COVID-19 pandemic","field_subtitle":"World Health Organization (AFRO): WHO, Lome 24 August 2022","URL":"https://www.afro.who.int/news/transforming-africas-health-system-wake-covid-19-pandemic","body":"As Africa strives to recover from the impact of the COVID-19 pandemic, health authorities and experts gathered in end August for the Seventy-second session of the World Health Organization (WHO) Regional Committee for Africa launched a new drive to find ways of revamping the region's health systems. At a special event on Rethinking and rebuilding resilient health systems in Africa during the 22 \u2013 26 August Regional Committee meeting in Lom\u00e9, Togo, delegates examined the measures that have worked in achieving universal access to health care as well as the shortfalls. They also explored ways to maintain essential services during outbreaks and the investments and actions needed to ensure equitable access to quality medical products and health technologies. The special event launched at the Regional Committee kicks off a collective process to support African countries as they ramp up efforts to recover from the pandemic-triggered disruptions and work to rebuild better their health systems. A series of consultations and actions will follow to support countries in achieving universal health coverage and health security.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"TRIPS Waiver proponents back at the table to push for therapeutics and diagnostics","field_subtitle":"Patnaik P: Geneva Health Files, Newsletter Edition #148, July 2022","URL":"https://tinyurl.com/2dy8rdcx","body":"While the supporters of the original TRIPS waiver are still coming to terms with the remains of the 20 month saga that yielded a ministerial decision clarifying the rules of compulsory licensing for the production of vaccines, they are back at the WTO to stomach another fight, this time, to discuss the way forward to boost the production of therapeutics and diagnostics by seeking to extend the applicability of the June decision to these medical products. This puts the co-sponsors, again, directly in opposition to industry interests where companies alone are projected to make billions off a single drug to treat COVID-19.  The co-sponsors point out that there are four times as many patent filings related to therapeutics compared to vaccines. Already, more than 5,200 patent applications related to COVID-19 were published across 49 patent offices between 2020-21, according to the World Intellectual Property Organization Patent Landscape Report, the co-sponsors cite. They argue that granting of patents could delay the entry of generic drugs, and in turn lead to price increases affecting access. They seek an extension of the policy tools provided in the June ministerial decision to therapeutics and diagnostics. This, they say, \u201cwill help developing countries to address IP barriers to the expansion and diversification of production\u201d.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Under-five mortality in the Democratic Republic of the Congo: secondary analyses of survey and conflict data by province","field_subtitle":"Schedwin M;  Furaha A B; Kapend R; Akilimali P; et al: Bulletin of the World Health Organisation 100(7), 422\u2013435, 2022","URL":"https://tinyurl.com/35pzsz66","body":"This study compared coverage of key child health policy indicators across provinces and to explore their association with under-five mortality and level of conflict in the Democratic Republic of the Congo. A secondary analysis of nationally representative data was implemented from 1380 health facilities and 20\u2009792 households in 2017\u20132018 was done. All grouped coverage scores demonstrated large ranges across the 26 provinces: newborn health: 20% to 61%; pneumonia: 26% to 86%; diarrhoea: 25% to 63%; malaria: 22% to 53%; and safe environment: 4% to 53%. The diarrhoea score demonstrated the strongest association with under-five mortality. Child mortality and the odds of coverage were higher in conflict-affected provinces for 13 out of 23 indicators. However, the authors also noted that children in unaffected provinces should not be neglected while addressing the needs of the most vulnerable in conflict settings. They notes that prevent, protect and treat strategies for diarrhoeal disease could help improve equity in child survival.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Using a theory of change in monitoring, evaluating and steering scale-up of a district-level health management strengthening intervention in Ghana, Malawi, and Uganda \u2013 lessons from the PERFORM2Scale consortium","field_subtitle":"Kok M; Bulthuis S; Dieleman M;  et al: BMC Health Services Research 22:1001 https://doi.org/10.1186/s12913-022-08354-y, 2022","URL":"https://tinyurl.com/5wumchy3","body":"This consortium did work to understand the benefits and challenges of using a theory of change (ToC) -based approach for monitoring and evaluating the scale-up of health system strengthening interventions. The consortium held annual ToC reflections that entailed multiple participatory methods, including individual scoring exercises, country and consortium-wide group discussions and visualizations, capturing the reflections around an initiative for strengthening district health management teams, to improve health workforce performance and service delivery at scale. The annual ToC reflections proved valuable in gaining a nuanced understanding of how change did happen and strategizing on actions to further steer the scale-up the intervention. It also led to adaptations of the ToC over time. Based on the experience the authors suggest that  ToC-based approaches are useful, should include a variety of stakeholders and require their continued commitment to reflection and learning on intervention implementation and scale-up. ToC-based approaches can help in adapting interventions as well as scale-up processes to be in tune with contextual changes and stakeholders involved, to potentially increase chances for successful scale-up.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Why enforcing more strict tobacco control measures will go a long way in protecting the future of Uganda","field_subtitle":"Dhafa E: CEHURD newsletter, August 2022","URL":"https://tinyurl.com/2uj9new6","body":"Tobacco use has remained a significant public health challenge in Uganda and a leading cause of non-communicable diseases including heart diseases and premature deaths. The author argues that tobacco is also the only legally available consumer product that kills people when it is used entirely as intended.  Even when the law is in place, tobacco is still used in various forms including smoked and smokeless tobacco. The author proposes that government strengthen existing schemes to make tobacco producers more responsible for the environmental and economic costs of dealing with tobacco waste products.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"WTO finally agrees on a TRIPS deal. But not everyone is happy","field_subtitle":"Green A: Devex, June 2022","URL":"https://tinyurl.com/9xbux3ku","body":"After its four-day ministerial conference spilled over into a sixth day in June, the World Trade Organization finally arrived at an agreement on the controversial TRIPS waiver. After heavily contested negotiations, member states agreed on a deal that temporarily removes intellectual property barriers around patents for COVID-19 vaccines, and postpone the  discussions on extending the waiver to treatments and tests by six months. The five-year agreement was struck after a marathon negotiating session at the WTO\u2019s highest meeting. It allows low- and middle-income countries to temporarily waive protections on those patents to produce the shots, either to use domestically or to send abroad. It pushes a decision on treatments and tests off by six months, though it is noted that WTO is notoriously bad at sticking to its deadlines. It also wiped away the original proposal\u2019s calls to temporarily waive protections on trade secrets, copyrights, and industrial designs. The biggest change \u2014 and one of the most contentious points of discussion at the ministerial conference \u2014 according to observers, was the limit the new deal imposed on eligibility. Any country was able to take advantage of existing WTO flexibilities. But under the deal, export eligibility is limited to LMICs. ","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Your status cannot hinder you\u201d: the importance of resilience among adolescents engaged in HIV care in Kenya","field_subtitle":"Adams C; Kiruki M; Karuga R; et al: BMC Public Health 22(1272), 1-13, 2022","URL":"https://tinyurl.com/4adtj7dz","body":"This paper identified key stigma-related barriers to ART adherence and strategies used by adolescents in overcoming these barriers. Data were collected by LVCT Health, a Kenyan organization with a programmatic focus on HIV testing, prevention, and care, interviewing 122 participants in Nairobi, Kisumu, and Mombasa, and in focus group discussions with adolescents living with HIV (ALHIV), peer leaders, and adolescents receiving HIV services in community settings irrespective of HIV status. Four major themes emerged. Knowledge and future-oriented goals can drive motivation for ALHIV to remain healthy. Disclosure to others strengthens support systems for ALHIV, medication-taking strategies and can overcome adherence challenges. A supportive clinic environment promotes continuous adolescent engagement in HIV care. These concepts were used to develop a model moderating negative effects of stigma among ALHIV. Strengths-based interventions, focused on increasing positive features in ALHIV in Kenya, and more formal involvement of adolescent peers to bolster adolescent support, are argued to have the potential to improve ART adherence among ALHIV.","php":"","field_issue_date":"2022-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"5TH CODESRIA/CASB Summer School in African Studies and Area Studies in Africa","field_subtitle":"Deadline for Applications: 30th June 2022","URL":"https://codesria.org/5th-codesria-casb-summer-school-in-african-studies-and-area-studies-in-africa/","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) and The Centre for African Studies in Basel (CASB) call for applications for their 5th Summer School in African Studies and Area Studies in Africa. The Summer School addresses the question \u201cHow Political is Knowledge?\u201d. The political economy of knowledge production in Africa is argued to require critical reflection, raising general questions about the relationship between knowledge, power and politics. The overall objective of the Summer School is to stimulate and consolidate interdisciplinary approaches to research on Africa, but also on other regions of the world undertaken from within the African continent. The 5th CODESRIA/ZASB Summer School invites applications from doctoral students interested in exploring these issues as part of a larger framework of engaging with methodological challenges in African Studies. Travel, accommodation and meals during the Summer School will be provided for participants from African Institutions. Application information is available on the website. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Africa and the corrosive international tax system","field_subtitle":"Mukumba C; Etter-Phoya R: Tax Justice Network, 2021","URL":"https://tinyurl.com/f2myv6yd","body":"Illicit financial flows are argued by the authors to punch holes in the public purse across the African continent. Over the past five decades Africa is reported to have lost in excess of US$ 1 trillion in illicit financial flows, dwarfing the continent's receipts of overseas development assistance during this period and the foreign direct investment into Africa. Based on research of national laws, policies and practice, each of the 70 countries included in the Corporate Tax Haven Index are given a score. African countries are found to contribute less to tax abuse than European Union and OECD member states and their dependencies, but have less robust transparency and anti-avoidance measures. The authors call for policy improvements in African countries to curb and protect against corporate tax abuse, and advocate for a UN Tax Convention. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Africa\u2019s reaction to the AU\u2019s \u2018African common position to the UN Food Systems Summit\u2019: A blueprint for corporate capture and industrial agriculture","field_subtitle":"Africa Common Position by Civil Society (ACPCS): At the  UN Food Systems Summit.July, 2021","URL":"https://tinyurl.com/wj3n5c82","body":"Sixty civil society organisations in Africa under the banner of an Africa Common Position by Civil Society (ACPCS) presented a statement in reaction to the AU\u2019s \u2018African common position to the UN Food Systems Summit.\u2019 In a well-attended and inclusive social movement process in July 2021, small-scale African producers of all kinds \u2013 fisherfolk, pastoralists, women, young people, agricultural workers, indigenous peoples and the urban food insecure \u2013 articulated their concerns that the United Nations Food Systems Summit (UNFSS) had been captured by multinational corporations, and called for Africa\u2019s food sovereignty and transformation of the industrial food system. The statement condemns the corporate hegemony of food systems, with food systems being depicted as being in need of saviour western technology, productivity and competitive enhancement and the gross power imbalances that corporations hold over food systems. The statement calls for the UN system to address the legitimate concerns raised by civil society and open spaces and meet responsibilities for this in the public sphere at both national and global level.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Analysis of aid flows to Uganda before and during Covid-19","field_subtitle":"Owori M: Development Initiatives, Online, 2021 ","URL":"https://devinit.org/resources/aid-uganda-covid-19/","body":"The overall profile of official development assistance (ODA) in Uganda is reported to be switching from grants to increased proportions of concessional loans, as international financial institution (IFI) lending became a significant source of foreign aid in 2020. Growth in IFI aid flows to Uganda between 2018 and 2020 was mainly driven by the World Bank, which contributed 77% of the total reported IFI contributions in the three years reviewed. The health sector received the largest share (US$205 million) of bilateral grant aid disbursements in 2020, but this allocation represented a 10% decline from 2019 to 2020. The allocation to the humanitarian sector in 2020 also declined, but the allocation to the agriculture and food security sector increased by 34% to US$128 million between 2019 and 2020, ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Be part of the exchanges at #EQUINETConf22 on Catalysing Change for Health and Social Justice!  ","field_subtitle":"EQUINET steering committee ","body":"The EQUINET Conference 2022 \u201cCatalysing change for health and social justice\u201d welcomes community members, workers, state personnel at all levels, civil society, parliamentarians, academics, trade unions, diverse professionals, innovators, producers and others to present ideas and hear experience from the east and southern Africa region. We will also learn how other regions are confronting equity challenges and  discuss and propose key areas of action and policy to promote health equity and social justice. We need your input so please don't get left behind! Find out more in the EQUINET update section of the newsletter, follow @EQUINETConf22 on twitter or visit the conference website at https://www.equinetafrica.org/conference/home.html. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis","field_subtitle":"Eze P; Lawani LO; Agu UJ; Acharya Y: Bulletin of the World Health Organisation 100(5), 337-351J,  doi: 10.2471/BLT.21.287673, 2022","URL":"https://tinyurl.com/3knyfwhn","body":"This study estimated the incidence of, and trends in, catastrophic health expenditure in sub-Saharan Africa. A systematic review of  scientific and grey literature was conducted to identify population-based studies on catastrophic health expenditure in sub-Saharan Africa published between 2000 and 2021. A meta-analysis was performed  using two definitions of catastrophic health expenditure: 10% of total household expenditure and 40% of household non-food expenditure. The results of individual studies were pooled by pairwise meta-analysis using the random-effects model. The authors identified 111 publications covering a total of 1 040 620 households across 31 sub-Saharan African countries. Overall, the pooled annual incidence of catastrophic health expenditure was 16.5% for a threshold of 10% of total household expenditure and 8.7% for a threshold of 40% of household non-food expenditure. Countries in central and southern sub-Saharan Africa had the highest and lowest incidence, respectively. A trend analysis found that, after initially declining in the 2000s, the incidence of catastrophic health expenditure in sub-Saharan Africa increased between 2010 and 2020. The incidence among people affected by specific diseases, such as noncommunicable diseases, HIV/AIDS and tuberculosis, was generally higher. Although data on catastrophic health expenditure for some countries were sparse, the available data suggest that a non-negligible share of households in sub-Saharan Africa experienced catastrophic expenditure when accessing health-care services, and that stronger financial protection measures are needed.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Challenging the Illusion: Health Equity Amidst New Variants","field_subtitle":"Essar MY; Lal A; Ahmad S; et al: International Journal of Public Health 67:1604896, doi: 10.3389/ijph.2022.1604896, 2022","URL":"https://www.ghspjournal.org/content/10/2/e2100648","body":"Low- and middle-income countries (LMICs) with limited capacities and infrastructures have experienced striking and disproportionate public health and economic losses during the COVID-19 pandemic\u2014particularly due to imposed lockdowns and restrictions. The pandemic\u2019s emerging variants are identified in this paper as a manifestation of unequal and unjust distribution of COVID-19 vaccination\u2014unmasking \u201chealth equity\u201d as an illusion. The authors state that firm actions have been taken by High income countries and powerful actors, who could be playing a leading role in offering solutions rather than privileging self-defeating interests. They urge that the ongoing COVID-19 response and future efforts for pandemic preparedness should ensure health equity is made an urgent, core priority\u2014rather than an afterthought.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Cities can care for people and enable them to care for others, making urban health possible","field_subtitle":"Obando F; Keith M: PEAK Urban Programme, University of Oxford, 2022","URL":"https://tinyurl.com/mryb5sd2","body":"By creating the conditions for health in many ways - through healthcare, childcare, public safety, community and economic development, parks and recreation, among others - local governments care for people. In this paper, three significant ways are discussed. A closer look at the role of local governments in providing water, sanitation and hygiene (WASH), urban planning, and transport shows that the local government contribution to healthy urban lives and equity is unparalleled but faces significant challenges. A contestation of public goods and private interests make the role of a local arbitrator essential. With local governments key actors in collective wellbeing and in generating equity, the authors argue that when they fall short, the consequences for health are disastrous. They provide a framework for navigating complexity and present and draw lessons from the participation of local governments in urban governance during the COVID-19 pandemic.   ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Co-building a New Eco-Social World: Leaving No One Behind, The People's Global Summit","field_subtitle":"IFSW, UNRISD, WFPHA et al: 29th June to 2nd July 2022 \u2013 Online","URL":"https://newecosocialworld.com","body":"The People\u2019s Global Summit is brings together individuals and communities, people of lived experiences, along with global organisations to co-build a combined global conversation on the creation of globally shared values for a new eco-social world that leaves no one behind. The vision of this people\u2019s global summit emerges from the pandemic, the climate crisis, and the need to co-build a new eco-social world based on values that shape policies and practices to ensure sustainability and good quality life-cycles \u2013 not only for each human being but for each part of our eco-systems on which we all depend, leaving no one behind. The people\u2019s global summit provides spaces for individuals as well as for group representatives to advance their ideas and provide a platform for engagement across different cultures, diverse lived experiences, professional groups, and perspectives. All contributions will shape the Global Values Declaration for a new eco-social world that will be delivered to the United Nations High-Level Political Forum in July 2022 and will create a catalyst for further global action.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community health workers and health equity in low- and middle-income countries: systematic review and recommendations for policy and practice","field_subtitle":"Ahmed S; Chase LE; Wagnild J; et al: International Journal for Equity in Health 21, doi: https://doi.org/10.1186/s12939-021-01615-y, 2022 ","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01615-y","body":"This systematic review aimed to synthesise research findings on the Community Health Worker (CHW) effectiveness at reaching the most disadvantaged groups in low- and middle-income countries (LMIC) contexts, and in reducing health inequities in the populations they serve. One hundred sixty-seven studies met the search criteria, reporting on CHW interventions in 33 LMIC. Quantitative synthesis showed that CHW programmes successfully reach many (although not all) marginalized groups, but that health inequalities often persist in the populations they serve. Qualitative findings suggest that disadvantaged groups experienced barriers to taking up CHW health advice and referrals and point to a range of strategies for improving the reach and impact of CHW programmes in these groups. Ensuring fair working conditions for CHWs and expanding opportunities for advocacy were also revealed as being important for bridging health equity gaps. In order to optimise the equity impacts of CHW programmes, the authors propose moving beyond seeing CHWs as a temporary sticking plaster, and instead building meaningful partnerships between CHWs, communities and policy-makers to confront and address the underlying structures of inequity.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Community Health Workers in Pandemics: Evidence and Investment Implications","field_subtitle":"Ballard M; Johnson A; Mwanza I; et al: Global Health: Science and Practice 10(2):e2100648; doi: https://doi.org/10.9745/GHSP-D-21-00648, 2022","URL":"https://www.ghspjournal.org/content/10/2/e2100648","body":"Community health workers (CHWs) have been a critical part of health care delivery across diverse contexts for over a century. This article argues that a strong and accessible national health system, including at the community level, is critical for pandemic preparedness and response. Community health workers who are equipped, trained, and paid as part of a well-functioning health system can help prevent epidemics from becoming pandemics and maintain health care delivery amid significant disruption. To achieve resilient health systems, bi/multilateral aid and private philanthropies need to review their investment practices to replace those that cause harm (high transaction costs, earmarking, short-termism, appropriation of sovereignty) with practices that ensure timely and effective implementation of priorities set by government stakeholders (pooling, longer commitments, and alignment with evidence-based guidelines).","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Confronting inequities in the \u2018donor\u2019-\u2018recipient\u2019 relationship in health in Uganda  ","field_subtitle":"Danny Gotto, Innovations for Development, Uganda","body":"Like many other countries in East and Southern Africa, Uganda\u2019s health sector is highly dependent on overseas development aid (ODA). The country receives considerable sums from external funders through grants, loans, and other forms. As initially conceived of, ODA intended to reduce poverty, and to support socio-economic development. Although initially conceived to be a form of temporary assistance, Uganda, like many other countries in the east and southern Africa, has continued to face financing gaps for these development aspirations. \u2018Short-term\u2019 foreign funding has become \u2018long-term\u2019 and Uganda, like others, has become increasingly dependent on aid to meet key health service obligations.\r\n\r\nThe COVID-19 pandemic threatens to turn this dependency into debt. In a 2021 analysis of aid flows to Uganda before and during COVID-19, Owori (https://devinit.org/resources/aid-uganda-covid-19/) reported bilateral grants to be the largest source of ODA to Uganda in 2020. The United States was noted to be the largest external funder, followed by the European Commission. However, Owori also found that the profile of official development assistance had switched in 2020 from grants to increased proportions of concessional loans from international financial institutions.  At a time when the country faces significant liabilities from the pandemic, and a rise in the debt to GDP ratio from 48% before COVID-19 to 52% in 2022, the shift from grants to loans adds further pressures to the public purse.  The \u2018East African\u2019 reported in February 2021 that the National Budget Framework Paper 2021/2022, approved by parliament, projected that Uganda will spend 97% of its total domestic revenue on debt servicing, with the US$231 million for this six times the health sector budget. Efforts to re-negotiate or restructure loans have not yet yielded meaningful progress. Uganda is yet to benefit from G20 Debt Service Suspension Initiative (DSSI) and China, the largest creditors is not part of the DSSI. This means that Uganda has to borrow to pay.\r\n\r\nThe level of global inequality between countries and between elites and many in society clearly calls for redistributive financing within and between countries. Foreign funding to the health sector has led to impressive areas of progress in Uganda, such as in relation to reducing HIV and responding to treatment and care needs for AIDS.  \r\n\r\nHowever, concerns have been raised in the past over the way ODA from high to low and middle income countries can encourage corruption, distort priorities, mask inefficiencies and shift attention away from domestic budget commitments, and from deeper international economic and investment issues. Despite long-standing and significant levels of external aid, Uganda\u2019s health sector still suffers from inadequate funding and infrastructure, wider health system deficits and weaknesses in governance. The provision of foreign assistance appears to have generated a culture of dependency from recipients and paternalism from funders. A \u2018donor\u2019 - \u2018recipient\u2019 relationship risks local expertise, knowledge and capacities being ignored, and can encourage neo-colonial and racist assumptions and attitudes. A northern aid industry has often placed itself in the position of managers, intermediaries, implementers, and monitors of ODA.  On the other side, it also leads to an unhealthy reliance on foreign funding to meet state and sector obligations in health, such as immunizing children that should be funded by the Uganda government. \r\n\r\nWhatever the well-meaning intentions, a mix of dependency and paternalism carries the risk of infantilizing leaders, and of absolving states of their responsibilities to their populations through domestic resources. It would be na\u00efve to ignore that ODA carries with it interests of both funder and recipient. This calls for transparency in and negotiation of these interests. Commitments have been stated to increase transparency in this relationship, but these commitments are not always delivered on, and still far too little information is shared with local actors. ODA financing of a large share of health expenditure comes with conditions for close monitoring and reporting by states to external funders, sometimes with stronger state accountability to high income country funders and tax payers that to the citizens and parliaments of recipient countries, marginalizing mechanisms for domestic accountability. While such accountability needs to be demanded within our countries and there have been improvements in aid accountability, Wild and Domingo have observed in the past that what is written on paper is often different from what is practiced (https://tinyurl.com/57jap9jn). A preference for vertical funding of health sector programmes, not all through state systems, and off-budget funding with parallel reporting mechanisms means that evidence is not always shared with domestic actors.  It is not easy to access information on external funding when off budget, such as in various forms of private- public partnerships or parallel institutions. Demands for domestic accountability also face power imbalances between funders and communities, and between high and low income countries. \r\n\r\nThese shortfalls and concerns are being voiced in many countries in the region, and by some stakeholders in high income countries, including those seeking to \u2018decolonise\u2019 ODA while still meeting obligations to global public goods and solidarity. This raises questions about how ODA is directed, given and used now and in the longer term, especially if the \u2018giving\u2019 creates repayment liabilities that the public will be paying for well into the future. \r\n\r\nThese issues need to be debated. In writing this oped with the intention to contribute to this dialogue, including on the actions to address the issues raised. For example, I suggest some areas of action. \r\n\r\nTransparency and access to information should be at the heart of the negotiation of and accountability on interests in ODA relationships, not only between states, but also to the public on both sides. The lack of transparency and blockages in information flow noted earlier, including between states and citizens need to be addressed. This includes bringing ODA \u2018on-budget\u2019 in the health sector to capture and align the resources towards national health priorities and systems, and to enable and improve the mechanisms for and practice of public domain reporting and oversight.\r\n\r\nThe priorities brought by ODA need to be aligned to national health system priorities. The upward accountability to funders and high income source countries and power imbalances between low- and high-income countries can be argued to generate a reliance on solidarity and inadequate incentives for ODA funders to make good on their commitments under the Paris Declaration and other global commitments. ODA funders need to understand, engage with and align to the contexts, priorities and cultures of countries they engage with, and to invest time and resources upfront to engage to a greater degree in designing their investments and projects with local actors. This is important to avoid overlooking and under-investing in local health problems and priorities, and in the institutional and system needs to implement them.  It can be argued that the shift noted earlier in Uganda from grant to loan funding, for example, reflects more the interests of high income country funders than the post-pandemic realities faced by the country and its communities. \r\n\r\nThis places a demand on states to build strategic capacities and alliances to negotiate domestic interests, to look beyond immediate sums to their implications and future burdens. However, there is also an obligation on ODA funders to not exploit or exacerbate weaknesses in recipient capacities and accountability mechanisms, but reinforce or support their strengths. For both sides this is a business of \u2018relationships\u2019 and diplomacy, and one in which power inequities and the institutional barriers on both sides of the relationship need to be more explicitly addressed, to achieve outcomes that matter for sustained population health equity.\r\n\r\nWe welcome your feedback or queries on the issues raised in this editorial. Please send them to the EQUINET secretariat. You can read more from I4DEV at http://www.i4dev.or.ug/","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"COVID-19 Crisis and the Informal Economy ","field_subtitle":"WIEGO: Study Report, 2022","URL":"https://www.wiego.org/covid-19-crisis-and-informal-economy-study-0","body":"Women in Informal Employment: Globalizing and Organizing (WIEGO) is a global network focused on empowering the working poor, especially women, in the informal economy to secure their livelihoods. WIEGO implemented this study in two rounds to capture changes across the different stages of the crisis during the second and third quarters of 2020, and how workers adapted by the first quarter of 2021. The study was implemented in 12 cities, including Dar es Salaam in Tanzania and Durban in South Africa. The work provides a platform to give visibility to the experience and voices of informal workers in policy. The organizations of informal workers involved in the study called for continuing relief, inclusive recovery and longer-term reforms for informal workers going forward. These demands, with concrete examples, were categorized into a common framework. a \u201cSummary of Demands\u201d to support these and other organizations of informal workers in their on-going advocacy and negotiations for a full and just recovery and for a \u201cbetter deal\u201d in the future for informal workers.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"COVID-19 pandemic restrictions did not harm HIV care outcomes in Uganda","field_subtitle":"Magak E: NAM AIDSMAP, Online 2022","URL":"https://tinyurl.com/3jp62sbt","body":"Despite the strict COVID-19 pandemic restrictions in Uganda, viral load testing and viral load suppression rates improved by 68% and 35% during the first lockdown, while mortality reduced by 25% among people living with HIV in Kampala, according to a presentation by Dr Izudi, Makerere University, at the INTEREST 2022 conference. In 2020, modelling studies of the COVID-19 pandemic\u2019s impact on HIV estimated that interruptions in ART would have the largest effect on HIV-related mortality in Africa, with a three-month interruption of ART supply in 13 African countries estimated to translate to a 35 to 131% rise in mortality in 2021. Observational data from six large HIV clinics and 9952 participants in Kampala compared a pre-pandemic cohort from March 2018 to February 2019 of people with HIV who had not experienced the COVID-19 restrictions, and an exposed cohort from June 2020 to June 2021 of people with HIV who  experienced the restrictions.  Patients exposed to restrictions had a 68% increase in viral load testing and a 35% increase in viral load suppression compared to the comparison group. Their mortality was also 25% lower than the control group,","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Developing context relevant and inclusive course outlines and reading lists","field_subtitle":"Teaching Health Economics Special Interest Group: Webinar online, Online: June 9, 2022","URL":"https://www.healtheconomics.org/page/UpcomingWebinars","body":"The Teaching Health Economics Special Interest Group (THE SIG) has organized a series of virtual workshops during 2022. This workshop provides an overview of curriculum development and writing powerful learning outcomes for health economics courses and the importance of identifying topics and readings that are most relevant to the local context. The workshop considers how to ensure courses are inclusive and contain diverse perspectives, and information shared on how academics in low- and middle-income countries can directly access a wide range of publications to use in their teaching programs at no (or low) cost. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Diss 125: Protecting equity in the face of privatisation of health services in east and southern Africa","field_subtitle":"Loewenson R: EQUINET Discussion paper 125, TARSC, EQUINET, Harare","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQDiss125%20Countering%20privatisation%20May22.pdf","body":"Funding for public health services paid from general taxation, provided universally and free at the point of access, is considered the most effective way of redistributing resources from high to low income groups while contributing to improvements in health. Nonetheless, in recent decades the privatisation of health services has expanded, through the in privatisation of services and expansion of private sector services in parallel with the public system, or in various forms of commercialised market reforms within public sectors, and the growth of public-private partnerships. This paper outlines equity-related evidence on privatisation in the ESA region in terms of differential entitlements, assets, endowments, and capabilities; differentials in vulnerability; health outcomes; and in life course, long-term and wider system consequences. Drawing on this evidence, the paper suggests elements of the pathways for responding to the equity dimensions of privatisation of health services and reflections on which elements may have a broad impact on multiple dimensions of inequity. The presentation of areas for action on pathways for change is not intended to be prescriptive. It rather intends to stimulate and inform dialogue and advocacy, understanding that what may be relevant and feasible depends on the country context. Motivating actions to address the inequities inherent in privatisation implies countering a common narrative that limiting privatisation of services undermines development. In contrast it implies promoting the right to health care, as embedded in many constitutions of ESA countries, and the understanding that public sector health systems are central for universal health coverage.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 232: Be part of the exchanges at #EQUINETConf22 on Catalysing Change for Health and Social Justice!","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. \r\n","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Exchange experience! Submit an Abstract to the EQUINET 2002 CONFERENCE before June 15th 2022","field_subtitle":"EQUINET Steering committee: Abstract submission is open and closes 15 June 2022  ","URL":"https://www.equinetafrica.org/conference/abstract-submission.html","body":"The EQUINET Conference 2022 \u201cCatalysing change for health and social justice\u201d  invites submissions from different voices and in different forms for presentation at the conference within the three strategic areas of the conference. For Day1 July 28th: Reclaiming the Resources for Health, for Day 2 September 15th: Reclaiming the State, for Day 3 October 13th: Reclaiming Collective Agency and Solidarity. The abstract submission page at https://www.equinetafrica.org/conference/abstract-submission.html provides further information on content areas and the online submission form. We are inviting presentations of research, interventions, policy engagement with a focus on actions for equity oriented change. Your presentation may be an oral presentation but we are also inviting short videos, podcasts, zoom recordings of discussions, poems, photojournalism and other forms.  We expect presentations to be short (less than 15 minutes) so please indicate in the abstract how much time you envisage your input will need. We may provide some support for preparation of presentations for those with limited resources. Please complete the information in the online Abstract submission form below and ensure you submit before 15 June.  Accepted abstracts will be notified by 30 June. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Gender and Health","field_subtitle":"World Health Organisation: WHO, Geneva, 2021","URL":"https://tinyurl.com/yax522du","body":"Gender norms, roles and relations, and gender inequality and inequity, affect people\u2019s health all around the world. This Q&A examines the links between gender and health, highlighting WHO\u2019s ongoing work to address gender-related barriers to healthcare, advance gender equality and the empowerment of women and girls in all their diversity, and achieve health for all.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"How the marketing of formula milk influences our decisions on infant feeding.","field_subtitle":"World Health Organization, UNICEF,: WHO Geneva, 2022","URL":"https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/formula-milk-industry","body":"Formula milk companies are reported by World Health Organization (WHO) to be paying social media platforms and influencers to gain direct access to pregnant women and mothers at some of the most vulnerable moments in their lives. The global formula milk industry, valued at some US$ 55 billion, is said to be targeting new mothers with personalized social media content that is often not recognizable as advertising. This new WHO report titled Scope and impact of digital marketing strategies for promoting breast-milk substitutes has outlined the digital marketing techniques designed to influence the decisions new families make on how to feed their babies. Through tools like apps, virtual support groups or \u2018baby-clubs\u2019, paid social media influencers, promotions and competitions and advice forums or services, formula milk companies can buy or collect personal information and send personalized promotions to new pregnant women and mothers.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Improving vaccination equity in rural Uganda","field_subtitle":"Clinton Health Access Initiative: Uganda, March 2022","URL":"https://www.clintonhealthaccess.org/case-study-improving-vaccination-equity-in-rural-uganda/","body":"From November 2020, Clinton Health Access Initiative (CHAI) Uganda\u2019s vaccines team and Uganda government addressed challenges with routine immunisation service delivery to improve equity across 14 districts representing around 11 percent of the country\u2019s children under five. An assessment in December 2018 found that in the 14 focus districts there was limited interaction between health facilities and the communities they serve. In addition, health facilities were unable to systematically identify underserved communities within their catchment to use their limited resources in an optimal way, leading to a significant number of children un or under-immunised. To address this, health workers were trained on how to identify underserved villages proactively and systematically within their catchment areas and potential barriers to vaccination in these communities. The team piloted an intervention that monitors geographic variations in care-seeking trends in high-volume health facilities, detecting villages with the highest number of unimmunized (zero-dose) children within their catchment areas. Once these underserved villages are identified, health facilities hold meetings with community leaders and influencers to understand the barriers to immunisation and develop targeted mitigation strategies. This work is reported to have led to increased vaccination rates in underserved villages and to have improved the effectiveness of outreach sessions by targeting the underserved communities with high numbers of un- or under-vaccinated children. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Join the discussion! Register for the EQUINET 2002 CONFERENCE before July 15th 2022","field_subtitle":"EQUINET Steering committee: Registration is open and closes 15 July 2022  ","URL":"https://www.equinetafrica.org/conference/registration.html","body":"The EQUINET Conference 2022 \u201cCatalysing change for health and social justice\u201d  invites participation from community members, workers, state personnel at all levels, civil society, parliamentarians, academics, trade unions, diverse professionals, innovators, producers and others. The online conference will be 9am to 5pm Southern African time for the three full days: Day1 July 28th: Reclaiming the Resources for Health, Day 2 September 15th: Reclaiming the State, and Day 3 October 13th: Reclaiming Collective Agency and Solidarity.  Participants can register online for one, two or all three days of the conference at the registration page at https://www.equinetafrica.org/conference/registration.html.  Please register separately for each of the three days, using all three links for all three days if you want to attend all. All those attending a day of the conference will be automatically registered for the fourth half day 9am to 1pm on November 17th.  Registration is free. The inputs to the conference will inform the future work of the network. Please join and be part of it!","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Launching \u2018Lessons to Africa from Africa: Reclaiming Early Post-independence Progressive Policies\u2019","field_subtitle":"CODESRIA: Post-Colonialisms Today, Online, 2022","URL":"https://www.youtube.com/watch?v=xD3ETHZ6OrU","body":"This recording covers Day 1 of the launch of\u2019 Lessons to Africa from Africa: Reclaiming Early Post-independence Progressive Policies\u2019\u2014a special issue of CODESRIA\u2019s Africa Development journal from Post-Colonialisms Today. The authors share rich archival research on early post-independence Africa policies around industrialization, international solidarity, delinking from colonial currency, and more; and their relevance for today\u2019s development challenges. A Special Issue journal: https://journals.codesria.org/index.php/ad/issue/view/245 provides more detailed information on these policies, and why they hold lessons for today's efforts to disengage from neocolonial realities.   ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Policy response to COVID-19 in Senegal: power, politics, and the choice of policy instruments","field_subtitle":"Riddea V; Fayeb A: Policy Design and Practice, 1-20, https://doi.org/10.1080/25741292.2022.2068400, 2022","URL":"https://tinyurl.com/56pcp5nc","body":"The authors explored and drew learning from how Senegal formulated its policy response to the COVID-19 pandemic. The response was rapid, comprising conventional policy instruments used previously for containing Ebola. The policy-making process involved several agencies, which resulted in significant leadership and coordination problems. Community participation and engagement with relevant scientific communities were limited, despite their recognized importance in the response. Instead, international funders had a significant influence on the choice of policy tools. The paper contributes to thinking on the autonomy of policy instruments and  calls for a review of how academics, civil society, and decision-makers collaborate to design public policies and policy tools based on evidence and context, and not only politics. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Postdoctoral Research Fellowships for 2022/ 2023, South Africa","field_subtitle":"Deadline for Applications: June 5, 2022 ","URL":"https://tinyurl.com/2sk94792","body":"The DSI-NRF South African Research Chair in Industrial Development (SARChI-ID) has positions available for postdoctoral research fellowships. The fellowships are attached to a prestigious international project titled \u2018Accelerating Vaccine Production in Africa: A Centres of Excellence Initiative\u2019 that seeks to foster interactions between select African universities and reputed university counterparts in the USA and Europe. There are no teaching obligations. In keeping with the focus of the project, postdocs will be expected to conduct research and engage in translational policy advice at the country and regional level in Africa. The fellowships are for an initial one year period, with possibilities of renewal for up to December 2023 attached to this project, and continuation thereafter. Fellows will be paid a monthly stipend and are provided with office space, laptops, and access to funding for research and travel. In addition to the standard postdoctoral stipends, fellows will receive additional remuneration for project activities.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Seventh Global Symposium on Health Systems Research","field_subtitle":"Registration open, October 31 - November 4, 2022, Bogota, Colombia","URL":"https://healthsystemsresearch.org/hsr2022/","body":"The Seventh Global Symposium on Health Systems Research (HSR2022) will take place at the \u00c1gora Bogot\u00e1 Centro de Convenciones in Bogota, Colombia from October 31 \u2013 November 4, 2022, bringing together approximately 2,000 health systems researchers, policymakers and practitioners from around the world. The Symposium face the challenge of optimally sharing \u2013 and learning from \u2013 the experiences of the last two years, not only on the  stress that health systems faced, and successes encountered during the pandemic, but also on interactions between politics, policy, and service provision and the role of vulnerable and already marginalized populations and the role of power in policy development; and of communities and individuals play. Registration for the conference is now open. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Tackling health inequities in indigenous communities","field_subtitle":"World Health Organisation: WHO, Geneva, 2022","URL":"https://tinyurl.com/2z868j8b","body":"There are currently 476 million indigenous people globally who experience structural racial and ethnicity-based discrimination, higher rates of health risks and poorer health outcomes. Their leadership and participation in public health is argued to be central to understand and address their health issues. In May 2022, WHO hosted a side event at the 21st session of the UN Permanent Forum under the theme \u201cindigenous peoples, business, autonomy and the human rights principles of due diligence including free, prior and informed consent.\" The session explored the \u2018causes of the causes\u2019 of these health inequities and considered measures to tackle them, with members of indigenous communities speaking out on health systems strengthening, restorative justice, racism and discrimination, traditional medicine and health practices, access to water and social determinants of health like housing and education.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The 13th Best Practices Forum and 29th Directors Joint Consultative Committee Meeting","field_subtitle":"13 to 15 July 2022, Nairobi, Kenya","URL":"https://ecsahc.org/the-13th-best-practices-forum-and-29th-directors-joint-consultative-committee-meeting/","body":"The East, Central and Southern African Health Community (ECSA-HC) is an inter-governmental organization that fosters and promotes regional cooperation in health. The aim of the Best Practices Forum (BPF) and the Directors Joint Consultative Committee (DJCC) meetings is to share best practices and research evidence, identify relevant health policy issues and making recommendations to the Health Ministers Conference, towards the improvement of health programming and outcomes in the region. The upcoming conference will provide a forum for health scientists, policy makers, development partners and other stakeholders in health to present their best practices and research evidence that inform policies and programming in the ECSA region. The theme for the 13th BPF is Stronger Health Systems Post Covid-19 for the Attainment of Universal Health Coverage in the ECSA Region. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The importance of prioritizing politics in Good Governance for Medicines Initiative in Zimbabwe: a qualitative policy analysis study","field_subtitle":"Mhazo AT; Maponga CC: Health Policy and Planning 37(5) 634\u2013643, doi: https://doi.org/10.1093/heapol/czac007, 2022","URL":"https://tinyurl.com/ynzb27a3","body":"In 2004, the World Health Organization (WHO) launched the Good Governance for Medicines (GGM) initiative, with the aim of fighting corruption in the pharmaceutical sector. In the case of Zimbabwe, implementation of the initiative slowed down after the development phase. Often, lack of funding and technical considerations are cited as major reasons for issue de-prioritization whilst ignoring the influence of politics in mediating policy diffusion. Between June and August 2021, an in-depth document review was conducted and individuals involved with GGM in Zimbabwe interviewed to understand the political determinants of GGM prioritization in Zimbabwe. The Shiffman and Smith framework was used to guide and direct the analysis. The authors found that the inception of GGM was facilitated by capable leaders, effective guiding institutions and resonance of the idea with the political environment. Prioritization from inception to implementation was constrained by limited citizen engagement, restriction of the issue to the pharmaceutical domain and a political transition that re-oriented policy priorities and reconfigured individual actor power. The portrayal of corruption as a priority problem requiring policy action has been hampered by the political sensitivity of the issue, lack of credible indicators on the prevalence and severity of the problem and challenges to measure the effectiveness of interventions such as the GGM. Despite the slowdown, from 2018 GGM actors have taken advantage of momentous policy windows to reconstitute their power by opportunistically framing GGM within the broader framework of access to essential medicines leading to the creation of new policy alliances and establishment of strategic political structures. To sustain the political prioritization, the author argues that actors need to lobby for the institutionalization of GGM within the Ministry of Health strategy, sensitize citizens on the initiative, involve multiple stakeholders and frame the issue as a strategic intervention that underpins pharmaceutical sector performance within the national developmental framework.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Using cellphones to deliver health services to teens: a sub-Saharan Africa review","field_subtitle":"Somefun OD; Onukwugha FI; Smith L; Magadi M: The Conversation, May 2022","URL":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0261973","body":"Adolescents in sub-Saharan Africa have the highest rate of unplanned pregnancies, almost half (46%) of which end in abortion. Mobile health interventions using mobile phones or devices are argued to have become popular in addressing health issues and were assessed for their role in improving adolescents\u2019 uptake of sexual and reproductive health services. The results showed that mobile health interventions were effective. They improved adolescents\u2019 uptake of sexual and reproductive health services across a wide range of services, particularly contraceptive use. The findings suggest that mobile health interventions promoting prevention or ante-retroviral treatment adherence are acceptable to adolescents and feasible to deliver in sub-Saharan Africa. The authors  conclude that there is a need to develop mobile health interventions by and for young people. ","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"\u2018Working relationships\u2019 across difference - a realist review of community engagement with malaria research","field_subtitle":"Vincent R; Adhikari B; Duddy C, et al: Wellcome Open Research, 7(13), https://doi.org/10.12688/wellcomeopenres.17192.1, 2022","URL":"https://wellcomeopenresearch.org/articles/7-13/v1","body":"The authors  conducted a realist review to understand how and why community engagement with health research contributes to the pattern of outcomes observed, with a focus on malaria research. Community engagement was found to rely on the development of provisional \u2018working relationships\u2019 across differences, primarily of wealth, power and culture that bring tangible research related benefits. Contextual factors that affect these working relationships were reported to include the research organisation commitment to and resources for engagement, while a prevailing \u2018dominant health research paradigm context\u2019 was reported to undermine working relationships, as did differences of wealth and power between research centres and local populations and health systems; histories of colonialism and vertical health interventions; and external funding and control of health research. Accommodation of such ethically problematic characteristics in the dominant health research paradigm can undermine community engagement and reproduce this paradigm rather than challenge it with a different logic of collaborative partnership.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"\u201cAfter 25 years of democracy we are still stigmatized and discriminated against\u2026\u201d: Health care experiences of HIV positive older black gay men in a township in South Africa","field_subtitle":"Mange T; Henderson N; Lukelelo N: The Journal of Practice Teaching and Learning  19(1-2). https://doi.org/10.1921/jpts.v19i1-2.1674, 2022 ","URL":"https://hst.devman.co.za/devman/resource/7727/162817/","body":"Older gay black men living with HIV and AIDS and their aging and health care concerns are reported to be invisible in research in South Africa, with the focus being on younger LGBTQI+  men.  This qualitative study explored the aging and health-care experiences of older gay black men in a selected township in the Cape Metropole, with the purpose of finding strategies to deal with their real life concerns and also interviewed health professionals working at the local clinic. A key finding was that health-care professionals, particularly nurses at a local clinic, stigmatize older black men living with HIV and AIDS and that rejection by their families and the death of their life partners leads to isolation, loneliness and depression. The authors propose training of health-care professionals by social workers and workshops to educate families of older LGBTQI+ people on their aging concerns.","php":"","field_issue_date":"2022-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"A comparative human rights analysis of laws and policies for adolescent contraception in Uganda and Kenya","field_subtitle":"Perehudoff K;  Kibira D; Wuyts E; et al: Reproductive Health 19(37), 1-14, 2022","URL":"https://tinyurl.com/2p8afpf9","body":"This report outlines how far national laws and policies for adolescent contraception in Uganda and Kenya are consistent with WHO standards and human rights law. Of the 93 laws and policies screened, 26 documents were included. Ugandan policies have 6 out of 9 WHO recommendations and miss WHO\u2019s recommendations for adolescent contraception availability, quality, and accountability. Kenyan policies consistently address multiple WHO recommendations, most frequently for contraception availability and accessibility for adolescents and address 8 out of 9 WHO recommendations, except for that on accountability. The current policy landscapes for adolescent contraception in Uganda and Kenya include important references to human rights and evidence-based practice. However the authors suggest that there is still room for improvement, and that aligning national laws and policies with WHO\u2019s recommendations on contraceptive information and services for adolescents may support interventions to improve health outcomes, provided these frameworks are effectively implemented.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Africa CDC is Elevated to the Status of a Continental Public Health Agency ","field_subtitle":"Adepoju P: Health Policy Watch, February 2022","URL":"https://healthpolicy-watch.news/africa-cdc-gets/","body":"The African Union (AU) has decided to elevate its African Centres for Disease Control and Prevention (Africa CDC) to the status of an autonomous public health agency for the continent \u2013 rather than operating simply as technical arm of the AU. The elevation of the Africa CDC \u2013 which will now report directly to Heads of State of AU Member Countries \u2013 is reported to signal the growing member state commitment to strengthening the continent\u2019s response to current and future disease outbreaks. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Application of community dialogue approach to prevent adolescent pregnancy, early marriage and school dropout in Zambia: a case study","field_subtitle":"Zulu I; Zulu J; Svanemyr J; Michelo C; et al:  Reproductive Health 19(30), 1-9, 2022","URL":"https://tinyurl.com/y4axph6d","body":"This paper presents parents\u2019 perspectives on the application of the community dialogue approach in addressing adolescents\u2019 early pregnancy and school dropout in a 2018 cluster randomized controlled trial in rural Zambia.  The guardians/parents perceived the community dialogue to be a relevant approach for addressing social and cultural norms regarding early pregnancy, marriage and school dropout. It was embraced for its value in initiating individual and collective change. The facilitators\u2019 interactive approach and dialogue in the community meetings coupled with the use of films and role plays with the parents, lead to active participation and open discussions about sexual and reproductive health topics during the community dialogue meetings. Group interactions and sharing of experiences helped parents clarify their sexual and reproductive health values and subsequently made them feel able to communicate about sexual and reproductive health issues with their children. However, cultural and religious beliefs among the parents regarding some topics, like the use of condoms and contraceptives, complicated the delivery of reproductive health messages from the parents to their children. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Assessing the effects of mining projects on child health in sub-Saharan Africa: a multi-country analysis","field_subtitle":"Cossa H; Dietler D; Macete E; Munguambe K: Globalization and Health 18(7), 1-16, 2022","URL":"https://tinyurl.com/bdxanae5","body":"To assess the impact of mines on child health, this study analyses socio-demographic, health, and mining data before and after several mining projects were commissioned in sub-Saharan Africa. Data of 90,951 children living around 81 mining sites in 23 countries in sub-Saharan Africa were analysed for child mortality indicators, and 79,962 children from 59 mining areas in 18 sub-Saharan Africa countries were analysed for diarrhoea, cough, and anthropometric indicators. The results presented suggest that the impacts of mining on child health vary throughout the mine\u2019s life cycle. Mining development was found to contribute positively to the income and livelihoods of the impacted communities in the initial years of mining operations, but that these benefits are likely to be at least partially offset by food insecurity and environmental pollution during early and later mining stages, respectively. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Assessing the impact of Covid-19 on older people in the African Region","field_subtitle":"WHO Regional Office for Africa: WHO, Brazzaville, 2021","URL":"https://reliefweb.int/sites/reliefweb.int/files/resources/9789290234548-eng.pdf","body":"The COVID-19 pandemic has had a significant impact on older persons globally and in the African region. Although overall the region\u2019s population is younger relative to many other world regions, the WHO AFRO region has a population just over 62 million older people and is ageing rapidly, with the number of older people expected to triple in the next three decades. This desktop review, complemented with regional and national stakeholder interviews for six country case studies assessed the impact of COVID-19 on older people. The six case study countries were South Africa, Ghana, Rwanda, Mozambique, Senegal and Mauritius. The findings indicated impacts on falling incomes, rising poverty and food insecurity in older people, particularly in the face of weak social protection systems. Older people faced increasing isolation and challenges in accessing resources and services, and barriers to online systems. Long-term care services for older people were heavily impacted by COVID-19 and the authors point to 'ageism' in ignoring older people's needs and roles in recovery policies and plans. The authors recommend member states in the region expedite policy implementation in the context of the Decade of Healthy Ageing 2021-2030 to address these challenges through strengthened health care systems, community-based associations and networks of older people, age friendly environments and social protection mechanisms. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Bring your experiences and ideas to the EQUINET conference in 2022!","field_subtitle":"Watch out for the announcement and call for submissions in April 2022 ","body":"EQUINET is holding a regional conference in 2022. We are living in a time of widening inequity, globally and in our region, but also of intensifying levers of change. The conference is for you! The EQUINET steering committee is inviting voices from all levels, disciplines, sectors and institutions that contribute to health equity in the region to share, discuss, network and reflect on experiences, ideas and actions, and to consolidate proposals for advancing equity in health and wellbeing in our region. The conference will be online, with thematic conference days held intermittently between July and November 2022. We will include a range of forms of evidence, including studies, stories, artistic and visual evidence, on our challenges and actions to reclaim the resources for health, our states, and our public services, and collective agency and solidarity in health. Leading up to the final day, we will explore how we organise as a network of equity actors from in the region. The full announcement with information on the conference, the registration and the call for submissions will be shared in April. To receive further information by email please subscribe at https://www.equinetafrica.org/content/subscribe.html ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Does disability increase households\u2019 health financial risk: evidence from the Uganda demographic and health survey","field_subtitle":"Guets W and Behera D K: Global Health Research and Policy 7(2), 1-8, 2022","URL":"https://tinyurl.com/5exvbaw2","body":"The authors examined the influence of disability and socio-demographic factors on households\u2019 health financial risks in Uganda, using nationally representative cross-sectional data for 19305 households from the 2016 Uganda Demographic and Health Survey. Financial risk was measured by money paid for health care services. Almost 32% of households paid money for health care services access, among which 32% paid through out-of-pocket. Almost 41% of household heads were affected by disability. The majority of families went to the public sector for health care services. The mean age was 45 years. The findings indicated that disability is significantly associated with the household financial risk, as is a choice to use private sector health care services. The authors recommend identifying families with disability and those experiencing difficult living conditions for health authorities to enhance health coverage progress.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"EQ Diss 124: Health sector financing and COVID-19: East and Southern Africa trends and a Zambia case study","field_subtitle":"Chitah B: UNZA, EQUINET Discussion paper 124, EQUINET, Harare, 2022","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss124%20Health%20fin%20%20and%20COVID%20%20Jan2022.pdf","body":"EQUINET commissioned this study from the author at University of Zambia to explore trends in equity-related healthcare expenditures in East and southern Africa (ESA) countries prior to the pandemic (2000\u20132019), and, through a deeper case study of expenditures in Zambia, how financing changed during the COVID-19 pandemic in 2020/21. The regional analysis reviewed selected indicators available from the WHO Global Health Expenditure database for 2000\u20132019 of the: extent to which governments prioritise health in domestic budget spending; level of financial protection; level of government pro-poor spending on primary health care; and the share of public versus private financing in total health expenditure. The financing trends for 2000\u20132019 in ESA countries raise issues around health system preparedness for the pandemic, while the Zambia case study demonstrates the consequent impact of the responses to COVID-19 on health system financing.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Information sheet 7 on COVID-19: Turning vaccines to vaccination in the region","field_subtitle":"TARSC, EQUINET: Harare, 2022","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20COVID%20brief7%20%20Jan2022.pdf","body":"EQUINET information sheets on COVID-19 summarise information from and provide links to official, scientific and other resources on east and southern Africa (ESA) covering selected themes related to equity in the pandemic. They complement and do not substitute information from public health authorities. Brief 7 summarises pandemic developments in the region to December 2021, with a focus on equity in vaccination coverage. It covers: 1: Recent trends in COVID-19 in ESA countries; 2: Vaccine supply to the ESA region; 3: Storage and distribution of vaccines in the region; 4: Vaccine uptake and vaccination coverage; and 5: Addressing equity - from vaccines to vaccinated populations.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 231: Meet commitments to public sector financing of public health to walk the talk of\u2019 \u2018pandemic preparedness\u2019","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Everywhere basic income has been tried, in one map","field_subtitle":"Samuel S: Vox, Online, 2020","URL":"https://www.vox.com/future-perfect/2020/2/19/21112570/universal-basic-income-ubi-map","body":"The idea of a basic income was, for decades, something of a policy fantasy. But in the last decade many basic income programs have emerged. This site maps there presence with links to information on them. For example in Kenya a big experiment in universal basic income (UBI) is  described. The charity GiveDirectly is making payments of roughly 75 cents (US$) per adult per day, delivered monthly for 12 years to more than 20,000 people spread out across 245 rural villages, with some evidence from a related intervention that this stimulated the local economy and benefited not only the recipients themselves but also people in nearby villages. This site lists all the places that are trying or have tried some version of basic income, noting that UBI is unconditional and different to conditional cash transfers, which may require recipients to send their kids to school or go for health checkups. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Health Economics Research Centre (HERC) Virtual Visitor Scheme (Round 1: Africa)","field_subtitle":"Deadline for applications: 4 March 2022","URL":"https://tinyurl.com/2cb4nrbc","body":"The Health Economics Research Centre (HERC), University of Oxford has created a \u201cvirtual visitors\u201d scheme to allow early career researchers from low and middle income (LMIC) countries to virtually attend via the internet seminars, events and short courses. In addition, the virtual visitor will be assigned mentors from HERC to discuss their research and explore future projects. The virtual visitor will generally be attached to HERC for a period of six months. During this time the visitor can attend relevant HERC short courses, including the Applied Methods of Cost- Effectiveness Analysis, at no cost. The scheme is entirely virtual and does not involve travelling to the UK, or any funding.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health Equity Tourism: Ravaging the Justice Landscape","field_subtitle":"Lett E; Adekunle D; McMurray P; et al: Journal of Medical Systems 46 (17), 2022","URL":"https://link.springer.com/article/10.1007/s10916-022-01803-5","body":" \u201cHealth equity tourism\u201d is described as the process of previously unengaged investigators pivoting into health equity research without developing the necessary expertise for high-quality work. In this essay, the authors define the phenomenon and provide an explanation of the antecedent conditions that facilitated its development. They outline its consequences as recapitulating systems of inequity within the academy and diluting a landscape carefully curated by scholars who have demonstrated sustained commitments to equity research as a primary scientific discipline and praxis. The authors provide a set of principles to guide equity researchers.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"How are global health policies transferred to sub-Saharan Africa countries? A systematic critical review of literature.","field_subtitle":"Odoch, W.D., Senkubuge, F., Masese, A.B. et al:. Global Health 18, (25), 2022.","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-022-00821-9","body":"This review sought to contribute to literature in this area by exploring how health policy agendas have been transferred from global to national level in sub-Saharan Africa. Nine articles satisfied the eligibility criteria. The predominant policy transfer mechanism in the health sector in sub-Saharan Africa is voluntarism, but there  are cases of coercion, albeit usually with some level of negotiation. Agency, context and nature of the issue are key influencers in policy transfers. The transfer is likely to be smooth if it is mainly technical and changes are within the confines of a given disease programmatic area. Policies with potential implications on bureaucratic and political status quo are more challenging to transfer. The authors propose that policy transfer, irrespective of the mechanism, requires local alignment and appreciation of context by the principal agents, availability of financial resources, a coordination platform and good working relations amongst stakeholders. Potential effects of the policy on the bureaucratic structure and political status are also important during the policy transfer process.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"HSG Symposium 2022: Call for Abstracts ","field_subtitle":"Deadline for Individual Abstracts: April 15, 2022 (12 pm noon EST)","URL":"https://healthsystemsresearch.org/hsr2022/call-for-abstracts/","body":"HSG is pleased to invite abstract submissions for the 7th Global Symposium on Health Systems Research (HSR2022), to be held in Bogota, Colombia October 31 \u2013 November 4, 2022. Health systems face significant challenges all around the world. The experience of the COVID-19 pandemic reveals how valuable strong health systems are to society, lays bare multiple weaknesses in low-, middle- and high-income settings alike, and has also shown us that now, more than ever, trust and solidarity, equity and social justice are the central and most important values from which to build back stronger, more resilient health systems. With the theme 'Systems Performance in the Political Agenda: Sharing lessons for current and future global challenges', HSR2022 aims to face the challenge of optimally sharing \u2013 and learning from \u2013 the experiences of the last two years. See the website for details on abstract submission.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Incentives for mothers, health workers and \u201cboda\u2013boda\u201d riders to improve community-based referral process and deliveries in the rural community: a case of Busoga Region in Uganda","field_subtitle":"Muluya K M; Mugisha J F; Kithuka P; et al: Reproductive Health 19(24), 1-9, 2022","URL":"https://tinyurl.com/24vvysh6","body":"Th authors report how financial and non-monetary incentives provided for 6 months to mothers, health workers and boda\u2013boda (motorbike) riders improved the community-based referral process and deliveries in the rural community of Busoga region in Uganda. The incentives included training, training allowances, refreshments during the training, transport fares payable by mothers to boda\u2013boda riders, free telephone calls through establishment of a pre-paid Closed Caller User Group, provision of bonus airtime to all registered Closed Caller User Group participants and rewards to best performers. The study used a mixed methods design. The proportion of mothers who delivered from health centres and used boda\u2013boda transport were 71% in the intervention arm compared to 51% in the control arm. Of the mothers who delivered from the health centres, majority (69%) were transported by trained boda\u2013boda riders while only 31% were transported by untrained boda\u2013boda riders. Of the mothers transported by the boda boda riders, 21% in the intervention arm reported that the riders responded to their calls within 20 min, an improvement from 4% before the intervention, while in the control arm there was limited change.  The authors suggest that such incentives and partnerships for different stakeholders along the maternal health chain are key for effective referral processes.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Inequality kills: The unparalleled action needed to combat unprecedented inequality in the wake of COVID-19","field_subtitle":"OXFAM International:: Policy Papers, Oxfam, 2022","URL":"https://oxfamilibrary.openrepository.com/bitstream/handle/10546/621341/bp-inequality-kills-170122-en.pdf","body":"This report observes that the wealth of the  world\u2019s 10 richest men has doubled since the pandemic began, while the incomes of the majority of the global population has fallen due to COVID-19, with widening economic, gender, and racial inequalities within countries and inequality between countries. The report explores the structural causes in policy choices that are made for the richest and most powerful people. Inequality is reported to contribute to the death of at least one person every four seconds. The authors recommend a radical redesign of economies to be centered on equality, clawing back extreme wealth through progressive taxation; investments  in powerful, proven inequality-busting public measures; and bold shifts in power in economies and society.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Inside Facebook's African Sweatshop","field_subtitle":"Perrigo B: Time, February 2022","URL":"https://time.com/6147458/facebook-africa-content-moderation-employee-treatment/","body":"This investigative journalism examines the workplace conditions of outsourced Facebook content moderators in Nairobi, Kenya. They perform the task of viewing and removing illegal or banned content from Facebook before it is seen by the average user. While demanding, including of multiple language skills, the workers were reported to be amongst the lowest-paid for the platform anywhere in the world, and to experience a workplace culture characterized by mental trauma, intimidation, and alleged suppression of the right to unionize. The authors question whether the corporate is protecting the wellbeing of the very people upon whom it relies to ensure its platform is safe  in the continent. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Meet commitments to public sector financing of public health to walk the talk of\u2019 \u2018pandemic preparedness\u2019","field_subtitle":"Bona Chitah, University of Zambia","body":"\r\nAfter a long period of domestic underfunding of public health services, particularly prevention and promotion services, the COVID-19 pandemic generated massive immediate demand to fund these same services. It arrived at a time when many public health systems in east and southern Africa (ESA) were fragmented, with challenges in service quality and provision and unmet need in the population. An analysis of health financing in ESA countries included in this newsletter showed that the pandemic called for a massive scale up of investment in testing; surveillance; infection prevention; waste management and health promotion. These were all areas that had seen declining investment in most ESA countries in the decade before the pandemic.\r\n\r\nThe regional analysis reviewed selected indicators available from the WHO Global Health Expenditure database for 2000\u20132019 of the extent to which governments prioritise health in domestic budget spending; provide financial protection; and spend on primary health care. A country case study then gave a deeper look at the health financing demand for the response to the pandemic, using national ministry of health data for 2020\u20132021 and projections for 2023.  \r\n\r\nBetween 2000 and 2019, less than half of ESA countries included progressively increased their share of health spending in the budget and by 2019, only two met the Abuja Declaration commitment of 15% of government budget spending on the health sector. By 2019, seven ESA countries had out-of-pocket spending (OOPS) above the upper limit of 20% suggested by WHO to avoid catastrophic expenditures and impoverishment, four of them considerably so. For nine of the 16 ESA countries (including Zambia) in 2019, less than 50% of spending on primary health care (PHC) came from government spending, suggesting a high degree of reliance on external funders for this key area of pro-poor spending. \r\n\r\nIt can be argued that those countries that gave less priority to public sector health in government spending and that provided less financial protection against impoverishment for users through OOPS could have been in a weaker position at the onset of the COVID-19 pandemic in relation to provide public health sector leadership, protect wider services and protect households during the pandemic. Adequate domestic spending on PHC is necessary to resource the public and community health and primary care levels of health systems that are key in pandemic responses. \r\n\r\nWhile Zambia had low OOPS, its share of government spending on health had also been falling prior to 2020, and, with a low share of government spending in total PHC expenditures, was dependent on external funds for these services. As overall health spending fell in real terms in the years immediately before the pandemic, the budget increasingly focused on curative care, with a falling share of spending on health promotion and prevention. \r\n\r\nHence, while Zambia implemented features of a robust preventive, health promotion and care response, the prior financing trends and a wide reported gap between needs versus resources mobilised suggests funding constraints to achieving the full scope of what intended in policy. The financial plans for the health sector response to the pandemic showed that, contrary to prior spending patterns, the greater share of resources were needed for prevention-related activities including testing, infection prevention and control, including for the health workforce, for health products and waste management systems. These are also areas where the funding gap was noted to be highest. It appeared (excluding vaccination donations) that external funder committed support was more focused on treatment and care, rather than for the wider range of prevention services.  This funding gap thus placed high demand for domestic resource mobilisation, at a time when the pandemic also led to economic disruption, recession and increased debt, intensifying resource scarcity, for both households and for health sector spending. \r\n\r\n The Zambian health ministry COVID-19 budget showed a sudden, urgent and costly increase imposed by the need to mitigate COVID, with some reports of reversals in gains made in areas such as maternal and child health programmes as resources were redirected to address emergent pandemic needs and health workers were over-stretched. \r\n\r\nEstimates of the funding needed for the pandemic response indicate budget needs that are nearly 60 times higher than the last recorded government health spending in the 2016 national health accounts. While the response to an emergency inevitably demands new resources, there is a question of how far a sustained period of under-financing of critical prevention infrastructure, supplies and services over many years contributed to this gap. Conversely, the benefit of areas of previous investment is apparent in Zambia\u2019s ability to make use of existing HIV, malaria and TB related laboratory services to rapidly decentralise laboratory capacity for COVID-19. \r\n\r\nAs the evidence focused on broad trends in the region and a focus on only one country on pandemic budgets, it  would be useful to explore further the experience across other ESA countries. However, for health financing in the region, the evidence suggests that pandemic preparedness is not an acute event, but rather a sustained process of investment in public health services and personnel that may be more likely to enable rapid repurposing and switching to address new pandemic needs. This implies governments meeting the Abuja commitment, not letting the public sector share of financing fall to levels that undermine domestic public sector leadership of the multiple actors in preparing for and responding to public health priorities, and more consistently prioritising prevention and promotion and PHC services in domestic health financing. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  More information can be found in EQUINET Discussion paper 124 on the EQUINET website.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"New Special Supplement: Reimagining Health Systems for Better Health and Social Justice","field_subtitle":"Health Systems Global: HSG, 2021","URL":"https://tinyurl.com/y89nfxp8","body":"Health Systems Global (HSG) and Health Policy and Planning (HPP), with the support of the International Development Research Centre (IDRC), announce the publication of a Special Supplement \u2013 Reimagining health systems for better health and social justice. This Supplement distills and spotlights some of the debates and discussions that took place during the Sixth Global Symposium on Health Systems Research (HSR2020) \u2013 Re-imagining health systems for better health and social justice. Articles in the supplement include the editorial Reimagining Health Systems: Reflections from the 6th Global Symposium on Health Systems Research and original manuscripts on equity in public health spending in Ethiopia, universal health coverage in Ghana, organizational structure and human agency within the South African health system and social accountability in Malawi. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"OWSD PhD Fellowships","field_subtitle":"Call for applications, closing on 15 April 2022.","URL":"https://owsd.net/career-development/phd-fellowship","body":"The Fellowship is offered to women scientists from science- and technology-lagging countries (STLCs) to undertake PhD research in the natural, engineering and information technology sciences at a host institute in another developing country in the Global South. The general purpose of the fellowship programme is to contribute to the emergence of a new generation of women leaders in science and technology, and to promote their effective participation in the scientific and technological development of their countries. The OWSD PhD Fellowship is offered only to women candidates. Candidates must confirm that they intend to return to their home country as soon as possible after completion of the fellowship. See the website for further and application details. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Probable futures","field_subtitle":"Probable futures collective: Video, 2022","URL":"https://probablefutures.org","body":"Probable Futures is an online site for science, applications, and imagination. It was founded in 2020 by a group of concerned leaders and citizens who started asking climate scientists direct, practical questions about what climate change would be like in different places around the world: What does the world look like at 1.5\u00b0C of warming? What will it feel like? At 2\u00b0C? 3\u00b0C? Do these different levels of warming mean radically different outcomes for society? Could we communicate the consequences of each increment of warming so vividly that everyone\u2014from parents and teachers to poets and CEOs\u2014can better understand, prepare for, and address what is coming? This site provides maps and information so that climate change is no longer an abstraction. In the portrayal the results are stark, the consequences real and personal and the portrayals of the future useful, intuitive, and profound. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Promoting social dialogue to improve working conditions for Community Health Workers in Malawi","field_subtitle":"Public Services International: PSI, Malawi, 2021","URL":"https://tinyurl.com/2p8mtxpm","body":"Community Health Workers (CHWs) occupy a unique position in-between the community and state bureaucracy, which the authors report to be challenging for CHWs to balance as they are accountable to both. This intermediary position poses disadvantages for CHWs when the expectations of the community and the state bureaucracy differ, leading to high workload and demotivation among CHWs. Nevertheless, given the acute shortage in the health workforce in Malawi, CHWs are an essential cadre in driving forward efforts to achieve universal health coverage. This publication aims to support efforts to understand the working conditions of CHWs and to achieve decent work for CHWs. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Promoting social dialogue to improve working conditions for Community Health Workers in South Africa","field_subtitle":"Public Services International: PSI, South Africa, 2021","URL":"https://tinyurl.com/bdh2fppn","body":"This manual looks at Community Health Workers (CHWs) in South Africa and their crucial role in the health system. The official health policy of the National Department of Health, \u201cRestructuring the national health system for universal Primary Health Care (NDOH 1996) mentioned the important role of CHWs but did not incorporate them into the health system. More recent policies acknowledge CHWs as a vital part of the health team, for the success of Primary Health Care (PHC), but implementation has been delayed. The publication draws attention to the present working conditions of CHWs, their demands and how trade unions can assist them.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Qualitative assessment of community health workers\u2019 perspective on their motivation in community-based primary health care in rural Malawi","field_subtitle":"Ndambo M K; Munyaneza F; Aron M B; et al: BMC Health Services Research 22(179), 1-13, 2022","URL":"https://tinyurl.com/yeyk3vk4","body":"Few studies have described the Community Health Worker (CHW) perspective on their intrinsic and extrinsic motivation in relation to their activities. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March\u2013April 2019 in seven purposively selected catchment areas. The results indicate that enabling factors are primarily intrinsic, such as positive patient outcomes, community respect, and recognition by the formal health care system, but that this can lead to the challenge of increased scope and workload. Extrinsic factors such as the increased scope and workload from original expectations, lack of resources for their work, and rugged geography present challenges, but with a positive work environment and supportive relationships between CHWs and supervisors enabling the CHWs. The authors suggest that challenges can be mitigated through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust, and by giving focus to enhancing motivational factors in primary health care systems.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Regulation of medicines advertisement in Zimbabwe: an assessment of the impact of pharmaceutical promotion on the prescribing behaviour of healthcare professionals","field_subtitle":"Semu T C; Ngara B and Mudzviti T: BMC Health Services Research 21(1337), 1-7, 2021","URL":"https://tinyurl.com/bdfmrrwy","body":"The authors present results of a cross sectional study the levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion among 330 healthcare practitioners in Zimbabwe, using face-to-face interviews and a web-based online survey. The study found that healthcare practitioners in Zimbabwe have a favourable relative importance index score of knowledge (95%), attitudes (67%), and perceptions (90%). This outcome and a positive perception of the regulation of pharmaceuticals related to health care workers\u2019 profession, gender, education level, the nature of the working institution and the number of prescriptions involved per week. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Report of the East and Southern Africa Regional People\u2019s Health University","field_subtitle":"EQUINET, PHM: 2021","URL":"https://equinetafrica.org/sites/default/files/uploads/documents/ESA%20RPHU%20Report%202021_0.pdf","body":"The first East and Southern Africa Regional People\u2019s Health University (ESA RPHU) jointly convened by the People\u2019s Health Movement (PHM) and Regional Network for Equity in Health in East and Southern Africa (EQUINET) was held virtually between 29 July and 12 November 2021 with the theme \u2018Past, present and future struggles for Health equity\u2019. The course aimed to build and share evidence, experience, analysis, and knowledge on the drivers of health equity to support efforts and activism within countries, and regional co-operation and joint engagement, from local to global level, on shared priorities. The course further aimed to share evidence, practical experiences, insights and learning from action, including on the implications of the COVID-19 pandemic in the region. To widen uptake in the region, background readings and presentations from sessions are available on the ESA RPHU Resources page.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"SARS-CoV-2 infection in Africa: A systematic review and meta-analysis of standardised seroprevalence studies, from January 2020 to December 2021","field_subtitle":"Lewis HC; Ware H; Whelan M; et al.medRxiv 02.14.22270934; doi: https://doi.org/10.1101/2022.02.14.22270934, 2022","URL":"https://www.medrxiv.org/content/10.1101/2022.02.14.22270934v1","body":"This preprint article presents a meta-analysis of population-based seroprevalence studies conducted in Africa published 01-01-2020 to 30-12-2021 to estimate SARS-CoV-2 seroprevalence in Africa. The authors aim to inform evidence-based decision making on Public Health and Social Measures (PHSM) and vaccine strategy.  From 54 full texts or early results, reporting 151 distinct seroprevalence studies in Africa, 63% had a low/moderate risk of bias. SARS-CoV-2 seroprevalence rose from 3% in Q2 2020 to 65% in Q3 2021. The ratios of seroprevalence from infection to cumulative incidence of confirmed cases was large (overall: 97:1, ranging from 10:1 to 958:1) and steady over time. Seroprevalence was highly heterogeneous both within countries - urban vs. rural (lower seroprevalence for rural geographic areas), children vs. adults (children aged 0-9 years had the lowest seroprevalence) - and between countries and African sub-regions (Middle, Western and Eastern Africa associated with higher seroprevalence).The high seroprevalence in Africa suggests greater population exposure to SARS-CoV-2 and protection against COVID-19 disease than indicated by surveillance data. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Two years of COVID-19 in Africa: lessons for the world","field_subtitle":"Happi CT; Nkengasong JN; Nature, Online, January 2022","URL":"https://www.nature.com/articles/d41586-021-03821-8","body":"In the early months of the COVID-19 pandemic, Africa\u2019s rapid and coordinated response, informed by emerging data, was remarkable. Now, in 2022, as vast vaccination campaigns have enabled the global north to gain some control over the pandemic, Africa lags behind. In principle, Africa could build on the astonishing gains it has made in surveillance and public-health responsiveness to outbreaks in recent years. It could sufficiently invest in commodities to ensure its health security, and position itself as a world leader in fighting infectious diseases. The authors argue that there is no alternative to this. If the continent does not work towards guaranteeing self-sufficiency, it will fail to address the infectious-disease threats of the twenty-first century and to achieve its development goals. In tracing the history of pandemic responses, the authors suggest that historically, efforts to assist Africa have tended to be siloed. They take a top-down approach, with decision-making coming from a central body outside the continent, not from African institutions and experts. Efforts have generally focused on short-term crisis management, not on the kinds of sustainable systems, such as manufacturing capability for diagnostics, that could help Africa to take charge of its health security. To reconfigure to greater self-determination, the authors propose that the continent honour their commitments to allocate at least 15% of their annual budgets to the health sector, strengthen national public-health institutions, and accelerate translational research and development. ","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Utility of HIV support groups in advancing implementation research in resource-limited settings: experiences from an urban-setting HIV support group in Zimbabwe","field_subtitle":"Mazambara F;  Chagwena D; Mudzviti T; et al: AIDS Research and Therapy 19(7), 2022 ","URL":"https://tinyurl.com/yckzejj6","body":"This paper describes how an adult HIV peer-support group in urban Zimbabwe enabled implementation research, and client recruitment and retention, with successes, challenges and lessons documented over eight years. The interventions involved psychosocial support, nutrition care and support, adherence education and income generating projects. More than 900 people participated in peer-support group activities every month and 400 were engaged in income generating activities. The support group provided a platform for identification of research priorities, patient recruitment and retention and for dissemination of research findings.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"What Is COVID-19 Teaching Us About Community Health Systems? A Reflection From a Rapid Community-Led Mutual Aid Response in Cape Town, South Africa","field_subtitle":"van Ryneveld M; Whyle E;  Brady L: International Journal of Health Policy and Management, 11, 5-8, 2022","URL":"https://www.ijhpm.com/article_3904.html","body":"The COVID-19 pandemic exposed the wide gaps in South Africa's formal social safety net, with the country's high levels of inequality, unemployment and poor public infrastructure combining to produce devastating consequences for a vast majority in the country living through lockdown. In Cape Town, a movement of self-organising, neighbourhood-level community action networks (CANs) has contributed significantly to the community-based response to COVID-19 and its ensuing epidemiological and social challenges. This article describes and explains the organising principles that inform this community response, and reflects on the possibilities and limits of such movements as they interface with the state and its top-down ways of working, often producing contradictions and complexities. This presents an opportunity for recognising and understanding the power of informal networks and collective action in community health systems in times of unprecedented crisis, and brings into focus the importance of finding ways to engage with the state and its formal health system response that do not jeopardise this potential.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"What is health policy & systems research and how can it strengthen health systems?","field_subtitle":"Health Systems Global: Video, 2017","URL":"https://www.youtube.com/watch?v=GDv3bSX3GVQ","body":"A short film produced by Health Systems Global and the Alliance for Health Policy and Systems Research outlining the field of Health Policy and Systems Research (HPSR) and the role it can play in strengthening health systems around the world.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Will the National Budget Framework Paper for FY 2022/23 Promote Equitable and Transformative Post COVID 19 Economic Recovery? ","field_subtitle":"SEATINI Uganda: Position paper, Uganda, 2022 ","URL":"https://tinyurl.com/bd6jwxbz","body":"This position paper aims to analyze Uganda's National Budget Framework Paper (NBFP) for the financial year 2022/23 and its priorities, interventions and policy proposals for an equitable and transformative post-COVID 19 economic recovery. The authors indicate that COVID 19 and the measures to contain its\r\nspread have had an unprecedented negative impact on Uganda\u2019s economy and people\u2019s livelihoods. While commending the measures for restoring business activity, they suggest that these are inaccessible for and have weak outreach to small and medium enterprises, listing the barriers. They recommend deepening resources and measures for financial inclusion and wellbeing of the population, including investment in areas such as infrastructures, local wealth creation,  investment in the public health system, education, water and sanitation and in local production of essential pharmaceutical. The report indicates that an equitable and transformative economic recovery post COVID 19 will require a rethink of policies and practices to address the disconnect between aspirations for recovery and budget allocations and programming.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"WTO: Dangers of \u201ctake-it-or-leave-it\u201d compromise outcome on TRIPS waiver","field_subtitle":"Third World Network: SUNS #9521, February 2022","URL":"https://twn.my/title2/health.info/2022/hi220207.htm","body":"In the face of growing \u201cvaccine inequity\u201d amidst the ongoing COVID-19 pandemic across countries, the authors observe that the chances of finalizing a credible outcome on the temporary TRIPS waiver at the WTO seem to be getting slimmer, with the likelihood of a \u201ctake-it-or-leave-it\u201d compromise solution being foisted on the members apparently gaining ground, according to people familiar with the development. In her brief statement at a TRIPS Council meeting on 22 February, the Deputy Director-General (DDG) Ms Anabel Gonzalez from Costa Rica is reported to have said that the progress has been difficult during the ongoing quadrilateral consultations between the four members on the temporary TRIPS waiver and the EU\u2019s proposal on compulsory licensing which mostly restates Article 31 of the TRIPS Agreement. South Africa reminded members that while it welcomes the support from the global community in establishing an mRNA hub in South Africa, as well as manufacturing facilities in Kenya, Tunisia, Nigeria, Senegal and Egypt, it noted that the full operationalization of the mRNA hub faces hurdles due to the intellectual property barriers. At the TRIPS Council meeting, members adopted the draft statement proposed by the TRIPS Council chair to continue discussions on either the waiver or the EU\u2019s proposal on compulsory licensing, due to lack of convergence among the members.","php":"","field_issue_date":"2022-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A huge thanks and wishes for wellbeing as we end 2021 ","field_subtitle":"EQUINET Steering committee","body":"We thank the many people we have exchanged, interacted, worked and struggled with in 2021 for the reflections, perspectives, experiences and energy you bring to efforts to advance equity and justice in our countries, region and globally. We see clearly the many challenges we face, old and new, but also the opportunities, alliances, ideas and capacities we can build on to confront and propose alternatives to the baggage of policies, systems and injustices that undermine our physical, social, economic, ecological health and well-being. Wishing you a healthy, restful year end. We look forward to our joint endeavours in 2022!   ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Analysis of the management of the tenth Ebola virus disease outbreak in the Democratic Republic of Congo: developing a multidisciplinary response model to strengthen the healthcare system during disease outbreaks","field_subtitle":"Vivalya B M; Ayodeji O K; Bafwa Y T;   et al.: Globalization and Health 17:121, 1-7, 2021  ","URL":"https://tinyurl.com/286e2c8f","body":"The declaration of any public health emergency in the Democratic Republic of Congo (DRC) is usually followed by the provision of technical and organizational support from international organizations, which build a parallel and short-time healthcare emergency response centred on preventing risks spreading, including to other countries. The authors propose a contrasting model of strengthening of preparedness and response structures to public health emergencies vis-\u00e0-vis the existing health systems in DRC. This is argued to be important to reduce tensions between local recruitment, the impact on the quality of wider healthcare in regions affected by EVD on one hand, and the involvement of international recruitment and its impact on social trust in the emergency response on the other. The authors propose providing a local healthcare workforce skilled to treat infectious diseases, the compulsory implementation of training programs focused on the emergency response in countries commonly affected by EVD outbreaks including the DRC. These innovations are proposed to reduce the burden of the range of health problems prior to and in the aftermath of any public health emergency in DRC as well as early recognition and treatment of EVD.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Uganda: a policy landscape analysis","field_subtitle":"Ahaibwe G; Karim SA; Thow AM; et al.: Global Health Action, 14:1, 1-9, 2021","URL":"https://www.tandfonline.com/doi/10.1080/16549716.2021.1892307","body":"Uganda is experiencing an increase in nutrition-related non-communicable diseases (NCDs) including from overconsumption of sugar-sweetened beverages. Fiscal and taxation policies aim to address this, but make their adoption and implementation are constrained by political and economic challenges. The authors  investigated the policy and political landscape related to this in Uganda, using a desk-based policy analysis  and four key informant consultations. While nutrition-related NCDs were recognised as an emerging problem in Uganda and government has adopted a comprehensive approach to improve diets, its implementation is slow. There is limited recognition of the consumption of sugar and sugar-sweetened beverages as a contributor to these NCDs in policy documents, existing taxes on soft drinks are lower than the WHO recommended rate of 20% and do not target sugar content. The authors report that the soft drink industry has been influential in framing the taxation debate, with the Ministry of Finance reducing taxation of sugar-sweetened beverages to maintain competitiveness in a regional market. The Ministry of Health and other public health actors in civil society have been successful (albeit marginally) in countering reductions in taxation, and a platform for sugar-sweetened beverage taxation advocacy exists in Uganda. Compelling local research that explicitly links soft drink taxes to health goals is argued to be essential to advance sugar-sweetened beverage taxation.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Beyond Corporate Social Responsibility: Strengthening Human Rights Due Diligence through the Legally Binding Instrument on Business and Human Rights","field_subtitle":"Ter\u00e1n D: The South Centre, Research Paper 138, 2021","URL":"https://tinyurl.com/y28efu7b","body":"Mandatory human rights due diligence (HRDD) requirements can serve to promote the adoption of a strong international framework of corporate accountability and remedy for human rights violations in the context of business activities. This paper identifies the elements of a human rights due diligence and their implementation through analysing current regional and State practice in the adoption of mandatory HRDD legislation in different sectors. It discusses the principles that characterize the approach taken by the United Nations Open-ended Intergovernmental Working Group on the adoption of a Legally Binding Instrument on transnational corporations and other business enterprises and how it could serve as an important cornerstone for modern rule making on the issue of business and human rights.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Challenges in health service delivery under public-private partnership in Tanzania: stakeholders\u2019 views from Dar es Salaam region","field_subtitle":"Nuhu S; Mpambije CJ; Ngussa K: BMC Health Services Research 20, 765, 1-12, 2020","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05638-z#citeas","body":"Public-private partnership in the health sector was introduced to improve the delivery of health services in Tanzania, but the expected outcomes have not been fully realised. This study investigated challenges encountered in implementing public-private partnership (PPP) institutional arrangements in health service delivery in Kinondoni Municipality, Dar es Salaam, Tanzania through interviews and document review. Findings revealed that although PPPs are hailed for supplementing the government\u2019s efforts in the provision of health services, institutional arrangements for the smooth provision of these services are lacking. The challenges include inadequate resources, ineffective monitoring and evaluation, insufficient consultations between partners, inadequate legal and policy frameworks and ineffective implementation practices. The authors suggest that these areas need to be addressed in pursuing PPPs.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"COP26 Special Report on Climate Change and Health: The Health Argument for Climate Action","field_subtitle":"World Health Organisation: WHO, Geneva, 2021","URL":"https://www.who.int/publications/i/item/cop26-special-report","body":"The 10 recommendations in the COP26 Special Report on Climate Change and Health propose a set of priority actions from the global health community to governments and policy makers, calling on them to act with urgency on the current climate and health crises. The recommendations were developed in consultation with over 150 organizations and 400 experts and health professionals. They were intended to inform governments and other stakeholders ahead of the 26th Conference of the Parties (COP26) of the United Nations Framework Convention on Climate Change (UNFCCC) and to highlight various opportunities for governments to prioritize health and equity in the international climate movement and sustainable development agenda. Each recommendation comes with a selection of resources and case studies to help inspire and guide policymakers and practitioners in implementing the suggested solutions.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"COVID-19: Comparison of the Response in Rwanda, South Africa and Zimbabwe","field_subtitle":"Dzinamarira T;  Mapingure M; Rwibasira G; et al.: MEDICC Review 23:3-4, 15-20, 2021 ","URL":"https://tinyurl.com/3h2wtnev","body":"African countries have mounted different response strategies to COVID-19, eliciting varied outcomes. In this paper the authors compare these response strategies in Rwanda, South Africa and Zimbabwe and discuss lessons that could be shared. In particular, Rwanda has a robust and coordinated national health system that has effectively contained the epidemic. South Africa has considerable testing capacity, which has been used productively in a national response largely funded by local resources, while Zimbabwe has an effective point-of-entry approach that utilizes strategic information. The authors propose meetings between countries to share experiences and lessons learned during the COVD-19 pandemic.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Do international trade and investment agreements generate regulatory chill in public health policymaking? A case study of nutrition and alcohol policy in South Africa","field_subtitle":"Milsom P; Smith R; Modisenyane S M and Walls H: Globalization and Health 17:104, 1-17, 2021 ","URL":"https://tinyurl.com/3kucxxzt","body":"This study identified barriers to setting regulation (regulatory chill) and implementing regulation related to nutrition and alcohol as a result of trade or investment dispute measures in South Africa. The work was implemented through semi-structured interviews with 36 policy actors, analysed using thematic analysis. Trade obligations were found to generate a significantly greater anticipatory-type chilling effect on nutrition and alcohol regulation than investment treaty obligations, and investor-state and WTO state-state disputes affected implementation of regulation. No cases were reported of trade threats an investor disputes but there were reported cases of these actors using arguments related to South Africa\u2019s trade obligations to oppose policy action in these areas.  The risk of policy action was related to the perceived legitimacy or bias of the dispute system, costs involved in pursuing and capacity to pay costs of regulation/defending disputes and social views and confidence in a successful dispute outcome. The authors observe that currently, South Africa\u2019s trade obligations have a more prominent role in inhibiting nutrition and alcohol regulation than investment treaty-related concerns, but that strategies to protect public health policy space in the context of both international trade and investment treaty and dispute settlement contexts remain important.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Emerging Voices for Global Health (EV4GH) 2022","field_subtitle":"Call for applicants: Submission deadline 15 April 2022","URL":"https://ev4gh.net/emerging-voices-for-global-health-2022/","body":"EV4GH 2022 is a blended learning training program that uses innovative training methods and activities to enable emerging researchers, other health system actors, and change agents born after 1 January 1982 to present their work and engage on various global health platforms. It consists of an e-coaching and distance learning phase, followed by a face-to-face training phase held prior to the 2022 Health System Global Symposium. The global network of emerging voices (EVs) fosters networking and learning across contexts and regions. After the training program, EVs become members of the EV4GH thematic working group (TWG) and can then join other HSG TWGs.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 230: We are struggling for health equity in Africa\u2026 is victory certain?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Feasibility and acceptability of a peer youth led curriculum to improve HIV knowledge in Northern Tanzania: resilience and intervention experience from the perspective of peer leaders","field_subtitle":"Hosaka K R J; Mmbaga  B T; Gallis J A; Dow D E: BMC Public Health 21:1925, 1-9, 2021 ","URL":"https://tinyurl.com/hfs6jehz","body":"The authors describe the change in 12-24 year old peer leaders' knowledge and leadership of a peer youth led HIV curriculum applied during monthly Saturday adolescent HIV clinics at two clinical sites in Moshi, Tanzania. Peer leaders previously participated in a mental health and life skills intervention called Sauti ya Vijana and were recommended for leadership by Sauti ya Vijana facilitators and clinic staff. Peer leaders demonstrated high fidelity to activities in each lesson and participant feedback was positive for curriculum delivery. Participants\u2019 knowledge improved in nine of ten sessions. Peer leaders reported improved leadership confidence and resilience, and their perception was that the curriculum helped normalize the HIV experience for Youth Living with HIV attending clinic. Nevertheless, anticipated stigma, difficulty disclosing HIV status, and teaching ability remained barriers. This study provides evidence to support efforts to scale and sustain peer youth led interventions for Youth Living with HIV.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Female adolescents living with HIV telling their story through \u2018my story\u2019 book in Malawi: A visual methodology innovation","field_subtitle":"Mwalabu G;, Mbendera I; Petrucka P; Manjanja V: PLoS ONE 16(10), e0257126, 2021","URL":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257126","body":"Female adolescents living with Human Immunodeficiency Virus (HIV) face lifelong challenges in reproductive and sexual health ranging from relational, social and legal-ethical considerations. A visual method and storybook research innovation was used with young female adolescents in Malawi that initiate sex as early as 15 years, mostly with adult partners,  given their reluctance to discuss sexual matters through more direct questions during interviews. The researchers thus used invoke youth-friendly research approaches to address these issues and enable these vulnerable individuals to articulate their experience and advocate their preferred changes.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Feminists for a People\u2019s Vaccine","field_subtitle":"Development Alternatives with Women for a New Era (DAWN) and Third World Network (TWN): 2021","URL":"https://feminists4peoplesvaccine.org","body":"DAWN and TWN are facilitating the Feminists for a People\u2019s Vaccine Campaign (FPV) for equitable, accessible, and affordable COVID-19 vaccines, drugs, therapeutics, and equipment and access to Medicines. The campaign brings the perspective of feminists from the Global South and partners and allies in the North to challenge the causes and consequences of extreme inequalities in access to medicines. Geography, wealth, income, gender, race, caste, ethnicity, disability, sexual orientation, gender identity and other factors shape who has access and who has not, who will live and who will die. The FPV Campaign analyses the changing pandemic panorama and initiatives such as the Trade-Related Aspects of Intellectual Property Rights Agreement (TRIPS) Waiver proposal, the COVAX Facility and South versus North imbalances in global trade, investment and financing affecting access to these technologies.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Health insurance and health system (un) responsiveness: a qualitative study with elderly in rural Tanzania","field_subtitle":"Amani P J;  Hurtig A; Frumence G; et al.: BMC Health Services Research 21:1140, 1-11, 2021 ","URL":"https://tinyurl.com/49v2v84n","body":"This study explored the experiences and perceptions of healthcare services from the perspective of insured and uninsured elderly in rural Tanzania, using eight focus group discussions with 78 insured and uninsured elderly men and women 60 years of age or older who had utilised healthcare services in the past 12 months prior to the study. Elderly participants appreciated that health insurance had facilitated the access to healthcare and protected them from certain costs, but also complained that health insurance had failed to provide equitable access due to limited-service benefits and restricted use of services within schemes. Although elderly perspectives varied, insured individuals generally expressed dissatisfaction with their healthcare. The authors argue that the national health insurance policy should be revisited to improve its implementation, expand the scope of service coverage and improve service quality issues, including long administrative procedures related to health insurance.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Health Systems Performance in the Political Agenda: Sharing lessons for current and future global challenges:  7th Global Symposium on Health Systems Research","field_subtitle":"October 31 \u2013 November 4, 2022, Bogot\u00e1, Colombia","URL":"https://tinyurl.com/3rzwsp9a","body":"The 7th Global Symposium will share and learning from the experiences of the last two years. Strong health systems build on foundation of primary health care and empowered communities. The challenge ahead is to explore the role values such as trust, solidarity, equity, and social justice play moving forward. HSR2022 will explore this in the following sub-themes: The politics and policies of health systems; Intersectoral collaboration and integrative governance on the road for health in all policies; The changing dynamics of health provision models to promote equity and the central role of human resources for health; The role of comprehensive primary care in promoting sustainability and The contribution of new technologies. The deadline for abstract submission for organised sessions is 15th February, 2021, and for individual papers is 15th April, 2021. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"I don\u2019t know when he will be back\u201d: life-changing events challenge the community ART Group model\u2013 a qualitative research study, Tete, Mozambique","field_subtitle":"Tarquino IAP; Venables E; Simone RR; et al.:  BMC Public Health 21:2004, 1-9, 2021","URL":"https://tinyurl.com/8btrpvzt","body":"Since 2008 in Mozambique, patients stable on antiretroviral therapy (ART) can join Community ART Groups (CAG), peer groups in which members are involved in adherence support and community ART delivery. More than 10 years after the implementation of the first CAGs, this study explored the impact of changes in circumstances and daily life events of CAG members. The CAG dynamic was affected by life events and changing circumstances including a loss of geographical proximity or a change in social relationships. Family CAGs facilitated reporting and antiretroviral therapy distribution, but conflict between CAG members meant some CAGs ceased to function, pill counts were not carried out, members met less frequently or stopped meeting entirely and ART uptake declined. In a more positive contrast, some CAGs responded to adherence challenges by strengthening peer support through counselling and observed pill intake. Health care providers were reported to push people living with HIV to join CAGs, instead of allowing voluntary participation.  They agreed that strengthening CAG rules and membership criteria could help to overcome the identified problems. The authors propose that changing life circumstances of, relationships between and participation by CAG members need to factored into a more flexible implementation model, including intensified peer support and feedback mechanisms between CAG members and health-care providers.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"I have started the change I want: advocating for climate change in Zimbabwe","field_subtitle":"Nyathi N: Voices of Youth, 2020","URL":"https://tinyurl.com/ybz8kstr","body":"This young writer explains: \"What keeps me on the frontline for climate justice is the notion that I don't only represent my nation but my entire generation because climate justice concerns our future...We deserve to live happily as well, but to attain that healthy, happy living we will not stop speaking out for what we want and what we deserve, to bring about a child-safe and sustainable future. I have dedicated my voice as a voice of the voiceless, to call for immediate action and there is no better time for acting than now\". UNICEF teamed up with 'Fridays for Future' to highlight young activists on the front lines of climate change, like Nyathi. Discover other climate activists and stories on how climate change is affecting young people today.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Information sheet 6 on COVID-19: Long COVID in East and Southern Africa","field_subtitle":"EQUINET, TARSC and the Post COVID Treatment Network - Africa: Harare, 2021","URL":"https://tinyurl.com/324zbnb3","body":"This sixth EQUINET/TARSC information sheet on the COVID-19 pandemic in east and southern African (ESA) countries has been produced in co-operation with the Post COVID Treatment Network - Africa.  In a prolonged pandemic, capacities and understanding have grown around various dimensions of the management of COVID-19. There is now growing evidence of people who continue experience symptoms more than 12 weeks after their initial infection, or \u2018long COVID\u2019. This information sheet summarises information on long COVID, and its distribution in the ESA region, responses to it and the equity issues it raises.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Inter-sectoral financing is essential to address the social determinants of health","field_subtitle":"Peter Binyaruka, Ifakara Health Institute, Tanzania","body":"The Commission on Social determinants of Health showed persuasively in 2008  that health is determined by the social conditions in which people are born, grow, live, work and age, referred to as the social determinants of health (SDH). These conditions are shaped by the distribution of money, power and resources from global, to local levels. \r\n\r\nHealth is therefore everyone\u2019s business. Efforts to address SDH should be taken by all policy makers, and not just those within the health sector. Health services play a role but cannot do it on their own. For example, Kuruvilla and others in 2014 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121875/) showed that almost a half of the reduction in under-5 children\u2019s deaths globally between 1990 and 2010 resulted from investments outside the health sector, such as in education and infrastructure. This was also recognised in the 1978 Alma-Ata Declaration on primary health care (PHC), with inter-sectoral action central to comprehensive PHC and \u2018Health for All\u2019. The Sustainable Development Goals (SDGs) also call for simultaneous, coordinated action across a range of sectors. \r\n\r\nDespite this recognition, economists particularly in a \u2018STRIVE\u2019 consortium noted that cross\u2013sectoral interventions are often underfinanced and their potentials benefits undervalued. \r\n\r\nThe consortium, with others such as UNDP, identified \u2018co-financing\u2019 as an approach where two or more sectors or budget holders, each with different development objectives, can co-fund an intervention or investment to advance their respective objectives simultaneously. Cross-sectoral co-financing does not necessarily need additional resources, therefore, but rather optimal allocation of existing resources. It is a relevant approach in financing high-impact interventions that leads to multi-sectoral benefits across the interconnected development goals and targets.\r\n\r\nOne example of such co-financing to address SDH is a conditional cash transfer that aims for multiple outcomes across sectors. In Mexico, for example, two social protection programmes, PROGRESA in 1997 and OPORTUNIDADES from 2002 gave such cash transfers directly to low-income rural households to enable and encourage parents to send their children to school, to use preventive and care services, and to improve child feeding and nutrition. Positive experience of this multi-sectoral approach has stimulated its spread to other Latin American countries. Malawi\u2019s introduction of a cash transfer in 2008/9 to keep girls in school was found after 18 months to have led to improved girls\u2019 school enrolment, test scores and reduced school drop-out, to have reduced girl\u2019 risk of HIV by 64%, and to have reduced teen pregnancy and depression (https://tinyurl.com/96ktkyuj).\r\n\r\nEconomists argue for co-financing for SDH to improve public policy intervention, and value for money. \r\n\r\nPublic intervention is argued to be essential in SDH to correct for market failures in relation to efficiency, to deliver maximum outcomes at the lowest cost. Public intervention is needed to address market failures in relation to equity and the distribution of outcomes according to need. These market failures arise for various reasons, including asymmetries in access to information, barriers to using services and as a profit-focused market is a poor performer on public good. With many SDH influenced by markets in our current global and national economies, there is a clear economic rationale for public intervention to ensure equity in health.  \r\n\r\nEconomists also argue that we need to integrate \u2018health value for money\u2019 to make optimal use of limited available funds, including by using innovative cross-sectoral co-financing approaches to address multiple SDH. Economic evaluations thus prefer cost-benefit analysis to assess whether multiple benefits across sectors outweigh the associated costs, to be able to point to \u2018good value for money\u2019. This does face challenges of measuring the multiple benefits accrued from multiple sectors, and the various opportunity and inter-sectoral costs. Notwithstanding these challenges, a cost-benefit analysis is argued to be more useful for public policy than cost-effectiveness analyses, as the latter have limited scope and focus on single outcomes, undermining the potential for achieving benefits across multiple sectors. \r\n\r\nWe thus have public health and economic arguments to encourage and inform co-financing investments to address SDH. In doing this, there are some issues to consider.\r\n\r\nCountries in our region are already facing constraints, fluctuations and uncertainty in domestic and public financing. There is also limited financial autonomy within and between sectors. This implies that the resources for co-financing should be mobilised and pooled from multiple funders/ sectors and are best spent in the first instance on SDH that will have highest impact, to generate confidence in the approach. \r\n\r\nCo-financing needs to address budgeting and reporting issues. In most setting, governments have siloed budgeting within single sectors, with little focus on cross-sectoral budgeting. The resource allocation and spending approach is also rigid, constrained, and slow to reform. Going forward, co-financing calls for a change in public budgeting and accounting and a move from input-based to output-based budgeting, that is the allocation of resources based on shared interventions and goals across sectors.  \r\n\r\nWe need to recognise that the involvement of many funders may lead to mistrust in managing the pooled funds, including between ministries. Ministries may fear losing budget control and visibility with pooled funds and co-financers may fear weak accountability or corruption in use of such pooled funds. Strengthening the public finance management system to ensure transparency and accountability can help to address such mistrust, while visibly showing joint ministry contributions to a common programme, as was the case in Oportunidades in Mexico, can help to promote visibility in co-financing.\r\n\r\nHigh-level policy stakeholders have critical role in decisions on co-financing, including in supporting its implementation in practice. For example, there might be a clear agreement to co-finance but political uncertainty and bureaucratic issues may limit the disbursements of funds to it. This needs time and engagement to inform and ensure the \u2018buy-in\u2019 of co-financing by national leaders and ministries. We also need to build the necessary cross sectoral dialogue and coordination mechanisms, and to facilitate the leadership and capacities for the approach.\r\n\r\nAll of this calls for evidence, including on successful experiences of cross-sectoral financing.  Here we need to acknowledge an evidence gap in making the case in our region. We need in our region to generate and share evidence on the impacts and value for money evidence when making multi-sectoral interventions on SDH. This includes addressing the currently weak monitoring and evaluation of these initiatives and implementing research that informs policy decisions towards co-financing. \r\n\r\nIt is clear that we not only need attention to innovative ways of raising resources for health, but also innovative ways of using those resources to address SDH, especially those that are leading to inequities across multiple health and wellbeing outcomes. Co-financing offers one such approach. It calls for evidence and processes to build political and implementer support, trust and confidence, including to lever necessary reforms in our public finance management systems. If we can address the challenges, even for focused initiatives that we can learn from, we have the opportunity to use co-financing to support interventions that have greater value for money and multiple benefits across sectors, including for equity. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  More information on the STRIVE consortium can be found at http://strive.lshtm.ac.uk/.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Interactive: Who's funding the COVID-19 response and what are the priorities?","field_subtitle":"Cornish L: Devex, Online, 2021","URL":"https://tinyurl.com/3pdxctay","body":"In this online resource Devex has tracked COVID-19 funding for combating the coronavirus, including the contracts, grants, new programs, tenders, and direct funding from global, bilateral, regional, state and non-state actors. Funding data is available through an interactive dashboard that shows where the funding is going, who is supplying the money, and what funding is focusing on.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"It was hell in the community\u2019: a qualitative study of maternal and child health care during health care worker strikes in Kenya","field_subtitle":"Scanlon M L; Maldonado L Y; Ikemeri J E; et al:  International Journal for Equity in Health 20:210, 1-12, 2021 ","URL":"https://tinyurl.com/yu8v333f","body":"This paper investigated maternal and child health care and services during nationwide strikes by health care workers in 2017 from the perspective of pregnant women, community health volunteers, and health facility managers, using in-depth interviews and focus group discussions. Participants reported that strikes by health care workers significantly impacted the availability and quality of maternal and child health services in 2017 and had indirect economic effects due to households paying for services in the private sector. Participants felt poor households, particularly poor women, were most affected since they were more likely to rely on public services, while community health volunteers highlighted their own poor working conditions. Strikes strained relationships and trust between communities and the health system that were identified as essential to maternal and child health care and highlighted and exacerbated inequities in the health system. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Losses to OECD tax havens could vaccinate global population three times over, study reveals","field_subtitle":"Mansour M: Tax Justice Network, November 2021","URL":"https://tinyurl.com/3va4as47","body":"Countries globally are losing a total of $483 billion in tax a year to global tax abuse committed by multinational corporations and wealthy individuals \u2013 enough to fully vaccinate the global population against Covid-19 more than three times over. The State of Tax Justice 2021 \u2013 published by the Tax Justice Network, the Global Alliance for Tax Justice and the global union federation Public Services International \u2013 reports that of the $483 billion in tax that countries lose a year, $312 billion is lost to cross-border corporate tax abuse by multinational corporations and $171 billion is lost to offshore tax evasion by wealthy individuals. The 2021 edition of the State of Tax Justice documents how a small number of rich countries with de facto control over global tax rules are responsible for the majority of tax losses suffered by the rest of the world, with lower income countries hardest hit by these tax losses. The findings are galvanising calls to move rule-making on international tax from the OECD to the UN, and to adopt more equitable unitary systems of tax collection and disbursement that would apply total tax revenue on TNCs to where their production activities and revenue generation is taking place. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Making Change Visible: Evaluating Efforts to Advance Social Participation in Health, An Implementer\u2019s Resource","field_subtitle":"Loewenson R; Simpson S; Dudding R; Obando F; et al:  TARSC, Shaping Health, 2021","URL":"https://www.shapinghealth.org/reports-and-papers","body":"If you are responsible for\u2014or engaged or interested in\u2014advancing social/community participation in health (SPH) in your local area, this resource was developed for you. There are a variety of resources available on how to organise SPH, but there is limited guidance on how to evaluate its effectiveness. This publication aims to fill that gap. It is thus not about how to implement SPH, but rather how to evaluate SPH efforts. The Resource outlines how to conduct a baseline assessment, creating a critical reference point at the start of the SPH intervention to plan work and enable you to track changes as they are achieved. It guides you in carrying out a performance evaluation, to assess how well the SPH intervention is performing during implementation, for you to review and make any 'course corrections' needed. Finally, it explains how to conduct an outcome or impact evaluation, assessing the changes achieved, directly and indirectly, as a result of the SPH intervention. The use of the Resource is being piloted  in 2022, so if you are interested, please get in touch. .","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Neoliberal disease: COVID-19, co-pathogenesis and global health insecurities","field_subtitle":"Sparke M; Williams O: Environment and Planning A: Economy and Space, 1-18,  2021","URL":"https://journals.sagepub.com/doi/full/10.1177/0308518X211048905","body":"The authors present how COVID-19 has exposed, exploited and exacerbated the health-damaging transformations of neoliberal globalization. To explain why, the authors point to a combinatory cascade of socio-viral co-pathogenesis that they call neoliberal disease. From the vectors of vulnerability created by unequal and unstable market societies, to the reduced response capacities of market states and health systems, to the constrained ability of official global health security agencies and regulations to offer effective global health governance, they authors show how the virus has found weaknesses in a market-transformed global body politic. Turning the inequalities and inadequacies of neoliberal societies and states into global health insecurities, the pandemic raises questions about whether the world now faces an inflection point when political dis-ease with neoliberal norms will lead to new kinds of post-neoliberal policy-making. The authors conclude, however, that the prospects for such political-economic transformation on a global scale remain quite limited. despite the evidence of the extraordinary damage described.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"New scientific research and writing mentorship initiative towards diversity in research on alcohol control policies","field_subtitle":"Call for applications: Closing date: 15 December 2020 ","URL":"https://www.who.int/news/item/08-11-2021-new-scientific-research-and-writing-mentorship-initiative-towards-diversity-in-research-on-alcohol-control-policies","body":"The World Health Organization\u2019s Less Alcohol Unit, Department of Health Promotion, the Alcohol Research Group (ARG) and the Alliance for Health Policy and Systems Research have launched a new scientific research and writing mentorship initiative. The initiative aims to support early-stage researchers from low- and middle-income countries in their work to analyse, report and publish a study related to strengthening alcohol policies tackling the determinants driving the acceptability, availability and affordability of alcohol consumption. Overall, the initiative seeks to accelerate the finalization of scientific research with the support of expert mentors. Mentees (early-stage researchers) will be paired with mentors (senior academics) to participate in this 9-month initiative commencing no later than 1st January 2022. Through regular, at-distance access to mentors, the initiative aims to ensure researchers have the necessary guidance to finalize a study with contextually relevant results. Mentees are encouraged, and will be supported by their mentors, to submit their study findings for scientific publication. As an output of the initiative, a summary slide deck should be prepared for the further dissemination of results. A maximum of ten (10) mentees will be selected for the initial cohort.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Nutrition related non-communicable diseases and sugar sweetened beverage policies: a landscape analysis in Zambia","field_subtitle":"Mukanu M;  Karim SA; Hofman K;  Erzse A; et al:  Global Health Action, 14:1, 1-11, 2021","URL":"https://www.tandfonline.com/doi/epub/10.1080/16549716.2021.1872172?needAccess=true","body":"This study identified opportunities to strengthen policies relating to sugar-sweetened beverage taxation in Zambia, through: (1) understanding the policy landscape and political context in which policies for nutrition-related non-communicable diseases are being developed, particularly sugar-sweetened beverage taxation, and exploring the potential use of revenue arising from sugar-sweetened beverage taxation to support improved nutrition. The authors conducted a retrospective qualitative policy analysis and key informant interviews with 10 policy actors. Increased regulation of sugar-sweetened beverages was a priority for the health sector, in conflict with economic interests to grow the manufacturing sector, including the food and beverage industries. The authors suggest that this conflict between public health and economic priorities, poor public information and incoherent policy objectives might have contributed to the adoption of a weakened excise tax. The authors suggest that the fact that it did not prevent the introduction of a differential sugar tax on sugar-sweetened beverages implies that there are opportunities to strengthen the existing taxation of sugar-sweetened beverages in Zambia, especially if backed by inclusive in policy formulation and comprehensive monitoring of risk factors.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Patient-public engagement strategies for health system improvement in sub-Saharan Africa: a systematic scoping review","field_subtitle":"Ankomah S E; Fusheini A; Ballard C; et al.: BMC Health Services Research 21:1047, 1-16, 2021","URL":"https://tinyurl.com/z8tnh79c","body":"This systematic review of 18 papers published between 1999 and 2019 describes Patient-Public Engagement (PPE) research in Sub-Saharan Africa in relation to theories of PPE; and identifies knowledge gaps to inform future PPE development. Five PPE strategies implemented were traditional leadership support, community advisory boards, community education and sensitisation, community health volunteers or workers, and embedding PPE within existing community structures. PPE initiatives were located at either the \u2018involvement\u2019 or \u2018consultation\u2019 stages of the engagement continuum, rather than higher-level engagement. Most PPE studies were at the \u2018service design\u2019 level of the health system or were focused on engagement in health research. No identified studies reported investigating PPE at the \u2018individual treatment\u2019 or \u2018macro policy or strategic\u2019 level. The authors suggest that the findings call expanding for PPE at all health system levels and different areas of health system improvement.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Practical Epidemiology: Using Epidemiology to Support Primary Health Care","field_subtitle":"Vaughan JP, Victora C, , Chowdhury AMR: OUP, 2021","URL":"https://global.oup.com/academic/product/practical-epidemiology-9780192848741?q=Practical%20Epidemiology&lang=en&cc=gb","body":"This book focuses on district health systems and is intended for those working in primary health care. It presents practical uses for epidemiological concepts and methods and how to use population information to strengthen planning, management and evaluation. It is available open access online as a downloadable pdf, and a hardcopy can also be purchased. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Reflections on participating in the Regional People Health University","field_subtitle":"Mevice Makandwa, EQUINET newsletter team ","body":"Every three months, together with others, I read and capture a wide range of materials on health equity in the region for the EQUINET newsletter. But the East and Southern Africa Regional People\u2019s Health University (RPHU) has been a learning curve for me in many ways! I learned a lot in terms of the struggles for health equity. The information shared depend my understanding of the political economy of health, reclaiming the resources for health, of equity in health technology, and the commodification, privatisation in health and on building a movement for health equity. The sessions provided me with insight on how the corporate world is affecting health in the region and why.  I learned about multiple dimensions of injustice bedevilling our health systems and our need to strengthen our various platforms that are engaging on health equity. \r\n\r\nOur sessions were organised and flowed. From the coordination between PHM and EQUINET we were exposed to different areas of expertise from within our region, and to people who shared vast experience with us. We heard contributions, rich in evidence based research, and exchanged ideas and experiences from countries in the region that demonstrated solidarity in action. COVID-19 was not dealt with separately on the agenda but was a topical issue in different sessions as many countries in the region are grappling with funding, vaccines and information related to the pandemic and its impacts. What I heard towards the end of the sessions about how solidarity movements are built has made me rethink what I must do in my own actions towards health equity. The RPHU raised the value of actively participating in platforms that might contribute to the health equity agenda through sharing information and experiences and acting upon this.  \r\n\r\nOverall, I realised from the sessions on reclaiming the resources for health, reclaiming public health, the discussions on trade and health, on health rights and on social participation in health of the link of local to national to regional links that we need to build to champion health equity issues. The group work we did gave me a lot of ideas on regional contributions towards health equity through organised work. \r\n\r\nMy expectations of the RPHU were surpassed!  Despite my own experience in this area, the sessions opened me to thinking more critically about what the individuals could do better to advance health equity. Building a consortium is a fantastic way of information dissemination and sharing. In that we need to keep doing better in ensuring equity in our own work. Health equity is about not leaving anyone behind.  While most voices were heard in the RPHU, we did not hear the perspectives of people living with disability, including on their concerns around COVID-19, and we need to. The regional organisers (PHM and EQUINET) have spread to different countries in the region, but the grassroots level still remains too silent, including in our networks. I realised that strengthening grassroots level participation and action will be critical, if we are to build an effective movement for health equity across the countries of the region.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Report: Rebels, doctors and merchants of violence: How the fight against Ebola became part of the conflict in Eastern DRC","field_subtitle":"Congo Research Group; NYU Center on International Cooperation: Online, 2021","URL":"https://tinyurl.com/yf3y4c3u","body":"Between 2018 and 2020 in the eastern Democratic Republic of the Congo (DRC) the Ebola epidemic hit an area of ongoing hostilities among dozens of belligerents, including Congolese security forces. The Riposte, a combined national and international response to contain the disease, was not only affected by the violence, but the authors argue may have unintentionally contributed to the conflict. Despite the vast sums spent, Ebola continued to spread in North Kivu and Ituri provinces, which were already hard hit by decades of armed violence. On the ground, in an effort to protect itself from armed attacks and reduce community resistance, the Riposte through agents of the National Intelligence Agency (ANR), in collaboration with the Congolese Ministry of Health and the WHO (in contradiction with UN standard operating procedure), agreed to pay both government security forces and non-state armed groups. Over 20 months, between $489 million and $738 million was spent on Ebola in this part of the country.  The authors describe the impact of these payments. By engaging with some armed groups in conflict with others the Riposte is reported to have become embroiled in the violence. The authors point to how this monetized the violence, with some armed groups seeking to prolong the epidemic to continue to profit from what has been called \u201cEbola Business.\u201d The report cautions against making payments to parties to conflict in exchange for access so as not to inadvertently turn humanitarian operations into a source of profit for those involved in conflict and undermine the impartiality of humanitarian action. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Reporting guidelines: simple and powerful tools to increase the impact and visibility of your research: a virtual course on enhancing the value of research with research reporting standards","field_subtitle":"PAHO: Virtual Campus for Public Health, Online, 2021","URL":"https://tinyurl.com/2p8y87nf","body":"The EQUATOR Network and the Pan American Health Organization / World Health Organization (PAHO) has developed an online course aimed at increasing the value of research by enabling people who are planning to conduct, report, edit, publish or appraise research for health, with current research reporting standards. This introductory course is targeted at a wide range of actors interested in research quality and the use of reports for decision-making. The course provides an overview of good reporting practice at all stages of the research pathway.  The ideal time to take this course is as an introductory activity before beginning and finalizing your research proposal.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Risk assessment for COVID\u201019 transmission at household level in sub\u2010Saharan Africa: evidence from DHS","field_subtitle":"Makinde O; Akinyemi J; Ntoimo L; et al: Genus 77:24, 1-20, 2021","URL":"https://genus.springeropen.com/track/pdf/10.1186/s41118-021-00130-w.pdf","body":"Although household habitat conditions matter for disease transmission and control, especially in the case of COVID-19, inadequate attention is being given to these risk factors, especially in Africa, where household living conditions are largely suboptimal. This study assesses household sanitation and isolation capacities to understand the COVID-19 transmission risk at household level across Africa, using a secondary analysis of the Demographic and Health Surveys of 16 African countries implemented between 2015 and 2018, exploring handwashing and self-isolation capacities and households with elderly persons most at risk of the disease.  Handwashing capacity was highest in Tanzania (48%), and lowest in Chad (4%), varying by household location (urban or rural), as well as household wealth. Isolation capacity was highest in South Africa (77%), and lowest in Ethiopia (31%). Senegal had the largest proportion of households with an elderly person (42%), while Angola (16%) had the lowest. There were strong, independent relationships between handwashing and isolation capacities in a majority of countries. Also, strong associations were found between isolation capacity and presence of older persons in households. Household capacity for COVID-19 prevention varied significantly across countries, with those having elderly household members not necessarily having the best handwashing or isolation capacity. The authors propose from the findings that each country needs to use such information on household risk at population level to shape communication and intervention strategies.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The potential of school-based WASH programming to support children as agents of change in rural Zambian households","field_subtitle":"Winter J C; Darmstadt G L; Lee S J; Davis J: BMC Public Health 21:1812, 1-13, 2021 ","URL":"https://tinyurl.com/5ncakbxc","body":"Water, sanitation, and hygiene (WASH) interventions frequently assume that students who learn positive WASH behaviours will disseminate this information to their families. School-based programs rely on students to act as \u201cagents of change\u201d to translate impact from school to home. The authors conducted a quasi-experimental, prospective cohort study in 12 schools in rural, southern Zambia to assess this with students in grades 1\u20134, using in-person interviews with students, their teachers and caregivers. Student knowledge increased significantly, but primarily among students in grade 1. Students reporting sharing messages from the intervention with caregivers rose from 7% to 23%, particularly in students in grade 4. The authors propose that future work should prioritize developing curricula that reflect the variability in needs, capabilities and support in the home and community among primary school students rather than applying a single approach for a wide range of ages and contexts.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Videos and readings on health equity on the East and Southern Africa Regional Peoples Health University (ESA RPHU) resources page","field_subtitle":"EQUINET and PHM, 2021","URL":"https://www.equinetafrica.org/rphu/rphu-resources","body":"The 10 week EQUINET and PHM ESA RPHU ended in mid-November. There are a number of interesting  resources and reading materials on the RPHU website and videos of many of the presentations, that we welcome you to read, view and share more widely and use on your own activities. These materials, made available under fair use for your non-commercial educational purposes, cover topics from the course including on: Political economy and reclaiming resources for health; Ideas of health and wellbeing, SDH and reclaiming comprehensive public health; Health systems and Comprehensive primary health care (PHC); Power, values, rights, law and reclaiming collective agency; Commodification, privatization in health and reclaiming the state; Equity in health technology; Social participation and organising activism for health; and Building a movement for health equity. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Waiver from certain provisions of the TRIPS agreement for the prevention, containment and treatment of COVID-19","field_subtitle":"Third World Network: TWN, 2021 ","URL":"https://twn.my/title2/intellectual_property/trips_waiver_proposal.htm","body":"TWN provides  gathers a list of interventions by the co-sponsors, statements and op-eds supporting the waiver proposal and news reports about the proposal made by India, South Africa and others (IP/C/W/669) to the World Trade Organization seeking a waiver from certain provisions of the TRIPS Agreement (patents, trade secrets, copyright and industrial designs) in relation to the containment, prevention and treatment of COVID-19. This proposal is now co-sponsored by 62 developing countries (the Africa Group, the Least Developed Country Group, Bolivia, Fiji, Indonesia, Pakistan, Mongolia, Vanuatu and Venezuela) and has received global support from most of the other developing countries and the international community, but still faces opposition and counter measures from some high income countries, elaborated on the TWN website.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"We are struggling for health equity in Africa\u2026 is victory certain?","field_subtitle":"Danny Gotto, Executive Director, Innovations for Development, Uganda ","body":"On the 29th July this year, I embarked on a three-month training program of an East and Southern African Regional People\u2019s Health University (RPHU) themed \u201cPast, Present and Future struggles for Health equity\u201d. The RPHU was organized by EQUINET and PHM for health activists from the region. As a member of PHM-Uganda and an activist for the struggle for health for all, I couldn\u2019t miss the opportunity. I was enthusiastic to join others from the region to explore these issues further. I wanted to ground myself in the discourse of health equity, to get a firm understanding of what it means in the context and reality of my country and the region, and to appreciate how equity can be achieved for the millions that continue to suffer a wider spectrum of different forms of health injustice. I wanted to learn from others in the region how the struggle for health equity and social justice has evolved over the years, the successes and failures but also opportunities to fight back against systems of oppression and to build a people-centred health system.  \r\n\r\nLike the rest of sub-Saharan Africa, Uganda has been battered by the COVID-19 pandemic. The social pains of COVID-19 have been profound in the areas of health, livelihoods, education and governance. Although the COVID-19 pandemic can\u2019t be blamed on anyone in Africa, Africans, and especially the leadership, can\u2019t be excused for any failures to adequately respond to it, for our weak health systems and for an unacceptable absence of an Afro-centric power and strategy to counter the hegemony of global powers in access to essential health technologies. \r\n\r\nThe RPHU brought together a diverse pool of well-informed persons on all the topics covered. The topics and issues included for discussion exposed the wide range of issues affecting health equity. In fact the topics needed more time to articulate and especially for participants to have time to share and reflect on their own lived country-specific experiences. However, the resources availed before and after sessions were sufficient to help those interested to immerse in the literature, to further grasp the subject matter.\r\n\r\nI enjoyed the discussions around the social determinants of health, linking health systems to comprehensive Primary Health Care. These concerns and those of power, values, and laws remain central in building health equity in Africa. The exposure I got to the external factors driving health inequity in our region was a wake-up call, including when global governance frameworks are championed and imposed on Africa by international agencies and western countries. .\r\n\r\nIndeed, I am rethinking my approach to activism and advocacy in general. My quest and challenges continue to be around building a community-driven, people-centred activism that is self-sustaining and able to drive change. In Uganda, the public is often passive and inclined to fall into despondency, especially on political matters. My take-home struggle is to build a mass movement of actors collectively working for a common purpose of health equity. Financing that struggle for health equity, and particularly our dependency on western philanthropy continues, however, to be the \u201celephant in the room\u201d for me. It must be confronted head-on. If indeed we are to achieve health equity on the continent, we must find the drive, resources and strategy within ourselves.\r\n\r\nAs the days of the training moved towards the end, key questions continue to linger in my mind. Is there a correct order in the sequence of actions to realize health equity? What should a country like Uganda prioritize, given the limited resources? Can a country achieve health equity without democracy, or should the struggle first centre on political liberation, and then the rest follows? The RPHU couldn\u2019t cover all these wider issues, but in my mind, I can\u2019t see health equity being realized in a corrupt, inept and undemocratic space, where the voice of a common person doesn\u2019t matter and the abused are so powerless to fight back.\r\n\r\nAs we go into the final week, I recommend to the organizers, lets reimagine the post-training initiatives. We are still discussing the post RPHU activities, but what participants do after the training is the most fundamental aspect. How can the organizers continue to nurture collaboration, and partnership beyond the training? Can EQUINET and PHM continue to provide a platform where peer-activists from the RPHU can continue to share and learn from one another, or engage in joint initiatives of common interest in the region? As was well articulated in the RPHU, no country can achieve health equity alone. We need a concerted effort across the region.  ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"When will the doctor be around so that I come by?!\u2019 Geo-socio effects on health care supply, access and utilisation: experiences from Kalangala Islands, Uganda","field_subtitle":"Kwiringira J N; Mugisha J; Akugizibwe M; et al.: BMC Health Services Research 21:1163, 1-13, 2021","URL":"https://tinyurl.com/d6vj7xzv","body":"This study explored the intersecting geographical, ecological and social factors affecting access to health care in a social epidemiology analysis in Uganda, using literature review and an ethnographic exploration of the lived experiences of community members while seeking and accessing health care, understanding that health system activities are diverse but interconnected in a complex way.  When and how to travel for care was beyond a matter of having a health need/ being sick and need arising. A motivated workforce was found to be as critical as health facilities themselves in determining healthcare outcomes, and geography alone is not a sufficient factor in determining health outcomes.. ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"WHO Estimates Africa\u2019s COVID-19 Caseload is Seven Times Higher Than Official Count","field_subtitle":"Cullinan K: Health Policy Watch, 2021","URL":"https://healthpolicy-watch.org/africa-covid-caseload/","body":"Africa is estimated to have seven times more COVID-19 cases and three times as many deaths as officially reported, according to the World Health Organization (WHO) Africa region. This means that the continent could have around 59 million cases and 634,500 deaths. \u201cWe\u2019re using a model to estimate the degree of under-estimation. The analysis indicates that as few as one in seven cases is being detected, meaning that the true COVID-19 burden in Africa could be around 59 million people,\u201d said Dr Matshidiso Moeti, WHO\u2019s Africa executive director.  WHO recommends that countries perform 10 tests per 10,000 people each week yet around 20 countries \u2013 more than a third of African countries \u2013 do not reach this benchmark, said Moeti. The WHO has thus decided to invest $1.8 million to roll out COVID-19 rapid tests in hot spots, starting with pilots in eight countries. Despite this undercount, WHO Africa officials observe lower deaths in Africa than other global regions.  ","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"WHO Young Professionals Programme","field_subtitle":"Call for applications: No closing date indicated ","URL":"https://www.who.int/careers/young-professionals-programme","body":"Apply to the WHO's Young Professionals Programme aimed to provide career support, networking, mentoring, and tailored learning opportunities. The Programme intends to increase the representation of nationals from Least Developed Countries in WHO\u2019s workforce and will develop capacity from and for developing countries through a structured program with clear learning objectives.","php":"","field_issue_date":"2021-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"10 Images that illustrate the shameful global vaccine inequity","field_subtitle":"Pai M: Microbiology online, August 2021","URL":"https://tinyurl.com/54snw88s","body":"This series of 10 images tell the story behind the \u2018great vaccine apartheid\u2019 argued by the author to be the single biggest moral and scientific failure during this the COVID-19 pandemic.  ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"A critical cartography of domestic violence policies in Mozambique","field_subtitle":"Jeth\u00e1 E; Keygnaert I; Seedat M; et al: Reproductive Health 18 (169), 1-11, 2021","URL":"https://tinyurl.com/5527rmzy","body":"The authors mapped the Mozambican legislative and policy responses to domestic violence to analyse their alignment with international treaties and conventions and with each other, using a critical cartography and content analysis. The authors identified a total of fifteen national domestic violence documents of which five were on laws, one on policy and nine institutional strategic/action plans. Most of the national domestic violence documents focused on strategies for assistance/care of victims and prevention of domestic violence. Little focus was found on advocacy, monitoring and evaluation. Mozambique has signed several international and regional treaties and conventions on domestic violence, but the authors found an inconsistency in the alignment of international treaties and conventions with national policies and laws, and a gap in the translation of national policies and laws into strategic plans and multi-sectoral approaches.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013\u20132018: Results of health facility surveys and implications for COVID-19 transmission","field_subtitle":"Kanyangarara M; Allen S; Jiwani S S; et al: BMC Health Services Research 21(601), 1-11, 2021","URL":"https://tinyurl.com/7e3fxj4","body":"The authors assessed the availability of water, sanitation and hygiene and standard precautions for infection prevention in 16456 health facilities across 18 countries in sub-Saharan Africa, as well as inequalities by location and managing authority, using data from health facility surveys conducted between 2013 and 2018 in 18 sub-Saharan African countries. Across countries, an estimated 88% had an improved water source, 94% had an improved toilet, 74% had soap and running water or alcohol-based hand rub, and 17% had standard precautions for infection prevention available. There was wide variability in access to water, sanitation and hygiene services between rural and urban health facilities and between public and private facilities, with consistently lower access in both rural and public facilities. In both rural and urban areas, access to water, sanitation and hygiene services was better at health facilities than households. Availability of water, sanitation and hygiene services in health facilities in sub-Saharan Africa has improved but remains below the global target of 80\u2009% in many countries, with improvement essential to minimize the risk of COVID-19 transmission.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Accredited and non-accredited short courses and programmesin health systems","field_subtitle":"Health Systems Training Institute: HSTi, South Africa","URL":"https://www.hstinstitute.co.za/Training/Pages/Adult-Primary-Care.aspx","body":"The Health Systems Training Institute (HSTi) is the training arm of the Health Systems Trust in South Africa. It offers a range of courses with different application dates, including in Primary Care; community healthcare stakeholder engagement; health information, indicators and analysis; Research methods for health; and other health system topics.  ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"An assessment of the knowledge, practices and resources during the delivery of malaria health care services among private health care practitioners: a cross section study in the Mid-Western Region of Uganda","field_subtitle":"Wanzira H; Tumwine D; Bukoma P; et al: BMC Health Services Research 21(788), 1-12, 2021","URL":"https://tinyurl.com/jup9kzzs","body":"This study documented the knowledge, practices and resources during the delivery of malaria care services, among private health practitioners in the Mid- Western region of Uganda, an area of moderate malaria transmission. The authors determined the proportion of health workers that adequately provided malaria case management according to national standards in interviews with 135-health facilities staff. The study revealed sub-optimal malaria case management knowledge and practices at private health facilities with only 14\u2009% of health care workers demonstrating correct malaria case management cascade practices. To strengthen the quality of malaria case management, they recommend guidelines and tools, training; continuous mentorship and supervision; provision of adequate stock of essential medicines; and communication and data management at private health facilities.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Asinakuthula Collective","field_subtitle":"Asinakuthula Collective: Online archive and resource, 2021","URL":"https://www.asinakuthula.org/","body":"Asinakuthula Collective are a Collective of teachers, students, researchers and creatives invested in breaking the silences, marginalised narratives and vacuums of content surrounding the lives, roles, experiences and complexity of black African women in history. The collective has two public events every year, a memorial lecture and a masterclass, and carries out on-going archival work, knowledge production, teaching and learning that is made available online as a resource for those seeking to integrate women\u2019s voices in their work.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Botswana pays equivalent of $15 a dose for Sinovac's COVID-19 vaccine","field_subtitle":"Reuters: Gaborone, Botswana, July 2021","URL":"https://tinyurl.com/vf6jhnp3","body":"Botswana's health minister Edwin Dikiloti said on Friday in an address to parliament that the government was paying the equivalent of $15 a dose for the COVID-19 vaccine developed by China's Sinovac Biotech and almost $29 a dose for U.S. company Moderna's vaccine. The minister added that the COVAX facility co-led by the WHO had only delivered 82000 doses despite an upfront payment the government had made as a self-financing participant, in the hopes of securing far more doses. An AU arrangement is expected to deliver over 1.1 million doses of Johnson & Johnson's vaccine in the third and fourth quarters. Apart from the vaccines paid for, the Indian government donated 30000 doses of the COVISHIELD vaccine manufactured by the Serum Institute of India and China donated 200000 doses of Sinovac's vaccine, while Botswana is in talks with Pfizer about a possible 2 million dose deal.  In 2019, Botswana had a total population of 2.3 million people. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Burnt by the scorching sun: climate-induced livelihood transformations, reproductive health, and fertility trajectories in drought-affected communities of Zambia","field_subtitle":"Rosen J G; Mulenga D; Phiri L; et al:  BMC Public Health 21(1501), 1-14, 2021","URL":"https://tinyurl.com/3hpdwm2b","body":"The authors explored the impact of severe and prolonged droughts on gendered livelihood transitions, women\u2019s social and financial wellbeing, and sexual and reproductive health (SRH) outcomes in two Zambian provinces through in-depth interviews and focus group discussions with 165 adult women and men in five drought-affected districts, and key informant interviews with civic leaders and healthcare providers. Across districts, participants emphasized the toll drought had taken on their livelihoods and communities, leaving farming households with reduced income and food, with many turning to alternative income sources. Female-headed households were perceived as particularly vulnerable to drought, as women\u2019s breadwinning and caregiving responsibilities increased, especially in households where women\u2019s partners out-migrated in search of employment. As household incomes declined, women and girls\u2019 vulnerabilities increased: young children increasingly entered the workforce, and young girls were married when families could not afford school fees and struggled to support them financially. With less income due to drought, many participants could not afford travel to health facilities or resorted to purchasing health commodities, including for family planning, from private retail pharmacies when unavailable from government facilities. Women expressed desires for smaller families, fearing drought would constrain their capacity to support larger families. While participants cited some ongoing activities in their communities to support climate change adaptation, most acknowledged current interventions were insufficient. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Can East African workers overcome cooptation and suppression?","field_subtitle":"Wilmot P; Pius T: Roar Mag, July 2021","URL":"https://roarmag.org/essays/east-african-labor-organizing/","body":"Are radical worker struggles, which waned as a result of protracted government efforts to infiltrate and co-opt organized labour, making a comeback in East Africa? The authors observe that internal and external challenges workers and unions face today do not lend themselves to simply calling strikes to force collective bargaining agreements, with traditional tools taking a backseat to the ingenuity of informally organized workers. They suggest that a 'development' narrative in East Africa must be challenged or communities will be fighting for incremental compensations for land and livelihoods instead of stopping expansionist projects that will pit them against one another in the long run.  The authors argue that the hope emerging among organized labour in East Africa may not be found in the offices of general secretaries or even necessarily in registered unions, but in collectives of workers that exercise their agency, courage and creative power at the industry level and in their communities and workplaces. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Conflicts of interest: an invisible force shaping health systems and policies","field_subtitle":"Rahman-Shepherd A; Balasubramaniam P; Gautham M; et al: The Lancet Global Health 9(8), E1055-E1056, 2021","URL":"https://tinyurl.com/27842vpv","body":"Despite frustration about why public health evidence does not influence policy decisions as much as it should, there has been little attention to a fundamental force in decision making: conflicts of interest. Conflicts of interest arise when the potential for individual or group gain compromises the professional judgment of policy makers or health-care providers, and underpin rent-seeking and informal practice across the world. The authors characterise three different types of conflicts of interest that are particularly pervasive in mixed or pluralistic health systems that need to be considered in health policy and research: The first type occurs when policy makers or regulators have multiple or dual roles.The second type occurs because of hidden financial relationships between formal and informal health-care providers. The third type occurs when policy makers are influenced into taking a course of action that is more likely to win political support, rather than following public health evidence.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Costs of integrating HIV self-testing in public health facilities in Malawi, South Africa, Zambia and Zimbabwe","field_subtitle":"Sande L; Matsimela K; Mwenge L: et al: BMJ Global Health, doi:10.1136/bmjgh-2021-005191, 2021","URL":"https://gh.bmj.com/content/bmjgh/6/Suppl_4/e005191.full.pdf","body":"As countries approach the UNAIDS 95-95-95 targets, there is a need for innovative and cost-saving HIV testing approaches that can increase testing coverage in hard-to-reach populations. The HIV Self-Testing Africa-Initiative distributed HIV self-test (HIVST) kits using unincentivised HIV testing counsellors across 31 public facilities in Malawi, South Africa, Zambia and Zimbabwe. HIVST was distributed either through secondary (partner\u2019s use) distribution alone or primary (own use) and secondary distribution approaches. The authors evaluated the costs of adding HIVST to existing HIV testing from the providers\u2019 perspective in the 31 public health facilities across the four countries between 2018 and 2019 using expenditure analysis and bottom-up costing approaches. They found that costs of integrating HIV self-testing in the public health facilities ranged from US$4.27-US$13.42 per kit distributed. Personnel and cost of test kits were important cost drivers. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"COVID-19: the turning point for gender equality","field_subtitle":"Fisseha S; Sen G; Adhanom Ghebreyesus T; et al: The Lancet 398(10299) 471-474, 2021","URL":"https://tinyurl.com/frunjyuu","body":"The authors raise that the impacts of the COVID-19 pandemic have gone far beyond the disease itself. In addition to the increasing number of COVID-19 deaths, the pandemic has deepened social and economic inequalities. These indirect impacts have been compounded by pervasive gender inequalities, with profound consequences, especially for women, girls, and people of diverse gender identities. There has been an escalation in gender-based violence within households, increasing numbers of child marriages and female genital mutilation, and an increased burden of unpaid care work, with impacts on mental health. Communities of people affected by HIV are, again, at the crossroads of injustice and targeted discrimination. Measures to control the pandemic have reduced access to essential health and social welfare services, including sexual and reproductive health services, reduced employment and labour force participation, and decimated many household incomes. Here again, women have borne the brunt of marginalisation, particularly those working in the informal sector.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda","field_subtitle":"Zakumumpa H; Tumwine C; Milliam K; et al: BMC Health Services Research 21(692), 1-11, 2021","URL":"https://tinyurl.com/hcd6wy8r","body":"This paper explored the health-system resilience at the sub-national level in Uganda with regard to strategies for dispensing antiretrovirals during Covid-19 lockdown. The authors conducted a qualitative case-study of eight districts purposively selected from Eastern and Western Uganda. Between June and September 2020, through interviews with district health team leaders, ART clinic managers, representatives of PEPFAR implementing organizations and focus group discussions with recipients of HIV care. Five broad strategies for distributing antiretrovirals during \u2018lockdown\u2019 emerged: (i) accelerating home-based delivery of antiretrovirals; (ii) extending multi-month dispensing from three to six months for stable patients; (iii) leveraging the Community Drug Distribution Points model for ART refill pick-ups at outreach sites in the community; (iv) increasing reliance on health information systems, including geospatial technologies, to support ART refill distribution in unmapped rural settings and (v) leveraging Covid-19 outbreak response funding to deliver ART refills to rural homesteads. While Covid-19 \u2018lockdown\u2019 restrictions undoubtedly impeded access to facility-based HIV services, they revived interest by providers and demand by patients for community-based ART delivery models in case-study districts in Uganda.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Diss 123: Equity in the public and private health sector responses to COVID-19 in east and southern Africa","field_subtitle":"Chanda-Kapata P: EQUINET, Harare, 2021","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20123%20PP%20Mix%20in%20COVID%202021.pdf","body":"The COVID-19 pandemic has strained the already stretched health systems in East and Southern Africa (ESA) countries, and was affected by previous levels of public leadership and engagement with the private sector. The response involved a range of collaborations between the public and private sectors. Country plans were public sector-led, in co-operation with international development partners, with partnerships between the public and private sectors in the response both in and beyond the health sector. This desk review commissioned by EQUINET presents evidence from online materials and EQUINET steering committee key informants on features of the public and private sector health system roles in the response to COVID-19. The work differentiates the private for-profit sector from the private not-for-profit sector. The review explores the equity implications of these responses, and suggests implications for (re)investing in strengthened public health system preparedness and functioning and private sector co-ordination in ESA countries.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Diss paper 122: Youth mental health in the context of COVID-19 in East and Southern Africa: A desk review","field_subtitle":"Muhia J; Nanji N: IWG, TARSC, EQUINET: Harare, 2021","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20122%20YMH%20in%20ESA%20_1.pdf","body":"This desk review reports available published information relating to youth mental health in east and southern Africa (ESA). It was implemented within and informs collaborative work on youth mental health in the region in EQUINET between Training and Research Support Centre (TARSC), the International Working Group for Health Systems Strengthening (IWGHSS) and the pra4equity and PAROnline network, specifically Country Minders for Peoples Development (CMPD), Malawi, and the Centre for Youth Driven Development Initiative (CFYDDI), Uganda. The desk review explored patterns and determinants of youth mental health in the region; how the coronavirus (COVID-19) pandemic and responses to it have affected this; where youth seek and obtain support for mental health needs and the perceived challenges and gaps. It presents recommendations for improving the responses to mental health challenges. The COVID-19 lockdown and social distancing measures led to difficulties, with online learning and loss of work and rising costs intensifying some factors and increasing mental stress, as well as suicidal ideas and substance and alcohol abuse among youth. Youth mental health is a pertinent issue for the ESA region, more so due to the impact of the pandemic, but is not well recognised by formal services and policy. The review evidence points to a need, intensified by COVID-19, to co-create with young people strategies for preventing and responding to youth mental illness and its drivers and consequences.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Domesticated Poly-Violence Against Women During the 2020 Covid-19 Lockdown in South Africa","field_subtitle":"Nduna M; Oyama Tshona S: Psychological Studies, doi: https://doi.org/10.1007/s12646-021-00616-9, 2021","URL":"https://link.springer.com/article/10.1007/s12646-021-00616-9","body":"In South Africa, an increased risk for gender-based domestic violence against women during the COVID-19 lockdown was reported by various sources including the national gender-based violence call centre (GBVCC), the South African Police Service and the civil society. Public life, which is frequently a coping mechanism and an escape for some women and girls at risk of domestic violence, was curtailed by the lockdown rules that forbade movement. Informal sources of help for victims of abuse were limited due to closure of economic activities, and community-based services for domestic violence were not permitted to open. Some victims of domestic violence struggled with public transport to access informal help, or to visit the police, social workers and other sources of help. Some organisations offered online and telephone services and the authors suggest that the risk of violence during crisis periods could be averted by a more sustained and wider focus on reducing risk of all forms of violations against women.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 229: Youth mental health facing a deficit of caring ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Fast Facts on Climate Change and Health","field_subtitle":"World Health Organisation: WHO, Geneva, August 2021","URL":"https://www.who.int/publications/i/item/fast-facts-on-climate-change-health","body":"Climate change is resulting in poorer health outcomes, increasing mortality and is a driver of health inequities. This fact sheet on climate change and health is part of the Climate Fast Facts series of the United Nations Climate Action team discusses how health is well placed to be a significant part of the solution; the positive health impacts from stronger climate change action can motivate stronger global ambition; how health systems which are resilient to climate change can help protect their populations from the negative impacts (in the short and longer terms); and how sustainable low carbon health systems can make a substantial contribution to reducing national and global emissions.  ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Gaps and opportunities for cervical cancer prevention, diagnosis, treatment and care: evidence from midterm review of the Zimbabwe cervical cancer prevention and control strategy (2016\u20132020)","field_subtitle":"Tapera O; Nyakabau A M; Simango N; et al: BMC Public Health 21(1478), 1-13, 2021","URL":"https://tinyurl.com/42csn4ey","body":"This analysis identified the gaps and opportunities for cervical cancer prevention, diagnosis, treatment, and care to inform the next cervical cancer strategy in Zimbabwe.  A mixed methods approach was used. This midterm review revealed a myriad of gaps of the strategy particularly in diagnosis, treatment and care of cervical cancer and the primary focus was on secondary prevention. There was no national data on the proportion of women who ever tested for cervical cancer, or to quantify the level of awareness and advocacy for cervical cancer prevention which existed nationally. Some health facilities were inappropriately screening women above 50\u2009years old using VIAC. Gaps were identified in pathology services, in data on investigations at the national level, in limited funding, personnel, equipment, and commodities as well as lack of leadership at the national level to coordinate the various components of the cervical cancer programme. Numerous opportunities were identified to build upon the successes realized to date, with the findings emphasising the importance of effective and holistic planning and public investment in cervical cancer screening.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Health Security and the COVID-19 Pandemic: Health and Security for Whom?","field_subtitle":"Almeida C:  Think Global Health, August 2021","URL":"http://www.thinkglobalhealth.org/article/health-security-and-covid-19-pandemic-health-and-security-whom","body":"The concept of health security has long been prominent and controversial in global efforts to protect health. The author asserts that paradoxically, the COVID-19 pandemic has provided evidence of this concept's failure and reignited interest in it for the post-pandemic world. The article outlines how past shortcomings and present interest highlight the continued failure to address political and economic structural problems that generate inequities and produce neither health nor security for most of the world\u2019s population. Thinking beyond the pandemic, she proposes that policymakers should reject health security and center policy on promoting human solidarity and protecting the human right to life.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Health workers\u2019 perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda","field_subtitle":"Rutebemberwa E; Nyamurungi K; Joshi S; et al: BMC Public Health 21(1464), 1-9, 2021","URL":"https://tinyurl.com/w2jxb88e","body":"The authors explored perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda, using nine focus group discussions and eight key informant interviews in high volume health centres, general hospitals and referral hospitals. Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. Tobacco cessation activities should be provided in a continuum with coordination of different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"I can no longer do my work like how I used to\u2019: a mixed methods longitudinal cohort study exploring how informal working mothers balance the requirements of livelihood and safe childcare in South Africa","field_subtitle":"Horwood C; Hinton R; Haskins L; et al: BMC Women's Health 21(288), 1-15, 2021","URL":"https://tinyurl.com/hyfynv5a","body":"A mixed-methods longitudinal cohort study conducted among informal women workers in Kwazulu-Natal, South Africa between July 2018 and August 2019 and a photovoice activity with groups of participants to explore the childcare environment explored informal-sector working women's experience of child care. Women returned to work soon after the baby was born, often earlier than planned, because of financial responsibilities to provide for the household and new baby. They had limited childcare choices and most preferred to leave their babies with family members at home, as the most convenient, low-cost option, or mothers paid carers or formal childcare. Formal childcare was reported to be poor quality, unaffordable and not suited to the needs of informal workers. Mothers expressed concern about carers\u2019 reliability and the safety of the childcare environment. Flexibility of informal work allowed some mothers to adapt their work to care for their child themselves, but others were unable to arrange consistent childcare, sometimes leaving the child with unsuitable carers to avoid losing paid work. Mothers were frequently anxious about leaving the child but felt they had no choice as they needed to work. Maternity protection for informal workers would support these mothers to stay home longer to care for themselves, their family and their baby, and good quality, affordable childcare would provide stability for mothers and give children the opportunity to thrive.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Incentive grants for young researchers from LMICs: Implementation research to scale up national NCD and mental health-related responses for achieving SDG 3.4 ","field_subtitle":"Deadline for Applications: 30 September 2021","URL":"https://tinyurl.com/27zebcxr","body":"These grants support research projects that Identify gaps, implementation challenges, and national priorities, and propose solutions with the potential to influence policy and practices for NCD prevention and control and promotion of mental health and well-being in LMICs; and that engage diverse stakeholders across sectors and actors throughout the research process;. The would should explore the best strategies to create strong partnerships between governments, NGOs, the private sector, researchers, communities, and individuals (particularly vulnerable populations) to address NCD prevention and control and promotion of mental health and well-being and identify lessons about implementation and propose feasible actionable solutions within the context. The results of this work may inform further research into this area in the future, including testing such practices and mechanisms in various settings. The submitted proposals can address a wide variety of issues aimed at scaling up NCD prevention and control and promotion of mental health and well-being, establishing multisectoral and multistakeholder coordination mechanisms, and understanding innovative integrated delivery models to shift from disease-focused treatment approaches to sustainable person-centered health systems. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Intervention \u2013 \u201cImpermanence: On Frantz Fanon\u2019s Geographies\u201d","field_subtitle":"Aguiar J; Chowdhury A; Falk M; et al: Antipode Online, August 2021","URL":"https://antipodeonline.org/2021/08/18/frantz-fanons-geographies/","body":"This 'cartographic' and political economy analysis of Frantz Fanon\u2019s \u2018geographies\u2019 points to a series of narrative maps that draw attention to the differential geographies of racism and colonialism, using geography, landscape, cartography, architecture, space, place, and borders, to make sense of blackness and oppression and liberation. Fanon\u2019s envisions anti-colonial geographies as always in flux, nested in, yet cannot be fully defined by, the colonial imperative. Stasis \u2013 even the street or the walls of the clinic \u2013 is impossible. Colonial geographies are thus identified as unsustainable because, even in their heaviness, they are impermanent, in flux, and alterable. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Limits of neoliberalism: HIV, COVID-19, and the importance of healthcare systems in Malawi","field_subtitle":"Zhou A: Global Public Health 16(8-9), doi: https://doi.org/10.1080/17441692.2021.1940237, 2021","URL":"https://www.tandfonline.com/doi/full/10.1080/17441692.2021.1940237","body":"How have prior experiences with managing HIV prepared African countries for COVID-19? Drawing on qualitative methods, this article examines the impact of HIV interventions on the healthcare system in Malawi and its implications for addressing COVID-19. The author argues that the historical and continued influence of neoliberalism in global health manifests in the structures and routines of clinical practice. In Malawi\u2019s health centres, a parallel NGO system of care has become grafted onto state healthcare, with NGOs managing HIV commodities and providing care to HIV patients. While HIV NGOs do support the work of government providers, it is limited to tasks that align with their programmatic goals. Outside of external funder priorities, the conditions of public healthcare are said to be lagging, and government providers struggle with shortages of staff, medical resources, and basic infrastructure, all of which has been compounded by COVID-19.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Mapping Algorithms Are Failing to Address Urban Inequalities in the Global South","field_subtitle":"Costa-Lima M; Freitas C; Farias S: Failed Architecture, 2021","URL":"https://tinyurl.com/ecadmy3","body":"Algorithms act according to what they are trained for, and human beings are the ones training them. Therefore, when algorithms are clearly reinforcing existing inequalities, it is crucial to question who writes these algorithms, and in whose interests they are writing them. More importantly, these people should be held accountable for the socio-spatial effects of their products. As local governments have failed to build a good spatial data infrastructure for informal settlements, other stakeholders are stepping in and the authors raise the threat posed by algorithms moderated by big tech corporations deciding the boundaries ad features of neighbourhoods.  ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"New consortium working to boost vaccine production in South Africa","field_subtitle":"World Health Organisation: WHO, Geneva, 2021","URL":"https://tinyurl.com/wuurdurk","body":"The Medicines Patent Pool and the World Health Organization,  Afrigen Biologics Limited, the Biologicals and Vaccines Institute of Southern Africa  (Biovac), the South African Medical Research Council and Africa Centres for Disease Control and Prevention have signed a letter of intent to bring together partners to establish the South African mRNA technology transfer hub to enable greater and more diversified vaccines manufacturing capability, to respond to the current COVID-19 pandemic and future pandemics. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Profiteering from vaccine inequity: a crime against humanity?","field_subtitle":"Hassan F, Yarney G, Abbasi K: BMJ, 374:n2027, 2021","URL":"https://www.bmj.com/content/374/bmj.n2027","body":"The rich world is refusing to share vaccines with poorer countries speedily or equitably. Whereas 60% of the population in the UK is fully vaccinated, in Uganda it is only 1%. The 50 least wealthy nations, home to 20% of the world\u2019s population, have received just 2% of all vaccine doses. The authors argue that the rich world should be ashamed. They present evidence of the corporate profits being made on vaccines and posit that pandemic profiteering is a human rights violation that demands investigation and scrutiny. The Universal Declaration of Human Rights states that everyone has the right \u201cto share in scientific advancement and its benefits. The excess of deaths in Africa, Latin America and Asia is attributed to: a free market, profit driven enterprise based on patent and intellectual property protection, combined with a lack of political will. Contrary to claims, it is possible to make enough vaccines for the world and state that the moral scandal, enabled by corporate and political permission of mass death, is tantamount to a crime against humanity.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Proposal for a WHO treaty on pandemics raises concerns ","field_subtitle":"Ramakrishnan N; Gopakumar K: Third World Network, 2021","URL":"https://tinyurl.com/ny2za8jz","body":"This policy brief critically analyses the option of a new pandemic treaty or other international legal instrument to enhance the pandemic preparedness and response. Part I provides an account of the origin of the idea of the pandemic treaty. Part II examines whether there is any legal vacuum which prevents the needed pandemic preparedness and response. Part III deals with the fragmentation of international health response and raises the concern that the new treaty will exacerbate fragmentation instead of consolidating the response. Part IV explains what to expect from the new treaty and the major process-related issues involved in the new pandemic treaty negotiations. The authors argue that instead of developing a new international instrument it is better to strengthen or amend the existing IHR. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Risk Factors, Mental Health and Psychosocial Needs, and Coping Among the Children Under the Care of Female Sex Workers and Adolescent Girls Surviving in Sex Work Settings","field_subtitle":"Kyomya M; Mukwaya R; Achan E; et al: PEAH \u2013 Policies for Equitable Access to Health, Geneva 2021","URL":"http://www.peah.it/2021/07/9950/","body":"This assessment identified risk factors, mental health, psychosocial needs and mechanisms of coping by children under the care of female sex workers (FSWs) and adolescent girls surviving in sex work settings of Kampala, Gulu, Mbarara, Wakiso and Busia in Uganda. The study found stigma and discrimination, poor accommodation facilities, sexual abuse by clients of sex workers and substance abuse among children, adolescent girls and mothers, gender-based violence and low levels of literacy, with a high prevalence of mental health disorders, including depression, suicide, post traumatic stress symptoms and generalised anxiety disorder. Adolescent girls surviving in sex work settings, presented higher rates of common mental health disorders. particularly those aged 11-14 years. The study found that the risk factors are not addressed given that children under the care of FSWs and adolescent girls are often neglected by systems. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Strengthening Research and Practice in Community Health Systems: A Research Agenda and Manifesto","field_subtitle":"Tetui M; Hurtig A-K; Jonsson F; et al: International Journal of Health Policy and Management, doi: 10.34172/IJHPM.2021.71, 2021 ","URL":"https://tinyurl.com/27842vpv","body":"While there have been increased calls for strengthening community health systems (CHSs), key priorities for this field have not been fully articulated. This paper seeks to fill this gap, presenting a collaboratively defined research agenda, accompanied by a \u2018manifesto\u2019 on strengthening research and practice in the CHS. Eight domains of research priorities for CHSs were identified: clarifying the purpose and values of the CHS, ensure inclusivity; design, implementation and monitoring of strategies to strengthen the CHS; social, political and historical contexts of CHS; community health workers (CHWs); social accountability; the interface between the CHS and the broader health system; governance and stewardship; and finally, the ethical methodologies for researching the CHS. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process","field_subtitle":"Kigume R; Maluka S: BMC Health Services Research 21(646), 1-8, 2021","URL":"https://tinyurl.com/wkv8wzrf","body":"This qualitative study investigated the implementation of Tiba Kwa Kadi scheme in four urban districts of Tanzania using semi-structured interviews, focus group discussions and review of documents. While Tiba Kwa Kadi scheme contributed to access to health services, many challenges which hindered its performance, including frequent stock-out of drugs and medical supplies. This frustrated Tiba Kwa Kadi members and contributed to non-renewal of membership. The scheme was also affected by poor collections and management of the revenue collected from members, limited benefit packages and low awareness of the community. Similar to rural-based Community Health Fund, the Tiba Kwa Kadi scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. The authors recommend that government integrate or merge community-based health insurance schemes into a single national pool with decentralised arms.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The failure of private health services: COVID-19 induced crises in low- and middle-income country (LMIC) health systems","field_subtitle":"Williams O; Chun Yung K; Gr\u00e9pin K: Global Public Health 16(8-9), 2021","URL":"https://www.tandfonline.com/doi/full/10.1080/17441692.2021.1874470","body":"For decades, governments and development partners promoted neoliberal policies in the health sector in many low and middle income countries, largely motivated by the belief that public services were too weak to meet population needs. Private health markets as a governance and policy solution to the delivery of health services enabled forms of market failure to persist in these countries. These were exposed during the COVID-19 pandemic, as analysed by the authors using data from an assembled database of COVID-19 related news items sourced from the Global Database of Events, Language, and Tone. They identify how pre-existing market failure and failures of redistribution have led to the rise of three urgent crises: a financial and liquidity crisis among private providers, a crisis of service provision and pricing, and an attendant crisis in state-provider relations. They note that COVID-19 has exposed important failures of the public-private models of health systems.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Tobacco supply and demand strategies used in African countries","field_subtitle":"Crosbie E; Defrank V; Egbe CO: Bulletin of the World Health Organisation 99(7), 539-540, 2021","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8243026/","body":"The number of smokers in Africa is anticipated to rise from 15.8% in 2010 to 21.9% by 2030, the largest projected increase in the world. The authors examine the role of the main tobacco companies operating in Africa: Philip Morris International, British American Tobacco, Imperial Brands and Japan Tobacco International, in this rise, and in the illicit trade in tobacco to force market entry into new and emerging markets. The authors point to the tactics used, including: preventing policy measures designed to control illicit tobacco trade by entering into voluntary partnerships with law enforcement and custom agencies, with governments not effectively enforcing existing laws;  and using promotional tactics, including price reductions, coupons and giveaways to increase the demand and usage of tobacco. Tobacco companies consistently claim on their websites, in the media and in policy circles that they aim to stop illicit tobacco trade and only market to adult smokers. However, the authors raise that these tactics are recruiting a new generation of smokers in Africa. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"University of Global Health Equity and Kigali Public Library Hamwe Festival 2021: Short Stories Contest","field_subtitle":"Deadline for Applications: 12 September 2021","URL":"https://ughe.org/hamwe-festival-2021-short-stories-contest/","body":"The University of Global Health Equity (UGHE) and Kigali Public Library (KPL) are jointly organising a short stories contest as part of the third edition of Hamwe Festival.  The organisers are seeking short stories written in English or in French, about life in the era of COVID-19. Writers from 18 to 30 years old from all countries are invited to participate. With this contest, the organisers wish to highlight stories that showcase how health equity and other areas of social justice have been exacerbated during this global crisis and how the current pandemic has affected the lives of individuals and communities. ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Urban Studies Foundation: Postdoctoral Research Fellowships","field_subtitle":"Deadline for Applications: 1 November 2021","URL":"https://urbanstudiesfoundation.org/funding/postdoctoral-research-fellowships/","body":"The Urban Studies Foundation (USF) announces a new round of Postdoctoral Research Fellowship funding with up to five fellowships each worth up to a total of \u00a3180,000 over a maximum of three years. Successful candidates may be based anywhere globally, and should propose a programme of work which will advance scholarly knowledge of any element of cities and urbanisation to the highest international standards of peer review. The award will be paid to an eligible institute of higher education (HEI) where the fellowship is to be held. A successful applicant should have a Mentor based in that institution with whom they will work closely for the duration of the fellowship.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Video clips from the East and Southern Africa Regional Peoples Health University, Theme: Past, present and future struggles for Health equity","field_subtitle":"EQUINET and PHM: Clips from weeks 2 and 3, August 2021","URL":"https://www.equinetafrica.org/rphu/rphu-resources","body":"The first East and Southern Africa Regional People\u2019s Health University (ESA RPHU) jointly convened by PHM and EQUINET is being held virtually between July 29 and November 12 2021 with 10 weeks of interactive sessions to build and share evidence, experience, analysis and knowledge on health equity to support regional co-operation and joint engagement, from local to global level, on shared priorities.  The course programme is at https://www.equinetafrica.org/rphu/rphu-programme with different issues affecting health equity in the region and learning from COVID-19.  Open access online dissemination of plenary presentations and resources is available on the RPHU resources page. It currently includes video clips of a panel discussion moderated by Dr Rene Loewenson TARSC/EQUINET with Dr Firoze Manji, Daraja Press and Professor Patrick Bond, University of Western Cape, explored the Political Economy of Health in East and Southern Africa; David van Wyk from Benchmarks Foundation on a case study of health equity in mining in South Africa; Mariam Mayet, Executive Director of the  African Centre for Biodiversity on global and corporate activities in industrial agriculture and gene technologies in relation to malaria; Thusang Butale BFTU and Danny Gotto I4Dev on experiences of extractive activities in Botswana and Uganda;  Masuma Mamdani, EQUINET on social determinants of health;  Shakira Choonora on an Intersectional lens to health inequities; Sue Godt on Emerging commercial determinants of health and the reality in the region and Peter Binyaruka, Ifakara Health Institute (IHI), Tanzania presentation on co-financing to address social determinants of health equity. The Resources page is being updated with new content as the course progresses. \r\n","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Virtual Symposium: Finding Joy in Healthcare in Africa ","field_subtitle":"WiSER University of the Witwatersrand, Medical and Health Humanities Africa network, Primary Health Care Directorate, University of Cape Town: 1-2 September, 2021, Online","URL":"https://tinyurl.com/27dtjw68","body":"Dominant perceptions of healthcare in Africa portray it either in terms of failure, disrepair, chaos and disappointment. Little attention is paid, within scholarly research, to the joy that accompanies pursuing or achieving health and wellbeing. This inaugural symposium explores, from past, present and future perspectives, how healthcare practitioners, health systems and people seeking healthcare in Africa approach issues of joy, trust, confidence, or comfort at individual, familial, community or national levels. The organisers invite artists, activists, health practitioners and academics to re-imagine health and healthcare in Africa through workshops, academic papers, discussion forums and two keynote addresses. (Note abstract submission has closed).","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Which UHC? Features for Equity and Universalism ","field_subtitle":"Loewenson R: International Journal of Health Policy and Management x(x), 104, doi:10.34172/ijhpm.2021.89, 2021","URL":"https://tinyurl.com/6udf6vkt","body":"Equity and universality are implicit in universal health coverage (UHC), although ambiguity has led to differing interpretations and policy emphases that limit their achievement. Diverse country experiences indicate a policy focus on differences in service availability and costs of care, and neoliberal policies that have focused UHC on segmented financing and disease-focused benefit packages, ignoring evidence on financing, service, rights-based and social features that enable equity, continuity of care and improved population health. Public policies that do not confront these neoliberal pressures limit equity-promoting features in UHC. In raising the impetus for UHC and widening public awareness of the need for public health systems, COVID-19 presents an opportunity for challenging market driven approaches to UHC, but also a need to make clear the features that are essential for ensuring equity in the progression towards universal health systems.","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Youth mental health facing a deficit of caring","field_subtitle":"Pelagia Nziramwoyo, Wilson Asibu, Joy Muhia, Nadine Nanji, Rene Loewenson","body":"Jacob, an 18 year old youth, lives in an East African country. When the pandemic came to his city, his boarding school shut and he left everything, including his friends, and travelled to be at home during the lockdown.  He thought this would be the best place, but once home he felt rising stress over lack of privacy in an overcrowded home, over trying to keep learning without adequate internet access, and over high data charges to keep in contact with teachers or friends.  He felt pressure from his parents to keep costs down while sustaining his learning  to merit the fees they had paid. They didn\u2019t seem to understand how the isolation and pressure was affecting him, and were preoccupied with their own demands. He became more and more withdrawn and depressed, couldn\u2019t talk to anyone, and fell further and further behind in his studies. When the school re-opened he didn\u2019t have the confidence to return. He felt depressed about his future, and that his life was not worth continuing. \r\n\r\nJacob\u2019s story is not unique. Young people from different east and southern Africa countries have reported or been found to experience a range of stresses and anxieties as a result of the COVID-19 pandemic.  Even before the pandemic, young people in the east and southern Africa (ESA) region were documented to experience depression, anxiety, post-traumatic stress disorders and suicidal ideas, while studies also noted the under-reporting of mental illness in young people.\r\n\r\nIn conversations with forty youth over 18 years of age from two ESA countries, many reported anxieties over relationships, parental expectations and school performance, as well as stresses from living in conditions of poverty, insecurity, hunger and social violence. These conditions were present before the pandemic. However, the pandemic was said to have worsened these sources of stress. Lockdowns in overcrowded homes, closures of schools and community centres disrupted various forms of peer and adult support, and young people reported feeling rising anxiety and frustration over their education and future. The youth pointed to stresses during the pandemic from increased risks of domestic violence and sexual abuse during lockdowns, from lost income, high food, data and other costs, and from uncertainty over the future. \r\n\r\nYoung people noted in the conversations how they were coping with these stresses. They said that social support from friends and peers, from supportive adults in and beyond the family, and from religious institutions played an important role in helping them cope with mental stress. So too did having funds to face challenges and sustain education, and having access to outdoor recreation and cultural activities. Online information, education, games and communication helped to sustain relationships and activities, although data charges were often not affordable. Some reported more harmful coping strategies, such as consumption of alcohol and harmful drugs to suppress anxieties. \r\n\r\nThe literature and the reports from young people themselves indicate that local services generally deal with youth mental health poorly, or not at all, and that there are limited youth-friendly mental health services. This has often placed the burden of care on families who themselves lack the information and tools to respond, and who still experience a stigma around mental disorders. While there is some report of youth counselling services, art therapy, online counselling, and digital applications to promote wellbeing, there is an evident need to expand the availability of a range of mental health services and capacities to manage the spectrum of disorders affecting young people.  In the conversations the youth also observed that families, youth peer counsellors and key adults should get greater support to promote communication and to help those facing mental health challenges. They prioritised prevention of mental ill-health, and recommended investment to tackle drivers of mental stress. They called for investment in jobs and enterprise opportunities, recreation facilities, school services, safe communities and information, and in opportunities for young people to participate in decisions affecting their lives in more mutually respectful interactions with authorities. \r\n\r\nThe way the region deals with this issue, including in the plans for the recovery from the pandemic, will have long term consequences. Jacob and others like him are the future. In one conversation, one young woman facing stress and feeling excluded from support said \u201cWe are in a country living alone and no one cares\u201d. This is a cry for us to address the unfair and unacceptable gap in recognising and responding to youth mental health, as a critical element of the \u2018complete mental, physical and  social wellbeing\u2019 envisaged in the definition of \u2018health\u2019. \r\n\r\nWe welcome your feedback or queries on the issues raised in this oped or interest in this work\u2013 please contact the EQUINET secretariat. You can read the literature review on youth mental health (EQUINET Discussion paper 122) at https://tinyurl.com/4vbj87rn  ","php":"","field_issue_date":"2021-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"#WHA74 WRAP: Pandemic Treaty Talks Eclipse Prevailing Vaccine Inequities","field_subtitle":"P Patnaik: Geneva Health Files, Edition #60, Geneva ","URL":"https://tinyurl.com/482h8d6z","body":"More than half way into the 74th World Health Assembly, a serious discussion on the efforts to address vaccine inequities is noted in this article to have been conspicuous by its absence. What has instead dominated much of the Assembly proceedings are talks for a pandemic treaty to address health emergencies in the future, and the important, but continuing push towards investigations on the origins of the virus, among other matters. In an issue that recaps the discussions at the current World Health Assembly, the Geneva Health Files in this piece notes \"it seems that there has not been enough attention on the here and the now in the midst of all the discussions on preparedness. In our view, this risks looking away from and a silent acceptance to the mounting deaths from COVID-19. It also shows unwillingness to acknowledge and accept the limitations of the current mechanisms that have not met expectations on not only vaccine equity but an overall international mechanism for meeting the needs on diagnostics and treatments for COVID-19\".   In a packed agenda for the week long remote meeting, the question is raised of why there is no dedicated forum to discuss why vaccines have not been delivered as promised, including to seek accountability for this and to revisit assumptions made about the mechanisms set up for this, including the ACT Accelerator and COVAX. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"2021 Social Policy in Africa Conference Development, Democracy and Social Policy: Remembering Thandika Mkandawire: 22-24 November 2021 University of South Africa, Pretoria, South Africa","field_subtitle":"Deadline for Abstracts: Friday, 27 August 2021","URL":"https://tinyurl.com/mw47rhxd","body":"The late Thandika Mkandawire contributed immensely to an intellectual project for a rejuvenation of Africa's developmental. This conference, invites contributions and papers that critically reflect on the exchange between the different literatures and imaginations on development, democracy and social policy, including critical reflections on the social policy responses to COVID-19 in the context of the stratified, segmented, and segregated social policy architecture that has been the staple of international agencies in the last three to four decades. Contributions need not be limited to the African context or experience, but should speak to experiences from the Global South.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"2021-22 Reckitt-LSHTM PhD studentships on Hygiene & Health in Sub-Saharan Africa","field_subtitle":"Deadline for Applications:  11 July 2021","URL":"https://tinyurl.com/f6f5y62h","body":"The London School of Hygiene & Tropical Medicine invites applications from candidates from Sub-Saharan Africa for fully-funded 4-year PhD studentships to start a research degree programme on 3 January 2022. There are three studentships available, linked to ongoing research projects that address the links between hygiene and health in Sub-Saharan Africa.  Further information and  applicant entry requirements are provided on the website link shown.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A critical discourse analysis of adolescent fertility in Zambia: a postcolonial perspective","field_subtitle":"Munakampe M; Michelo; C and Zulu J: Reproductive Health 18(75), 1-12, 2021","URL":"https://tinyurl.com/8azf9fzb","body":"This study explored competing discourses that shape adolescent fertility control in Zambia, through individual interviews and 9 focus group discussions with adolescents and other key-informants. Adolescent fertility discussions were influenced by marital norms and Christian beliefs, as well as health and rights values. While early marriage or child-bearing was discouraged, married adolescents and adolescents who had given birth before faced fewer challenges when accessing Sexual and Reproductive Health information and services compared to their unmarried or nulli-parous counterparts. Parents, teachers and health workers were conflicted about how to package Sexual and Reproductive Health information to young people, due to their roles in the community.  The authors assert that the competing moral worlds, correct in their own right, viewed within the historical and social context unearth significant barriers to the success of interventions targeted towards adolescents\u2019 fertility control in Zambia, propagating the growing problem of high adolescent fertility, and suggest proactive consideration of these discourses when designing and implementing adolescent fertility interventions.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"A New WHO International Treaty on Pandemic Preparedness and Response: Can It Address the Needs of the Global South?","field_subtitle":"Vel\u00e1squez G; Syam N: The South Centre, Policy Brief 93, 2021","URL":"https://tinyurl.com/3htf4r8e","body":"A recent joint communiqu\u00e9 by 25 Heads of Government and the WHO Director-General have called for the negotiation of a pandemic treaty to enable countries around the world to strengthen national, regional and global capacities and resilience to future pandemics, as a binding instrument to promote and protect health in the context of pandemics. The authors recommend that if WHO Member States decide that an international treaty is the way forward, it would be important to have clarity from the outset on the elements and areas that will be the subject of negotiation, by identifying aspects that the current crisis has revealed are not working. They recommend building on the existing instruments, notably the International Health Regulations and discuss critical issues that should be addressed in such a treaty if negotiations are launched,given that countries differ in needs, levels of development and capacities to implement treaty obligations.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Bayer breathing life into Gates\u2019 failed GM drought tolerant maize: Agrarian extractivism continues unabated on the African continent ","field_subtitle":"Masinjila S; Zendah R: African Centre for Biodiversity (ACB), South Africa, 2021","URL":"https://tinyurl.com/29hv2hbd","body":"This paper alerts to the implications of a Gate\u2019s funded project, Water Efficient Maize for Africa (WEMA), now known as TELA, for sub-Saharan countries. Bayer, with a stated aim of solving smallholder farmers\u2019 poverty woes, is stated by the authors to be using South Africa\u2019s permissive biosafety regulatory environment to multiply obsolete and deficient genetically modified (GM) seeds, for export to the countries in the project, despite lack of success with drought tolerance and insect resistance in South Africa. The paper indicates that the industry\u2019s claims of the insect resistant trait\u2019s ability to combat the now persistent fall armyworm in Africa have been invalidated with the emergence of resistance in countries in North and South America, including Brazil. The authors question why African countries are allowing the dumping of these obsolete technologies into their countries and urge African governments to reject the imposition of outdated GM technologies and to adopt workable and holistic solutions, including to support food systems.  ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Call for applicants: East and Southern Africa Regional Peoples Health University, Online 29 July to 12 November 2021 ","field_subtitle":"EQUINET and PHM:  Closing date 25 June 2021","URL":"https://tinyurl.com/4cm9vuxm","body":"The first East and Southern Africa Regional People\u2019s Health University (ESA RPHU) jointly convened by PHM and EQUINET is being held virtually between 29 July and 12 November with the theme \u2018Past, present and future struggles for Health equity\u2019. The course aims to build and share evidence, experience, analysis and knowledge on the drivers of health equity to support efforts and activism within countries, as new and existing members of PHM and EQUINET, and in regional co-operation and joint engagement, from local to global level, on shared priorities. The course aims to link key areas of evidence and knowledge to practical experiences and action to share insights and build learning from action. We invite applicants based / working in the east and southern Africa region in state, non-state, community-based institutions involved in health-related work, from health and other sectors  and disciplines that have an impact on health equity.  See the website link for further details on the course, features for applicant eligibility, and for the online application form. Applicant forms  must be received by 25 June  2021. Applicants will be informed by 12 July.\r\n","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Call for Applications for the TDR Postgraduate Training Scholarship - University of the Witwatersrand","field_subtitle":"Deadline for Applications: 31 July 2021","URL":"https://tinyurl.com/7846fhum","body":"The University of the Witwatersrand\u2019s School of Public Health invites suitably qualified candidates to apply for a full-time funded Master Degree Programme in the field of Implementation Science. The focus is on implementation research on infectious diseases of poverty, including the neglected tropical diseases, malaria, tuberculosis, HIV/TB co-infection and COVID-19. Implementation science is a growing field that supports the identification of health system bottlenecks and approaches to address them, and is particularly useful in low- and middle-income countries where many health interventions do not reach those who need them the most.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for submissions: Thandika Mkandawire Prize for Outstanding Scholarship in African Political Economy and Economic Development and Prize for Young Scholars","field_subtitle":"Deadline for Applications: 30 June 2021","URL":"https://tinyurl.com/mkf4hjjy","body":"The African Programme on Rethinking Development Economics (Aporde) and the South African Research Chair in Industrial Development (SARChI Industrial Development) are delighted to announce the inaugural Thandika Mkandawire Prize for Outstanding Scholarship in African Political Economy and Economic Development. This prize is to be awarded annually to recognise outstanding research papers by African scholars. A second award, the Thandika Mkandawire Prize for Young Scholars in African Political Economy and Economic Development, is specifically for young researchers.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Cape Town in common:  a handbook to reclaim local democracy in our city","field_subtitle":"Rossouw J: Bertha Foundation, South Africa","URL":"https://tinyurl.com/389rj7dy","body":"This handbook aims to support people across the city of Cape Town assert their democratic rights, and to come together to take charge of their wards. Unemployment, poverty and violence are deeply entrenched in the city which remains spatially divided and stubbornly unequal and the handbook discusses ways to bring everybody living in the ward together, across historical divides, to deliberate and get involved in finding practical solutions to the problems. This handbook  supports this with a \u2018manifesto of ordinary ideas\u2019 and practical ideas and tactics to reclaim local democracy.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"China, Africa and the Fast-Changing Geopolitics of Vaccines","field_subtitle":"Olander E: The China Africa Project, 2021","URL":"https://tinyurl.com/sj9mnxnu","body":"Most African countries expected to receive tens of millions of doses manufactured by Indian companies. But now that New Delhi has halted all exports, African officials have no other choice but to look elsewhere \u2014 and in many cases, that\u2019s leading them to Chinese and Russian suppliers. So far, Covax\u2019s vaccine distribution has failed to meet the needs of developing countries with just 43.4 million doses spread thinly across 119 countries. According to the USAID fact sheets on the US COVID-19 response, the United States has not provided any aid or relief to African countries so far this year. While Washington is refusing to ship vaccines overseas, Chinese vaccine manufacturing output is steadily rising. Both Sinopharm and Sinovac producers now say they are capable of producing at least 2 billion doses in 2021 alone. The author notes that it is entirely possible that the Chinese will be positioned to fill the supply gap in 2021 for a number of low income countries.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"COVID-19: Make it the Last Pandemic","field_subtitle":"The Independent Panel for Pandemic Preparedness & Response: Geneva, 2021","URL":"https://tinyurl.com/2v753de2","body":"The Independent Panel for Pandemic Preparedness and Response was set up by WHO to review the state of pandemic preparedness before COVID-19, the circumstances of the identification of SARS-CoV-2 and responses globally, regionally, and nationally, particularly in the early months of the pandemic, and its health system, social and economic consequences. This report of the panel indicates that preparedness was limited and disjointed, leaving health systems overwhelmed when actually confronted by a fast-moving and exponentially spreading virus. The panel concluded addressing this gap not requires sustained investment, and new approaches to peer review of country preparedness, and to the international alert system. The panel suggests  that the legally binding International Health Regulations (IHR) (2005) did not facilitate rapid action, and that the consequence of delays in response impacted most on already disadvantaged people. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"COVID: Using the rupture for change","field_subtitle":"Editor, EQUINET newsletter","body":"Our editorials usually provide a lens on a perspective and issue occurring within east and southern Africa. But what we currently see in different parts of the world are a call to solidarity and people's connection across regions, including to ensure that what is happening locally is not rendered invisible in global policy and accountability. We have seen scenes of human tragedy unfolding in Gaza and India and military violence faced by people protesting against the privatisation of health care in Colombia. In region to region solidarity this newsletter includes a message from the People's Health Movement in our region protesting those facing injury and threats to health in Colombia.   \r\n\r\nConnecting across regions and peoples seems critical at this moment for what sort of world we will create. Arundhati Roy in 'The pandemic is a portal' (open access) wrote \"Whatever it is, coronavirus has made the mighty kneel and brought the world to a halt like nothing else could. Our minds are still racing back and forth, longing for a return to \u201cnormality\u201d, trying to stitch our future to our past and refusing to acknowledge the rupture. But the rupture exists. And in the midst of this terrible despair, it offers us a chance to rethink the doomsday machine we have built for ourselves. Nothing could be worse than a return to normality. Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it\".   \r\n\r\nOur two editorials both point to global processes that demand engagement, vigilance, support and sustained activism across regions and peoples if we are to use this rupture for change. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Dala Kitchen: More than a cookbook","field_subtitle":"Whyle E, van Ryneveld M, Brady L (eds): Cape Town Together (CAN), South Africa","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/Dala%20Kitchen%20lowres.pdf","body":"Dala Kitchen (More Than A Cookbook) is a celebration of the work of Cape Town Together. During 2020, in response to the Covid-19 pandemic, thousands of people came together to support one another in a range of creative and radically generous ways. Through a series of recipes, how-to's, articles and stories Dala Kitchen tells the story of Cape Town Together, the CANs that comprise it, and the people that are at the heart of the network. Together, these stories capture a moment in time and demonstrate that, in the words of Arundhati Roy \"[a]nother world is not only possible, she is on her way.\". The version on this website is a low resolution version- a higher resolution copy will replace this shortly.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Domestic violence in Mozambique: from policy to practice","field_subtitle":"Jeth\u00e1 E; Keygnaert I; Martins E; Sidat M; et al: BMC Public Health 21(772) 1-13, 2021","URL":"https://tinyurl.com/kpt7twxp","body":"The authors identified gaps in Mozambique in the implementation of existing national policies and laws for domestic violence in the services providing care for domestic violence survivors, through content analysis of guidelines and protocols and interviews with institutional gender focal points. While the guidelines were seen to be relevant, many respondents identified gaps in their implementation, due to weaknesses in penalties for offenders, the scarcity of care providers with appropriate training and socio-cultural factors. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Door opens for TRIPS waiver textual negotiations","field_subtitle":"Third World Network (TWN) Info Service on Health Issues: TWN, issue 6, 2021","URL":"https://twn.my/title2/health.info/2021/hi210506.htm","body":"With the Biden-Harris Administration taking the United States out of the \"blocking\" countries, all eyes are now on Europe and Japan among others as momentum grows for text-based negotiations on the temporary TRIPS waiver for combating the Covid-19 pandemic. The World Trade Organisation director-general Ms Okonjo-Iweala met with German Chancellor Angela Merkel and  the TRIPS waiver is likely to have been included in the talks cannot be ruled out in the wake of a global call from 100 former leaders, including half of the US Democratic Congressmen and women, Nobel Laureates, and around 400 international civil society organizations, to agree to the TRIPS waiver. The EU's evolving positions seem to be focused on a \"third way\" approach\u2014promoted by the European Union and several members of the Ottawa Group- that seeks to address issues such as export restrictions, more bilateral and other licensing agreements, and ensuring the supply of vaccines by countries which have huge stocks of unused vaccines. The authors note that the insistence on a \"360 degree view\" on the waiver could involve a payment from the waiver co-sponsors, as powerful pharmaceutical companies have also stepped up their campaign against the waiver.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Emerging African Scholars' Virtual PhD Workshop, Online","field_subtitle":"The Association for Research On Civil Society In Africa; The Association For Research On Nonprofit Organizations And Voluntary Action; Ford Foundation: 4 June 2021","URL":"https://arocsa.org/eas-call-2021/","body":"The Emerging African Scholars Program in Africa is hosting a full day virtual PhD Workshop to provide guidance for emerging scholars on career paths, help sharpen research skills and address the challenges that African PhD students face.  The program is open to doctoral students from Africa whose research focus is on non-profit management, philanthropy, civil society, social entrepreneurship and voluntary action studies in Africa. Students who have defended a dissertation proposal, not yet defended a dissertation proposal and whose dissertation plans are not yet fully formed are all encouraged to apply. This workshop is free of charge and will be conducted online.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"End Inequalities. End AIDS. Global AIDS Strategy 2021-2026","field_subtitle":"UNAIDS:Geneva 2021","URL":"https://tinyurl.com/zttdu5xd","body":"The new Global AIDS Strategy (2021\u20132026) uses an inequalities lens to identify, reduce and end inequalities that represent barriers to people living with and affected by HIV, countries and communities from ending AIDS. The Strategy outlines a comprehensive framework for transformative actions to confront these inequalities and to respect, protect human rights in the HIV response. It puts people at the centre to ensure that they benefit from optimal standards in service planning and delivery, to remove social and structural barriers that prevent people from accessing HIV services, to empower communities to lead the way, to strengthen and adapt systems so they work for the people who are most acutely affected by inequalities, and to fully mobilize the resources needed to end AIDS.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Engaging globally with how to achieve healthy societies: insights from India, Latin America and East and Southern Africa","field_subtitle":"Loewenson R; Villar E; Baru R; Marten R: BMJ Global Health 6(4), e005257, 1-13, 2021","URL":"https://tinyurl.com/5nr7d9sn","body":"This paper explores the features and drivers of frameworks for healthy societies that had wide or sustained policy influence post-1978, globally and in selected southern regions, in India, Latin America and East and Southern Africa. The  authors implemented a thematic analysis of 150 online documents and reviewed the findings with expertise from the regions covered. Globally, comprehensive primary healthcare, whole-of-government and rights-based approaches have focused on social determinants and social agency to improve health as a basis for development. Biomedical, selective and disease-focused technology-driven approaches have, however, generally dominated, positioning health improvements as subsequent to macroeconomic growth. Historical approaches in the three southern regions that integrated reciprocity and harmony with nature were suppressed by biomedical models during colonialism and by postcolonial neoliberal economic reforms. With widening differences between biosecurity approaches on the one hand and holistic, ecological approaches on the other, economic, the context in the 2000s of ecological, pandemic crises and social inequality is argued to imply that which ideas dominate will be critical for health futures. The authors point to what this implies for building approaches to healthy societies, including for a more equitable circulation of ideas between regions in framing global ideas. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 228: COVID: Using the rupture for change","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Examining unit costs for COVID-19 case management in Kenya","field_subtitle":" Barasa E; Kairu A; Ng'ang'a W; Maritim M; BMJ Global Health 6(6), e004159, 1-8, 2021","URL":"https://tinyurl.com/yewn32cc","body":"This paper estimated per-day unit costs of COVID-19 case management for patients from costs in three public COVID-19 treatment hospitals in Kenya, and using input prices from a recent costing survey of 20 hospitals in Kenya and from market prices for Kenya. The paper details the per-day, per-patient unit costs for asymptomatic patients and patients with mild-to-moderate COVID-19 disease under home-based care,  the significantly higher costs of managing the same patients in an isolation centre or hospital, and the per-day unit costs for patients with severe COVID-19 disease managed in general hospital wards and in intensive care units. COVID-19 case management costs were found to be substantial, ranging between two and four times the average claims value reported by Kenya\u2019s public health insurer. The authors indicate that Kenya will need to mobilise substantial resources and explore service delivery adaptations to reduce unit costs.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Global Infectious Disease Research Training, Fogarty International","field_subtitle":"Deadline for applications: August 3, 2021","URL":"https://tinyurl.com/x8nsfzf6","body":"The Global Infectious Disease research training program addresses research training needs related to infectious diseases that are predominantly endemic in or impact upon people living in developing countries. The training focuses on a major endemic or life-threatening emerging infectious disease, neglected tropical disease, infections that frequently occur as a co-infection in HIV infected individuals, or infections associated with non-communicable disease conditions of public health importance in low- and middle-income countries. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global progress report on water, sanitation and hygiene in health care facilities: fundamentals first","field_subtitle":"World Health Organization: WHO, Geneva, 2020 ","URL":"https://tinyurl.com/sz6yn2xz","body":"This report provides a comprehensive summary of global progress on improving water, sanitation, hygiene, waste management and environmental cleaning (WASH) in health care facilities and is intended to stimulate solution driven country and partner actions to further address major gaps. It provides practical steps to improving WASH in health care facilities, selected country case studies illustrating bottlenecks, gaps, and successful strategies, and recommendations for addressing gaps and sustaining services.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Health Equity Assessment Toolkit","field_subtitle":"World Health Organisation: WHO, Geneva, 2021","URL":"https://www.who.int/data/gho/health-equity/assessment_toolkit","body":"The Health Equity Assessment Toolkit (HEAT) is a software application that facilitates the assessment of within-country health inequalities. It was developed for use on desktop or laptop computers and mobile devices and has a Health Equity Monitor database and a version that allows users to upload and work with their own database. The application allows users to explore current or time trends in inequality in a setting of interest, such as a country, province or district; and compare inequality between settings. Inequalities are visualized in a variety of interactive graphs, maps and tables. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health research knowledge translation into policy in Zambia: policy-maker and researcher perspectives","field_subtitle":"Malama A; Zulu J; Nzala S; et al: Health Research Policy and Systems 19(42), 1-11, 2021 ","URL":"https://tinyurl.com/3x3c925f","body":"The authors explored how health research knowledge is translated into policy in Zambia, and what facilitates or hinders this, from document review and key informant interview.  While the document review suggested policy efforts to promote knowledge translation, the interviews raised challenges in coordination and linkages between knowledge and policy-making processes, attributed to lack of research knowledge translation capacity, limited resources and lack of knowledge hubs. However, the authors suggest that emerging local research leadership and a stock of underused local health are an opportunity to enhance knowledge to policy links, if supported.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health spending and vaccination coverage in low-income countries","field_subtitle":"Castillo-Zunino F; Keskinocak P; Nazzal D; Freeman M: BMJ Global Health 2021;6:e004823, 1-9, 2021","URL":"https://tinyurl.com/2ny6ppmm","body":"The authors investigated what financial changes in low income countries (LICs) lead to childhood immunisation changes, controlling for population density, land area and female years of education. During 2014\u20132018, gross domestic product per capita, total or private health spending per capita and aggregated development assistance for health per capita were not significant predictors of vaccination coverage in LIC. Government health spending per capita and total/government spending per birth on routine immunisation vaccines were significant positive predictors of vaccination coverage. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Hubs of Interdisciplinary Research and Training in Global Environmental and Occupational Health (GEOHealth)","field_subtitle":"Deadline for applications: July 8, 2021","URL":"https://tinyurl.com/3fy759bb","body":"The Fogarty Global Environmental and Occupational Health program calls for applicants from institutions in low- or middle-income countries to function as regional hubs for collaborative research, data management, research training, curriculum and outreach material development, and policy support around high-priority local, national and regional environmental and occupational health threats. GEOHealth hubs are supported by two coordinated linked awards to a LMIC institution for research and a U.S. institution to coordinate research training. Together the GEOHealth hubs form the GEOHealth network, a platform for coordinated environmental and occupational health research and research training activities. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa","field_subtitle":"Adeyemi O; Lyons M; Njim T; Okebe J; et al: BMJ Global Health6:e004669, 1-9, 2021","URL":"https://tinyurl.com/4xn47vvz","body":"This paper assessed the extent in East Africa to which policies reflect calls for HIV-NCD service integration, through document review. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes, in response both to increasing levels of NCDs and more person-centred services for people living with HIV. Other countries, however, have no reported plans for HIV and NCD care integration. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Introduction to Global Health, University of Stellenbosch","field_subtitle":"10 weeks, online","URL":"https://shortcourses.sun.ac.za/courses/c-10/2021-5602.html","body":"This short course aims to provide academic staff, students, researchers, reviewers and editors with the understanding of the global health within the African context and beyond. The course is delivered online over 10 weeks. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Neo-colonial economies and ecologies, smallholder farmers and multiple shocks: The case of cyclones Idai and Kenneth in Mozambique and Zimbabwe","field_subtitle":"African Centre for Biodiversity (ACB)L ACB, South Africa, 2020","URL":"https://tinyurl.com/4js8xnxj","body":"The African Centre for Biodiversity (ACB)  exposes how the two cyclones that battered Mozambique and parts of Malawi and Zimbabwe in March and April 2019 must be understood against the backdrop of the political and economic drivers of ecological degradation. These include development loans and aid, rapacious natural resource extraction and social and cultural displacement. The authors examine the interconnections between climate change, deforestation, agricultural expansion and resource extractivism, as drivers of social and political instability and food insecurity in these countries, while enriching a small political elite. The paper unpacks how the national and international disaster response to the cyclones inadequately addressed the scale of the overlapping crises that the cyclones revealed, calling for approaches that go beyond narrow disaster management to one based on equity and justice in local economies and in relationships with the global economy.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Peoples Health movement message on Colombia","field_subtitle":"Peoples Health Movement (PHM): South Africa","body":"In an open letter to the Ambassador Extraordinary and Plenipotentiary, Colombia, the Peoples' Health Movement urged the government to abide by the Constitution, stop the violence, and join hands with citizens in defeating COVID urgently, and enacting policies that promote people\u2019s health, equality and social justice. The PHM wrote: \"We note with deep concern the criminalisation of protest and high levels of violence perpetrated  on legitimate and peaceful protestors by the Colombian government security forces and armed civilian groupings. Credible sources report the use of lethal weapons, including rifles and semi-automatic guns, against protesters around the country by police. At least 37 people have been killed; some reports give larger numbers. There are also reports of disappearances. As a result of extreme militarisation, some cities, including Cali and Palmira, are running out of food and medicine supplies; Internet signals and social networks essential for communication among citizens and communities have been blocked; and levels of fear and uncertainty are growing among the population. The protests occur against the background of the COVID-19 pandemic. COVID is exacerbating poverty and inequality. The number of Colombian people living in extreme poverty grew by 2.8 million last year. And more and more people face hunger.","php":"Further details: /newsletter/id/64836","field_issue_date":"2021-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Public Private Partnerships (PPPs) and Women\u2019s Human Rights: Feminist Analysis from the Global South","field_subtitle":"Development Alternatives with Women for a New Era (DAWN): DAWN, 2021","URL":"https://tinyurl.com/35rrvavb","body":"Corporations across the globe are capturing more and more of the public sphere, encroaching on all aspects of people\u2019s lives. This publication compiles analyses of different country experiences on public-private partnerships that in themselves have become a powerful tool to achieve what the authors observe is starting to look like the privatisation of life itself. Feminist researchers from the Global South have spent a year researching this theme in their home countries, including in Kenya and Zimbabwe. Together they present an analysis and critique of the state of PPPs today, and the consequences for women\u2019s lives, communities\u2019 wellbeing, and public health and social services. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Public Water and Covid-19: Dark Clouds and Silver Linings","field_subtitle":"McDonald D; Spronk S; Chavez D: Municipal Services Project, Transnational Institute and Latin American Council of Social Sciences (CLACSO): MSP, 2020","URL":"https://tinyurl.com/v72uynjc","body":"Covid-19 has again demonstrated the significance of safe, accessible and affordable water for all and the enormous disparities in service provision while at the same time dealing a blow to public water and sanitation operators around the world due to massive drops in revenues, rapidly rising costs and concerns about health and safety in the workplace. This book provides the first global overview of the response of public water operators to this crisis, shining a light on the complex challenges they face and how they have responded in different contexts. It looks specifically at \u2018public\u2019 water and asks how public ownership and public management have enabled (or not) equitable and democratic emergency services, and how these COVID-19 experiences could contribute to expanded and sustainable forms of public water services in the future","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Sales and pricing decisions for HIV self-test kits among local drug shops in Tanzania: a prospective cohort study","field_subtitle":"Chiu C; Hunter L; McCoy S; et al: BMC Health Services Research 21(434), 1-11, 2021","URL":"https://tinyurl.com/4pcbj254","body":"From August to December 2019, the authors provided free HIV self-test kits, a new product, to 26 pharmacy shops in Shinyanga, Tanzania to sell to the local community.  Sales volume, price, customer age and sex were measured using shop records, together with willingness-to-pay to restock test kits. Purchase prices ranged from 1000 to 6000 Tsh. Within shops, prices were 11.3% higher for 25 to 34 and 12.7% higher for 45+ year olds relative to 15 to19 year olds and 13.5% lower for men on average. Although prices varied between shops, prices varied little within shops over time, and did not converge over the study period or cluster geospatially. Shopkeepers charged buyers different prices depending on buyers\u2019 age and sex and there was low demand among shopkeepers to restock at the end of the study. The authors propose that careful consideration is needed to align the motivations of retailers with public health priorities while meeting their private for-profit needs.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"South African physician emigration and return migration, 1991\u20132017: a trend analysis. ","field_subtitle":"Nwadiuko J; Switzer G; Stern J; et al: Health Policy and Planning, doi: 10.1080/17441692.2021.1900316, March 2021","URL":"https://pubmed.ncbi.nlm.nih.gov/33734007/","body":"This study used physician registry data to analyse patterns of emigration and return migration only among South Africa-trained physicians registered to practice in top destination countries such as Australia, Canada, New Zealand, the USA or the UK between 1991 and 2017, which represent the top five emigration destinations for this group. It found a 6-fold decline in emigration rates from SA between 1991 and 2017, with declines in emigration to all five destination countries. About one in three South Africa physicians returned from destination countries as of 2017. Annual physician emigration fell by 0.16% for every $100 rise in South Africa gross domestic product per capita. As of 2017, 21.6% of all South Africa physicians had active registration in destination nations, down from a peak of 33.5% in 2005, a decline largely due to return migration. Changes to the UK\u2019s licensing regulations were seen to be likely affected migration patterns while the Global Code of Practice on International Recruitment contributed little to changes. The authors propose that return migration monitoring be incorporated into health workforce planning.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The COVID-19 TRIPS Waiver: What happens after grabbing the tail of the tiger?","field_subtitle":"Riaz Tayob, SEATINI, South Africa","body":"Without any doubt, it is a success for South Africa, India and other co-sponsors of the TRIPS Waiver proposal, along with progressive political, professional and civil society voices, that the United States of America changed its position on the TRIPS Waiver. The waiver proposes a time-limited waive of patents and other rights related to essential health products for COVID-19 in the World Trade Organisation (WTO) TRIPS agreement. \r\n\r\nThe TRIPS Waiver proposals are now moving to text-based negotiations. If historical experience on access to medicines and the current power relations are anything to go by, the waiver proposers have grabbed the tail of the proverbial tiger in pushing for more distributed production of vaccines, diagnostics and therapeutics. What is to be done now that the US has agreed to talks?\r\n\r\nIt is important to understand that this stage does not represent agreement on the waiver. It has now merely advanced as an agenda item for discussion. The terms of the waiver have yet to be worked out. Even once agreed, implementation demands rapid support to increase production capacities for the range of products and systems that are able to distribute them, particularly in resource constrained settings. For all products covered, and particularly for vaccines and therapeutics, the waiver time frame and production capacities would need to be able to deal with current and emergent viral mutations and the updates required for a potentially endemic situation of an evolving virus.\r\n \r\nMuch remains to be done and the convergence of progressive forces that have pushed the waiver to this point need to robustly take on these remaining challenges to realise equitable access to vaccines, diagnostics and therapeutics. \r\n\r\nThe text-based negotiations and counter-lobbying by big pharma and others pose a risk of the proposals being diluted. As faced by HIV treatment activists in struggles over access to medicines, the proposals will face an incremental detraction from the largely wealthy countries seeking to preserve economic interests. Germany, the influential European power, remains opposed to the waiver, notwithstanding the US change in position. The tables seem to have turned on this. In the HIV-related Doha negotiations in 2001, the US played the \u2018bad cop\u2019 and the Europeans the \u2018good cop\u2019. While the European Parliament is largely supportive of the waiver it has limited legislative power, as intellectual property is in the European Commission\u2019s domain. Further, the US trade representative to the WTO has said these negotiations will take time, as if they and not they virus are setting the timeline. \r\n\r\nAlready, the revisions that South Africa and India have made point to some of the areas that may be weakened: The duration of the waiver, with proposals for 3 years subject to renewal, must be adequate for the distributed transfer of capacities in an evolving situation. The necessary scope of technologies -vaccines, diagnostics, medical devices and therapeutics \u2013 is in the revised text and should not be whittled down. It is unclear if it will apply to patents only, or as in the current waiver proposal, to other key elements of intellectual property such as trade secrets, industrial designs and copyright. \r\n\r\nThe struggle for access to HIV-related medicines has much to teach. Two agreements were reached at the WTO, the 2001 Doha Declaration on Public Health, and the 2003 \u2018August 30th Decision\u2019. Both were victories to build on, but proved to fall short in meaningfully addressing access. They allowed rich countries that could not be seen to deny access to HIV treatments to virtue signal, but sustained hurdles for countries in applying the flexibilities they provided. This largely sustained dependency on imports for the lower income countries most affected by HIV. \r\n\r\nThe Doha declaration did establish the important principle of trade agreements being \u201cinterpreted and implemented in a manner supportive of WTO members' right to protect public health\u201d, and levered improved, albeit not universal, access to HIV-related medicines. But, as the current pandemic has shown, they do not provide adequate measures for vaccines, diagnostics and other technologies essential for a public health response, and did not adequately shift priorities, power or production capacities to address unfair barriers in global trade rules to meeting public health challenges. \r\n\r\nWhile the World Health Organisation (WHO) Director General has stood fast in articulating support for the waiver and called the inequity in vaccine access \u2018vaccine apartheid\u2019, WHO has less power in this debate and lacks the enforcement mechanism that the WTO has for its rules. WHO was out-manoeuvred by the Gates Foundation and rich countries\u2019 preference for the ACT-Accelerator and COVAX at a time when the deeper proposals for patent pooling and technology transfer were made through the COVID-19 Technology Access Pool (C-TAP). The delay in enabling distributed production and weakness of COVAX is already evident in the shortfalls in supplies reaching low and middle income countries through COVAX, more sharply now with the pandemic demand in India restricting vaccine exports. The African Union recently warned African countries that delays in supplies may mean that they will need to restart their two dose vaccine programmes, or complete them with one dose vaccines that may not be distributed until late 2021. This global failure to meet health need makes virtue signalling on solidarity at the same time as self-protecting a profitable system reliant on patents and other monopoly rights particularly hollow. This is especially so in the context of the massive amounts of public funding that enabled innovations and the public support in opposing high income western countries for the waiver. \r\n\r\nIt can of course be argued that diplomacy involves compromise and that radical change demands sustained struggle. But the process is itself taking place in a space that is biased towards existing wealth. Negotiations at the WTO run on arcane principles and are largely not transparent. The rich countries hold much sway, including through supportive WTO officials. Important negotiations take place in so-called \u2018green rooms,\u2019 where experience indicates that consensus is achieved largely by excluding dissenters from the table. A current proposal by some high income countries to prioritise voluntary licensing arrangements as a solution is a symptomatic treatment, still under the control of big pharma, fails to address the causes of import dependency in Africa and other low and middle income countries and should not be used as a lever to delay or focus attention away from the waiver. \r\n\r\nProposers and supporters of the Waiver have grabbed the tail of the tiger. If the proposals are to avoid a death by a thousand cuts, this is the time to intensify focus. The transparency of these negotiations at the WTO and active vigilance, support and sustained activism will be essential to ensure that the outcomes achieved protect the public health rights and aspirations that have been behind the TRIPS Waiver to date.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"The health policy response to COVID-19 in Malawi ","field_subtitle":"Mzumara G; Chawani M; Sakala M, et al:  BMJ Global Health, 6:e006035, 2021","URL":"https://gh.bmj.com/content/6/5/e006035","body":"Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and registered its first confirmed coronavirus case on 2 April 2020. This paper documents decisions made in response to the COVID-19 pandemic from January to August 2020. Malawi's response to the pandemic was found to have been multi-sectoral and implemented through 15 focused working groups termed clusters. Each cluster was charged with providing policy direction in their own area of focus. All clusters then fed into one central committee for major decisions and reporting to head of state. This led to a range of responses, including an international travel ban, school closures at all levels, cancellation of public events, decongesting workplaces and public transport, mandatory face coverings and testing symptomatic people. Supportive interventions included risk communication and community engagement in multiple languages and over a variety of mediums, as well as efforts to improve access to water, sanitation, nutrition and unconditional social-cash transfers for poor urban and rural households.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The Independent Panel did not meet the moment","field_subtitle":"Sara Davis, Global Health Centre, Graduate Institute, Geneva","body":"The Independent Panel for Pandemic Preparedness and Response (https://theindependentpanel.org), tasked by WHO with reviewing the global management of the COVID-19 pandemic has fulfilled its terms of reference. But despite the best efforts of the panelists, it did not meet the moment. The world might still need an Independent Panel -- but one that is transparent, accountable and participatory. \r\n\r\nThis Independent Panel report does summarize many of the issues the world has witnessed in the past 14 months: weak pandemic preparedness, lugubrious bureaucracies, and government passivity. It poetically describes global inequalities, including the stark sacrifices of healthcare workers. However, its narrow recommendations sidestep many of these tough challenges in favour of expanding global governance: a Global Health Threats Council with heads of state, adopting new global statements and treaties, greater funding and authority for WHO, and a massive new $10 billion pandemic financing facility. It calls for countries to unite to establish a new international system for outbreak monitoring and alerts. \r\n\r\nSome of these recommendations are sensible, others less likely, but in seeking to avoid assigning blame, the panel ducks accountability, and its vision falls short of the scale of the problems revealed by COVID-19. \r\n\r\nThe recommendations on vaccine access exemplify this. The panel urges funding for COVAX, a worthy goal; but COVAX\u2019s 20% coverage targets cannot reach global herd immunity and prevent the spread of potentially dangerous new variants, and there is no clear plan for the remaining 80%. The panel called for high-income countries to speedily negotiate an intellectual property waiver and donate 1 billion doses by September 1 to low- and middle-income countries. Given the global need of 10 billion doses today, as Madhu Pai argued in his powerful intervention at the launch event of the report, this is vaccine charity, not vaccine equity. The panel does not address the stark inequalities among countries that have fueled the virus.\r\n\r\nTroublingly, considering that several of the panelists have been outspoken human rights advocates in the past, the Independent Panel also sidestepped numerous grave human rights abuses in the COVID-19 pandemic: praising the world\u2019s most brutal authoritarian lockdowns as models, without a single caveat about government overreach. In particular, as critics have pointed out, the report omits mention of Chinese suppression of health data, though it is well-documented that this has caused numerous real headaches for WHO. \r\n\r\nIn March 2020, China\u2019s State Council cracked down on independent research, issuing a directive requiring political vetting of any research on the coronavirus. A Chinese scientist publishing the coronavirus genome sequence on an open platform had his laboratory closed. Over 800 Chinese individuals were sanctioned by police for COVID-related speech, and individual citizen journalists were disappeared while patients who organized online had their chat groups deleted. This is all consistent with the modern history of China\u2019s health system struggling with whether to report up or censor outbreak alerts, from HIV to SARS to, most recently, H1N1. \r\n\r\nGiven this tortured history with health data, which has been repeated in other countries, it would have been reasonable for the Independent Panel to query when and whether the world will learn of the next outbreak of a new virus. If a UN panel cannot state that suppression of scientists is incompatible with the International Health Regulations, or even with the founding principles of the UN itself, how many doctors might hesitate to blow the whistle? \r\n\r\nHowever, this aversion to sensitive political realities threads through the report, which mentions human rights only once, at the end. The report does describe staggering global inequalities, but without recommendations, though these could have been drawn from many sources: guidance from the UN Human Rights Office, from UNAIDS, from global associations of nurses and other medical workers, or even from the panel\u2019s own commissioned background papers . \r\n\r\nThese omissions are concerning, but rather than blaming the panellists, we might reflect on the largely closed process. A process grounded in a robust, public consultation with civil society and community voices, frontline health care workers and trade unions, might have produced a different result.\r\n\r\nTo put an end to and recover from a catastrophe on the scale of COVID-19 requires greater scope. A democratic and public review of what happened and what did not happen in each region, with the public participating to reflect on what we lived through and bore witness to, could build the global public momentum for real learning and change. \r\n\r\nSuch open and transparent processes have taken place effectively as part of transitional justice in many countries. For example, we can reflect on the Global Commission on HIV and the Law: a global commission on a pandemic hosted by UNDP, it included regional desk reviews based on open submissions, public hearings recorded and archived online, and participation of community activists, who could then use the recommendations and tools that came out of the process to advocate for law and policy reforms at the national level. Its reports continue to be a reliable \u2013 and independent -- resource for scholars, officials, policymakers and activists. \r\n\r\nAn independent commission on pandemic policy could enable wider consultation that creates a lasting historical record, greater trust in science, and a global movement for transformational change. Are we ready to face the difficult truths that such a panel might show us?\r\n\r\nThis oped is reproduced with permission from Geneva Health Files Newsletter #57 (https://genevahealthfiles.substack.com/p/at-risk-covax-plans-to-vaccinate ) The report of the Independent Panel for Pandemic Preparedness and Response \u2018COVID-19: Make it the Last Pandemic\u2019 is included in this newsletter issue and the launch of the report can be viewed at https://www.youtube.com/watch?v=_-OSqIrF0qA&t=2662s. Please send feedback or queries on the issues raised in the oped to the author at sara.davis[at]graduateinstitute.ch. ","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"The role of gender power relations on women\u2019s health outcomes: evidence from a maternal health coverage survey in Simiyu region, Tanzania","field_subtitle":"Garrison-Desany H;  Wilson E; Munos M; Sawadogo-Lewis T; et al: BMC Public Health  21(909), 1-15, 2021 ","URL":"https://tinyurl.com/2smjvfu","body":"The authors investigated how gender power relations within households affected women\u2019s health outcomes in Simiyu region, Tanzania. Women who reported being able to make their own health decisions were 1.57 times more likely to use condoms. Women who reported that they decide how many children they had also reported high contraception use. Seeking care at the health facility was also associated with women\u2019s autonomy for making major household purchases. The authors observe that the association between decision-making and other gender domains with women\u2019s health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. They suggest that future studies should integrate and analyze gender-sensitive questions within coverage surveys.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Towards universal health coverage in the WHO African Region: assessing health system functionality, incorporating lessons from COVID-19","field_subtitle":"Karamagi CH;  Tumusiime P;  Titi-Ofei R; et al: BMJ Global Health 6(3) 2021","URL":"https://gh.bmj.com/content/6/3/e004618","body":"The move towards universal health coverage is premised on having well-functioning health systems. The authors present an approach to provide countries with information on the functionality of their systems in a manner that will facilitate movement towards universal health coverage. They propose four capacities: access to, quality of, demand for essential services and its resilience to external shocks and provide results for the 47 countries of the WHO African Region based on this. The functionality of health systems in these countries ranged from 34.4 to 75.8 on a 0\u2013100 scale. Access to essential services represents the lowest capacity. Funding levels from public and out-of-pocket sources represented the strongest predictors of system functionality. The authors propose that such assessment on the capacities that define system functionality  can help countries to identify where to focus to improve the functioning of the health system.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"We need to rethink the whole international economic system in terms of rights for poor countries","field_subtitle":"Piketty T: Le Monde, 2021","URL":"https://tinyurl.com/9z27t29e","body":"By refusing to lift the patents on vaccines against Covid-19, the author argues that western high income countries have shown an inability to take into account the needs of the South. Beyond the right to produce, the commentary proposes that the debate on the reform of international taxation cannot be reduced to a discussion between rich countries aimed at sharing the profits currently located in tax havens. Plans being discussed at the Organisation for Economic Cooperation and Development envisage that multinationals will make a single declaration of their profits at the global level, in itself is an excellent thing. But when it comes to allocating this tax base between countries, the plan is to use a mixture of criteria (wage bills and sales in different territories) which in practice will result in rich countries receiving more than 95% of the reallocated profits, leaving negligible funds for poor countries. The author suggests that low income countries need to be at the table in such discussions.","php":"","field_issue_date":"2021-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":" Equitable recovery from COVID-19: bring global commitments to community level ","field_subtitle":"Loewenson R; D\u2019Ambruoso L; Minh Duc D; Hjermann R; et al: BMJ Global Health 6:e004757, 2021","URL":"https://gh.bmj.com/content/6/1/e004757","body":"High level speakers at the December 2020 United Nations General Assembly pointed to the growing inequalities and stress to health, social, economic and democratic systems caused by COVID-19, calling for a range of collective interest driven responses and measures for a sustainable recovery. The pandemic, lockdown and other responses, along with underfunded, poorly prepared and overstretched public sector social and health systems in many countries worsened many dimensions of health and well-being that were already facing deficits, generating a rising health and social debt in communities, the scale and long-term consequences of which are as yet unknown, especially for the most marginalised in society. Rather than \u2018getting back to normal\u2019, the authors argue that recovery and \u2018reset\u2019 demands change to tackle the inequalities, conditions, services, socioeconomic and environmental policies that made people susceptible and vulnerable to COVID-19. Economic recovery should not replicate the features of the global economy that are generating pandemic and other crises. The authors suggest further that for global aspirations to translate into benefit for communities, an equitable recovery should include significant investment in: (1) universal, public sector, primary health care-oriented health services; (2) redistributive, universal rights-based and life course based social protection; and (3) people, especially in early childhood and in youth, as drivers of change. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"A People\u2019s Vaccine or Apartheid Vaccine? Challenging WTO and Big Pharma","field_subtitle":"Daraja Press, January 2021","URL":"https://darajapress.com/2021/01/29/a-peoples-vaccine-or-apartheid-vaccine","body":"Access to health technologies (vaccines, medicines, diagnostics, PPE, ventilators etc) depends on distributed local production. Nationalism and protectionism on these technologies has implied a sustained struggle to get sufficient access to meet population needs, and global measures such as CTAP (for voluntary patent pooling) and COVAX (for vaccine and technology pooling) have not had the support that matches need. One of the barriers is the patent protection in the TRIPS agreement. In this interview, Firoze Manji speaks with Leslie London, Professor of Public Health in the School of Public Health and Family Medicine University at the Cape Town (and an EQUINET steering committee member), and Jens Pedersen from Medicins Sans Frontiers on the issues of access. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"An Assessment of Domestic Financing for Reproductive, Maternal, Neonatal and Child Health (RMNCH) in Sub-Saharan Africa: Potential Gains and Fiscal Space","field_subtitle":"Atim C; Arthur E; Achala D; Novignon J: Applied Health Economics and Health Policy 18, 789\u2013799, 2020","URL":"https://link.springer.com/article/10.1007/s40258-019-00508-0","body":"This study analysed the gains from increased domestic financing for improving RMNCH outcomes in Sub-Saharan Africa (SSA). While there were significant gains from both domestic and external financing, the  estimated elasticities suggest that the gains from domestic public financing were much stronger. The fiscal space options identified include tax revenue performance improvements, improved public financial management, and borrowing, at least in the short to medium term. The results show that fiscal space from improved tax systems ranged from US$34.6 per capita in Uganda to US$310.6 per capita in Nigeria. The authors recommend increased domestic financing for health through innovations in domestic resource mobilization, particularly by improving the performance of tax systems.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Approaches to motivate physicians and nurses in low- and middle-income countries: a systematic literature review","field_subtitle":"Gupta J; Patwa M; Khuu A; Creanga A: Hum Resources for Health 19(4), 1-20, 2021 ","URL":"https://tinyurl.com/ov477hyt","body":"The paper reviews evidence on interventions used to motivate health workers in low- and middle-income countries. The review found supervision, compensation interventions and systems support to play a role.  The authors found there is limited evidence on successful interventions to motivate health workers in low- and middle-income countries and the authors call for studies that use validated and culturally appropriate tools to assess worker motivation.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Brief: Ensuring access to COVID-19 related vaccines and health technologies in East and Southern Africa","field_subtitle":"EQUINET: SEATINI and TARSC, 2021","URL":"https://tinyurl.com/guehqw9o","body":"The ability of African countries to mount effective and equitable responses to COVID-19 reflects in part the access that countries have to reliable, sustained, distributed supplies of diagnostics, medicines, vaccines and other health technologies. By 2021 significant inequality in access to vaccines has become clearly evident, a situation that the World Health Organisation director-general called a \u201ccatastrophic moral failure\u201d in January 2021. While noting that vaccine roll out in East and Southern Africa (ESA) is a dynamic situation, this brief discusses the different vaccines and the distribution of vaccines in the region and issues involved in the development and production of vaccines and other health technologies in the region. It raises areas where regional co-operation is taking place and suggests where it could be strengthened.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Call for expression of interest for Global Health Systems and Health Security Programme","field_subtitle":"Closing date for applications Friday 12th March","body":"University of Leeds Crucible programme is inviting  early career academics from different disciplines in institutions to apply for a transdisciplinary programme on Health Systems for Health Security. The programme is designed to introduce new ways of thinking and working and create long-term collaborations. it will have facilitated sessions, speakers from WHO, NGOs, private and public sector and time to collaborate. Participants will be invited to form project ideas together and for selected projects, Leeds University offers small funding awards to explore preliminary data. This will be a virtual event via zoom in 2021: 29-30 March; 24-25 June and 8-9 September and participants should commit to all dates and complete and send the expression of interest form by the closing date (contact K Banger for further information).\r\n","php":"Further details: /newsletter/id/64830","field_issue_date":"2021-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community health workers\u2019 involvement in the prevention and control of non-communicable diseases in Wakiso District, Uganda","field_subtitle":"Musoke D; Atusingwize E; Ikhile D; Nalinya S; et al: Globalization and Health 17(7), 1-11, 2021 ","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-020-00653-5","body":"This paper assessed the involvement of Community health workers (CHWs) in the prevention and control of non-communicable diseases (NCDs)in Wakiso District, Uganda with a focus on their knowledge, attitudes and practices, as well as community perceptions, through a cross-sectional mixed-methods study. The majority of CHWs correctly defined what NCDs are and mentioned high blood pressure, diabetes and cancer. Many CHWs said that healthy diet, physical activity, avoiding smoking/tobacco use, and limiting alcohol consumption were very important to prevent NCDs. The majority of CHWs who were involved in NCDs prevention and control reported challenges including inadequate knowledge, lack of training, and negative community perception towards NCDs. Community members were concerned that CHWs did not have enough training on NCDs and the community did not have much confidence in them regarding NCDs and rarely consulted them concerning these diseases. The authors recommend enhanced training and community engagement for CHWs to contribute to the prevention and control of NCDs.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Community perspectives on the COVID-19 response, Zimbabwe ","field_subtitle":"Mackworth-Young C; Chingono R; Mavodza C; Grace G; et al: Bulletin of the World Health Organisation 99(2) 85\u201391, 2021","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856363/","body":"The authors investigated community and health-care workers\u2019 perspectives on COVID-19 and on early pandemic responses during the first 2 weeks of national lockdown in Zimbabwe between March and April 2020.  Phone interviews were done with with one representative from each of four community-based organizations and 16 health-care workers involved in a trial of community-based services for young people. In addition, information on COVID-19 was collected from social media platforms, news outlets and government announcements. Data were analysed thematically. It  emerged that individuals were overloaded with information but lacked trusted sources, which resulted in widespread fear and unanswered questions; communities had limited ability to comply with prevention measures, such as social distancing, because access to long-term food supplies and water at home was limited and because income had to be earned daily; health-care workers perceived themselves to be vulnerable and undervalued because of a shortage of personal protective equipment and inadequate pay and other health conditions were side-lined because resources were redirected, with potentially wide-reaching implications. The authors recommend providing communities with basic needs and reliable information to enable them to follow prevention measures, health-care workers with personal protective equipment and adequate salaries and sustaining health-care services for conditions other than COVID-19.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Corona Diaries: Open source audio stories from around the world","field_subtitle":"Nieman Foundation for Journalism: USA, 2020","URL":"http://www.deathcertification.org","body":"Corona Diaries is an open platform allowing people around the world to voice their experiences during the pandemic. It\u2019s a place for stories big and small, joyful or sad, one off contributions or daily audio blogs. Every story is welcome. Initiated by former fellows of the Nieman Foundation for Journalism, the platform is intended for journalists, artists and creators of all types to then use to make into any media they choose under the Creative Commons licence. It is an open database of recordings forever growing and always accessible.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Covid-19 deaths in Africa: prospective systematic postmortem surveillance study","field_subtitle":"Mwananyanda L; Gill C; MacLeod W et al., :BMJ 372 :n334, 2021","URL":"https://www.bmj.com/content/372/bmj.n334","body":"The authors measured the fatalities from Covid-19 in Lusaka. PCR tests were done post mortem on 372 deceased people of all ages at the University Teaching Hospital morgue in Lusaka, Zambia, enrolled within 48 hours of death between June and September 2020; PCR results were available for 364 (97.8%). SARS-CoV-2 was detected in 58/364 (15.9%). Most deaths in people positive for covid-19 (51/70; 73%) occurred in the community and none had been tested for Covid-19 before death. Among the 19/70 people who died in hospital, six were tested before death, while for the 52/70 people with data on Covid-19 related symptoms, only five were tested before death. Covid-19 was identified in seven children, only one of whom had been tested before death. While the proportion of deaths with covid-19 increased with age, 76% were aged under 60 years. The authors  conclude that deaths with covid-19 were more common in Lusaka than indicated in official reports, with most occurring in the community, where testing capacity is lacking, but also due to lower levels of testing in facilities and in those presenting with typical symptoms of covid-19. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Covid-19 Vaccine Equity Tracker","field_subtitle":"Pandem-ic: Online, 2021","URL":"https://pandem-ic.com/","body":"This site tracks the COVID-19 pandemic through the lens of the country income classification. It tracks vaccine distribution relative to global needs and the coverage of total and priority populations, dividing countries into high-income; upper middle-income; lower middle-income and low income The site is refreshed daily.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Environments by Design: Health, Wellbeing and Place: Virtual conference 1-3 December 2021","field_subtitle":"Call for abstracts: submission date 25 June 2021","URL":"https://architecturemps.com/design-health/","body":"It is tempting to see the recent global concern about health and environments as new. The reality is, it has a long history. The public health profession grew in the housing conditions of the 19th century urban poor, demands for walkable neighbourhoods are long standing and the broader healthy cities agenda globally all pre-date COVID-19. This conference seeks to bring recent experiences and responses into dialogue with longer-standing areas of research into health, wellbeing and environments. The event will have multiple thematic strands built around submissions. The conference welcomes case studies, design proposals, research projects, investigative papers and theoretical considerations as written papers, Zoom and pre-recorded presentations.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET Information sheet 5 on COVID-19: Pandemic impacts on labour \u2013 experience and responses","field_subtitle":"EQUINET, TARSC, SATUCC, 2021 ","URL":"https://tinyurl.com/44lpu1i9","body":"This fifth information sheet in the COVID-19 series summarises information on how COVID-19 has affected working people in the ESA region, and the response by workers, unions, states and others, with recommendations for how to better address the impacts. Nearly a million African workers are estimated to have had COVID-19 in 2020, probably more given the low level of testing. Health workers (HWs), those in crowded or poorly protected workplaces or in crowded accommodation, those in common contact with the public and those in caring roles may be more at risk. Informal, migrant, young, disabled and female workers may be more vulnerable to COVID-related disease. Lockdowns and blocks in supply chains have disrupted key areas of employment, affecting working people\u2019s livelihoods, jobs and mental health, and leading to stigma and social insecurity and falling remittances from African migrants and revenues for social protection. Possible responses include public health measures, including now equitable access and vaccines; workplace infection control; social protection to prevent impoverishment; protection of jobs and wage subsidies. Workers and unions have contributed to these responses, despite the pandemic undermining union operations. The brief outlines recommendations to protect workers and their rights at work, noting that not implementing such measures makes the whole of society vulnerable.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 227: Working people have experienced COVID-19\u2019s blows, but are central to the region\u2019s recovery","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evaluating the African food supply against the nutrient intake goals set for preventing diet-related non-communicable diseases: 1990 to 2017 trend analysis","field_subtitle":"Gebremedhin S; Bekele T: Plos One 16(1), 2021","URL":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245241","body":"The authors evaluated African food balances against the recommendations for macronutrients, free sugars, types of fatty acids, cholesterol and fruits and vegetables over 1990 to 2017, with regional, sub-regional and country-level estimates. In Africa the energy supply increased by 16.6% from 2,685 in 1990 to 3,132 kcal/person/day in 2017. However, the energy contribution of carbohydrate, fat and protein remained constant and almost within acceptable range around 73, 10 and 9%, respectively. In 2017, calories from fats surpassed the 20% limit in upper-middle- or high-income and Southern Africa countries. Energy from free sugars remained constant around 7% but the figure exceeded the limit of 10% in upper-middle- or high-income countries (14.7%) and in Southern (14.8%) and Northern (10.5%) sub-regions. Between 1990 and 2017 the availability of dietary cholesterol per person surged by 14% but was below the upper limit of 300 mg/day. The supply of fruits and vegetables increased by 27.5% from 279 to 356 g/capita/day, but remained below the target of 400 g/capita/day in all sub-regions. While most population intake goals were found to be within acceptable range, the supply of fruits and vegetables are suboptimal and the increasing energy contributions of free sugars and fats are emerging concerns in specific sub-regions.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Explaining covid-19 performance: what factors might predict national responses?","field_subtitle":"Baum F; Freedom T; Musolino C; Abramovitz M; et al: BMJ 372(91), 2021","URL":"https://www.who.int/bulletin/volumes/99/1/20-250456/en/","body":"The Global Health Security Index predicted that the world in general was not well prepared for the pandemic but did not predict individual country preparedness. Ten factors seem to have contributed to the index failing to predict country responses, including limited consideration of globalisation, geography, and global governance, bias to high income countries, failure to assess health system capacity, overlooking the role of political leadership and ideology, overlooking the importance of context, the limits of national wealth as a predictive factor, no examination of inequalities within countries, the importance of social security and the provisions to protect people from losing their jobs and homes. The authors note that civil society capacity was not assessed, and the gap between capacity and its application was also not assessed. The authors argue that future assessments of pandemic preparedness need to take these 10 factors into account by adopting a systems approach which enables a focus on critical system components ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Global Wage Report 2020-21: Wages and minimum wages in the time of COVID-19 ","field_subtitle":"International Labour Organisation, Geneva, ILO, 2020","URL":"https://tinyurl.com/42h2cyye","body":"This ILO report examines the evolution of real wages globally and by region, as well as the relationship between minimum wages and inequality, and the wage impacts of COVID-19 . It identifies the conditions under which minimum wages can reduce inequality and how adequate minimum wages, statutory or negotiated, can play a key role in a human-centred recovery from the  pandemic. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Immunity certification for COVID-19: ethical considerations ","field_subtitle":"Voo T; Reis A; Thom\u00e9 B; Ho C; et al: Bulletin of the World Health Organisation99(2),155\u2013161, 2021  ","URL":"https://www.who.int/bulletin/volumes/99/2/20-280701/en/","body":"Some countries have considered using immunity certification as a strategy to relax restrictive measures by issuing an immunity passport for people certified as having protective immunity against SARS-CoV-2, the virus that causes COVID-19. The World Health Organization has advised against the implementation of immunity certification because of uncertainty about the length of time of immunity and concerns over the reliability of methods for determining immunity. However, even if immunity certification became well supported by science, the authors note many ethical issues in terms of the implementation process, its uses, measures in place to reduce potential harms, prevention of disproportionate burdens on non-certified individuals and potential violation of individual liberties and rights.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Investigation of an anthrax outbreak in Makoni District, Zimbabwe","field_subtitle":"Makurumidze R; Tafara Gombe N;Magure T; Tshimanga M:  BMC Public Health 21(298), 1-10, 2021","URL":"https://tinyurl.com/4g2pgnfn","body":"The authors investigated an anthrax outbreak in Makoni District, Zimbabwe, and assessed the environment, district preparedness and response, and outbreak prevention and control measures. They found that most of the cases were managed according to the national guidelines. Multivariable analysis demonstrated that meat sourced from other villages, skinning, and belonging to religions that permit eating meat from cattle killed due to unknown causes or butchered after unobserved death were associated with contracting anthrax. The poor availability of resources in the district caused a delayed response to the outbreak. Although the outbreak was eventually controlled through cattle vaccination and health education and awareness campaigns, the authors report that the response of the district office was initially delayed and insufficient. They call for strengthened emergency preparedness and response capacity at district level, for revival of zoonotic committees, awareness campaigns and improved surveillance, especially during outbreak seasons.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"It is painful and unpleasant: experiences of sexual violence among married adolescent girls in Shinyanga, Tanzania","field_subtitle":"Mwanukuzi C; Nyamhanga T: Reproductive Health 18(1), 1-7,  2021","URL":"https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-020-01058-8","body":"This article reports on a qualitative study of 20 married girls aged 12-17 years' experiences of sexual violence in the Shinyanga Region, Tanzania where there is high prevalence (59%) of child marriage. The study identified four analytical themes regarding the experience of sexual violence, namely: forced sex; rape; struggling against unpleasant and painful sex; and inculcation of the culture of tolerance of sexual violence. The study found that married adolescent girls suffer sexual coercion in silence, increasing their risk of acquiring sexually transmitted infections and or unwanted pregnancies. The authors make recommendations for sexual violence prevention strategies .","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"It\u2019s a secret between us: a qualitative study on children and care-giver experiences of HIV disclosure in Kinshasa, Democratic Republic of Congo","field_subtitle":"Sumbi E; Venables E; Harrison R; Garcia M: et al: BMC Public Health 21(313), 1-9, 2021","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10327-5","body":"This paper explored child and care-giver experiences of the process of disclosing HIV statuses to children, including reasons for delay, through 22 in-depth interviews with care-givers and 11 in-depth interviews with HIV positive children in Kinshasa.  Care-givers included biological parents, grandmothers, siblings and community members and 86% of them were female. Many care-givers had lost family members due to HIV and several were HIV positive themselves. Reasons for non-disclosure included fear of stigmatisation; wanting to protect the child and not having enough knowledge about HIV or the status of the child to disclose. Several children had multiple care-givers, which also delayed disclosure, as responsibility for the child was shared. In addition, some care-givers were struggling to accept their own HIV status and did not want their child to blame them for their own positive status by disclosing to them. The authors identify that child disclosure is a complex process for care-givers, health-care workers and the children themselves. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"IWG Fireside Chat: Looking Back, Looking Ahead","field_subtitle":"International Working Group on Health Systems Strengthening: IWG. February 2021","URL":"https://iwghss.org/2021/02/09/iwg-fireside-chat/","body":"In December, the IWG hosted an event with health professionals with experience in different fields to better understand leadership in health systems, and consolidated the reflections from the discussions. The discussion raised several key features, including: Investing in gender, racial, and geographic equity among global health leaders and health activists; improving teamwork and multidisciplinary collaborations between individuals and communities of diverse skills, capabilities and backgrounds; networking across health leaders and communities and promoting local ownership and leadership. The session also pointed to the importance for the success of public health interventions and initiatives that those affected and implementing them be at the centre of the design and interactions. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Market strategies used by processed food manufacturers to increase and consolidate their power: a systematic review and document analysis","field_subtitle":"Wood B; Williams O; Nagarajan V; Sacks G: Globalization and Health 17 (17), 2021","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00667-7#citeas","body":"The authors reviewed the market strategies deployed by processed food manufacturers to increase and consolidate their power from a systematic review of public health, business, legal and media content databases and of grey literature. The market strategies identified related to six interconnected objectives: i) reducing competition with equivalent sized rivals and maintaining dominance over smaller rivals; ii) raising barriers to market entry by new competitors; iii) countering the threat of market disruptors and driving dietary displacement in favour of their products; iv) increasing firm buyer power over suppliers; v) increasing firm seller power over retailers and distributors; and vi) leveraging  informational power asymmetries in relations with consumers. The authors note that analysing such market strategies promoting unhealthy foods helps to identify countervailing public policies, such as those related to merger control, unfair trading practices, and public procurement, as part of efforts to improve population diets.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Planetary Health Online Course","field_subtitle":"Planetary Health Alliance in partnership et al:Online and registration open","URL":"https://tinyurl.com/msh7hos9","body":"The course includes undergraduate-level modules, quizzes, activities, discussion forums, and supplementary resources on the following topics: Planetary health and climate change, Heat waves and heat stress, Air pollution and health, Infectious diseases sensitive to climate change, Pathways for planetary health: from social participation to management, Mental and relational health, Food and planetary health, Water and planetary health. The course is free.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Possible causalities between malnutrition and academic performances among primary schoolchildren: a cross-sectional study in rural Madagascar","field_subtitle":"Aiga H; Abe K; Randriamampionona E; Razafinombana A: BMJ Nutrition, Prevention & Health 0, 1-12, doi:10.1136/ bmjnph-2020-000192, 2021","URL":"https://tinyurl.com/ymov83uo","body":"A cross-sectional household survey in Antananarivo-Avaradrano district, Madagascar in November to December 2017 in 404 first and second grade pupils 5\u201314 years of age enrolled in 10 public primary schools explored the link between their nutritional status and academic performances. Not being stunted and attendance rate were identified to be possible causes of higher mathematical proficiency because they satisfied all conditions for a causality.  A hypothetical causal path indicates that \u2018not being stunted\u2019 is likely to have caused higher \u2018attendance rate\u2019 and thereby higher \u2018mathematical proficiency\u2019 in a two-step manner.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Preparedness of health care systems for Ebola outbreak response in Kasese and Rubirizi districts, Western Uganda","field_subtitle":"Kibuule M; Sekimpi D; Agaba A; Halage A; et al: BMC Public Health 21(236), 1-16, 2021","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10273-2","body":"This study assessed the preparedness of the health care facilities for the Ebola (EVD) outbreak response in Kasese and Rubirizi districts in western Uganda. It involved interviews with 189 health care workers and visits to 22 health facilities. Twelve out of the 22 of the health facilities did not have a line budget to respond to EVD and the majority of the facilities did not have case definition books, rapid response teams and/or committees, burial teams, and simulation drills. There were no personal protective equipment that could be used within 8\u2009h in case of an EVD outbreak in fourteen of the 22 health facilities. All facilities did not have viral haemorrhagic fever incident management centers, isolation units, guidelines for burial, and one-meter distance between a health care worker and a patient during triage. The authors recommend proactively tracking the level of preparedness to inform strategies for building capacity of health centers in terms of infrastructure, logistics and improving knowledge of health care workers.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Prevalence and Factors Associated with Mental and Emotional Health Outcomes among Africans during the COVID-19 Lockdown Period\u2014A Web-based Cross-Sectional Study","field_subtitle":"Langsi R; Osuagwu U; Goson P; Abu E; et al: International Journal of Environmental Research and Public Health 18(3), 899, 2021","URL":"https://www.mdpi.com/1660-4601/18/3/899","body":"This online study assessed the prevalence of mental health symptoms as well as emotional reactions among  2005 respondents aged 18 years and older in seven African countries between 17 April and 17 May 2020 corresponding to the lockdown period in these countries. Respondents self-reported feeling anxious, worried, angry, bored and frustrated. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Health care workers were less likely to report feeling angry than other types of workers. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Putting the public back into public health: Communities organising solidarity responses to Covid-19","field_subtitle":"Whyle E; van Ryneveld M; Brady L; Loewenson R: Maverick Citizen, December 2020 ","URL":"https://tinyurl.com/1x1pzgl8","body":"This oped draws on EQUINETs 42 case studies of community action on Covid-19 that collectively show innovative and solidarity-based approaches to prevent and care for Covid-19, to address social needs and hold states accountable, and in more detail on the experience with the Community Action Networks in South Africa. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Recorded sessions at the Alternative Mining Indaba (AMI)","field_subtitle":"AMI, February 2021","URL":"https://altminingindaba.co.za/wp-content/uploads/2021/02/Alternate-Mining-Indaba-Recording-Report.pdf","body":"Seven hundred participants gathered in the virtual 2021 Alternative Mining Indaba (AMI) on 8-12 February from trade unions, faith-based organizations, community-based organizations, civil society organizations, mining companies, academics and other stakeholders. The AMI, which supports a \u201cjust and people centred\u201d approach to mining, started as a civil society and community grassroots organizations platform to engage with the business-oriented African Mining Indaba, held annually in Cape Town, South Africa. This year, both events were hosted virtually. The sessions under the AMI theme 'Building forward together pivoting the extractives sector for adaptation and resilience against Covid-19' can be viewed online.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"SCORE global report on health data systems and capacity, 2020","field_subtitle":"World Health Organization: WHO, Geneva, 2021","URL":"https://www.who.int/data/data-collection-tools/score/dashboard#/","body":"The World Health Organization provides the first global assessment of country data and health information systems capacities in terms of five 'SCORE' aspects: Survey, Count, Optimize, Review and Enable. The report addresses gaps and inequalities in health information systems and provides recommendations for investment in areas that will have the greatest impact on the quality, availability, analysis, accessibility and use of data. There is a link to the SCORE Online Data Portal and an accompanying Visual Summary of country-level SCORE assessments.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Tanzania\u2019s Ministry of Health now urges precaution against Covid-19","field_subtitle":"Owere P: The Citizen, Tanzania, February 2021","URL":"https://tinyurl.com/dwju0o7r","body":"The Tanzanian Ministry of Health has now urged citizens to take all the required precautions against Covid-19 including wearing face masks. The statement issued on Sunday, February 21, 2021 by the Head of the Public Relations Unit, Gerard Chami said the Ministry continues to monitor and stress the implementation of precautionary measures against various non-communicable and communicable diseases including outbreaks and Covid-19. Precautions included hand washing, use of sanitizer, exercising, and protection for all those at risk such as the elderly, obese people, and those with chronic illnesses. The statement also urged Tanzanians to get proper nutrition including fruits and vegetables, use natural remedies registered by the council of traditional healers and as advised by relevant professionals and to visit health facilities on witnessing symptoms of illness.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Contribution of Social Dialogue to Gender Equality","field_subtitle":"International Labour Organisation: ILO, Geneva, 2021","URL":"https://tinyurl.com/3byjqhzp","body":"This thematic brief discusses actions that governments, employers\u2019 and workers\u2019 organisations, can take to advance gender equality through social dialogue, drawing on case studies from around the world, in different sectors, in the formal or the informal economy, and during the pandemic. It identifies the circumstances and factors that can help bring about transformative change. The brief examines the role of social dialogue in the application of relevant International Labour Standards on gender equality, including the ground-breaking Violence and Harassment Convention, 2019 (No. 190) and Recommendation No. 206 on the same subject matter. It concludes with some key recommendations for governments and employers\u2019 and workers\u2019 organisations.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania","field_subtitle":"Vossius C; Mduma E; Moshiro R; Mdoe P; et al: BMC Health Services Research  21 (99), 1-9, 2021 ","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06107-x","body":"This study assessed the impact of introducing user fees on 28 601 births at Haydom Lutheran Hospital, Tanzania, comparing the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017.  The monthly number of births fell by 17.3% after fees were introduced. After the introduction of ambulance and delivery fees, the study found an increase in labour complications and caesarean sections and a decrease in newborns with low birthweight. The authors suggest that this might indicate that women delayed seeking skilled birth attendance or did not seek help at all, possibly due to financial reasons, and argue that free delivery care should be a high priority.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Inequality Virus: Bringing together a world torn apart by coronavirus through a fair, just and sustainable economy","field_subtitle":"Berkhout E; Galasso N; Lawson M; Morales P; et al: Oxfam Briefing Paper, Oxfam International, 2021","URL":"https://tinyurl.com/kkykhkee","body":"This report highlights the ways that the coronavirus pandemic has the potential to lead to an increase in inequality in almost every country at once, the first time this has happened since records began. The virus has exposed, fed off and increased existing inequalities of wealth, gender and race. Over two million people have died, and hundreds of millions of people are being forced into poverty while many of the richest \u2013 individuals and corporations \u2013 are thriving. Billionaire fortunes returned to their pre-pandemic highs in just nine months, while recovery for the world\u2019s poorest people could take over a decade. While the pandemic has exposed a collective frailty and the inability of a deeply unequal economy to work for all, it has also shown the vital importance of government action to protect health and livelihoods. Transformative policies that seemed unthinkable before the crisis have suddenly been shown to be possible.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Unhealthy geopolitics: can the response to COVID-19 reform climate change policy?","field_subtitle":"Cole J; Dodds K: Bulletin of the World Health Organisation 99(2), 77-168, 2021","URL":"https://www.who.int/bulletin/volumes/99/2/20-269068/en/","body":"The geopolitics of pandemics and climate change intersect. Both are complex and urgent problems that demand collective action in the light of their global and trans-boundary scope. In this article a geopolitical framework is used to examine some of the tensions and contradictions in global governance and cooperation that are revealed by COVID-19. The authors argue that the pandemic provides an early warning of the dangers inherent in weakened international cooperation. The world\u2019s states, with their distinct national territories, are reacting individually rather than collectively to the COVID-19 pandemic. Many countries have introduced extraordinary measures that have closed, rather than opened up, international partnership and cooperation, including in border closures, restrictions on social mixing, domestic purchase of public health supplies and subsidies for local industry and commerce. For the poorest countries of the world, pandemics join a list of other challenges that are exacerbated by pressures of scarce resources, population density and climate disruption, and have a disproportionate impact on those living with environmental stresses. The authors highlight the need for a coordinated global response to addressing challenges that cannot be approached unilaterally.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"What do we know about COVID-19 spread in Africa?","field_subtitle":"Daraja Press, 5 February 2021","URL":"https://darajapress.com/2021/02/05/what-do-we-know-about-covid-19-spread-in-africa","body":"This interview between Firoze Manji Daraja press and Dr Rene Loewenson, Training and Research Support Centre explores evidence and knowledge gaps on COVID-19 in east and southern Africa, drawing on EQUINET information briefs and other sources. The interview identifies positive examples of state and public proactive responses to the pandemic in the region, the challenges faced and what learning that brings for equity in responding to pandemics.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Working people have experienced COVID-19\u2019s blows, but are central to the region\u2019s recovery","field_subtitle":"Matsiame Mafa, Rene Loewenson, Paliani Chinguwo, Mavis Koogotsitse","body":"\r\nThere is no doubt that the COVID-19 pandemic has affected working people. In September 2020, the International Labour Organisation (ILO) reported that beyond workers exposure to COVID-19 infection in their living and working conditions and experience of COVID-19-related disease, workplace closures and job losses have significantly reduced workers\u2019 incomes. \r\n\r\nAn EQUINET information sheet included in this newsletter, produced jointly with the Southern African Trade Union Co-ordination Council (SATUCC), outlines how COVID-19 has affected working people in the East and Southern Africa region, and the responses to these impacts. \r\n\r\nPublicly reported data on COVID-19 is not disaggregated by economic activity or occupation. It is thus difficult to know how the pandemic has differently affected different categories of workers. Health workers (HWs) are, however, widely understood to be at greater risk of infection due to the nature of their work, especially when they work without adequate personal protective equipment (PPE) or in conditions that lack adequate infection control measures. \r\n\r\nHowever other workers are also at risk, such as those who work in crowded, poorly ventilated workplaces. The Minerals Council of South Africa reported in June 2020, for example, that mineworkers had twice the rates of infection than the general population. Carers, vendors or service providers who are in common contact with the public may also have higher risk of exposure. There is a gender dimension to this, as many of these workers are women. Most HWs are female and African countries that disaggregate their data found that 72% of all HWs testing positive for COVID-19 were women. \r\n\r\nMigrant labour is common in the region. Migrant workers have faced challenges in accessing services or been trapped when lockdowns close borders on them. Border closures and costs of testing can lead to crowding at borders and an increase in use of irregular travel routes across frontiers, as was reported when migrants returned home at the end of 2020. \r\n\r\nWhile remote work is indicated as an option to prevent transmission, only about 10% of workers are estimated to be able to do this in the region, largely those at higher incomes who can afford data charges to the internet.  This is not possible for most workers. While workers are increasingly aware of what raises their risk of infection, the precarious nature of many jobs and incomes in the region mean that many continue to work in environments that they know put them at risk. As a union official from the metal workers union in South Africa (NUMSA) noted: \u201cThe workers are aware that these are extremely dangerous spaces, but decide to risk it simply because they don\u2019t have the means to stay in isolation, feed their children, or care for themselves without due pay.\u201d  \r\n\r\nBeyond the risks of infection, the response to COVID-19 has raised its own stresses for working people. Lockdowns and blocks in supply chains have disrupted jobs, livelihoods and mental health. \r\n\r\nA SATUCC study found that by mid-2020 over 42 000 labour contracts had been suspended in Mozambique; 680 000 employees had lost jobs in Malawi, and 70 000 in Zambia. An East African Confederation of Trade Unions (EATUC) assessment found that already by mid-May 2020, one million informal jobs and over 200 000 formal jobs had been lost in Kenya in the wake of the pandemic.  The pandemic meant that 68% of people with disabilities in Kenya were not able to work and perceived their jobs to be insecure due to their disability.  Where COVID-19-related messages have induced fear of outsiders, migrant workers may be stigmatized. Migrant job losses are reported to have reduced remittances that many families in the region rely on. \r\n\r\nThere is now guidance, including from the ILO and World Health Organisation, on the public health, workplace infection control and personal protective equipment measures required for different employment settings. Some ESA governments have also reduced income tax and VAT, provided wage subsidies and distributed food and other basic goods, as important areas of support for working people. \r\n\r\nHowever, there has often been a gap between guidance and practice, and schemes have not always reached the most insecure workers who need them the most. HWs in Zimbabwe, Kenya and South Africa have protested over lack of PPE, and the ILO reports that migrant workers often do not access the testing, treatment, wage subsidy and other social protection measures that are provided to other workers. Informal sector workers have difficulties with the formal documentation that social protection systems ask for. Vital information does not effectively reach workers with disabilities if it is not made available in sign languages, video captioning, or other forms that they can access. \r\n\r\nTrade unions have engaged on these issues, even though the pandemic has undermined union communication and operations. Beyond their contribution to national task forces on COVID-19 in some countries, unions have engaged when employers have taken wage subsidies but still imposed unpaid leave on or retrenched workers, or failed to provide PPE. Unions have also flagged wider concerns, such as how the conditions accompanying with international funding of rescheduled debt repayments may further undermine employment and the funding of public services.\r\n\r\nWhile there is now a significant focus on access to vaccines and technologies, a comprehensive public health response to the pandemic, including to distribute vaccines, depends on formal and informal, male and female workers from many sectors, and the full involvement and protection of communities. \r\n\r\nThis link between workers and communities is fundamental. As a union shop-steward noted in the recent Alternative Mining Indaba, \u201cin the day I am a mineworker,   but when I go home to my family I am the community.\u201d  \r\n\r\nWorking people of different types fill the gaps in the social protection systems in the region so that vulnerable people in communities are not further impoverished by the pandemic. The economic recovery that is now critical in our region will not be possible without workers and communities. It will also not be meaningful unless it is a recovery of the productive opportunities, jobs, incomes, capacities and protection of all working people in the region.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"WTO COVID-19 TRIPS waiver proposal: Myths, realities and an opportunity for governments to protect access to lifesaving medical tools in a pandemic","field_subtitle":"Medecins Sans Frontieres: Access Campaign, 2021","URL":"https://tinyurl.com/v4t2rb9n","body":"One of the challenges faced in the COVID-19 pandemic is the negative impact that intellectual property (IP) barriers have had in the past and are anticipated to have on the scale up of manufacturing and supply of lifesaving COVID-19 medical tools across the world. Because the pandemic is an exceptional global crisis, the World Trade Organization (WTO) can invoke a waiver of certain IP rights on these technologies under WTO rules. Given this, South Africa and India submitted a landmark proposal earlier this year to the WTO requesting that WTO members waive four categories of IP rights \u2013 copyright, industrial designs, patents and undisclosed information under the Agreement of Trade-Related Intellectual Property Rights (TRIPS) until the majority of the world population receives effective vaccines and develops immunity to COVID-19. In the course of discussion, opponents of the TRIPS waiver proposal have raised arguments against the waiver. This brief presents the reasons for the waiver, and addresses the counter arguments to the points raised by those opposing it.","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Young public health professionals reflect on leadership for just health systems","field_subtitle":"Ghiwa Nasser Eddine, Laura Haywood, Malvikha Manoj, Magali Collonnaz, IWG","body":"For emerging public health professionals like ourselves, the COVID-19 pandemic has lifted a smokescreen on inequities in health and made clear that we need to invest in and strengthen our health systems. While the pandemic is all consuming, other challenges have not stopped, and we face public health demands on many fronts. Antimicrobial resistance, social injustice, forced displacement, non-communicable diseases, and climate change are real concerns. \r\n\r\nWhile it should not have taken a pandemic to provoke self-reflection, it has opened a window of opportunity for new thinking, to transcend silos that have traditionally existed within public health, and to re-imagine a world where health systems work for all and not just for some. \r\n\r\nThis takes leadership. So as emerging public health professionals in the International Working Group for Health Systems Strengthening (IWG) we have been exploring and stimulating open discussion between ourselves on what it takes to build the sort of bold, committed, responsible and innovative health leadership that can face such challenges in a world that we see as ever-changing and often chaotic. We also do this by learning from health trailblazers that have accumulated experience, such as in a fireside chat we held at the end of 2020 on the theme \u2018Looking Back, Looking Forward\u2019 (at https://iwghss.org/2021/02/09/iwg-fireside-chat/). \r\n\r\nThese interactions have pointed to the importance of core values as the basis for a leadership that can guide efforts and rally others to collaborate on a common cause.  We have seen how public health efforts to tackle challenges advance when collective success is valued over individual success. In public health, the success of one requires the success of many. We also understand that health leadership means building people-centered comprehensive public health systems, where public health professionals consider, dialogue and work with the members of the community as the most critical aspect of every intervention or initiative they work on. \r\n\r\nThese insights led us to reflect on what health leadership means for us as emerging public health professionals, as we move forward on our career paths. \r\n\r\nFirst, we believe that we need to understand the history that lies behind today\u2019s realities and power, if we are to understand how the work we do will confront or shape this distribution of power. For example, colonial legacies that informed the emergence of global ideas in health persist today and continue to affect power imbalances across gender, race, and geography, among others. We see this when northern institutions and knowledge sources frame the dominant narrative in a way that minimizes the rich history of leadership and innovation in the global south. It is our responsibility to understand this history of health and development and what it has meant for public health today, to shape the actions we take.  \r\n\r\nSecondly, in our reflections, we perceive that we must constantly return to our values and convictions. These are not just words to write down, but actions to live by, whether in the organizations we work in, the work we do, or in our interactions with people. For example, \u2018respect for diversity, equity, and equality\u2019 is a core value for IWG, so we see that we need to reflect this in our own processes, by giving space for different perspectives, and co-producing outcomes that are the result of a united team effort that captures the diversity among all our members.\r\n\r\nFinally, in the face of pressures to compete, we see finding your team and collaborating as a critical feature of leadership in health. Health systems that work for all need diverse, empowered voices that work as a team, where we keep asking who is at the table, and more importantly, who is not at the table; and why. Having a collaborative, interdisciplinary, diverse team seems to not only strengthen practice, but also to mitigate blind-spots that may otherwise be ignored, particularly in efforts to advance justice and equity. \r\n\r\nAs emergent public health professionals we appreciate that the field we are in is complex and dynamic, but also fulfilling. What we think and do now is shaping our futures, but also the future of public health. Ultimately, it is up to each of us to be the change we want to see around us. The pandemic has opened a window of opportunity for us to step up and step into a more just vision for public health. Now, it is our turn as young professionals to make that vision happen.\r\n\r\nPlease send feedback or queries on the issues raised in the two editorials to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2021-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"'We are subjects, not objects in health\u2019: Communities taking action on COVID-19","field_subtitle":"Loewenson R; Colvin C; Rome N; Nolan E; et al: Training and Research Support Centre in the Regional Network for Equity in Health in East and Southern Africa (EQUINET) and Shaping Health, September 2020","URL":"https://tinyurl.com/yxrekzre","body":"This document provides evidence of practical and affirmative options of people-centred, participatory forms of community organising and engagement in diverse areas of prevention, care and wider social protection in responding to COVID-19. The 42 case studies from different regions intend to inspire, inform and support. They report the creative development and use of social media platforms for action across all areas of response, connecting people within and across communities and countries, giving voice and visibility to community experiences and linking people to key resources and services. They demonstrate that a compassionate society enhances public health. Many build on histories, ideologies, structures, organisation and relationships that began long before the pandemic, enabling a relatively rapid response to new challenges posed by COVID-19 and with an intention to sustain relevant innovations after the pandemic. They reach to socio-economically disadvantaged groups within communities, strengthening collective organisation, investing in capacities and leadership and making links with more powerful groups to address local priorities and negotiate delivery on state obligations. They build new relationships between communities and producers and between communities and health workers, and solidarity interactions with international agencies and diaspora communities. The challenges presented by the pandemic are creating demand and space for innovation, and in many settings communities are rising to that demand. The mobilization of affirmative community effort and creativity needs to be recognised in the story of the 2020 pandemic. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"All Risk and No Reward: How the Government and Mine Companies Fail to Protect the Right to Health of Miners and Ex-Miners in Botswana","field_subtitle":"Botswana Labour Migrants Association, Centre for Economic and Social Rights, Northwestern Pritzker School of Law Centre for International Human Rights, Botswana, 2020","URL":"https://tinyurl.com/y6adg245","body":"All Risk and No Reward presents the findings of a two-year investigation into the right to health of miners and ex-miners in Botswana. It describes in vivid detail a series of critical issues for their health and the health of their communities. The report also considers the Government and mine companies' financial responsibilities to equitably generate, allocate and spend sufficient funds for health. The report is based on extensive desk research, and interviews and focus groups discussions with more than 50 miners, ex-miners, family and community members, doctors and nurses, and government and industry officials in Botswana.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"An overview of reviews on strategies to reduce health inequalities","field_subtitle":"Garz\u00f3n-Orjuela N; Samac\u00e1-Samac\u00e1 D; Angulo S; et al: International Journal for Equity in Health 19(192), doi: https://doi.org/10.1186/s12939-020-01299-w, 2020","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01299-w","body":"Governments are incentivized to develop and implement health action programs focused on equity to ensure progress with effective strategies or interventions. This study identified strategies that facilitate the reduction of health inequalities. A systematic search strategy identified 4095 articles, of which 97 were included in the synthesis. Most of the studies included focused on the general population, vulnerable populations and minority populations. The subjects of general health and healthy lifestyles were the most commonly addressed. According to the classification of the type of intervention, the domain covered most was the delivery arrangements, followed by the domain of implementation strategies. The most frequent group of outcomes was the reported outcome in (clinical) patients, followed by social outcomes. The authors note that the strategies that facilitate the reduction of health inequalities must be intersectoral and multidisciplinary in nature, including all sectors with the health system. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Announcement on the Maternal Health Judgement, Uganda","field_subtitle":"Centre for Human Rights and Development: Youtube, Uganda, 2020","URL":"https://www.youtube.com/watch?v=UwU4KRraomw","body":"After a long nine years of waiting, the Centre for Human Rights and Development (CEHURD) finally received the judgment in the famous Petition 16 maternal health case on 19th August, 2020. The Constitutional Court agreed with CEHURD submissions and all judges accepted all the grounds of the petition. Through this judgment, the right to maternal health care (and the right to health broadly) has been granted a place in Uganda\u2019s Constitution. This judgment recognizes provision of basic maternal health care services and emergency obstetric care as an obligation by the government. It\u2019s through unremitting advocacy, litigation and activism that CEHURD achieved this landmark decision. It took a whole movement/coalition on maternal health to realize what a few thought would be possible. CEHURD now turn their efforts to the implementation. Investing in maternal health is a political and social imperative, as well as a cost effective investment in strong health systems overall. The #Petition16 judgment entails some very powerful declarations and orders on health financing. This case creates positive jurisprudence and makes it possible for people to sustain a cause of action in the right to health against the state for failing to provide the basic minimum health care package.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Archive of Forgetfulness: Conversations with Neighbours","field_subtitle":"Tayob H; Kona B: Archive of Forgetfulness, South Africa, November 2020","URL":"https://tinyurl.com/yxwzqxby","body":"Archive of Forgetfulness presents a podcast series: Conversations with Neighbours. The conversations explore, among other themes, art in times of crisis, questions around memory and archival absences, and the possibilities and limitations of translation. You will hear from artists, musicians, curators, researchers and theatre-makers in Egypt, Nigeria, Rwanda, South Africa and Sudan. The conversations interrogate ways of narrating movement across borders, suggesting a re-mapping of relations across the continent, north and south, east and west, home and away.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Assessing the geographical distribution of comorbidity among commercially insured individuals in South Africa","field_subtitle":"Mannie C; Kharrazi H: BMC Public Health 20(1709), 1-11, doi: https://doi.org/10.1186/s12889-020-09771-6, 2020","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09771-6","body":"This study assessed the geographical distribution of comorbidity and its associated financial implications among commercially insured individuals in South Africa. The authors aggregated individual risk scores to determine the average risk score per district, also known as the comorbidity index, to describe the overall disease burden of each district The authors observed consistently high comorbidity index scores in districts of the Free State and KwaZulu-Natal provinces for all population groups before and after age adjustment. Some areas exhibited almost 30% higher healthcare utilization after age adjustment. Districts in the Northern Cape and Limpopo provinces had the lowest comorbidity index scores with 40% lower than expected healthcare utilization in some areas after age adjustment. The results show underlying disparities in the comorbidity index at national, provincial, and district levels. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Basic Epidemiological Concepts - 2020 (2nd cohort)","field_subtitle":"Pan American Health Organisation: PAHO, 2020","URL":"https://tinyurl.com/y6nxdmrl","body":"This Skills Online Program aims to help public health practitioners develop and strengthen their knowledge and skills in order to make better-informed public health decisions. The EPI1: Basic Epidemiological Concepts module is the first in a set of three modules on epidemiology in public health and is the only one currently being offered through PAHO's Virtual Campus for Public Health. The module provides an introduction to some key epidemiologic concepts, allowing participants the opportunity to enhance their understanding of the fundamentals of epidemiology, and build skills in applying basic epidemiological principles to their work as public health practitioners.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Cape Town Together: organizing in a city of islands","field_subtitle":"Writers\u2019 Community Action Network: ROAR Mag, South Africa, June 2020","URL":"https://roarmag.org/essays/cape-town-together-organizing-in-a-city-of-islands/","body":"An emerging movement of self-organized, decentralized community action networks is responding to the local realities of COVID-19 in Cape Town, South Africa. It reflects an unprecedented city-wide response to COVID-19, based on principles of self-organizing, mutual aid and social solidarity. In early March 2020, just as South Africa was waking up to the spectacle of COVID-19 within its borders, a group of community organizers, activists, public health folk and artists came together and kick-started a community-led response to the pandemic. This became known as Cape Town Together, a growing network of neighbourhood-level Community Action Networks (CANs) spread across the city. The CANs act locally, while also sharing collective wisdom and various resources through the broader network of Cape Town Together. They work collaboratively, recognizing that everyone brings something to the table. Some are weavers and builders, others are storytellers, caregivers or healers. Some are disruptors whilst others are experimenters and guides. The CANs have galvanized a significant number of people from across the city around a shared experience. Many are seeing the inequality exposed by COVID-19 in a new light and will remain galvanized beyond the immediate crisis.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Challenges and Opportunities in China\u2019s Health Aid to Africa: Findings from Qualitative Interviews in Tanzania and Malawi","field_subtitle":"Daly G; Kaufman J; Lin S; Gao L; et al: Globalization and Health  16(71), 1-10 doi: https://doi.org/10.1186/s12992-020-00577-0, 2020","URL":"https://tinyurl.com/y3ue299l","body":"This paper presents a qualitative study of perceptions and opinions regarding Chinese-supported health related activities in Africa through in-depth interviews among local African and Chinese participants in Malawi and Tanzania. The findings revealed shared experiences and views related to challenges in communication; cultural perspectives and historical context; divergence between political and business agendas; organization of aid implementation; management and leadership; and sustainability. Participants were broadly supportive and highly valued Chinese investment in health. However, they also shared common insights on challenges in communication between health teams; and limited understanding of priorities and expectations, and the need to improve needs assessments, rigorous reporting, and monitoring and evaluation systems. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Communities, universal health coverage and primary health care ","field_subtitle":"Sacks E; Schleiff, M; Were M; Ahmed Mushtaque Chowdhuryc A; et al:  Bulletin of the World Health Organisation 98, 773\u2013780, doi: http://dx.doi.org/10.2471/BLT.20.252445, 2020  ","URL":"https://tinyurl.com/yx9sxlcz","body":"With much of the world\u2019s population still lacking access to basic health services, evidence shows that community-based interventions are effective for improving health-care utilization and outcomes when integrated with facility-based services. Community involvement is the cornerstone of local, equitable and integrated primary health care (PHC). Policies and actions to improve PHC must regard community members as more than passive recipients of health care. Instead, they should be leaders with a substantive role in planning, decision-making, implementation and evaluation. Metrics used for evaluating PHC and Universal health coverage largely focus on clinical health outcomes and the inputs and activities for achieving them. Little attention is paid to indicators of equitable coverage or measures of overall well-being, ownership, control or priority-setting, or to the extent to which communities have agency. In the future, communities must become more involved in evaluating the success of efforts to expand PHC. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Community engagement: a health promotion guide for universal health coverage in the hands of the people ","field_subtitle":"World Health Organization: WHO, Geneva, 2020","URL":"https://www.who.int/publications/i/item/9789240010529","body":"WHO has defined community engagement as \u201ca process of developing relationships that enable stakeholders to work together to address health-related issues and promote well-being to achieve positive health impact and outcomes\u201d. The organisation notes undeniable benefits to engaging communities in promoting health and wellbeing. This guide is intended for change agents involved in community work at the level of communities and healthy settings.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"COVID-19\u2019s impact on HIV treatment less severe than feared","field_subtitle":"UNAIDS: UNAIDS New York, 2020","URL":"https://tinyurl.com/yythw3x6","body":"Recent data has shown that the COVID-19 pandemic has had an impact on HIV testing services, but the impact on HIV treatment is less than originally feared. As of August 2020, the UNAIDS, World Health Organization and United Nations Children's Fund data collection exercise to identify national, regional and global disruptions of routine HIV services caused by COVID-19 had collected treatment data from 85 countries. Of these, 22 countries reported data over a sufficient number of months to enable the identification of trends.  Only five countries reported monthly declines in the number of people on treatment after April\u2014these include Zimbabwe in June, Peru and Guyana in July, the Dominican Republic in April, and Sierra Leone in May through to July. The remaining 18 countries did not show a decline and some countries showed a steady increase (e.g. Kenya, Ukraine, Togo and Tajikistan). However, among the 22 countries with trend data on numbers newly initiating treatment, all countries except Jamaica showed declines for at least one month or more relative to January. Only around eight of those countries showed a rebound in the number of people newly initiating treatment between January and July. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Davidson Gwatkin Equity Measurement Prize ","field_subtitle":"Date to submit nominations: 1 May 2021","URL":"https://www.equitytool.org/equity-measurement-prize/","body":"Metrics for Management is excited to announce the launch of the Davidson Gwatkin Equity Measurement Prize. This annual juried competition will award up to four cash prizes each valued between $5,000 and $10,000 to an individual or team of authors for research that uses the EquityTool and its data to assess and improve services that reach the poor or to gain insight into wealth equity in low- and middle-income countries.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Developed countries continue to block TRIPS waiver proposal","field_subtitle":"TWN: Info Service on WTO and Trade Issues (Nov20/24), November 2020","URL":"https://www.twn.my/title2/wto.info/2020/ti201124.htm","body":"Following the waiver proposal to suspend various provisions of the WTO\u2019s TRIPS Agreement in combating the COVID-19 pandemic, the United States, the European Union, Japan, and Switzerland among others are reported to have adopted \u201cstonewalling\u201d tactics to block progress towards a General Council decision on this issue. These countries have described the waiver as a departure from the past WTO agreements, lacking specific measures, arguing also that not protecting intellectual property (IP) will reduce investment in medical technology.  In response South Africa commented that current \u201cbilateral deals do not demonstrate global collaboration but rather reinforce nationalism, enlarging chasms of inequality.\u201d India said that while \u201cthe TRIPS flexibilities do allow limited policy space for public health, they were never designed to address a health crisis of this magnitude (such as the COVID-19 pandemic).\u201d The waiver proposal has come into a global stage where it is increasingly clear that the developing and least-developed countries are unlikely to get easy and affordable access for the new therapeutics and vaccines for COVID-19, calling for human lives to take precedence over the profits of the big pharmaceutical companies.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Engaging with faith groups to prevent violence against women in conflict-affected communities: results from two community surveys in the DRC","field_subtitle":"Le Roux E; Corboz J; Scott N; Sandilands M; et al: BMC International Health and Human Rights 20(27), 1-20, doi: https://doi.org/10.1186/s12914-020-00246-8, 2020","URL":"https://tinyurl.com/yy5bpgbj","body":"This paper addresses interventions to address intimate partner violence (IPV) against women and girls by engaging with faith communities and their leaders. Two community surveys were conducted, one before and one after the intervention, in three health areas in Ituri Province in the Democratic Republic of Congo. Questionnaires were interviewer-administered, with sensitive questions related to experience or perpetration of violence self-completed by participants. The study showed significantly more equitable gender attitudes and less tolerance for IPV after the interventions. Positive attitude change was not limited to those actively engaged within faith communities, with a positive shift across the entire community in terms of gender attitudes, rape myths and rape stigma scores, regardless of level of faith engagement. There was a significant decline in all aspects of IPV in the communities who experienced the intervention. This intervention was premised on the assumption that faith leaders and faith communities are a key entry point to influence an entire community. The research affirmed this assumption.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 226: Putting the public back into public health: communities organising solidarity responses to COVID-19","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Examining determinants of gender attitudes: evidence among Tanzanian adolescents","field_subtitle":"Palermo T: Chzhen Y:  Balvin N; Kajula L; et al:  BMC Women's Health  20(195), doi:  https://doi.org/10.1186/s12905-020-01057-8, 2020","URL":"https://tinyurl.com/y3n7lv3x","body":"This study examines determinants of gender attitudes among some of the poorest and most vulnerable adolescents in Tanzania using an ecological model. Data come from baseline interviews with 2458 males and females aged 14\u201319\u2009years conducted within a larger impact evaluation. Secondary school attendance was associated with more equitable gender attitudes. Females had less equitable gender attitudes than males in the sample. Having had sexual intercourse was associated with more gender equitable attitudes among females, but the reverse was true among males. Addressing gender inequity requires understanding gender socialisation at the level of social interactions. The finding that females had more inequitable gender attitudes than males in the study is argued by the authors to suggest that more emphasis be given to highlighting the rights of women with female adolescents. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Feral Atlas: The More-Than-Human Anthropocene","field_subtitle":"Tsing A; Deger J; Saxena A; Zhou F: Stanford University, doi: 10.21627/2020fa, 2020 ","URL":"https://feralatlas.org","body":"Feral Atlas invites you to explore the ecological worlds created when nonhuman entities become tangled up with human infrastructure projects. Seventy-nine field reports from scientists, humanists, and artists show you how to recognize \u201cferal\u201d ecologies, that is, ecologies that have been encouraged by human-built infrastructures, but which have developed and spread beyond human control. These infrastructural effects, Feral Atlas argues, are the Anthropocene. Playful, political, and insistently attuned to more-than-human histories, Feral Atlas does more than catalogue sites of imperial and industrial ruin. Stretching conventional notions of maps and mapping, it draws on the relational potential of the digital to offer new ways of analysing\u2014and apprehending\u2014the Anthropocene; while acknowledging danger, it demonstrates how in situ observation and transdisciplinary collaboration can cultivate vital forms of recognition and response to the urgent environmental challenges of our times.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Hostile Environment(s) \u2013 Designing Hostility, Building Refugia","field_subtitle":"Pezzani L:  ar/ge kunst, Bolzano, unibz \u2013 Faculty of Design and Art in collaboration with Z33 \u2013 House of Contemporary Art, Design & Architecture, Hasselt, 2020","URL":"http://www.hostileenvironments.eu/about","body":"Hostile Environment(s) \u2013 Designing Hostility, Building Refugia is an expanded programme investigating the political ecology of migration and border violence. Through a series of lectures, workshops, screenings, commissioned texts and other materials delivered both online and in-person it provides an index and archive of materials that are regularly be updated with new content. The term \u201chostile environment\u201d draws from legislation in UK, denying migrants from Africa and other countries deemed to be illegal access to work, housing, services and education. Far from being an exceptional condition, however, this process of making (urban) space unlivable for some resonates with the ways in which certain \u201cnatural\u201d terrains (oceans, deserts, mountains) have been structured to deter and expel migrants. These materials seeks to capture these interconnected processes, investigating how certain forms of racialized violence have become as pervasive as the climate. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"How should community health workers in fragile contexts be supported: qualitative evidence from Sierra Leone, Liberia and Democratic Republic of Congo","field_subtitle":"Raven J; Wurie H; Idriss A; Bah A; et al: Human Resources for Health  18(58), 1\u201414, doi: https://doi.org/10.1186/s12960-020-00494-8, 2020","URL":"https://tinyurl.com/y4od9ztn","body":"This paper presents evidence from Sierra Leone, Liberia and Democratic Republic of Congo on how community health workers (CHWs) are .managed, the challenges they face and potential solutions. According to the findings: fragility disrupts education of community members so that they may not have the literacy levels required for the CHW role; with implications for the selection, role, training and performance of CHWs. Policy preferences about selection need discussion at the community level, so that they reflect community realities. CHWs\u2019 scope of work is varied and may change over time, requiring ongoing training. The modular, local and mix of practical and classroom training approach worked well, helping to address gender and literacy challenges and developing a supportive cohort of CHWs. A package of supervision, community support, regular provision of supplies, performance rewards and regular remuneration is argued to be vital to the retention and performance of CHWs, as are predictable supervision, supplies, community recognition and allowances. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"How to talk about COVID-19 in Africa","field_subtitle":"Nyabola N: The Boston Review, USA, October 2020","URL":"https://tinyurl.com/y5wwpyl4","body":"To ask why COVID-19 hasn\u2019t been deadlier in Africa is to suggest that more Africans should be dying. We need better questions. Almost every major international news outlet has asked a variation of the question. Some speculate that something structural or physiological has dampened the impact of COVID-19 on Africa\u2019s population; otherwise, Africa would be faring worse. Others argue that African governments are simply doing a better job of managing the disease than other regions, despite evidence to the contrary. Neither analysis reflects the complex realities of COVID-19 in Africa. The question itself, in its crudest form, has provoked considerable, justifiable anger on social media in various African countries. Yet as the deaths mount in Brazil, India, the United States, and the UK, and as Europe prepares for its second wave, the official death toll in African countries remains low. Even in South Africa, the most severely affected African country, confirmed deaths are far fewer than predicted. Experts are left wondering why their predictions were wrong. To ask why more Africans aren\u2019t dying of COVID-19 exposes the expectation that when the world suffers, Africa must suffer more. We can learn collectively from the questions we ask. Knowledge-making is about grappling with useful questions\u2014those that move humanity toward a greater understanding of shared circumstances. But questions that distract from meaningful comparisons dominate the current moment. \u201cWhy aren\u2019t more Africans dying of COVID-19,\u201d like so many questions about Africa, fails to illuminate.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Imagining Impacts \u2013 The Goethe-Institut in Africa","field_subtitle":"African Centre for Cities, October 2020","URL":"https://tinyurl.com/y69cx3qw","body":"The African Centre for Cities and the Goethe-Institut are collaborating on a project entitled Imagining Impacts that explores the role of culture on the continent through a range of regionally focused, and locally specific projects  related to 1) decolonisation and just transitions in Africa; 2) solidarity, support and social cohesion; 3) spaces for daring and dissent; and 4) power and agency. The project will provide events and activities in 2021 where these issues can be thought through collectively.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"In, against, beyond, corona","field_subtitle":"Butler M, Church Land Programme: Daraja Press, October 2020","URL":"https://darajapress.com/publication/in-against-beyond-corona","body":"The authors raise that the COVID-19 pandemic reveals what is wrong and toxic \u2014 in ourselves, in relation with others, and in relation with the rest of non-human nature and ask: 'is it possible to also look for what is good and life-affirming?' The authors argue that the future must be founded on \u2018kindness, social solidarity and an appropriate scale of time\u2019, a future that cherishes life and the connections that transcend borders. This pamphlet, part of Daraja Press\u2019s Thinking Freedom Series, distills learnings from the work of activists on the ground in the Church Land programme in KwaZulu-Natal province, South Africa.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"International AIDS Society\u2019s (IAS) COVID-19 Conference: Prevention!","field_subtitle":"Online, registration closes 14 January 2021","URL":"https://covid19.iasociety.org/about/","body":"IAS \u2013 the International AIDS Society \u2013 will host the IAS COVID-19 Conference: Prevention, with a special focus on prevention, on Tuesday, 2 February 2021. In recognition of the urgent need to analyse research, review policy and exchange frontline experiences related to the COVID-19 pandemic. The 2nd IAS COVID-19 Conference with a special focus on prevention will feature the latest in prevention related science, policy and practice. The conference will take place virtually and will include invited-speaker sessions and abstract presentations. The conference programme is designed to include the latest science on COVID-19 and its impact on health and beyond \u2013 with perspectives on policy, access and financing.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Legal and institutional foundations for universal health coverage, Kenya ","field_subtitle":"Mbindyo R; Kioko J; Siyoi F; et al: Bulletin of the World Health Organisation 98, 706\u2013718, doi: http://dx.doi.org/10.2471/BLT.19.237297, 2020","URL":"https://tinyurl.com/y2upkm4h","body":"To gain a picture of the extent of the health reforms over the first 10 years of the Kenyan constitution, the authors developed an adapted health-system framework, guided by World Health Organization concepts and definitions. The analysis revealed multiple structures (laws and implementing public bodies) formed across the health system, with many new stewardship structures aligned to devolution, but with fragmentation within the regulation sub-function. By deconstructing normative health-system functions, the framework enabled an all-inclusive mapping of various health-system attributes (functions, laws and implementing bodies). The authors believe their framework is a useful tool for countries who wish to develop and implement a conducive legal foundation for universal health coverage. Constitutional reform is argued to be a mobilizing force for large leaps in health institutional change, boosting stakeholder acceptance and authority to proceed.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Letter supporting proposal by India and South Africa on waiver from certain provisions of the TRIPS agreement for the prevention, containment and treatment of COVID-19","field_subtitle":"Civil society signatories: 2020","URL":"https://tinyurl.com/y3q9oc95","body":"This open letter calls on WTO Members to strongly support the adoption of the text proposed by India and South Africa in their proposal for \u201cWaiver from certain provisions of the TRIPS Agreement for the prevention, containment and treatment of COVID19\u201d (Waiver Proposal), recognising the consensus that curbing the spread of COVID-19 demands international collaboration to speed and scale up development, manufacturing, and supply of effective medical technologies, with calls including from several Heads of State for medical products for COVID-19 to be treated as global public goods. Seven months into the pandemic, there is no meaningful global policy solution to ensure access, inequality in access to critical technologies, rejection by the pharmaceutical industry of the COVID-19 Technology Access Pool (C-TAP) launched by WHO to voluntarily share knowledge, IP and data, has been rejected by the pharmaceutical industry and intellectual property infringement disputes.  While the TRIPS Agreement contains flexibilities that can promote access, many WTO Members may face challenges in using them promptly and effectively. The signatories argue that unless concrete steps are taken at the global level to address intellectual property and technology barriers, the above mentioned failures and shortcomings will replay as new medicines, vaccines and other medical products are rolled out. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model","field_subtitle":"Kimani R; Maina R; Shumba C; Shaibu S: Human Resources for Health 18(75), 1-5, doi:  https://doi.org/10.1186/s12960-020-00518-3, 2020","URL":"https://tinyurl.com/y5j3p37q","body":"Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The authors outline how the COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. The lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. They argue for a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. The authors propose strengthening community-based midwifery to avoid unnecessary movements, decrease the burden on hospitals, and minimise the risk of COVID-19 infection among women and their newborns.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Measures to strengthen primary health-care systems in low- and middle-income countries","field_subtitle":"Etienne V Langlois E; Andrew McKenzie A; et al.: Bulletin World Health Organisation 98, 781\u2013791, doi: http://dx.doi.org/10.2471/BLT.20.252742, 2020","URL":"https://tinyurl.com/yyd7okxn","body":"In this paper, the primary health-care (PHC) systems in 20 low- and middle-income countries were analysed using a semi-grounded approach. Options for strengthening PHC were identified by thematic content analysis. The authors found that despite the growing burden of non-communicable disease, many low- and middle-income countries lacked funds for preventive services;  community health workers were often under-resourced, poorly supported and lacked training;  out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in PHC was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of PHC. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. The authors argue for policy-making to be supported by adequate resources for PHC implementation and that government spending on PHC should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of PHC management is also said to be needed. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"None of us are safe, until we are all safe","field_subtitle":"Valley D; Brady L; Magiligwana A; Mgedle M: Cape Town Together, 2020","URL":"https://www.youtube.com/watch?v=MTyacJioDsA","body":"This video, accompanying a song by Mzikhona Mgedle from the Langa Community Action Network (CAN), captures the dynamism and energy of Cape Town Together and the Community Action Networks while highlighting the many ways in which COVID-19 has challenged South Africans to demonstrate new and better forms of solidarity. Across the geographic, economic and social barriers that are a consequence of Apartheid history, community-led COVID-response networks are forming partnerships based on trust, inter-personal connection and shared goals. The music video draws footage from a range of CAN projects, including community kitchens, medicine-delivery schemes and food gardens to demonstrate the power of collective action. As the song states, none of us are safe, until we are we are all safe","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Over 80 per cent of IMF Covid-19 loans will push austerity on poor countries","field_subtitle":"Oxfam: Oxfam UK, United Kingdom, 2020","URL":"http://oxfamapps.org/media/wjo37","body":"Over 80% of the International Monetary Fund\u2019s (IMF) Covid-19 loans recommend that poor countries hit hard by the economic fallout from the COVID-19 pandemic adopt tough new austerity measures in the aftermath of the health crisis. Since the pandemic was declared in March, 76 out of 91 IMF loans \u2013 84% \u2013 negotiated with 81 countries push for belt-tightening that could result in deep cuts to public healthcare systems and social protection. Government failure to tackle inequality \u2015through support for public services, workers\u2019 rights and a fair tax system\u2015 left them woefully ill-equipped to tackle the Covid-19 pandemic. The authors argue that the IMF has contributed to these failures by consistently pushing a policy agenda that seeks to balance national budgets through cuts to public services, increases in taxes paid by the poorest, and moves to undermine labour rights and protections. As a result, when Covid-19 hit, only one in three countries, covering less than a third of the global workforce, had safety nets for workers to fall back on if they lost their job or became sick. The analysis also found that just 8 out of 71 World Bank health emergency response projects approved between April and end of June this year aim to eliminate healthcare fees, which are prohibitive in at least 56 of these countries.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"PHASA 2021: \u2018Keeping the promise: closing the gap'","field_subtitle":"15 - 17 February 2021, University of Pretoria, City of Tshwane, South Africa ","URL":"http://phasa.samrc.ac.za/theme.html","body":"The Public Health Conference is organized every year by Public Health Association of South Africa to bring together public health professionals, researchers, policy-makers, academics, students and trainees to strengthen efforts to improve health and well-being, share the latest research and information, to promote best practices and to advocate for public health issues and policies grounded in research. The organisers note that 2020 stands at a cross road of two major events: it marks 20 years\u2019 anniversary of PHASA; and 10 years away from the 2030 sustainable development agenda. The Symposia core themes include: \u2018health and wellbeing\u2019, \u2018universal health coverage\u2019, and \u2018sustainable cities and communities\u2019. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Prevalence and patterns of gender-based violence across adolescent girls and young women in Mombasa, Kenya","field_subtitle":"Bhattacharjee P;  Ma H; Musyoki H; Cheuk E; et al: BMC Women's Health 20(229), 1-11,  doi: https://doi.org/10.1186/s12905-020-01081-8, 2020","URL":"https://tinyurl.com/yy8jhp2g","body":"This study sought to estimate the prevalence of gender-based violence (GBV) in adolescent girls and young women (AGYW) through a cross-sectional survey in Mombasa, Kenya in 2015. The main perpetrators of violence were intimate partners for young women engaged in casual sex, and both intimate partners and regular non-client partners for young women engaged in transactional sex. For young women engaged in sex work, first-time and regular paying clients were the main perpetrators of physical and sexual violence. Alcohol use, ever being pregnant and regular source of income were associated with physical and sexual violence though it differed by subgroup and type of violence. AGYW in these settings experience high vulnerability to physical, sexual and police violence. However, they are not a homogeneous group, and the variation in prevalence and predictors of violence needs to be understood to design effective programmes to address violence.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Putting the public back into public health: communities organising solidarity responses to COVID-19","field_subtitle":"Eleanor Whyle, University of Cape Town, Manya van Ryneveld, University of the Western Cape, Leanne Brady, University of Cape Town, Rene Loewenson, TARSC","body":"The COVID-19 pandemic and its socioeconomic consequences have affected all Eastern and Southern African (ESA) countries. The long-term impacts still remain to be seen. While COVID-19 affects everyone, it does not affect everyone equally. It has entrenched and exacerbated the extreme inequalities and injustices that existed before the pandemic. \r\n\r\nThe collective insecurity generated by the pandemic requires a decisive public health response. This response has, however, tended to apply centralised, top-down and undemocratic decision-making, often using \u2018war\u2019 narratives that prompt or reinforce fear, and that promote individual self-protection. Reactive interventions have not adequately taken local conditions and rights into account, prevented longer-term harms to health, including from gender violence, nor protected income, food security or social trust.\r\n\r\nHowever, the pandemic also offers an important opportunity to demonstrate that alternative, people-centred, democratic and collective responses are possible. Indeed they are essential, not just to prevent and contain infection and mitigate the impact of the pandemic, but also to \u2018build back\u2019 using a stronger, more compassionate and equity-driven form of public health. \r\n\r\nIn October, EQUINET published 42 case studies of community action on COVID-19 that collectively demonstrate examples of this (see https://tinyurl.com/yxrekzre).  The case studies come from different settings, income levels and dimensions of the response. They show innovative and solidarity-based approaches to prevent and care for COVID-19, to address social needs and hold states accountable. They provide a powerful argument for public participation and collective action in health. \r\n\r\nOne of the case studies, the Cape Town Together Community Action Network (CAN), tells the story of a self-organising network that emerged in March 2020 in South Africa as a community-led response to COVID-19.\r\n\r\nIn early March, it was clear from other countries that formal responses would struggle to keep up with the pace of the virus. As a network of autonomous, neighbourhood-level groups working together to respond to local challenges as and when they emerge, Cape Town Together felt that bottom-up community organising could spread faster than the virus and could rapidly identify and respond to its emerging health, social and economic impacts. \r\n\r\nThe Community Action Networks (CANs) actively work against a tendency to centralise planning, decision-making and management. They reject hierarchies of knowledge, resources and power. Each neighbourhood CAN operates independently and autonomously, while drawing on the collective energy and wisdom of the network as a whole. The hyper-local nature of the CANs allows for street-level organising, reminiscent of anti-apartheid activism. Generosity, trust and solidarity are important foundational principles. The CANs prioritise relationships over bureaucracy.  They are enabled by inter-personal connections built during lockdown conditions largely through online co-learning, WhatsApp groups and Zoom meetings. \r\n\r\nAt the peak of the pandemic this decentralised, self-governing structure provided vital support where formal social safety nets failed, including public health guidance, mask-making clubs, community gardens, community care centres for COVID-positive people who could not safely self-isolate at home, and food and medicine deliveries to elderly people.\r\n\r\nA few weeks after South Africa initiated its hard lockdown, 47% of households were suffering from extreme food insecurity. Across Cape Town, CANs distributed food parcels and established community kitchens. With rapid communication across the network, CANs shared experience and resources, learned from each other and worked with public health services to follow COVID-19 safety protocols in the community kitchens. Beyond the hot meals provided, the community kitchens became safe, organic spaces, enabling protective behaviours and information sharing. They responded to local social needs in a way that was inclusive, welcoming and free of stigma and shame. \r\n\r\nThe CANs generated community-level intelligence. In their inclusion of community members, researchers and local public servants, they enabled informal communication. They built trust between communities and health system actors, through dialogue and co-learning forums between CANs and health sector decision-makers. They made input into educational materials developed by the health department. With the lived local realities of those most affected by the pandemic often very different to that of health department officials, these connections proved invaluable in framing appropriate measures. \r\n\r\nThe CANs aim to support and not substitute state efforts, and this was initially possible. However, the shortcomings within state efforts became a subject of an increasingly politicised debate. For example, some CANs and local civil society organisations formed a coalition that protested the unlawful eviction of residents in informal settlements. Political actors reacted by asserting that the CANs were acting unlawfully and presented a political threat. When another CAN renovated a badly vandalised and unused public community hall, the local ward councillor accused them of unlawfully occupying the space. \r\n\r\nSuch tensions may be inevitable where community initiatives highlight deficits in state responses and provide different approaches. Bottom-up initiatives such as the CANs call for and contribute to alternative forms of governance that celebrate, enable and invest in community-led public health responses.  \r\n\r\nThe case studies in the EQUINET report show that community-engaged and -led responses and relationships are more likely when they build on prior histories of social networking and organisation around social justice. The relationships, the citizen scientist and activist leadership, the connections with public, professional and civil society organisations and prior activities on different dimensions of wellbeing enabled a relatively rapid, collectively-organised range of health responses to the pandemic. Information technology was used to organise collective understanding and action.  The case studies also show the importance of investing in comprehensive primary health care systems for an effective and equitable response to pandemics. If we continue to frame our health systems only in terms of efficiency-led measures to treat particular diseases and top-down responses to emergencies, we weaken the ability mobilise the relationships, capacities and creativity within communities, networks and service personnel, or the multi-sectoral responses needed to prevent and address the many health challenges we face from such crises. \r\n\r\nWe hear many negative stories about COVID-19. Yet these compassionate stories of equity, rights-driven and holistic responses also need to be documented and told. They show a solidarity-driven response to COVID-19, and that people are subjects not objects in health. \r\n\r\nPlease send feedback or queries on the issues raised to the EQUINET secretariat: admin@equinetafrica.org. For more information on the CANs please visit the https://capetowntogether.net/  and https://www.facebook.com/groups/CapeTownTogether","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Racial Equity 2030","field_subtitle":"Deadline for Applications: January 28, 2021","URL":"https://www.racialequity2030.org","body":"Racial Equity 2030 calls for bold solutions to drive an equitable future for children, their families and communities. This $90 million challenge seeks ideas from anywhere in the world and will scale them over the next decade to transform the systems and institutions that uphold inequity. Solutions may tackle the social, economic, political or institutional inequities one sees today. Teams of visionaries, change agents and community leaders from every sector are invited to join. Up to 10 Finalists will each receive a one-year $1 million planning grant and nine months of capacity-building support to further develop their project and strengthen their application. At least three awardees will each receive a $20 million grant and two will each receive a $10 million grant. Grants will be paid out over nine years. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Reclaiming comprehensive public health","field_subtitle":"Loewenson R; Accoe K; Bajpai N: Buse K: et al: BMJ Global Health 5(9) 1-5, doi: http://dx.doi.org/10.1136/bmjgh-2020-003886, 2020","URL":"https://gh.bmj.com/content/5/9/e003886.full","body":"Global and national responses to the COVID-19 pandemic highlight a long-standing tension between biosecurity-focused, authoritarian and sometimes militarised approaches to public health and, in contrast, comprehensive, social determinants, participatory and rights-based approaches. Notwithstanding principles that may limit rights in the interests of public health and the role of central measures in some circumstances, effective public health in a protracted pandemic like COVID-19 requires cooperation, communication, participatory decision-making and action that safeguards the Siracusa principles, respect for people\u2019s dignity and local-level realities and capacities. Yet there is mounting evidence of a dominant response to COVID-19 where decisions are being made and enforced in an overcentralised, non-transparent, top-down manner, often involving military coercion and abuse in communities, even while evidence shows the long-term harm to public health and human rights. In contrast, experiences of comprehensive, equity-focused, participatory public health approaches, which use diverse sources of knowledge, disciplines and capabilities, show the type of public health approach that will be more effective to meet the 21st century challenges of pandemics, climate, food and energy crises, growing social inequality, conflict and other threats to health.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Reclaiming Comprehensive Public Health: A Call to Action","field_subtitle":"","body":"A growing group of public health, social justice and human rights advocates, including a number from EQUINET, have released a Call to Action to heads of state and government at the 3-4 December UN General Assembly Special Session on COVID-19 to promote comprehensive, equity-focused and participatory public health approaches in countering the pandemic, drawing on and using diverse sources of knowledge, disciplines and capabilities.\r\n\r\nThe Call builds on a recent commentary by on Reclaiming Comprehensive Public Health in BMJ Global Health (the link is included in a later section in this newsletter) and contributions by a group of people working in public health from different regions globally, including a number from east and southern Africa. Over 250 individuals and leading organisations and networks have signed the Call so far and signatories are still invited. The full Call is at https://bit.ly/RCPHcall together with a link to sign on and other resources. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Recovering Better from COVID-19 Will Need a Rethink of Multilateralism","field_subtitle":"Kozul-Wright R: Development (2020) 1-5, doi: https://doi.org/10.1057/s41301-020-00264-y, 2020","URL":"https://link.springer.com/article/10.1057/s41301-020-00264-y","body":"The world economy is experiencing a deep recession amid a still unchecked pandemic.  The author argues that the commitment to recovering better will not materialize if, as happened after the global financial crisis, high income countries resort to a policy mix of austerity, liberalization and quantitative easing. Such an approach will only worsen a whole set of pre-existing conditions and in particular, high inequality, excessive debt (both public and private and weak investment\u2014that will lead to a lost decade, particularly for low income countries. What is proposed to be needed instead is an expansionary plan for global recovery, that can return even the most vulnerable countries to a stronger position than before the crisis. This paper sets out some of the key elements of such a plan and argues that its implementation will require systematic reforms to the multilateral trade and financial system if a more resilient recovery is to turn into a sustainable and inclusive future.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Spending, Accountability, and Recovery Measures included in IMF COVID-19 loans","field_subtitle":"Oxfam, United Kingdom, 2020","URL":"https://tinyurl.com/y2v4f3na","body":"To respond to the outbreak of the COVID-19 pandemic, the International Monetary Fund (IMF) has committed $1 trillion and so far provided $89 billion worth of financial assistance to countries around the world. Oxfam has tracked this COVID-19 financing and fiscal measures referenced in each of the 91 packages approved so far using official IMF reports for the respective countries. The tracker covers the amounts of funding IMF committed and disbursed to borrowing countries by region, types of financing instruments the Fund has employed, the borrowing countries\u2019 current debt situation, fiscal policy measures, particularly social spending aimed at addressing the crisis, anti-corruption and transparency measures which countries have committed to undertake, and proposed fiscal measures for the recovery period. The text provided in this tracker is a compilation of select and relevant quotes/excerpts from official IMF reports while the debt data was drawn from the World Bank\u2019s Debtor Reporting System. The tracker has been compiled for the benefit of persons and institutions wanting a snapshot view of what governments are borrowing, what they intend to do with these funds, what the IMF is encouraging countries to take during the pandemic and in the recovery period, and to give citizens and civil society a tool to hold their governments and the IMF accountable. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Thandika Mkandawire: A \u2018young\u2019 African economist\u2019s appreciation","field_subtitle":"Chelwa G: Journal of African Studies, doi: 10.1080/00020184.2020.1836913, 2020","URL":"https://www.tandfonline.com/doi/full/10.1080/00020184.2020.1836913","body":"At the invitation of African Studies, Grieve Chelwa reflects on Thandika Mkwandawire\u2019s life and work and impact on the social and economic sciences in Africa. Mkwandawire\u2019s career spanned over four decades with a long and diverse list of publications. Chelwa refers to five specific publications that have helped to make sense of Africa\u2019s place and the place of African economists in the seemingly never-ending debates about the continent\u2019s prospects for economic development. Chelwa calls these his favourite things, \u2018because Thandika was African development scholarship\u2019s saxophonist.\u2019","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Using evidence and analysis for an adaptive health system response to COVID-19 in Uganda in 2020","field_subtitle":"Kadowa I: EQUINET Case study paper, Ministry of Health Uganda, TARSC:  EQUINET: Harare, 2020","URL":"https://tinyurl.com/yyqrt6r4","body":"Uganda reported its first confirmed case of COVID-19 on 21 March 2020. The country has since implemented a series of public health measures to limit the spread of the virus. The pandemic has progressed from imported cases through sporadic community cases to stage four, with widespread community transmission. This paper documents how evidence and analysis were used to support decision-making for an adaptive health system response to COVID-19 in Uganda in 2020. A desk review was thus implemented using published and grey literature covering the period from February to October 2020 to document the nature and organisation of different data and related evidence used to support projections, planning and decision-making on the surveillance, prevention, care and health system response to COVID-19. The desk review also looked at how evidence was used and communicated across different actors to support adaptive responses. While there have been challenges, Uganda\u2019s response to COVID-19is reported to have been dynamic, responding to different sources of evidence, and through different institutional channels and actions, with the latter generating evidence and experience that feeds back to the response.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"What Does the Seventy-third World Health Assembly Mean For Socio-economic Survival of Countries, Food Security, and International Cooperation in the COVID-19 Pandemic","field_subtitle":"Ssemakula M: People\u2019s Health Movement (PHM) and Human Rights Research Documentation Centre (HURIC) \u2013UGANDA, 2020","URL":"https://tinyurl.com/y6xj6vwq","body":"COVID-19 has underpinned unprecedented economic instability and global food supply disruptions in Africa. This has put global cooperation (aid, partnerships and concession finance) on test after the economic downturn in the world economy performance. This article provides a discourse on damaging interruptions caused by the pandemic on socio- economic survival of countries and food security, and how that relates to the gaps in interventions in IHR core principles reported by WHO member states and UN agencies at seventy-third World Health Assembly, which PHM closely followed through its WHO Watch programme.","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"What Is COVID-19 Teaching Us About Community Health Systems? A Reflection From a Rapid Community-Led Mutual Aid Response in Cape Town, South Africa\u2019","field_subtitle":"Van Ryneveld M; Whyle E; Brady L;  Int Jo Health Policy and Management x(x), 1-4, doi: 10.34172/ijhpm.2020.167, 2020","URL":"https://www.ijhpm.com/article_3904_e4aea0e55d269d384d5371f3009ff358.pdf","body":"COVID-19 has exposed the wide gaps in South Africa\u2019s formal social safety net, with the country\u2019s high levels of inequality, unemployment and poor public infrastructure combining to produce devastating consequences for a vast majority in the country living through lockdown. In Cape Town, a movement of self- organising, neighbourhood-level community action networks (CANs) has contributed significantly to the community- based response to COVID-19 and the ensuing epidemiological and social challenges it has wrought. This article describes and explains the organising principles that inform this community response, with the view to reflect on the possibilities and limits of such movements as they interface with the state and its top-down ways of working, often producing contradictions and complexities. This presents an opportunity for recognising and understanding the power of informal networks and collective action in community health systems in times of unprecedented crisis, and brings into focus the importance of finding ways to engage with the state and its formal health system response that do not jeopardise this potential. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"What role can health policy and systems research play in supporting responses to COVID-19 that strengthen socially just health systems? ","field_subtitle":"Gilson L; Marchal B; Ayepong I; Barasa E; et al: Health Policy and Planning (czaa112), doi: https://doi.org/10.1093/heapol/czaa112, 2020","URL":"https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czaa112/5918196","body":"In the context of COVID-19, this paper outlines how health policy and systems research (HPSR) can both address current short-term challenges, and support the system transformations needed to strengthen people-centred and equitable health systems over the long term. Due to the acute nature of  the pandemic, few papers have yet focused on how health systems are coping with or adapting to the pandemic, or how health policy-making and decision-making has (or has not) changed in this time of crisis. This paper makes proposals for a structured research agenda to inform health policy and system responses to COVID-19 that can move us beyond the current crisis, and into the future, with a focus on low- and middle-income countries. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"\u201cThey have been neglected for a long time\u201d: a qualitative study on the role and recognition of rural health motivators in the Shiselweni region, Eswatini","field_subtitle":"Walker C; Burtscher D; Myeni J et al: Human Resources for Health 18(66) 1-9, doi:  https://doi.org/10.1186/s12960-020-00504-9, 2020","URL":"https://tinyurl.com/y68e27a9","body":"This study was implemented to understand the role of rural health motivators (RHMs) in decentralised HIV/TB activities.  Participants were purposively selected RHMs, community stakeholders and local and non-government personnel. Significant confusion of the RHM role was observed, with community expectations beyond formally endorsed tasks. Community participants expressed dissatisfaction with receiving health information only, preferring physical assistance in the form of goods. Gender emerged as a significant influencing factor on the acceptability of health messages and RHM engagement with community members. The findings highlight the lack of recognition of RHMs at community and national levels, hindering their capacity to successfully contribute to positive health outcomes for rural communities. ","php":"","field_issue_date":"2020-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Access to sexual and reproductive health commodities in East and Southern Africa: a cross-country comparison of availability, affordability and stock-outs in Kenya, Tanzania, Uganda and Zambia","field_subtitle":"Ooms G; Kibira D; Reed T; van den Ham H; et al: BMC Public Health 20(1053) doi: https://doi.org/10.1186/s12889-020-09155-w, 2020","URL":"https://tinyurl.com/y4l594od","body":"Price, availability and stock-out data was collected in July 2019 for over fifty lowest-priced sexual and reproductive health (SRH) commodities from public, private and private not-for-profit health facilities in Kenya, Tanzania, Uganda and Zambia. Affordability was calculated using the wage of a lowest-paid government worker. Accessibility was illustrated by combining the availability and affordability measures. Overall availability of SRHC was low at less than 50% in all sectors, areas and countries, with highest mean availability found in Kenyan public facilities. Stock-outs were common; the average number of stock-out days per month ranged from 3\u2009days in Kenya\u2019s private and private not-for-profit sectors, to 12\u2009days in Zambia\u2019s public sector. In the public sectors of Kenya, Uganda and Zambia, as well as in Zambia\u2019s private not-for-profit sector, all were free for the patient. In the other sectors unaffordability ranged from 2 to 9 SRH commodities being unaffordable. Accessibility was low across the countries, with Kenya\u2019s and Zambia\u2019s public sectors having six SRH commodities that met the accessibility threshold, while the private sector of Uganda had only one meeting the threshold. Accessibility of SRH  commodities remains a challenge. Low availability in the public sector is compounded by regular stock-outs, forcing patients to seek care in other sectors where there are availability and affordability challenges. The authors propose that the findings be used by national governments to identify the gaps and shortcomings in their supply chains.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"An overview of the commercial determinants of health","field_subtitle":"Mialon M: Globalization and Health 16(74), doi: https://doi.org/10.1186/s12992-020-00607-x, 2020","URL":"https://tinyurl.com/yyyjl3w3","body":"This desk review provides an overview of the commercial determinants of health. The commercial determinants of health are reported to cover three areas. First, they relate to unhealthy commodities that are contributing to ill-health. Secondly, they include business, market and political practices that are harmful to health and used to sell these commodities and secure a favourable policy environment. Finally, they include the global drivers of ill-health, such as market-driven economies and globalisation, that have facilitated the use of such harmful practices. The discussion on the commercial determinants of health is argued to offer an opportunity to shift the dominant paradigm in public health, so ill-health, damages to the environment, and health and social inequalities, might be better understood through a commercial determinant lens.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Brief: COVID-19 in East and Southern Africa: developments in the pandemic, July 2020 ","field_subtitle":"EQUINET and ECSA HC: Mimeo, 2020","URL":"https://tinyurl.com/yxrqw9e4","body":"This information sheet is the second presenting work summarising evidence as of July 17 2020 from official and scientific population data across countries in east and southern Africa (ESA) on the COVID-19 pandemic, the responses to it and the relationship with other indicators of population health, health systems and health determinants. The information sheet aims to address four questions: What is happening with COVID-19 testing and detection? How and where is the epidemic progressing over time? How has the health system responded? What are the implications for wider vulnerability? In terms of the epidemic profile, increased testing has improved case detection, although still at low levels for an effective public health response. The pandemic continued to take different forms in different ESA countries. In terms of the health system response, the evidence in July indicated continued constraints in accessing diagnostics, limiting case detection, despite reasonable surveillance capacities. In terms of wider vulnerability, the slower, sustained increase in cases in the ESA region were noted to raise concern on the effects of sustained implementation of measures such as school and workplace closures. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Challenges and Opportunities in China\u2019s Health Aid to Africa: Findings from Qualitative Interviews in Tanzania and Malawi","field_subtitle":"Daly G; Kaufman J; Lin S; Gao L; et al: Globalization and Health 16(71) doi: https://doi.org/10.1186/s12992-020-00577-0,  2020","URL":"https://tinyurl.com/y2o5uxtm","body":"Perceptions regarding Chinese-supported health related activities in Africa were gathered through in-depth interviews among local African and Chinese participants in Malawi and Tanzania. The findings revealed shared experiences and views related to challenges in communication; cultural perspectives and historical context; divergence between political and business agendas; organization of aid implementation; management and leadership; and sustainability. Participants were broadly supportive and highly valued Chinese health aid. However, they also shared common insights that relate to challenging coordination between China and recipient countries; impediments to communication between health teams; and limited understanding of priorities and expectations. Further, they share perspectives about the need for shaping the assistance based on needs assessments as well as the importance of rigorous reporting, and monitoring and evaluation systems. The authors\u2019 findings suggested that China faces similar challenges to those experienced by other longstanding development aid and global health funders. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Community Statement on Covid-19 Realities, and Demands for a More Adequate and People-centred Response - Chiawelo Budgeting for Change","field_subtitle":"Chiawelo Budgeting for Change (CBC) group: Studies in Poverty and Inequality Institute, South Africa, 2020","URL":"https://tinyurl.com/yy8hhkf2","body":"\u201cIn Chiawelo, we are united as a community; people are kind, loving and supportive but most of all it's a place full of diversity- it allows us to learn different cultures, languages and teaches us to respect different people\u201d. These are the words of eighteen-year-old Sanele Nkosi, the youngest member of the Chiawelo Budgeting for Change (CBC) Group, based in Soweto, Johannesburg. The group is a reflection of Sanele\u2019s words, including many different people from many different walks of life: traditional Healers, local community members, clinic workers, community health workers, ward based outreach teams, clinic committee members and local government officials amongst others. In this Community Statement, the group highlight with evidence the health realities and resource gaps faced around the COVID-19 pandemic, including lack of access to social protection, food security, sanitation and adequate health care, gender-based violence, unsafe transport and reopening of educational institutions, youth unemployment, lack of support to the small business sector, for those in chronic unemployment and for community-led COVID-19 responses and safety initiatives and poor working conditions for Community Health Workers.  They call for resources for a people- centred response to the COVID-19 pandemic and access to the rights people are entitled to.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Comparisons of social and demographic determinants of tobacco use in the Democratic Republic of the Congo","field_subtitle":"Colwell B; Mosema K; Bramble M; et al: Globalization and Health 16(66), doi: https://doi.org/10.1186/s12992-020-00593-0, 2020","URL":"https://tinyurl.com/y5jbk4f6","body":"This study examined social determinants of tobacco use in the Democratic Republic of the Congo (DRC), including region, sex, ethnicity, education, literacy, wealth index and place of residence, to gain insights on tobacco use among sub-national groups. The project analysed data from the DRC 2013\u20132014 Demographics and Health Survey. Tobacco use was found to be highest among working poor people, those with less education and low literacy. Older age people and those living in larger cities were more likely to smoke , although the relationship between age and smoking was not linear. Wealth was strongly related to smoking as was being engaged in services, skilled and unskilled manual labour and the army.  Being in a professional, technical or managerial position was highly protective against smoking.  The authors observe that the data indicate that tobacco use in the DRC, as is common in low income countries, is heavily concentrated in working poor people with lower educational status. Higher educational status is consistently predictive of avoiding tobacco use. They argue that examining only national-level data to ascertain tobacco use levels and patterns may lead to mistaken conclusions and inefficient and ineffective allocation of resources for control of tobacco use.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Conclusions and outcomes from SATUCC seminars during the 16th Southern African Civil Society Forum","field_subtitle":"SATUCC: Botswana, August 2020","URL":"https://satucc.org/2020/08/21/conclusions-outcomes-from-satucc-seminars-during-16th-civil-society-forum/","body":"The 16th Southern African Civil Society Forum (CSF) was held remotely in late August due to the challenges posed by COVID-19. In seminars at the forum hosted by SATUCC, and with evidence presented from studies implemented for SATUCC, it was noted that the pandemic has amplified a number of challenges that workers were already facing before COVID-19, such as increase of insecure and informal work, lack of social protection and rising unemployment, exacerbating poverty and inequalities. Youth were found to be more vulnerable due to high youth working poverty rates and because the youth are over-represented in vulnerable and informal employment. Young women are facing an increasing double burden to manage both paid work and unpaid care and household work due to widespread school closures. The sessions identified that trade unions should be actively involved in the formulation and implementation of responses to COVID-19 at both national and regional level and that the issues facing workers should be addressed in social dialogue and in the collective bargaining agreements. Trade unions should be pro-active in bringing alternative proposals for building sustainable economies after the pandemic. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Coronavirus: Ten African innovations to help tackle Covid-19","field_subtitle":"BBC, August 2020","URL":"https://www.bbc.co.uk/news/world-africa-53776027","body":"As Africa passes more than a million confirmed Covid-19 cases, innovators on the continent have responded to the challenges of the pandemic with a wide range of creative inventions. These innovations include the \u2018Doctor Car\u2019 designed by students from the Dakar Polytechnic School. This multifunctional robot is designed to lower the risk of Covid-19 contamination from patients to caregivers. The device is equipped with cameras and is remotely controlled via an app. The designers say it can move around the rooms of quarantined patients to take their temperatures and deliver drugs and food. Nine-year-old Kenyan schoolboy Stephen Wamukota invented a wooden hand-washing machine to help curb the spread of coronavirus. The machine allows users to tip a bucket of water to wash their hands by using a foot pedal. This helps users avoid touching surfaces to reduce the risk of infection. Other innovations include portable ventilators designed in Nigeria, 3d printed masks in South Africa, solar powered hand sinks from Ghana, and online platforms for x-rays from Tunisia.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"COVID-19 in East and Southern Africa: Rebuilding Differently and Better Must Start Now","field_subtitle":" Loewenson R: MEDICC Review 22(3), doi: https://doi.org/10.37757/MR2020.V22.N3.13, 2020","URL":"http://mediccreview.org/covid-19-in-east-and-southern-africa-rebuilding-differently-and-better-must-start-now/","body":"This paper outlines how for ESA countries, COVID-19 has exposed the weakness in being dependent on research and production outside the region of commodities that are needed in good time for communities and services across the region. This not only relates to current demand, like test kits. It forewarns that African countries will be last in the queue when COVID-19 treatments and vaccines are approved. Tariff reductions and reduced protections for domestic industry have suited a global strategy of \u2018lowest-cost-production\u2019 but leave ESA countries vulnerable in the global competition for products. The author also notes that COVID-19 has pointed to resources in the region that could play a more significant role in public health. The Ebola experience showed that an effective response demands collaborative work that involves communities and is supported by professionals, governments and accessible, capable public services. This is the same lesson learned from the gains made in health by applying primary health care strategies in the region, despite their being weakened by underfunding of public services. In contrast, the response to COVID-19 has often generated a self-protective response across countries in global trade and a command-and-control response within countries. Yet neither are effective strategies for a global pandemic that demands distributed local capacities and action. Noting the UN call to use COVID-19 as an opportunity \u201cto rebuild differently and better, the author observes that this begins with how we respond to COVID-19 today, and raises what this implies.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"COVID-19 Pandemic Disrupts HIV Continuum of Care and Prevention: Implications for Research and Practice Concerning Community-Based Organizations and Frontline Providers","field_subtitle":"Pinto R; Park S: AIDS and Behaviour 24(286-2489) doi: https://doi.org/10.1007/s10461-020-02893-3, 2020","URL":"https://link.springer.com/article/10.1007/s10461-020-02893-3#citeas","body":"More quickly than they could have anticipated, people living with (PLWH) and those at-risk for HIV felt the impact of the COVID-19 pandemic, as they were asked to shelter in place and distance themselves from others. In March and April 2020, community-based organizations (CBOs) closed, medical offices cut hours, and medical personnel shifted from primary care to COVID-19 hospital units, affecting the HIV Continuum of Care and Prevention\u2014that is, testing, pre-exposure prophylaxis (PrEP), and primary care. The authors call for further research, review and monitoring to provide evidence on referral practices and links that could help clients access the HIV services to which they are referred (\u201creferral completion\u201d). ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"COVID-19: South Africa, India call for enabling technology transfer in TRIPS","field_subtitle":"Third World Network: TWN Info Service on Health Issues, August 2020","URL":"https://twn.my/title2/health.info/2020/hi200805.htm","body":"At the WTO\u2019s TRIPS Council meeting on 30 July, members discussed South Africa\u2019s proposal (IP/C/W/665) for members to come up with proposals, share information and national experiences, pointing out how the 2030 SDGs may be achieved through an effective framework for technology transfer. India reminded the TRIPS Council that any discussion on \u201cE-Commerce will lack meaning if the gaping digital divide, partly arising out of lack of access to technologies and furthered by the pandemic, continues to exist.\u201d In conclusion, India said that \u201cit is of utmost importance for developing countries to adopt e-commerce and IP policies that are mutually supportive and in line with their developmental goals and policy specificities.\u201d ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"COVID-19: The place of the right to health in the national response for Uganda","field_subtitle":"Mulumba M: Center for Health Human Rights and Development (CEHURD), May 2020","URL":"https://tinyurl.com/y5gkdvo3","body":"As the state and non-state actors take steps in dealing with COVID-19, the author argues for an awareness of the need to urgently strike a balance between prevention approaches and rights with collective responsibilities. From a right to health perspective, it is important for the government of Uganda to ensure that prevention and treatment measures and commodities are available, accessible, and affordable for the most vulnerable communities including: the older persons, those under incarceration, refugees and very poor people. Community participation and solidarity are pillars that have historically been critical in controlling and managing similar outbreaks in Uganda. The author argues for an attentiveness to ensure that research and clinical trials comply with key ethical and human rights principles and that government makes full use of the policy space Uganda has in intellectual property as an LDC to enable it utilise new innovations. The paper points to the need to review and ensure provisions under the Public Health Act enable an effective and equitable response to pandemics like COVID-19, to ensure regulatory approval for new medicines and attention to developing new formulations for the prevention and treatment of COVID-19.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 225: Experiences and insights on COVID-19 and equity","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evidence for decisions in the time of COVID-19: Eyes on Africa","field_subtitle":"Jessani N; Langer L; van Rooyen C; Stewart R: The Thinker, Vol 84, 2020","URL":"https://tinyurl.com/yyuppbpr","body":"In this article the authors argue that many African governments have so far responded more proactively and effectively to Covid-19 than some governments in high income countries (HICs). Much of this capacity to respond effectively can be explained by an existing culture of using evidence to inform policy decision-making. African researchers are producing evidence on how to protect and prioritise already existing health interventions which can increase health system resilience and preparedness for Covid-19. The authors argue that African nations have generated and used evidence for decision- making on solutions to tackle the pandemic. Data-poverty and technology deficits are a challenge. The authors note that partnerships to assist with production, collation, and use of evidence are appearing nationally, regionally, and globally to support quick but measured evidence-informed decisions. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Experiences and insights on COVID-19 and equity","field_subtitle":"EQUINET steering committee ","body":"Equity issues infuse our experience of COVID-19 in the region and globally. It should also infuse the response. \r\n\r\nIt is not well measured in the aggregate data commonly reported, nor in the media profile given to individual cases in elite groups, but COVID-19 spreads through and worsens social inequality.  While the first spread of the pandemic may have come through richer, more mobile people and while all social classes have been affected by COVID-19, it would appear that the spread of the coronavirus exploits and exacerbates the social inequalities in the way we live, work, trade and travel in the region. \r\n\r\nPeople living in lower income areas are often crowded in smaller, poorly ventilated homes, with many generations living in the same crowded home, without safe water supplies to wash hands and immune systems are already battered by undernutrition, infectious and chronic diseases. Crowded transport systems, dusty, poorly ventilated working environments and pollution from cooking fuels and houses sited near landfills and industries raise the risk of respiratory diseases, asthma and occupational lung diseases, making people more susceptible to severe effects of the virus. If resilience refers to the ability to restore the \u2018normal\u2019 that we had before COVID-19 and all the inequalities that put people at risk, then we should not aim for resilience. We should aim for change. \r\n\r\nThere are also social inequalities in a response to COVID-19 that provides less access to and continuity of care for COVID-19 and other health problems. It raises burdens on those who are already more vulnerable.  As is happening in all countries affected by austerity, the chronic underfunding of and weaknesses in our public health services undermine care for poorer communities and protection of the health workers who work in them, notwithstanding the efforts being made by health ministries and other stakeholders. Private providers have expanded their role, but often without adequate public co-ordination and leadership and generally unaffordable for low income communities and enterprises. As noted by UNFPA, women represent a large share of health and social sector workers who are more at risk, while increased household tensions during lockdowns are increasing domestic and gender violence.\r\n\r\nWe are learning that a well-funded public health infrastructure is essential to keep all healthy and safe, that investing in prevention is primary and that transparency on resource flows is critical.  Globally, with protectionist responses from high income countries, patent barriers and past policies of importing rather than locally producing medicines and other health technologies in the region, ESA countries, like poor households, are last in the purchase queue. ESA countries are often dependent on charitable contributions or rising debt to obtain health technologies that should be regarded as a right and as public goods. Global mechanisms that depend on charity and two tier systems risk aggravating inequality in access across countries.\r\n\r\nWithout a vaccine, the response has largely been one of command and control, sometimes militarised, putting whole sectors, areas and communities into lockdown. Many households in the region already live hand-to-mouth and do not have the social security to stop work, or the means to work remotely, so lockdowns increase income inequality. Restrictions on public transport without safe alternatives leave poor households trying to reach essential services stranded. Macro-economic concerns have motivated formal sectors like mining to restart, but do not address these socio-economic insecurities in more marginalised communities. Migrants returning home or located away from home are sometimes stigmatised and treated more as a public health risk than a vulnerable community.  \r\n\r\nThese inequities call for local, national and regional responses. Social isolation measures have proved critical for the technical response to COVID-19. Yet for people who are compelled to work to secure daily incomes for their families, dialogue to find the best ways to protect both public health and livelihoods would seem to be more effective and sustainable than criminalising their actions. A biosecurity, top-down, secretive and militarised response to COVID-19 in the name of public health damages the trust, participation and collective solidarity that are essential for effective public health. In part this reflects whose knowledge and experience counts. Importing modelled concerns from high income countries on the adequacy of hospital resources can focus attention away from areas that the specific epidemiological and health system conditions in the region demand. While journal articles and scientific advisors compete for political attention, the experience, ideas and agency of those directly affected by the epidemic is often marginalised. \r\n\r\nYet there are many positive experiences in the region to report. Public officials, health workers, volunteers, including community health workers and health facility committees, have worked overtime to reach households, trace contacts and organise responses. Communities have formed solidarity networks to support vulnerable households with food and care and have held the state accountable for interventions. Parents have schooled children and teachers have found alternative ways to teach students during lockdowns. Small enterprises and local universities have produced affordable face masks and other technologies; local producers have switched lines to produce ventilators and local artists have produced music and murals to promote social awareness. Communities have provided support for returning migrants; diaspora and local people have crowd funded for support initiatives and local enterprises have contributed to solidarity funding of health technologies. COVID-19 has provoked social attention on health worker and gender rights. It has shown that ignoring social inequalities in health and their determinants and under-investing in comprehensive primary health care and public health threaten our society and economies as a whole. \r\n\r\nWe need to measure, publicly report on and visibly address these dimensions of inequality and to integrate the experience and ideas of all those affected. Not doing so undermines the effectiveness of our current and future responses. As Anand Giridharadas has said: \u201cYour health is as safe as that of the worst-insured, worst-cared-for person in your society. It will be decided by the height of the floor, not the ceiling\u201d.  Even while African political leaderships are calling for global leaders to stop the debt outflow and patent and procurement barriers that are undermining responses within the region, we need to also confront the inequality that COVID-19 is intensifying within our countries. \r\n\r\nSo we are reaching out to you! Are you working on or concerned by any of these dimensions of inequality?  Are there others that you want to raise? If so, please share your concerns, ideas and work! As a community that promotes equity values, EQUINET would like to learn more, share more, inform and voice more on these issues. If you have blogs, webinars, poems, art, stories, case studies, published work or videos on these issues or other equity concerns in the region that you want to share, please let us know so we can provide a platform to share them. Let us know if there are interesting case studies that we can support, or if you have ideas for joint work with EQUINET. Send feedback to us by email or on the feedback form on the EQUINET website and we will follow up with you.  \r\n\r\nThe pandemic is a threat. It must also be an opportunity in our region to confront conditions and mantras that have generated the worsening inequality, rights violations, precarious labour, capital outflows, underfunded and commercialised systems and ecological decline that make us vulnerable to epidemics and that undermine capacities to respond in our collective interest. \r\n\r\nWe welcome your feedback on the issues and invitation in this oped \u2013 please send them to the EQUINET secretariat: admin@equinetafrica.org. Please visit our website for information sheets produced by EQUINET.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Fostering local production of essential medicines in Nigeria ","field_subtitle":"Fatokun O: Bulletin of the World Health Organisation 98, doi: http://dx.doi.org/10.2471/BLT.19.249508, 2020","URL":"https://www.who.int/bulletin/volumes/98/7/19-249508/en/","body":"Consistent availability and access to medicines in low- and middle-income countries is a challenge. As a result, the governments in these countries have shown increasing interest in local pharmaceutical production as a means of promoting technology transfer, building capacity and improving access to essential medicines. In Nigeria, the Five Plus Five-Year Validity (Migration to Local Production) policy aims to reduce the number of pharmaceutical products imported into Nigeria and encourage local production of essential medicines. The Five Plus policy follows a fiscal policy measure implemented since 2016 which reduced the import adjustment tax under the Economic Community of West African States Common External Tariff on pharmaceutical raw materials from 5\u201320% to 0% and imposed a 20% import adjustment tax on four groups of imported drugs that can be produced by local manufacturers, including antimalarials, antibiotics, alkaloid derivatives and vitamins. While local pharmaceutical production in some low-income countries is not viable because of limited local technical expertise or low economies of scale, this issue may not be the case in Nigeria, given its large population, huge potential market and local expertise and experience for the manufacture of essential medicines.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa","field_subtitle":"Jiwani S; Antiporta D: International Journal for Equity in Health 19(82) doi: https://doi.org/10.1186/s12939-020-01199-z, 2020","URL":"https://tinyurl.com/y668qmjp","body":"This paper explored the inequalities in access to water and soap for the COVID-19 responses since December 2019. . Although access to clean water and soap is universal in high-income settings, it remains a basic need many do not have in low- and middle-income settings. according to data from Demographic and Health Surveys of 16 countries in sub-Saharan Africa, using the most recent survey since 2015. The authors propose that interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies should be scaled up to reach the most vulnerable populations.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Lessons from COVID-19: Pharmaceutical Production as a Strategic Goal ","field_subtitle":"Correa C: South Centre, South Views 202, 2020 ","URL":"https://tinyurl.com/yyxp3vb9","body":"The economic and financial crisis generated by COVID-19 has deepened initiatives - which are not entirely new - to sustain local production of pharmaceuticals through a variety of mechanisms aimed at recovering 'strategic autonomy'. The pharmaceutical industry (including biotechnological products) can be one of the axes in new policy frameworks oriented to local production. A UNCTAD study concluded that in many developing countries companies have achieved the economies of scale required to produce medicines competitively and will expand over the next decade. Taking advantage of these opportunities to strengthen a pharmaceutical/ biotechnology industry may require the reformulation of industrial policies, to promote the sector as a generator of value added, employment and foreign exchange, as well as an instrument for achieving health autonomy to address public health needs. The author argues that this requires the deployment of well-articulated instruments, in line with the concept of 'mission-oriented industrial strategy'. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Parent-child communication about sexual issues in Zambia: a cross sectional study of adolescent girls and their parents","field_subtitle":"Isaksen K; Musonda P; Sand\u00f8y I: BMC Public Health 20(1120), doi: https://doi.org/10.1186/s12889-020-09218-y, 2020 ","URL":"https://tinyurl.com/y4jy6ph8","body":"This study from Zambia in 2018 examines the sociodemographic and psychosocial factors that are associated with whether parents communicate with their daughters about sexual issues, through structured, face to face interviews with 4343 adolescent girls and 3878 parents. Adolescent girls who felt connected to their parents and those who perceived their parents to be comfortable in communicating about sex were more likely to speak to their parents about sexual issues than those who did not. Girls whose parents used fear-based communication about sexual issues, and those who perceived their parents as being opposed to education about contraception, were less likely to do so. Girls enrolled in school were less likely to communicate with their parents about sex than those out of school. The authors suggest that parents can improve the chances of communicating with their children about sex by conveying non-judgmental attitudes, using open communication styles and neutral messages. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Postgraduate diploma and Masters in public health, School of Public Health at the University of the Western Cape, South Africa","field_subtitle":"Applications close 30 September 2020 ","URL":"http://www.uwcsoph.co.za/index.php/academic-programmes","body":"The School of Public Health at the University of the Western Cape, South Africa, equips graduates with the knowledge and skills to contribute to transforming the health and social development sectors in developing countries and improving the health status of populations. Students can study while they work, and gain credits incrementally towards a Master of Public Health (MPH) or Postgraduate  Diploma (PGD) in Public Health. These flexible, modular programmes use e-learning as its key learning and teaching medium, with optional contact sessions in Cape Town in February/March and June/July every year. Entry requirement is a three year Bachelor\u2019s degree or equivalent in any relevant discipline; and a minimum of one year work experience in the health or social development sectors.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Redressing the gender imbalance: a qualitative analysis of recruitment and retention in Mozambique\u2019s community health workforce","field_subtitle":"Steege R; Taegtmeyer M;  Ndima  S; Give C; et al: Human Resources for Health 18(37) doi: https://doi.org/10.1186/s12960-020-00476-w,  2020","URL":"https://tinyurl.com/yyva8gew","body":"Mozambique\u2019s community health programme has a disproportionate number of male community health workers (known as Agentes Polivalentes Elementares (APEs)). This paper seeks to explore the current recruitment imbalance processes for APEs and how these are shaped by gender norms, roles and relations, as well as how they influence the experience and retention of APEs in Maputo Province, Mozambique. The authors employed qualitative methods with APEs, APE supervisors, community leaders and a government official in two districts within Maputo Province. Women reported difficulty leaving family responsibilities behind, and men reported challenges in providing for their families during training as other income-generating opportunities were not available to them. These dynamics were particularly acute in the case of single mothers, serving both a provider and primary carer role. Differences in attrition by gender were reported: women are likely to leave the programme when they marry, whereas men tend to leave when offered another job with a higher salary. Age and geographic location were also important intersecting factors, younger male and female APEs seek employment opportunities in neighbouring South Africa, whereas older APEs are more content to remain. The authors suggest that responsive policies to support gender equity within APE recruitment processes are required to support and retain a gender-equitable APE cadre.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Reimagining the Global Symposium on Health Systems Research","field_subtitle":"HSR 2020: Sixth Global Symposium on Health Systems Research, November 2020","URL":"https://tinyurl.com/y28w79yl","body":"This year the Global symposium on health systems research will take place over a three-phase virtual symposium. During the original dates scheduled for the event in Dubai \u2013 8th to 12th November \u2013 there will be a shorter and smaller version of the usual symposium, with skills building sessions, and special panels, and three half days (10th to 12th) of plenary, a parallel sessions, and virtual networking. The second phase will feature two rounds of parallel sessions every two weeks from the end of November through to March 2021. This will enable more opportunities to more speakers than otherwise would have been possible. The second phase will be organised according to the HSR2020 sub-themes and some of these series will be hosted by Thematic Working Groups. The organisers aim for the third phase in March 2021 to take place face-to-face in Dubai, that will seek to synthesize the main learnings coming from HSR2020 and consider how they can best be applied to health systems. This will likely be a smaller invitation-only event and will have a strong focus on engaging with policy and decision-makers who can translate evidence into action.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"SADC Regional Response to COVID-19","field_subtitle":"Southern African Development Community: Bulletin 11, SADC, Botswana, August 2020","URL":"https://www.sadc.int/news-events/news/bulletin-11-sadc-regional-response-covid-19/","body":"The 11th Bulletin of the SADC Response to COVID-19 in English, French and Portuguese provides an overview of the global, continental and regional situation as well as the measures that have been put in place with the support of WHO. It reports that the COVID-19 situation continues to rise in some states in the region, destabilizing the economies and other systems, and leading to a precarious food and nutrition situation.  The report provides the short, medium and long term interventions that countries can put in place to address the situation in relation to issues such as food security, transport, health and economic recovery.  Transport and trade facilitation is noted to remain a major challenge while noting achievements in this, including the Tripartite Guidelines on Trade and Transport Facilitation for Safe, Efficient and Cost Effective Movement of Goods and Services during the COVID-19 Pandemic which harmonise the guidelines of SADC, East African Community (EAC) and the Common Market for Eastern and Southern Africa (COMESA).","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Sociodemographic Predictors of HIV Infection among Pregnant Women in Botswana: Cross-Sectional Study at 7 Health Facilities","field_subtitle":"Hamda S; Tshikuka J;  Joel D:  Journal of the International Association of Providers of AIDS Care (19) doi: https://doi.org/10.1177/2325958220925659, 2020 ","URL":"https://tinyurl.com/yxm9g8ts","body":"The authors determined the prevalence and sociodemographic predictors of HIV among pregnant women in Botswana through a cross-sectional study of 407 randomly enrolled women aged 18 to 49 years, attending 7 health facilities between November 2017 and March 2018. The HIV prevalence was 17%. Women aged 35 to 49 years had higher HIV prevalence than those 18 to 24 years. Illiterate and elementary school educated women had higher HIV prevalence than those with a tertiary education. Those with a history of alcohol intake had a higher HIV prevalence than those without. While HIV prevalence was lower than it was in 2011 the authors call for targeted interventions that integrate these identified dimensions of susceptibility.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Socioeconomic inequalities in food insecurity and malnutrition among under-five children: within and between-group inequalities in Zimbabwe","field_subtitle":"Lukwa A; Siya A; Zablon K;  Azam J; et al: BMC Public Health 20(1199), doi: https://doi.org/10.1186/s12889-020-09295-z, 2020","URL":"https://tinyurl.com/yykdb57n","body":"The authors explored socioeconomic inequalities trend in child health using Demographic Health Survey data sets of 2010\\11 and 2015. Food insecurity in under-five children was determined based on the World Health Organisation dietary diversity score. Theil indices for nutrition status showed socioeconomic inequality gaps to have widened, while food security status socioeconomic inequality gaps contracted for the period under review. The study concluded that unequal distribution of household wealth and residence status play critical roles in driving socioeconomic inequalities in child food insecurity and malnutrition. Child food insecurity and malnutrition are greatly influenced by where a child lives and their parental wealth.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"South Africa, Kenya and Zimbabwe: Repression and state violence are not public health strategies","field_subtitle":"Essop T; the Anti-Repression Working Group of the C-19 People\u2019s Coalition: Daily Maverick, South Africa, August 2020","URL":"https://tinyurl.com/y335qmd8","body":"The securitised interventions by the South African, Kenyan and Zimbabwean governments are argued by the author to be fundamentally out of tune with the needs of the moment and ineffective in dealing with the pandemic\u2019s multiple crises. They note that lockdown regulations have been used as a cover for suppressing legitimate concerns around the socio-economic fallout from nationwide lockdown measures that have undermined livelihoods and disproportionately affected poor people. This pattern of conduct calls into question the use of securitised approaches to the global health emergency and what it means for the broader public health response that is needed. In South Africa, Kenya and Zimbabwe, the brutality and heavy-handedness of the security forces is argued to not be new and that the current responses are rooted in systemic problems and failures of accountability  in policing in poor communities.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Status of COVID-19-in East and Southern Africa","field_subtitle":"Minja C: The East Central and Southern Africa Health Community (ECSA-HC), July 2020","URL":"https://tinyurl.com/y2oc4l6b","body":"The East Central and Southern Africa Health Community has continued to monitor the status of COVID-19 in Burundi, Eswatini, Kenya, Lesotho, Malawi, Mozambique, Mauritius, Rwanda, South Sudan, Tanzania, Uganda, Zambia and Zimbabwe and to support countries mitigate effects of COVID-19. Due to the prevailing restrictions of travel, much has been provided through online discussions and support. The report indicates that the number of reported confirmed cases of COVID-19 and cases under care in the region is increasing, in spite of the context of under-reporting. The authors note that governments wish to open up economies to take care of individual and national economic survival and call for targeted and population interventions for modified social distancing mechanisms and for support for diagnostics, care of recovering cases, contact tracing and surveillance across countries, taking note of the fluid movement of people across borders. Adopting regional collaborative efforts is argued to be cost-efficient. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The COVID-19 Action Fund for Africa","field_subtitle":"Fund oversight committee, 2020","URL":"https://tinyurl.com/yxphxc3n","body":"The COVID-19 Action Fund for Africa is an action-oriented collaborative of over 30 organizations dedicated to protecting Community Health Workers (CHWs) on the frontlines of Africa\u2019s COVID-19 response. The Fund\u2019s goal is to raise up to $100 million to supply personal protective equipment (PPE) to CHWs in as many as 24 African countries for approximately one year; shipments have already begun. The Fund matches donated PPE with government-identified gaps and conducts end-use verification processes with in-country partners to document arrival and distribution of the supplies. Integrated with national responses, this is the only known effort that pools resources for PPE items specifically for community health workers in Africa","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The COVID-19 pandemic and health inequalities","field_subtitle":"Bambra C; Riordan R; Ford J: et al: Epidemiology & Community Health, doi: 10.1136/jech-2020-214401, 2020","URL":"https://jech.bmj.com/content/early/2020/06/13/jech-2020-214401.info","body":"This essay examines the implications of the COVID-19 pandemic for health inequalities. It outlines historical and contemporary evidence of inequalities in pandemics\u2014drawing on international research into the Spanish influenza pandemic of 1918, the H1N1 outbreak of 2009 and the emerging international estimates of socio-economic, ethnic and geographical inequalities in COVID-19 infection and mortality rates. It then examines how these inequalities in COVID-19 are related to existing inequalities in chronic diseases and the social determinants of health, arguing that this is a syndemic pandemic. The authors explore the potential consequences for health inequalities of the lockdown measures implemented internationally as a response to the COVID-19 pandemic, focusing on the likely unequal impacts of the economic crisis. The essay concludes by reflecting on the longer-term public health policy responses needed to ensure that the COVID-19 pandemic does not increase health inequalities for future generations.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The South African Health Review (SAHR) 2021 Call for Abstracts ","field_subtitle":"Deadline for Abstracts: 31 October 2030","URL":"https://www.hst.org.za/media/Pages/SAHR-2021-Call-for-Abstracts.aspx","body":"The editors of the 2021 edition of the South African Health Review (SAHR) invite the submission of abstracts that examine health-sector responses to the COVID-19 pandemic. Preference will be given to abstracts on topics that consider: the impact of COVID-19 on existing health services and programmes; the impact of socio-economic disparities on prevention and treatment; the rationing of healthcare services and implications for equity of access; strengthening of the country\u2019s social compact, and emergence of innovative collaborations and partnerships; impact of measures taken to balance saving lives with saving livelihoods; and/or emerging lessons for the future management and prevention of pandemics and other public health emergencies.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Training Exposure and Self-Rated Competence among HIV Care Providers Working with Adolescents in Kenya","field_subtitle":"Karman E; Wilson K; Mugo C; Slyke J; et al: Journal of the International Association of Providers of AIDS Care (19) doi: https://doi.org/10.1177/2325958220935264, 2020","URL":"https://tinyurl.com/y6yhfke7","body":"This paper examined the training coverage and self-reported competence, knowledge, abilities, and attitudes, of health care workers caring for adolescents living with HIV in Kenya. Surveys were conducted with 24 managers and 142 health care workers. Health care workers had a median of 3 years of experience working with adolescents living with HIV, and 40% reported exposure to any adolescents living with HIV training. Median overall competence was 78%. More years caring for adolescents living with HIV and any prior training in adolescent HIV care were associated with significantly higher self-rated competence. Training coverage for adolescent HIV care remains sub-optimal. The authors suggest that targeting health care workers with less work experience and training exposure may be a useful and efficient approach to improve quality of youth-friendly HIV services.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Trends in climate, extractives and health equity in the east and southern Africa ","field_subtitle":"Zimbabwe Environmental Law Association for the Regional Network for Equity in Health in East and Southern Africa (EQUINET), 2020 ","URL":"https://tinyurl.com/y35lna4e","body":"This paper presents the current situation and projected trends related to climate change in east and southern Africa (ESA); the implications for the health of current and future generations of these trends and; the policy choices and alternatives to respond to them. ESA contributes the least of any world region to global greenhouse gas emissions yet will be more vulnerable to the impacts of climate change than any other region. Extractive sectors exacerbate climate change through deforestation and high emission levels of greenhouse gases. Climate change is expected to cause reduced rainfall and a greater frequency of extreme events in the region, and ESA countries will be vulnerable due to their economic reliance on rainfed agriculture and water resources.The region faces resource and other constraints to implement adaptation policies, or for key areas such as the development and production of green technologies. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Trends in extraction of biodiversity and genetic resources in east and southern Africa ","field_subtitle":"Mayet M, Mentz-Lagrange S, African Centre for Biodiversity:  EQUINET, 2020 ","URL":"https://tinyurl.com/y5llp3fm","body":"This paper presents the current situation and projected trends related to biodiversity and genetic resources in east and southern Africa (ESA), the implications for the wellbeing of current and future generations of these trends, and the policy choices and alternatives to respond to these trends and the factors that influence policy design and uptake of choices. The biodiversity, genetic diversity of plants, animals and forests in ESA countries are declining at alarming rates, risking the health and wellbeing of populations in the region. Losses of biodiversity and genetic resources have led to poorer diets, poorer living conditions, encroachment on areas with animal populations and an erosion of wild foods and medicinal plants that raise the risk of chronic and zoonotic diseases and pandemics. Current policies have not reversed these trends, nor met the targets of the Convention on Biodiversity (CBD). The authors argue that this calls for an urgent paradigm shift from industrial agriculture to diversified agro-ecological systems and a one health approach, that recognise the complex, intergenerational interconnections between human and animal health, plants and a shared environment. The authors call for a movement to defend genetic diversity as a common good, not something that can be extracted and privately profited from. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Trends in extraction of mineral resources in east and southern Africa ","field_subtitle":"Caramento A: EQUINET, 2020 ","URL":"https://tinyurl.com/y2fmcj9y","body":"This paper presents the current situation and projected trends related to extraction of mineral resources in east and southern Africa (ESA), the implications for the wellbeing of current and future generations of these trends, and the policy choices and alternatives to respond to these trends and the factors that influence policy design and uptake of choices. The author notes several changes in the coming decades that have numerous implications for health and wellbeing in ESA, including as a result of land displacement and precarious jobs. A demand for greater and wider health and developmental benefits from current and future mineral extraction has led to resource nationalism. The paper notes that it means effectively projecting, monitoring and preventing the impacts of mineral extraction on health and environments; adopting financial transparency and accountability measures and employing strategies and responses that are built from bottom-up through consultation with small scale miners, communities, workers and the wider public.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Trends in water resources in east and southern Africa ","field_subtitle":"Loewenson R, Training and Research Support Centre: EQUINET, 2020 ","URL":"https://tinyurl.com/yyygmzbb","body":"This paper presents the current situation and projected trends related to water in east and southern Africa (ESA), the implications for the wellbeing of current and future generations of these trends, and  the policy choices and alternatives to respond to these trends and the factors that influence policy design and uptake of choices. Maldistribution and water scarcity and stress are predicted to intensify in coming decades. Southern countries will become significantly drier and east Africa will have higher rainfall. Climate change will amplify existing variability but may be less critical than growing demand for water. A growing, urbanised population, expanded enterprise and agriculture will deplete and can pollute water resources, with lowest income households least served. Water scarcity contributes to ill health, food insecurity, poverty and increases women\u2019s burdens. There is a potential for vicious or virtuous cycles between these impacts and water resources, depending on the policy choices made.  Inequality and stress is not inevitable. There is potentially adequate water to meet the basic needs of all in the region and for sustaining ecosystems if managed through co-operation, paying attention to equity, interdependence and long-term outcomes. The dividends from investments in water systems thus need to be made more visible as well as the harms of competitive, short term choices. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Universal Health Coverage: From aspirations to reality","field_subtitle":"Mamdani M: Global Social Policy 20(2) 242-246, doi: https://doi.org/10.1177/1468018120922227, 2020","URL":"https://journals.sagepub.com/doi/full/10.1177/1468018120922227","body":"Written in response to the United Nation\u2019s High Level Political Declaration on UHC in September 2019, this issue has a focus on universal health coverage (UHC). Written before the COVID-19 pandemic, the articles reiterate that robust health systems matter and that the implications of a system\u2019s universality, accessibility and quality reach far beyond any particular nation. The articles are open access for a limited period of time. This paper in the series examines the experience of advancing UHC in East and Southern Africa, drawing in part on learning from work in EQUINET.  Underpinning the UHC agenda is the belief that access to health care is a fundamental human right that advances equality and safeguards human dignity. Achieving UHC is a huge endeavour and requires buy-in at all levels of the system. It calls for strategic leadership, evidence and review. There has been a significant expansion in the technical information and knowledge available to support UHC. Making progress towards achieving it is, however, not simply a technical issue: it is an issue of power, political choice and leadership. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Watch the GAP! A critical civil society perspective on the development, potential impact and implementation of the \u2018Global Action Plan for Healthy Lives and Well-Being for All\u2019","field_subtitle":"Koutsoumpa M; Nsibirwa; Schwarz T; et al: Kampala Initiative, July 2020","URL":"https://tinyurl.com/y5d7svee","body":"The authors review how the global plan fits with national health policies and ownership in Uganda, and global health governance. They report that despite a \u2018whole-of-society\u2019 approach, the decision-making power in the global plan remains with governments. Community and civil society participation are highlighted throughout the GAP and comprise one of its seven core themes. However, despite the announcement of the GAP plan in October 2018, it was not until June 2019 that a public consultation process started, seeking feedback from non-state and state actors to some chapters of the GAP. At the same time, the authors raise concern that a  \u2018whole-of-society\u2019 approach opens the door for the private-for-profit corporate sector to engage in health, further encouraging a move to a privatised, undemocratic and inequitable global health governance. Without explicit and concrete frameworks for monitoring, mutual accountability and clear and effective participation to address ever-growing power imbalances, they question whether the goal of accelerating achievement of health for all by 2030 can be met, and suggest that the COVID-19 pandemic could be a first test case for the GAP. ","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19","field_subtitle":"World Health Organisation, WHO/2019-nCoV/IPC_WASH/2020.4, July 2020","URL":"https://tinyurl.com/yxflygtu","body":"The provision of safe water, sanitation and waste management and hygienic conditions are essential for protecting human health during all infectious disease outbreaks, including of COVID-19. Ensuring evidenced-based and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and healthcare facilities will help prevent human-to-human transmission of COVID-19. This guidance provides additional details on risks associated with excreta and untreated sewage, hand hygiene, protecting WASH workers and supporting the continuation and strengthening of WASH services, especially in underserved areas.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"We all have the same right to have health services: a case study of Namati\u2019s legal empowerment program in Mozambique","field_subtitle":"Schaaf M; Falcao J; Feinglass E; Kitchell E; et all: BMC Public Health 20(1084) doi: https://doi.org/10.1186/s12889-020-09190-7, 2020","URL":"https://tinyurl.com/y58n7got","body":"This paper is a case study of legal empowerment through community paralegals and Village Health Committees in Mozambique. The authors explored how community paralegals solved cases, the impact they had on health services, and how their work affected the relationship between the community and the health sector at the local level. Case resolution conferred a sense of empowerment to clients, brought immediate, concrete improvements in health service quality at the health facilities concerned and seemingly instigated a virtuous circle of rights-claiming. The program also engendered improvements in relations between clients and the health system. The authors identified three key mechanisms underlying case resolution, including: bolstered administrative capacity within the health sector, reduced transaction and political costs for health providers, and provider fear of administrative sanction.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions in 36 countries in the African Region ","field_subtitle":"Wehrmeister F; Mback\u00e9 Fay\u00e9 C; da Silva I; et al: Bulletin of the World Health Organization 98(6), 2020","URL":"https://www.who.int/bulletin/volumes/98/6/19-249078.pdf","body":"The authors investigated whether sub-Saharan African countries have succeeded in reducing wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions, using post 1995 survey data from 36 countries, grouped into Central, East, Southern and West Africa subregions. Wealth-related inequalities were prevalent in all subregions, highest for West Africa and lowest for Southern Africa. Absolute income was not a predictor of coverage, as higher coverage was observed  in Southern (around 70%) compared with Central and West (around 40%) subregions for the same income. Wealth-related inequalities in coverage were reduced by the greatest amount in Southern Africa, and no evidence was found of inequality reduction in Central Africa. The data show that most countries in sub-Saharan Africa have succeeded in reducing wealth-related inequalities in the coverage of essential health services, even in the presence of conflict, economic hardship or political instability","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"What has been the progress in addressing financial risk in Uganda? Analysis of catastrophe and impoverishment due to health payments","field_subtitle":"Kwesiga B; Aliti T; Nabukhonzo P; Najuko S;   et al:  BMC Health Services Research 20(741) doi: https://doi.org/10.1186/s12913-020-05500-, 2020 ","URL":"https://tinyurl.com/y3262voc","body":"This study of progress in financial risk protection in Uganda used data from the Uganda National Household Surveys for 2005/06, 2009/10, 2012/13 and 2016/17, measuring financial risk protection in terms of catastrophic health care payments and impoverishment. Although catastrophic health payments at the 10% threshold decreased from 22.4% in 2005/06 to 13.8% in 2012/13, they increased to 14.2% in 2016/17. The percentage of Ugandans pushed below the national poverty line decreased from 5.2% in 2005/06 to 2.7% in 2016/17. The distribution of both catastrophic health payments and impoverishment varied across socio-economic status, location and residence. The authors suggest targeted interventions reduce \u2018out-of-pocket\u2019 (OOP) payments among those affected and ensure that public health services are funded adequately, through forms of mandatory prepayment.","php":"","field_issue_date":"2020-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":" Securing COVID-19 related diagnostics, health technology, medicines and vaccines for African public health","field_subtitle":"ECSA HC; EQUINET: EQUINET, Harare","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20ECSA%20brief%20COVID19%20health%20tech%20May2020.pdf","body":"The ability of African countries to mount effective and equitable responses to COVID-19 reflects in part the access that countries have to reliable, sustained, distributed supplies of diagnostics (antigen and antibody test kits and equipment for decentralised laboratories) and health technologies (personal protective equipment (PPEs), oxygen and constant positive airway pressure equipment). As medicines and vaccines are developed and approved for COVID-19 they too need to be available at mass scale and locally distributed. Currently, African countries, like many others, face shortfalls in all of these essential commodities relative to need. Various global, multilateral and bilateral arrangements have been proposed to address innovation in and access to these technologies. This brief shares information on initiatives related to diagnostics, health technologies, medicines and vaccines, the issues for African countries and options for addressing them in the dialogue and negotiations at global fora. It covers African interests and options in relation to (i) securing solidarity-based bilateral and multilateral resource streams for supply needs; (ii) using existing TRIPS flexibilities (iii) enabling open innovation and sharing of intellectual property and (iv) enabling open manufacturing and distributed and local production of these technologies. The pressure is thus growing for all COVID-19 related drugs, diagnostics, vaccines and health products, existing or future, to be considered global public goods, as expressed by the UN Secretary General on 24 April. At the same time, the brief argues that the way to make these products available to everyone, everywhere, must be by structurally linking open innovation and open manufacture to distributed production and access. Current experience suggests that any other approach may fall short on delivering timely and equitably distributed access for African countries.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"4th CODESRIA/CASB Summer School in African Studies and Area Studies in Africa: The Normative Order in African Studies, Dakar, Senegal, 14-18 September 2020","field_subtitle":"Deadline for applications: 17 July 2020 ","URL":"https://www.codesria.org/spip.php?article3025&lang=en","body":"The Council for the Development of Social Science Research in Africa and The Centre for African Studies in Basel call for applications for their 4th Summer School in African Studies and Area Studies in Africa. The overall objective of the Summer School is to stimulate and consolidate interdisciplinary approaches to research on Africa, but also on other regions of the world undertaken from within the African continent. The Summer School is open for PhD students and emerging scholars enrolled and working at Higher Education institutions in any country. Applications in the following disciplines are highly encouraged: Social Anthropology, Sociology, History, Religion, Philosophy, Gender studies and Political science. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A crisis to learn and change from","field_subtitle":"Editor, EQUINET newsletter","body":"\r\nIn the past two months, drawing on a diversity of inputs, EQUINET has produced a series of information sheets on different aspects of COVID-19 in ESA countries. For  1st June we take a pause on these information briefs to send out our regular quarterly newsletter, with thanks to the newsletter team for meeting the challenges of co-production from various corners of a lockdown. Given the context, there are many articles and resources in the newsletter relating to COVID-19, but there are also those relating to other health challenges and health system developments that continue to be present, to offer learning and to demand attention in our region.\r\n\r\nYet we are in a crisis, not understood as an event to recover from, but in the way the Chinese word for crisis brings together two characters \u2013 \u201cwei ji\u201d, with wei standing for danger and ji standing for opportunity. A crisis to learn and change from.\r\n\r\nDifferent dangers and risks in the COVID-19 pandemic are emerging and are the subject of an explosion of information and exchanges across countries, institutions and disciplines. The information exchanges range from stories of lived experience, responses and ideas to evidence from trials, information systems, global case tracking, reviews and analyses. Constrained by size, the newsletter only points to some of these in the region and many many more are reported daily in different platforms.\r\nThe pandemic tells us a lot about the status of our societies. COVID-19 has shown us how globalisation has opened up multiple digital channels for information to flow, how scientific collaboration can rapidly advance and share knowledge and how communities show solidarity, initiative and empathy.\r\n\r\nIt also shows where there are gaps. We talk about the poorest but the voices of the poorest communities and poorest countries are often overshadowed or absent, sometimes even silenced by the very responses to COVID-19. We see the limits in global solidarity as many African countries struggle with the diversion of critical resources to debt repayment and fail to access key diagnostics and medicines. We talk about causes, but treat each outbreak, including COVID-19, as disconnected emergencies, delinked from their deeper, sustained and common drivers in the nature of production and commercial systems, in the destruction of habitats and biodiversity and in the lack of investment in basic standards of water, sanitation, housing, clean energy and other public health inputs, drivers that converge to expose significant concentrations of people to new and old pathogens and to repeated pandemics. The 2008 Commission on the Social Determinants of Health used to say of the health sector \u201cwe cannot keep treating people to send them back to the same conditions that made them ill\u201d. It seems we need to expand this to \u201cwe cannot keep responding to public health and climate emergencies and sending ourselves as a global community back to the same conditions that led to them.\u201d\r\n\r\nThere are also signs of opportunities for recalibrating this pathway that is externalising and distributing pollution, climate change, precarious employment, different forms of malnutrition, pandemics, violence and other harms that threaten us as a society and as a species. The online conversations often flag responses to COVID-19 that work with and support communities and local health workers as more successful, especially when built on prior investments in distributed primary health care and socio-economic well-being. There are items in the newsletter that raise similar themes around responses to HIV, health workforce management or gender based violence.\r\n\r\nBut recalibration also needs to take place at global level. The recent World Health Assembly (WHA) resolution on COVID-19 (included in the newsletter) refers to vaccines as a global public good (implying free from intellectual property protection). There is also a link to a call from leaderships from across all regions that COVID-19 vaccines, diagnostics, tests and treatments be provided free of charge to everyone, everywhere. At the opening of the WHA, the UN Secretary General Antonio Guterres stated that \u201cthe recovery from the COVID-19 crisis must lead to more equal, inclusive and sustainable economies and societies\u201d , as \u201can opportunity to address the climate crisis and inequality of all kinds\u201d\u2026 and \u201cto rebuild differently and better\u201d. \r\n\r\nThe pandemic has provoked a sense that it cannot be \u2018business as usual\u2019 . For example, the Africa Group, Zambia and other country inputs to the WHA, and an ECSA HC and EQUINET brief included in this issue, raise some immediate, practical issues, including debt relief or cancellation for African countries to invest in the response and rebuild, and the removal of barriers to innovation and technology transfer for local manufacturing of diagnostics, medicines, vaccines for COVID-19 in Africa. How such issues are now treated in global forums, such as the forthcoming World Trade Organisation Ministerial and beyond, and how far our international, national and local responses reflect \u2018more equal, inclusive and sustainable economies and societies\u2019 will signal how far and for whom this crisis has been an opportunity for change, or a continuity of danger.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"A Preliminary Human Rights Assessment of Legislative and Regulatory Responses to the COVID-19 Pandemic across 11 Jurisdictions ","field_subtitle":"Bonavero Institute of Human Rights: Bonavero Report No 3/2020, May 2020","URL":"https://tinyurl.com/y9ugfesg","body":"The current context indicates that exceptional measures designed to combat the spread of COVID-19 need to be continually evaluated, taking into account the positive obligations that States bear to protect life, access to health and health security, and the extent to which these obligations should be shaped by countervailing negative rights. The authors indicate that striking an appropriate balance between these positive obligations and countervailing negative rights, in this rapidly evolving environment, can only be successfully achieved in an environment of democratic, judicial and scientific contestation. Moreover, in the context of positive obligations, it is imperative to emphasise the least coercive means through which public health can be achieved. This report provides a human rights analysis using this lens of a cross section of jurisdictions from different countries globally, including South Africa and Zimbabwe.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"A scoping review on family medicine in sub-Saharan Africa: practice, positioning and impact in African health care systems","field_subtitle":"Flinkenfl\u00f6gel M; Sethlare V; Cubaka V; Makasa M; et al:  Human Resources for Health  18(27), 1-18, 2020 ","URL":"https://tinyurl.com/y8adha6x","body":"This review describes, from a systematic review, the current status of family medicine in sub-Saharan Africa and maps existing evidence of its strengths, weaknesses, effectiveness and impact, and identifies knowledge gaps. Family medicine was first established in South Africa and Nigeria, followed by Ghana, several East African countries and more recently additional Southern African countries. Implementation varies between and within countries. The strengths were found to be having \u201call- round specialists\u201d, providing mentorship and supervision, and there were positive perceptions of the impact of family medicine. Family medicine was found to be a developing discipline in sub-Saharan Africa. The authors indicate that assessing its impact on the health of populations requires a more critical mass of family physicians and clarity on their position in the health system and their role in universal health coverage.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"An assessment of workers\u2019 rights in the mining sector during the COVID-19 Lockdown","field_subtitle":"Mlevu S: Centre for Natural Resource Governance, Zimbabwe, May 2020","URL":"https://tinyurl.com/y94t63sh","body":"This situation update from the Centre for Natural Resource Governance Zimbabwe looks at how the mining companies have been handling labour concerns as they have been operating during the lockdown. The authors report from various mines that companies have been making piecemeal commitments to health and safety of the employees, with some ignoring stipulated health measures. It also identifies only one company in Mutoko that invested time and money towards the health and safety of their employees during the lockdown. During the lockdown, the authors report that some workers have failed to get their salaries, while some workers have gone for 3 months without pay. The authors recommend that government convene a Tripartite Negotiating Forum to discuss the conduct of employers and their employees during the lockdown, that the Labour Act be revised to provide for the conduct of employers and employees during emergencies; that companies provide decent accommodation to their employees to minimise staff movements and contact with community members and protective equipment for all workers despite rank or grade who are working during the pandemic. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Assessing the relationship between gender based violence and COVID-19 pandemic in Uganda","field_subtitle":"Kabonesa C; Kindi F: Konrad Adenauer Stiftung, April 2020","URL":"https://tinyurl.com/y7aafs9h","body":"The authors interrogate the relationship between gender based violence (GBV) and COVID-19 in Uganda through documentary reviews and in-depth interviews from selected key informants. The authors find an increase in cases of GBV that calls for government ministries and agencies to prioritize measures to address the issue. They recommend gender sensitization of communities on GBV and its effects especially in situations of health related emergencies. The authors find that the majority of the fights are heightened by men having limited funds to fulfil their provisioning roles, and recommend that vulnerable households should be identified and provided with food. They also argue that is important to provide women with a platform where they can air their views and concerns about COVID-19 and GBV.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Call for Papers: International Labour Review","field_subtitle":"Deadline for abstracts: 30 June 2020","URL":"http://www.ilo.org/revue","body":"The International Labour Review (ILR) is calling for the submission of papers related to the COVID-19 pandemic and the world of work with a view to the publication of a special multidisciplinary issue in English, French and Spanish. Submissions are encouraged from all fields related to the world of work, such as economics, law, industrial relations, social policy, sociology, psychosocial studies, environmental studies and history. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Constitutional implications of COVID-19: Arrests and the use of force to enforce lockdown","field_subtitle":"Brickhill J: JUTA Talking Points, Issue 11, South Africa","URL":"https://tinyurl.com/ybm2sova","body":"This brief is one of a weekly analysis of constitutional issues arising from COVID-19 and the responses to it. In this instalment, the author outlines the role of the courts and the arrest and the use of force by the police and the military in enforcing the lockdown, following the judgment in Khosa v Minister of Defence and Military Veterans [2020] ZAGPPHC 147 in South Africa. The author finds that arrest in the context of COVID-19 runs the risk of subverting the very purpose of the lockdown regulations, by exposing enforcement officers and arrested civilians to a greater risk of contracting the virus. The South African Police Service has released guidelines on the use of force by security services, in a circular dated 19 May 2020 that set out principles on the use of force, the prohibition of torture and provide information on where to make complaints about police misconduct. The author proposes that thorough investigation and action on those implicated in any injury related to lockdown enforcement and ensuring an effective complaints mechanism are the crucial.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Coordinating health workforce management in a devolved context: lessons from Kenya","field_subtitle":"Thuku M; Muriuki J; Adano U; et al: Human Resources for Health  18 (26), 1-7, 2020","URL":"https://tinyurl.com/y8u4tawf","body":"This case study describes how Kenya created an inter-county, multi-stakeholder coordination framework that promotes consensus, commitment, and cooperation in devolved human resources management. The coordination framework has been instrumental in expediting development, customization, and dissemination of policies, enabling national human resources for health officers to mentor their county counterparts, and providing collaborative platforms for multiple stakeholders to resolve challenges and harmonize practices nationwide. Successes catalyzed through the inter-county forums include hiring over 20 000 health workers to address shortages; expanding the national human resources information system to all 47 counties; developing guidelines for sharing specialist providers; and establishing professionalized human resources for health units in all 47 counties. The coordination framework supports alignment of county health operations with national goals while enabling national policy responses to health gaps in the counties. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"COVID-19 in Africa: care and protection for frontline healthcare workers","field_subtitle":"Chersich M; Gray G;  Fairlie L;  Eichbaum Q; et al: Globalization and Health 16(46), 1-6, 2020","URL":"https://tinyurl.com/ybhtm4dx","body":"This paper provides a survey of the challenges and proposed interventions to protect healthcare workers on the continent, drawing on articles identified on Medline (Pubmed) in a search on 24 March 2020. Global jostling means that supplies of personal protective equipment are limited in Africa. Even low-cost interventions such as facemasks for patients with a cough and water supplies for handwashing may be challenging, as is \u2018physical distancing\u2019 in overcrowded primary health care clinics, raising the risk for healthcare workers and their families. The authors argue, however, that the continent has learnt invaluable lessons from Ebola and HIV control. HIV counselors and community healthcare workers are key and could promote social distancing and related interventions, dispel myths, support healthcare workers, perform symptom screening and trace contacts. Staff motivation and retention may be enhanced through carefully managed risk \u2018allowances\u2019 or compensation. International support with personnel and protective equipment, especially from China, could turn the pandemic\u2019s trajectory in Africa around. Telemedicine holds promise as it rationalises personnel and reduces patient contact and thus infection risks. The authors argue that healthcare workers, using their authoritative voice, can promote effective COVID-19 policies and prioritization of their safety. Prioritizing healthcare workers for SARS-CoV-2 testing, hospital beds and targeted research, as well as ensuring that public figures and the population acknowledge the commitment of healthcare workers may help to maintain morale, while international support and national commitment could help safeguard healthcare workers in Africa, essential for limiting the pandemic\u2019s impacts on the continent.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"COVID-19 soars women\u2019s water burden","field_subtitle":"Gender desk team: Daily Nation, Kenya, April 2020","URL":"https://tinyurl.com/y886gn4v","body":"Coronavirus has increased demand for and consumption of water in households. At the same time this presents Water scarcity presents a challenge for women in rural areas and informal settlements. Rural women walk up to 30 kilometres to fetch water from rivers, dams and boreholes. This may mean that some rural family members minimise use of the water; exposing them to health risks. Urban slum women now spend up to an extra Kenya Sh120 daily on water, and those that can't afford to buy are reported to resort to the polluted city river. This article highlights the experiences of women in rural and urban Kenya in gathering water needed for their work and families in light of COVID-19. It illustrates the lived experience of additional burdens that the pandemic now places on them, affecting their livelihoods and their physical and mental wellbeing.  ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"EQUINET Diss 121: Public health and mining in East and Southern Africa: A desk review of the evidence","field_subtitle":"Chanda-Kapata P: EQUINET Discussion paper 121, EQUINET, Harare, 2020","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss121%20Mining%20and%20health%20April2020.pdf","body":"This desk review, commissioned by EQUINET through TARSC as part of the ongoing work on the extractive sector in the region aims to inform public sector professionals, policy-makers, civil society and parliamentarians on the population health impacts of large- and small-scale mining activities in East and Southern Africa. The paper specifies the known health risks for the different types of small- and large-scale mines in the ESA region. Poor communities are likely to be more affected as they have limited choices for employment, sub-optimal housing and limited access to safe drinking water. People living close to mining sites or near mine dumps and those whose livelihoods are tied to rivers for domestic and agriculture water are exposed to polluted environments due to mining wastes and contaminated air and drinking water. Discrepancies exist between what is documented and known about the health risks of mining globally and documented levels of these health outcomes in the ESA region. The author presents various reasons for this. Health impacts assessments are not always done before mines are licensed. After mines are licensed, these health outcomes may be poorly monitored. Information on the numbers and health status many living and working in mining and of ex-miners remains limited.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Information sheet 1 on COVID-19","field_subtitle":"TARSC: March 2020","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20COVID%20brief1%20%2020March.pdf","body":"This information sheet aims to assist by bringing together information and links to resources from various sources on a range of issues related to COVID-19 covering: 1: Basic information on the virus and its health impact 2: The level and growth of the pandemic 3: What individuals and communities can do to prevent and respond to COVID-19 4: What workplaces and organisations can do to prevent and respond to COVID-19 5: Protection and support of health and other frontline workers 6: What countries are doing to prevent and respond to COVID-19. While the specific focus intends to be on east and southern Africa, this first information sheet provides information drawn from other regions and more mature epidemics that may be useful for those in the ESA region or that may raise issues to discuss and plan for in the region. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Information sheet 2 on COVID-19","field_subtitle":"TARSC: EQUINET, April, 2020","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20COVID%20brief2%20%201April2020.pdf","body":"This is the second information brief from EQUINET to summarise and provides links to official, scientific and other resources as of April 1st 2020 to support an understanding of and individual to regional level responses to COVID-19. This brief complements and does not substitute information from your public health authorities. This brief covers: 1: Developments in the COVID-19 epidemic 2: The health system response 3: Policy, politics and rights 4: Support for and in different communities 5: The macro-economic challenges 6: What does this all mean for equity?","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Information sheet 3 on COVID-19","field_subtitle":"TARSC: EQUINET, April 2020 ","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20COVID%20brief3%20%2015April2020_0.pdf","body":"This is the third information brief from EQUINET to summarise and provides links to official, scientific and other resources as of April 14 2020 to support an understanding of and individual to regional level responses to COVID-19. This brief complements and does not substitute information from your public health authorities. This brief covers: developments in the COVID-19 epidemic; a discussion on population evidence and models; initiatives on health technologies; an update on the African engagement on releasing resources from debt and various resources.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Information sheet 4 on COVID-19","field_subtitle":"TARSC: EQUINET, May 2020","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20COVID%20brief4%20%201May2020.pdf","body":"This is the fourth information sheet on COVID-19 from EQUINET. It summarises information from and provides links to official, scientific and other resources as of end April 2020 on 1: Developments in the COVID-19 epidemic 2: Rolling back lockdowns- when and what next? 3: What COVID-19 has meant for the risks and returns from migration 4: An update on access to medicines and vaccines, and 5: Resources, COVID-19 and the creative economy.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 224: ","field_subtitle":"A crisis to learn and change from","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health in Low- and Middle-Income Countries","field_subtitle":"Riley T; Sully E; Ahmed Z; Biddlecom Z: International Perspectives on Sexual and Reproductive Health 46, 73-76, 2020","URL":"https://tinyurl.com/yctkd3rl","body":"The strain that the COVID-19 outbreak imposes on health systems will undoubtedly impact the sexual and reproductive health of individuals living in low- and middle-income countries (LMICs); however, sexual and reproductive health will also be affected by societal responses to the pandemic, such as when local or national lockdowns close services not deemed to be essential, as well as from consequences of travel restrictions and economic slowdowns. Previous public health emergencies have shown that the impact of an epidemic on sexual and reproductive health often goes unrecognized, because the effects relate to indirect consequences of strained health care systems, disruptions in care and redirected resources. The authors argue for the learning from prior epidemics to be used to put in place critical resources and systems, and ensuring the provision of essential sexual and reproductive health services to avoid health system disruptions that would have devastating, lasting effects on individuals and communities.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic","field_subtitle":"Parker M; Fraser C; Abeler-D\u00f6rner L: Journal of Medical Ethics, doi:10.1136/medethics-2020-106314, May 2020","URL":"https://jme.bmj.com/content/early/2020/05/05/medethics-2020-106314","body":"In this paper the authors discuss ethical implications of the use of mobile phone apps in the control of COVID-19. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks but the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this many countries globally have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of \u2018proximity events\u2019 these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for \u2018intelligent physical distancing\u2019 in such contexts raises a number of important ethical questions that need to be understood and analysed against the public health benefits. The authors explore the relative benefit and harms; the impact on identified individuals; the implications for privacy and liberty; the responsibilities of institutions and professionals; and the longer term equity, ethical and public trust issues of how the data is deleted or used, issues that are not only relevant for COVID-19 but also for future outbreaks. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Evidence for Transformative Change: UNRISD Survey on Responses to Covid-19 and Vulnerable Communities","field_subtitle":"United Nations Research Institute for Social Development: UNRISD, Geneva, 2020","URL":"https://tinyurl.com/ydx65u28","body":"The Covid-19 pandemic is hitting vulnerable people the hardest in both high- and low-income countries. At the same time, in areas where infection rates are currently lower and policies still taking shape, there is a window of opportunity for informed analysis to provide added value. With the help of its global network of experts, UNRISD is gathering and quickly analysing how well current government policies on Covid-19 in all countries and regions are responding to the needs of vulnerable people. The result will be evidence-based recommendations on how governments can make sure their Covid-19 response policies leave no one behind. There can be no one-size-fits all answers and national and local government policy making in different regions must also respond to different social, economic, political and cultural contexts. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study","field_subtitle":"Kimani S; Kabiru C;  Muteshi J;  Guyo J:  BMC International Health and Human Rights 20(3), 1-12, 2020","URL":"https://tinyurl.com/y9fazw39","body":"This paper explored barriers to care seeking in public health facilities in Kenya among Somali women after complications related to female genital mutilation/cutting (FGM/C). The authors used interviews and focus group discussions to collect data from women aged 15\u201349\u2009years living with FGM/C, their partners, community leaders, and health providers in Nairobi and Garissa Counties. Barriers to care-seeking included the high cost of care, distance from health facilities, lack of a referral system and concerns on quality and privacy of care. Women faced cultural taboos in discussing sexual health with male clinicians, while fear of legal sanctions given the anti-FGM/C laws deterred women with complications from seeking healthcare. The authors suggest that the health system consider integrating FGM/C-related interventions with existing maternal child health services for cost effectiveness, efficiency and quality care, address health-related financial, physical and communication barriers, and ensure culturally-sensitive and confidential care.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Gender, HRH, COVID-19 Resources","field_subtitle":"Open source Google doc","URL":"https://tinyurl.com/y9mlkhrc","body":"This open source Google doc is collating resources on gender and COVID-19. The doc comprises short summaries of articles which are organised under themes including \u2018data and resources\u2019, \u2018gender based violence\u2019, \u2018women\u2019s contributions\u2019, \u2018women\u2019s leadership\u2019, \u2018unpaid care work\u2019, \u2018PPE\u2019, \u2018gender transformative policy\u2019 and \u2018gender pay gap\u2019. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Gender-based violence prevention, risk mitigation and response during COVID-19","field_subtitle":"United Nations High Commissioner for Refugees: UNHCR, Geneva, March 2020","URL":"https://data2.unhcr.org/en/documents/download/75296","body":"This briefing gives an overview of risks of gender-based violence (GBV) in the context of COVID-19. Confinement is expected to increase risks of intimate partner violence for displaced women and girls, worsened socio-economic situation exposes refugee women and girls to increased risks of sexual exploitation by community members and humanitarian workers and there will be challenges in access to regular GBV services. The briefing includes recommendations to mitigate risks and ensure access to GBV services. They include considering from the outset, the gendered impacts of COVID-19, considering the different physical, cultural, security and sanitary needs of women, men, boys and girls in quarantines, providing dignity kits to ensure menstrual health and consulting women and girls on preparedness plans and interventions. Programming through women-led organizations should be prioritised whenever feasible.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"How best we can achieve a universal health system: a public conversation ","field_subtitle":"McIntyre D: Health Systems Trust, March 2020","URL":"https://tinyurl.com/yd9vkr8k","body":"Emeritus Professor Diane McIntyre presents her chapter on: 'How best we can achieve a universal health system: a public conversation'. The chapter was published in the recent South African Health Review. She calls for a broadening of the national discourse on universal health coverage and proposes that the term is replaced with the term 'universal health system' which she suggests is less open to misinterpretation.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"IHEA webinars on health economics and COVID-19","field_subtitle":"IHEA: Online, May 2020","URL":"https://www.healtheconomics.org/page/webinars","body":"iHEA runs a webinar series on a range of health economics topics, with a current emphasis on issues related to COVID-19 . The website provides a list and link to all upcoming webinars, with new webinar details being posted regularly.  Several of these webinars will be held on a multilingual webinar platform to enable wider reach.  ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Managing the pregnant woman during the COVID-19 pandemic in South Africa: A clinical guide for health workers and clinical managers ","field_subtitle":"Department of Health: Republic of South Africa, April 2020","URL":"https://tinyurl.com/y8ccegcm","body":"These guidelines provide guidance to healthcare workers and managers for the management and treatment of pregnant women in the context of COVID-19, read in conjunction with current Maternal and Neonatal health Guidelines and Guidelines for Clinical Management of suspected or confirmed COVID-19 disease. The guidelines change as knowledge regarding strategies to address COVID- 19 develop globally and in South Africa and are updated regularly online.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"OPEN LETTER: Uniting Behind A People\u2019s Vaccine Against COVID-19","field_subtitle":"Heads of state and Oxfam International: May 2020","URL":"https://tinyurl.com/yatbwjz9","body":"This open letter signed by presidents, ministers of state, professors and heads of institutions calls for a people\u2019s vaccine against COVID-19, available to all, in all countries, free of charge. The signatories argue that the World Health Assembly must forge a global agreement that ensures rapid universal access to quality-assured vaccines and treatments with need prioritized above the ability to pay. Access to vaccines and treatments as global public goods are in the interests of all humanity. Signatories call for a global agreement on COVID-19 vaccines, diagnostics and treatments \u2014 implemented under the leadership of the World Health Organization \u2014 that ensures mandatory worldwide sharing of all COVID-19 related knowledge, data and technologies with a pool of COVID-19 licenses freely available to all countries.  Further, signatories call for a global and equitable rapid manufacturing and distribution plan \u2014 that is fully-funded by rich nations \u2014 for the vaccine and all COVID-19 products and technologies that guarantees transparent \u2018at true cost-prices\u2019 and supplies according to need. The signatories call for an agreement to guarantee COVID-19 vaccines, diagnostics, tests and treatments are provided free of charge to everyone, everywhere. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Overcoming the \u2018tyranny of the urgent\u2019: integrating gender into disease outbreak preparedness and response","field_subtitle":"Smith K: Gender and Development 27(2) 355-369, 2019","URL":"https://www.tandfonline.com/doi/full/10.1080/13552074.2019.1615288","body":"This article provides a multi-level analysis of gender-related gaps in outbreak responses and illustrates the national and local impacts of failures to challenge gender assumptions and incorporate gender as a priority. The implications of neglecting gender dynamics, as well as the potential of equity-based approaches to disease outbreak responses, is illustrated through a case study of the Social Enterprise Network for Development (SEND) Sierra Leone, a non-government organisation (NGO) based in Kailahun, during the Ebola outbreak. Global policy responses can learn from examples such as SEND Sierra Leone. SEND did not include a gendered approach in its response as an afterthought; it was at the heart of the response because SEND had an established gender strategy. The authors argue that all levels of outbreak response need specific policies to ensure sexual and reproductive health. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study","field_subtitle":"Sande O; Burtscher D; Kathumba D; Tweya H; et al: BMC Public Health 20(685), 1-8, 2020","URL":"https://tinyurl.com/y8y42b33","body":"The authors explored how the nurse-led community-based ART programme in Malawi was perceived, through interview of patients and nurses providing the care. Patients reported saving money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations. Patients\u2019 nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. The patients interviewed in this study preferred the nurse-led community ART programme approach to the facility-based model of care because of the features above. The authors note that  community-led healthcare programmes need to plan for the provision of transportation for care providers; the physical structure of community sites; the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Research Ethics and COVID-19","field_subtitle":"Rings Research in Gender & Ethics, Health Systems Global, Resilient and Responsive Health Systems, REACH, Wellcome: 2020","URL":"https://ethicsresource.ringsgenderresearch.org/covid-19-resources/","body":"In the light of the COVID-19 pandemic a collective of organisations have taken urgent action to collate useful guidance and resources related to research ethics. The resources are organized under the following categories: general guidance, social justice, health systems strengthening, preparedness, care and resource rationing, emergency powers, health care worker wellbeing, gender, quarantine and other mandatory measures, clinical trails, guidance for funders and other resource collections. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Seventy Third World Health Assembly and Resolution 73.1 on the COVID-19 response","field_subtitle":"World Health Assembly: WHA 73.1 Geneva, 19 May 2020 ","URL":"https://apps.who.int/gb/ebwha/pdf_files/WHA73/A73_CONF1Rev1-en.pdf","body":"The May 2020 session of the World Health Assembly was held as a virtual 'de minimis' meeting by video conferencing, with consideration of most items deferred to written procedure or a resumed meeting later in the year. In opening the Assembly the WHO Director General Dr Tedros Ghebreyesus stated \"COVID-19 is not just a global health emergency; it is a vivid demonstration of the fact that there is no health security without resilient health systems, or without addressing the social, economic, commercial and environmental determinants of health\".  The full speech is available at https://apps.who.int/gb/ebwha/pdf_files/WHA73/A73_3-en.pdf.  The virtual WHA discussed and endorsed a key resolution sponsored by multiple countries, including Zambia in the east and southern Africa region  and the Africa group and its member states. The resolution is shown at the website provided. The chair of the Africa group noted in the deliberations the importance of making full use of the flexibilities contained in the TRIPS Agreement and the Doha Declaration on the TRIPS Agreement and Public Health and called for the transfer of technology and know-how for medicines for vaccines, diagnostics and other commodities to meet demand and ensure equity. He also called for debt relief to enable countries to meet the demands of responses and the economic impact of the pandemic. The statements by countries to the WHA73 are reported at https://apps.who.int/gb/statements/WHA73/ ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The Impact of COVID-19 on SADC Economy","field_subtitle":"SADC Macroeconomic Subcommittee, SADC Secretariat: SADC, Gaborone, May, 2020 ","URL":"https://www.sadc.int/files/8015/8988/3255/COVID-19_SADC_Economy_Report.pdf","body":"This report presents the impact of the COVID-19 Pandemic and implications for SADC Region as monitored by the SADC Macroeconomic Subcommittee, supported by the SADC Secretariat. It provides policy recommendations to Member States. The report recommends policy interventions in the face of the significant global economic downturn from COVID-19, including adding to the focus on health and humanitarian responses, strengthening early warning systems, response and mitigation of pandemics and disasters that have proved to be major threats to education, tourism, informal sector and other sectors; and developing Roadmaps and Action Plans that prioritize investments and channel scarce resources to identified economic sectors to resuscitate their economies, strengthen resilience and improve competitiveness, based on the SADC macroeconomic convergence programme.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The integration of occupational- and household-based chronic stress among South African women employed as public hospital nurses","field_subtitle":"Cohen J; Venter W: PLOS One 15(5), e0231693, 2020","URL":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231693","body":"This study explored the lived experience of public hospital-employed, black women nurses\u2019 to better understand their stressors and what may help to reduce it. Through semi-structured life history interviews with 71 nurses in Johannesburg, nurses described daily lives of chronic distress, with extreme pressures on their incomes, time, and resources. Much of this pressure was said to come from the number and intensity of family dependents, related financial obligations and debt. This revised from social norms which assign women primary responsibility for unpaid household work, which nurses struggle with as unsustainable, anxiety-inducing and with pay and paid work schedules that make meeting that responsibility virtually impossible. The structure of the nursing occupation contributes to stress outside the workplace, while the structure of nurses\u2019 households contributes to stress and emotional exhaustion. This implies that workplace-oriented interventions may assist but alone are unlikely to adequately address the overall level of stress. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Uganda\u2019s experience in Ebola virus disease outbreak preparedness, 2018\u20132019","field_subtitle":"Aceng J; Ario A; Muruta A; Makumbi I; et al: Globalization and Health 16(24), 1-12, 2020","URL":"https://tinyurl.com/yad79k6v","body":"In August 2018, the Uganda Ministry of Health activated the Public Health Emergency Operations Centre and the National Task Force for public health emergencies to plan, guide, and coordinate Ebola Virus Disease (EVD) preparedness in the country. The National Task Force selected an Incident Management Team, constituting a National Rapid Response Team that supported activation of the District Task Forces and District Rapid Response Teams that jointly assessed levels of preparedness in 30 designated high-risk districts. The Ministry of Health, with technical guidance from the World Health Organisation, led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at points of entry and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. The authors observe the need to sustain these efforts as a multi-hazard framework to avail resources for preparedness and management of incidents at the source, effectively cutting costs of using a \u201cfire-fighting\u201d approach during public health emergencies.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"UN Women Calls for Integration of Violence Against Women Data and Services in COVID-19 Surveys","field_subtitle":"UN Women East & Southern Africa: Kenya, 2020","URL":"https://mailchi.mp/6f266ed24b49/covid-19-gender-equality-matters","body":"To understand better both impact of and responses to COVID-19, UN Women is recommending stand-alone surveys or integration of questions on violence against women in socio-economic and gender surveys to assess the prevalence and responses to gender based violence during COVID-19.  This data is argued to be critical to support evidence-based interventions and to make available lifesaving services. UN Women in East and Southern Africa is working closely with the partner agencies and providing technical support to develop model surveys and guidelines to support quality assessments. This briefing also provides case study analyses of gendered effects of COVID-19 in Uganda, Kenya, South Africa, Ethiopia, Burundi, Zimbabwe, Mozambique and Malawi.","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Webinar: Africa and the Pandemic: Clampdown, Survival and Resistance","field_subtitle":"Review of African Political Economy: ROAPE, May 2020","URL":"https://tinyurl.com/ycoa7qwh","body":"The webinar, chaired by ROAPE\u2019s Yao Graham in Ghana, asked what is happening across Africa since governments ordered the clampdown. The discussants looked at the impact on the continent of the Covid-19 pandemic and the measures taken against it. All the speakers addressed what was happening at grassroots and national level, and how the popular classes were being affected. Reporting from Kenya, Gacheke Gachihi and Lena Anyuolo asked if the state was really fighting Covid-19 or the poor? They argued that since the curfew was enforced across the country the police continue to brutalise and terrorise people living in informal settlements. Femi Aborisade reported a constant struggle for food and survival in Nigeria, and an intensification in the repression of the poor during the country\u2019s lockdown. In South Africa, Heike Becker looked at the reaction of the government, the struggles of poor communities and the urgency of building new activist groups and politics in the country. Tafadwza Choto from Zimbabwe reported that the government was using the virus as a cover for wider repression. Taking on the broader political economy of the crisis, Gyekye Tanoh addressed how economies and politics are likely to be reshaped by the virus and its consequences, with a likely impact of the global recession on the continent, the IMF and IFI responses and the  costs for workers, peasants, social movements, activists, and radical projects. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"\u201cGet us partnerships!\u201d - a qualitative study of Angolan and Mozambican health academics\u2019 experiences with North/South partnerships","field_subtitle":"Craveiro I; Carvalho A; Ferrinho P; et al: Globalization and Health 16(33), 1-10, 2020","URL":"https://tinyurl.com/y9deunat","body":"This paper examines how Angolan and Mozambican health sciences researchers experience international collaborations,  using evidence from semi-structured interviews and focus group discussions. Participants shared a sense of asymmetry between African researchers and European trainers in processes that did not fully acknowledge their local contexts, compromising the prospective development of partnerships in health. They argue that more attention be devoted to understanding how participants experience capacity building processes, integrating the diversity of their aspirations and perceptions. ","php":"","field_issue_date":"2020-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"'Alternative Mining Indaba': you should not only take oil and diamonds","field_subtitle":"Evans J: News 24, February 2020","URL":"https://www.medicusmundi.org/kampaladeclaration/","body":"A group of about 70 people from the Alternative Mining Indaba marched to the Mining Indaba 2020 held at Cape Town International Conference Centre to highlight their concerns over the problems extractive mining is causing for communities who live near mines. Rev. Martha Mutswakatira, from the Reformed Church in Zimbabwe, who had walked down Adderley Street with the civil society activists in her white collar on Wednesday, said communities are carrying the cost of damages caused by extractive mining. One man from Angola among the Alternative Mining Indaba picket said: \"When you come to Africa you need to invest in people: You should not only take oil and diamonds, and leave people with their hands empty.\" They demanded legal reforms, responsible supply chains, and that mines that pollute be prosecuted.  They also called for the legalisation of artisanal mining, with licences being granted to these miners, and that miners and mineworkers be entitled to health and social care. They recommend carbon taxing of mining companies, not allowing social initiatives by mines to be tax deductible, and a move away from fossil fuels. The group also called for the mining industry to provide compensation for former miners' whose health has been adversely affected. Their memorandum was accepted by a delegation which included the International Council on Mining and Minerals; the Department of Minerals and Energy and the Minerals Council South Africa.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"6th SA TB Conference 2020","field_subtitle":"2-5 June, Durban, South Africa","URL":"https://tbconference.co.za","body":"The 6th South African TB Conference is a platform for stakeholders from government, the private sector, academia, NGO\u2019s, and advocacy groups to share experiences and plan strategic initiatives.  The programme will include international faculty and globally recognised local participants that will cover key cross-cutting themes (drug-sensitive TB, drug-resistant TB, paediatric TB, HIV/TB co-infection, EPTB, and prevention, diagnosis and treatment) across 4 thematic tracks (clinical science, basic science, public health including health systems and surveillance and human rights/ stigma/ advocacy).","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A just economy needs to tackle the climate and health debt from mining","field_subtitle":"Extractives and Health Group, East and Southern Africa","body":"\r\nThe ongoing extraction of minerals and biodiversity from Africa is not only a contributor to climate change. It leaves us less able to respond to climate change and is generating a social, health and natural resource debt burden for current and future generations. \r\n\r\nThat is why in the recent 2020 Alternative Mining Indaba (AMI), delegates from trade unions, ex-mineworkers, civil society and technical institutions who came together in Extractives and Health Group claimed that any framing of a just transition to address climate change must at the same time address the legacy of past health burdens and prevent such burdens now and into the future. \r\n\r\nWhat are these \u2018debts\u2019? They don\u2019t appear in the balance sheets of banks, ministries of finance or international finance institutions. They appear in the form of lead poisoning in children living in the shadow of mines, undermining their development; as mercury poisoning in communities living near mine dumps; or as chronic silicosis in thousands of ex- mineworkers across the region.  They appear in the displacement of people away from fertile land, in contamination of drinking water, land and air and in the cancers, respiratory and other diseases this causes. The debt grows as an opportunity cost when mining companies do not contribute to local infrastructures, economies and services, or to skills and capacities for technological innovation, or when taxes collected do not return to develop local communities. The debt is there in the absence of information and voice given to communities in decisions and claims that affect their lives. \r\n\r\nSometimes part of the debt is translated into a number. In July 2019, the South Gauteng High Court approved a class action settlement worth at least 5 billion Rand (approximately USd350 million), to be paid as compensation for injury and illness for eligible ex-mineworkers and their dependents in Southern Africa. However, the Southern African Miners Association (SAMA), who organise ex-mineworkers, told the AMI that this figure is only the tip of the still buried level of occupational illness in ex-mineworkers.\r\n\r\nAt a regional workshop held before the AMI, convened by EQUINET with the regional trade union body, SATUCC and with SAMA and Benchmarks Foundation, delegates from organisations representing or working with mineworker, ex-mineworker, community, health and economic justice constituencies identified a shared concern over the way mining is affecting our current and future environments for health. It was perceived that we are not getting the current or future economic and social benefit we should get from mining and that rights are not being protected and claims ignored. \r\n\r\nFrom the work that different organisations are already doing on these issues and from work in the region on HIV, TB and occupational health, it was evident that we have a platform to build on to address this. The meeting identified the building blocks of what needs to be done, not as isolated pockets of activity, but in a more integrated way across all countries of the region. \r\n\r\nWe must prevent the harms. The information, tools and capacities to map, assess and report on the conditions affecting health should be in the hands of communities, workers and ex-mine workers across the region, to be able to bring conditions affecting health to wider attention. While environment impact assessments are done in many countries, this is not enough. There should be a legal duty to carry out health impact assessments before licensing and during mine operations in all countries. These assessments should ensure, implement and monitor plans to prevent risks to health from mining. They should also assess the living conditions, the potential impacts on displaced communities and post closure and set plans to prevent negative impacts. They should be done jointly with workers and communities and publicly reported. \r\n\r\nThe rights of current and future generations should be protected. In many of our countries the laws are outdated, have gaps, or are not well enforced. As the AMI declaration stated, the right to life and to health for current and future generations must be central in whatever laws, policies and practices we design and implement. Health cannot be left to voluntary corporate social responsibility. There are over 25 international standards from United Nations and other institutions on the social obligations of the sector. SADC itself said in 2006 that it should set harmonised health standards in mining and that \u2018member States should develop, adopt and enforce appropriate and uniform health, safety and environmental guidelines for the sector as an immediate milestone area\u2019. It is time we implemented this commitment, not just for TB, HIV and occupational diseases, but for all the public health issues being faced in the sector. \r\n\r\nThe regional meeting shared information on efforts underway to inform and organise affected communities in the region. They included health literacy activities and the Tunatazama action voices alert where community activists share their knowledge and experiences on mining on a website at http://communitymonitors.net/.  There are efforts underway to identify clean energy and green technologies that can limit health damage at source and measures to promote recycling and reuse of metal products. Accessing such information, building capacities for healthy innovation and having a voice in decisions is a right and an investment, especially for the young people whose futures depend on the choices we make today. The trickle of resources that goes to this in comparison to the flow of investment funds that go to the extraction of materials suggest that we have an imbalance that needs to be addressed in the value we are placing on the relative contribution of economic, social and natural resource inputs to our future wellbeing.\r\n\r\nThe regional meeting and the AMI highlighted many practical things we can do to meet the health and natural resource debt and to rebalance future policies and practices. We know that the right to life and health supersedes all other claims and that the natural resources of the region are ours to guard for future generations. We also know, as stated in the 2020 AMI declaration, that these  rights \u201chave been won through social struggle and are a source of social power and organization\u201d. The formation of an Extractives and Health Group that crosscuts different constituencies and disciplines recognises the need to work collectively if we are to advance alternatives that meet past debts and that prevent the current and future liabilities of extraction.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. You can read the meeting report and further information on this work on the EQUINET website. Please also find further information on the websites of the partner institutions named in the oped and of the Alternative Mining Indaba.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Action Voices: Bench Marks Foundation Community Monitoring School ","field_subtitle":"Bench Marks Foundation: South Africa, 2013","URL":"http://www.bench-marks.org.za/publications/action_voices_2013.pdf","body":"The Bench Marks Foundation developed the concept of the Community Monitoring School because a vacuum of knowledge exists within communities when dealing with big corporations. The message of the Community Monitoring School is \u201cnothing for us without us\u201d. Tunatazama is a Kiswahili word that means \u201cwe are watching\u201d and the 2013 school\u2019s motto was \u201cWe are Watching You!\u201d For any significant reform in the mines to occur, the present power and knowledge imbalances between corporations and communities need to be overcome. In Phase One of the school programme, the focus is on helping participants develop confidence and skills in documenting and analysing community problems. They write short articles on their observations and post these on the project\u2019s website. Some of these articles appear in the first section of this publication. In Phase Two of the programme, direct action in the community is combined with school sessions on planning, review and evaluation. In the second section a reflective analysis is conducted on the process. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Africa Is a Country Fellowship","field_subtitle":"Rolling deadline","URL":"https://tinyurl.com/w4xt256","body":"The purpose of the AIAC Fellowship is to support the production of original work and new knowledge on Africa-related topics that are under-recognized and under-covered in traditional media, new media, and other public forums. It particularly seeks to amplify voices and perspectives from the left that address the major political, social, and economic issues affecting Africans in ways that are original, accessible, and engaging to a variety of audiences. Fellows will be writers and/or other cultural/intellectual producers who can contribute meaningfully to transforming and expanding knowledge about Africa and the diaspora. Each fellow will receive a grant of up to US$3,000 to create original work on a topic of their choice for AIAC over a 9-month period. While most fellows will produce essays and/or reporting and analysis, AIAC are also open to work in other formats, such as photo essays, documentary videos, and more. Fiction, poetry, and fine and performing arts are not eligible for support from this program.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Guest Researchers\u2019 Scholarship Programme","field_subtitle":"Deadline for Applications: 1 April 2020","URL":"https://tinyurl.com/tle76kd","body":"There is an opportunity for postdoctoral researchers in Africa to pursue their own research projects, thereby indirectly strengthening academia in African countries. The scholarship offers access to the Institute's library and other resources that provide for a stimulating research environment. The maximum duration of the stay is 90 days, minimum is 60 days. The scholarship includes a return air-fare (economy class), accommodation, a subsistence allowance  plus an installation grant and access to a workspace and desk computer.  Guest Researchers have the possibility to present their research at the Nordic Africa Institute and to visit other institutions in the Nordic countries.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Aliens\u2019 on the Copperbelt: Zambianisation, Nationalism and Non-Zambian Africans in the Mining Industry","field_subtitle":"Money D: Journal of Southern African Studies 45(5), 859-875, 2019","URL":"https://tinyurl.com/tl3cpb9","body":"Following Zambia\u2019s independence in 1964, several thousand non-Zambian Africans were identified and progressively removed from the Copperbelt mines as part of a state-driven policy of \u2018Zambianisation\u2019. Curiously, this process has been overlooked among the multitude of detailed studies on the mining industry and Zambianisation, which is usually regarded as being about the removal of the industrial colour bar on the mines. This article challenges that perspective by examining the position and fate of non-Zambian African mineworkers, beginning with patterns of labour recruitment established in the colonial period and through the situation following independence to the protracted economic decline in the 1980s. Two arguments are made by the author. First, Zambian nationalism and the creation of Zambian citizenship were accompanied on the Copperbelt by the identification and exclusion of non-Zambians, in contrast to a strand in the literature which stresses that exclusionary nationalism and xenophobia are relatively recent developments. Second, one of the central and consistent aims of Zambianisation was the removal of \u2018alien\u2019 Africans from the mining industry and their replacement with Zambian nationals as a key objective of the Zambian government, supported by the mineworkers\u2019 union.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"BMJ Global Health Grant 2020","field_subtitle":"Deadline for Applications: 20 April 2020","URL":"https://gh.bmj.com/pages/bmj-global-health-grant-2020/","body":"In support of early career researchers working in the field of global health from low-income and lower-middle-income countries, BMJ is offering the BMJ Global Health Grant to one successful applicant. Applicants may apply for up to \u00a35,000 to your attendance at the Sixth Global Symposium on Health Systems Research (HSR 2020), taking place in Dubai, United Arab Emirates, 8\u201312 November 2020. The grant will be used to cover costs of attending the conference, including the event registration fee, return travel and accommodation costs, visa application fee and subsistence for the days on which the conference is held. The grant will be awarded to the applicant whose abstract describes the most original methodological contribution to the field of global health and whose summary demonstrates the greatest importance and potential impact in advancing the field.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Busting four myths about Universal Health Coverage","field_subtitle":"Samman E: Overseas Development Institute, December 2020","URL":"https://tinyurl.com/tdorn9h","body":"New research sheds light on the experience of almost 50 countries that have attained Universal Health Coverage (UHC) or made strides toward doing so. This research indicates that while there isn\u2019t a one-size-fits-all approach, there are parallels \u2013 and opinions on what aids or prevents UHC are often misinformed. It\u2019s often thought that countries strive for UHC during periods of stability but research shows that most major moves towards UHC are triggered by a change in circumstances that breaks a country\u2019s usual pattern that has prevented healthcare reform. It\u2019s much more difficult to roll out UHC during fragile times \u2013 finances are often limited and subject to competing claims. But fragility appears to be a powerful motivation for UHC: disruption weakens powerbases that may oppose UHC and governments use healthcare to build legitimacy. Cost is often cited as a barrier to UHC but the gross national income in low- and middle-income countries where UHC is seen as cost-effective is only $1,524 more than those that think it is not \u2013 a 13% difference. Healthcare can be a contentious political issue. Dissatisfaction often remains strong until countries reach universality. But once achieved, UHC is usually robustly accepted across the political spectrum. Moreover, this consensus tends to prevail even in difficult situations. Around eight countries in the sample (15%) appear to have faced threats to their health system \u2013 including armed conflict in Ukraine and state fragility in Tanzania. The implications are argued to be clear: all countries have the potential to move towards UHC. The main barriers to UHC roll-out are political.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Call for applicants: Desk review on \"Public-private partnerships (PPPs) in the health sector- what implications for equity in east and southern Africa\"","field_subtitle":"Deadline for Applications: 9 March 2020","URL":"https://www.equinetafrica.org/content/grants","body":"This is a call for a desk review of public private partnerships (PPPs) in the health sector (health services) in east and southern African countries commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The paper aims to inform public sector professionals, policy makers, civil society and parliamentarians on the health sector and health equity impacts of PPPs in health services in the countries of east and southern Africa. It will cover the full spectrum of services provided in the health sector, viz promotive, preventive, curative and rehabilitative in East and Southern African countries.. The paper will be drafted, reviewed and final version produced between March and end July 2020. EQUINET will organise internal and external review. The commissioned author will be paid a gross fee of US$6000 for the paper. See the website for further detail. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Children\u2019s rights provide a powerful lever to challenge chronic disease risks ","field_subtitle":"Leslie London, School of Public Health and Family Medicine, University of Cape Town","body":"\r\nIndustry marketing aimed at children presents a major challenge to efforts to control the global crisis of non-communicable diseases (NCDs). Advertising and promotion of tobacco, alcohol, sugar-sweetened drinks and other unhealthy processed foods are common in all countries. They are a particular threat in countries with weak laws, poor enforcement and political cultures that are beholden to foreign investment. Africa is particularly vulnerable to unhealthy marketing by corporates. \r\n\r\nInternationally, attention is growing on what works best to reduce the risk of NCDs, and to the role that human rights-based approaches have in this. In particular, the Convention on the Rights of the Child (CRC) can act as a strategic lever against health risks from corporate practice. Under the CRC, governments have obligations to protect children from economic exploitation and harm generated by the activities and products of tobacco, food and beverages industries. Governments are also obliged to protect children from information harmful to their health and development. This includes the marketing of unhealthy goods. However few governments in low-income countries implement measures to meet these particular obligations to protect the best interest of the child. \r\n\r\nThe European Scientific Network on Law and Tobacco (ESNLT) hosted a roundtable in mid-2019 to generate a better understanding of the successes and potential constraints of a child rights-based approach to address the global NCD epidemic. (See  https://www.rug.nl/rechten/onderzoek/expertisecentra/ghlg/outcome_document_25_june_geneva.pdf). Participants were researchers, mainly from high-income countries, with some from low- and middle-income countries. The meeting also involved personnel from World Health Organisation and UNICEF staff working on NCDs and human rights. In the meeting, participants shared experiences of using a child-rights approach in domestic and international responses to NCDs and identified new opportunities to use a child-rights approach and to advocate for these approaches to be applied in addressing industry behaviours relevant to the risk factors for NCD. \r\n\r\nParticipants in the meeting explored how to apply a child rights-based approach to support regulation of NCD-related risks, particularly in low-income countries, vulnerable settings and trade policies, and how best to disseminate this knowledge more widely. Various recommendations were made in the meeting.  Participants proposed networking with academics and civil society working with broader child rights and health equity issues to advance awareness, advocacy and implementation of these approaches, working also with public health networks like EQUINET in low- and middle-income countries, especially where civil society space is constrained.  It was proposed that regional blocs such as the East Africa Community and Southern African Development Community be engaged to promote effective regulation of NCD risks related to marketing practices, including in relation to online and cross-border marketing and trading. Participants observed that evidence needed to be generated and shared on effective strategies and that this knowledge be brought into online and distance training courses to strengthen regulatory capacities and into postgraduate training linking human rights, law and public health. One suggestion was for a test case to be brought in one country that has constitutional provisions protecting these rights, such as South Africa. These actions could tap into existing resources. For example, the World Federation of Public Health Nutritionists has set up a mechanism for reporting conflicts of interest. The learning from this could be consolidated and shared. \r\n\r\nIt was significant that the ESNLT engaged beyond high-income countries and is addressing wider risk factors for NCDs. Bringing together a diverse set of actors in the meeting helped to build links across different disciplines and opened avenues for future collaboration.  Linking with existing networks can help to identify capacity gaps and to stimulate and support research and advocacy. Education of both public health and law professionals can expose each to the respective field of the other to promote collaboration and team approaches. This interaction has already been stimulated by the meeting. For example, soon after it, one of the participants was invited to give a keynote address at the Association of Schools of Public Health Conference in Africa to highlight the role of law in public health.  \r\n\r\nThe meeting also proposed that international organizations, such as WHO, UNICEF, the Office of the United Nations High Commissioner for Human Rights, the UN Human Rights Committee and the UN Committee on the Rights of the Child, link to reduce capacity gaps and overlaps in their work and outputs. A child rights-based approach and qualitative assessment of country performance could be included in WHO assessments of how far regulations targeting the main risk factors are implemented. Evidence on NCD-related issues could be included in country reporting to the Committee on the Rights of the Child and shadow reporting by civil society promoted. \r\n\r\nThis is not simply a technical matter. Industry actors are well-resourced, powerful and able to thwart regulation of NCD risk factors.  This power imbalance calls for co-operation across international and national organizations, civil society organizations, academia and public officials. For regional networks such as EQUINET, the fact that every country in Africa has ratified the CRC and all but 6 have ratified the African Charter on the Rights and Welfare of the Child offers an opportunity and policy space to use human and child rights-based approaches to tackle health equity challenges, including the prevention of corporate and market-induced risks for NCDs.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Contradictions within the SDGs: are sin taxes for health improvement at odds with employment and economic growth in Zambia","field_subtitle":"Hangoma P; Surgey G: Globalization and Health 15(82)1-9, 2019","URL":"https://tinyurl.com/uv98jyc","body":"To achieve Sustainable Development Goal 3.4, countries have been urged to introduce sin taxes, such as those on sugar. Others have argued that such taxes may affect employment, economic growth and increase poverty. There is limited or no reliable evidence on this. Using a conceptual framework of relationships among SDGs as contradictory, reinforcing, or neutral, the authors used the recent introduction in Zambia of an equivalent 3% tax on non-alcoholic beverages, implicitly targeted at sugar-sweetened beverages to test the issue. While the goal of reducing non-communicable diseases is stated, concerns were raised that such a tax would be detrimental to the Zambia sugar value chain which contributes about 6% to GDP. The authors discuss that contradictions depend on a number of contextual factors, and make two conclusions about sugar taxation in Zambia. First, they argue that the current tax rate of 3% is likely neutral to be because it is too low to have any health or employment effects. However, the revenue raised can be reinvested to improve livelihoods. Secondly, they suggest increasing the tax rate but taking care to ensure that the rate is not too high to generate contradictions, carefully assessing important parameters such as elasticities and alternative economic livelihoods. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Crowdfunding and global health disparities: an exploratory conceptual and empirical analysis","field_subtitle":"Kenworthy N: Globalisation and Health 15(70, Suppl 1), 1-10, 2019","URL":"https://tinyurl.com/uawuhym","body":"The use of crowdfunding platforms to cover the costs of healthcare is growing rapidly within low-, middle-, and high-income countries as a new funding modality in global health. To map and document how medical crowdfunding is shaped by, and shapes, health disparities, this article offers an exploratory conceptual and empirical analysis of medical crowdfunding platforms and practices around the world. Data are drawn from a mixed-methods analysis of medical crowdfunding campaigns, as well as an ongoing ethnographic study of crowdfunding platforms and the people who use them. Drawing on empirical data and case examples, this article describes three main ways that crowdfunding is impacting health equity and health politics around the world: 1) as a technological determinant of health, wherein data ownership, algorithms and platform politics influence health inequities; 2) as a commercial determinant of health, wherein corporate influence reshapes healthcare markets and health data; 3) and as a determinant of health politics, affecting how citizens view health rights and the future of health coverage. Rather than viewing crowdfunding as a social media fad or a purely beneficial technology, researchers and publics must recognize it as a complex innovation that is reshaping health systems, influencing health disparities, and shifting political norms, even as it introduces new ways of connecting and caring for those in the midst of health crises. More analysis, and better access to data, is needed to inform policy and address crowdfunding as a source of health disparities.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Decentralising Non-Communicable Diseases (NCD) management in rural southern Africa: evaluation of a pilot implementation study","field_subtitle":"Sharp A; Riches N; Mims A; Ntshalintshali S; et al: BMC Public Health 20(44)1-8, 2020","URL":"https://tinyurl.com/ww3ot3j","body":"This study assessed the feasibility and impact of decentralised care for non-communicable diseases (NCDs) within nurse-led clinics in order improve access and inform healthcare planning in Eswatini and similar settings. In collaboration with the Eswatini Ministry of Health, the authors developed and implemented a package of interventions to support nurse-led delivery of care, including clinical desk-guide for hypertension and diabetes, training modules, treatment cards and registries and patient leaflets. One thousand one hundred twenty-five patients were recruited to the study. Of these patients, 573 attended for at least 4 appointments. There was a significant reduction in mean blood pressure among hypertensive patients after four visits of 9.9 mmHg systolic and 4.7 mmHg diastolic, and a non-significant reduction in fasting blood glucose among diabetic patients of 1.2 mmol/l. Key components of non-communicable disease care were completed consistently by nurses throughout the intervention period, including a trend towards patients progressing from monotherapy to dual therapy in accordance with prescribing guidelines. The findings suggest that management of diabetes and hypertension care in a rural district setting can be safely delivered by nurses in community clinics according to a shared care protocol. Improved access is likely to lead to improved patient compliance with treatment.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Development assistance for community health workers in 114 low- and middle-income countries, 2007\u20132017 ","field_subtitle":"Lu C; Palazuelos D; Luan Y; Sachs SE; et al: Bulletin of the World Health Organisation 98(1) 1-76, 2020 ","URL":"https://www.who.int/bulletin/volumes/98/1/19-235499.pdf","body":"This study estimated the level and trend of development assistance for community health worker-related projects in low- and middle- income countries between 2007 and 2017. Data was extracted from the Organisation for Economic Co-operation and Development\u2019s creditor reporting system on aid funding for projects to support community health workers (CHWs) in 114 countries over 2007\u20132017. Between 2007 and 2017, total development assistance targeting CHW projects was around US$ 5 298 million, accounting for 2.5% of the US$ 209 278 million total development assistance for health. Sub-Saharan Africa received a total US$ 3 718 million, the largest per capita assistance over 11 years. Development assistance to projects that focused on infectious diseases and child and maternal health received most funds during the study period. The share of development assistance invested in the CHW projects was, however, small, unstable and decreasing in recent years. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out quarterly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 223: A just economy needs to tackle the climate and health debt from mining","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Health equity monitoring is essential in public health: lessons from Mozambique","field_subtitle":"Llop-Giron\u00e9s A; Cash-Gibson L; Chicumbe S; Alvarez F; et al: Globalization and Health 15(67) 1-7, 2019","URL":"https://tinyurl.com/s4a4af7","body":"This paper presents an evaluation of the current capacity of the national health information systems in Mozambique, and the available indicators to monitor health inequalities, in line with Sustainable Development Goals 3. A data source mapping of the health information system in Mozambique was conducted. Eight data sources contain health information to measure and monitor progress towards health equity in line with the 27 Sustainable Development Goal 3 indicators. Seven indicators bear information with nationally funded data sources, ten with data sources externally funded, and ten indicators either lack information or it does not applicable for the matter of the study. None of the 27 indicators associated with Sustainable Development Goal 3 can be fully disaggregated by equity stratifiers; they either lack some information or do not have information at all. The indicators that contain more information are related to maternal and child health. The authors report that there are important information gaps in Mozambique\u2019s current national health information system which prevents it from being able to comprehensively measure and monitor health equity. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Human Development Report 2019. Beyond income, beyond averages, beyond today:  Inequalities in human development in the 21st century ","field_subtitle":"United Nations Development Programme, New York, 2019","URL":"https://www.hst.org.za/publications/NonHST%20Publications/hdr2019.pdf","body":"Inequalities in human development are a roadblock to achieving the 2030 Agenda for Sustainable Development. They are not just about disparities in income and wealth and cannot be accounted for simply by using summary measures of inequality that focus on a single dimension. This 2019 Report explores inequalities in human development by going beyond income, beyond averages and beyond today. It asks what forms of inequality matter and what drives them, recognizing that pernicious inequalities are generally better thought of as a symptom of broader problems in a society and economy. It also asks what policies can tackle those drivers\u2014policies that can simultaneously help nations to grow their economies, improve human development and reduce inequality.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Hwange women exposed to the vagaries of coal mining. . . as one dies poaching coke","field_subtitle":"Mlevu S: Centre for Natural Resource Governance, 2020 ","URL":"https://tinyurl.com/s7mw5mq","body":"Centre for Natural Resource Governance shared, with sorrow, news of the death of a Hwange woman after a tunnel she was using to sneak into Hwange Colliery Company Limited\u2019s (HCCL) premises collapsed on her and her colleague. As Zimbabwe\u2019s economy declines the Hwange Community now survives largely through several illicit activities, which include sneaking into the company premised through a tunnel to steal coking coke. The centre makes several recommendations. Firstly, that the Ministry of Finance and Ministry of Women Affairs and Small to Medium Enterprises should immediately avail grants for income generating projects to support women in Hwange. This will help women who are not on formal employment to avoid risky livelihood options. They propose that the HCCL must provide safety and security measures that will inhibit people from illegally taking coal coke in their premises. HCCL should also fully implement safety, health and environment initiatives around their premises so that lives can be saved. The centre also recommends that the government provides social and economic security for women mining affected areas and that the Environmental Management Agency regularly monitors SHE compliance in all companies without bias.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Justice for South African Gold Miners","field_subtitle":"Action for Southern Africa (ACTSA); South Africa, 2020","URL":"https://actsa.org/campaigns/justice-for-south-african-gold-miners/","body":"Thousands of ex-gold mineworkers in South Africa are suffering from silicosis and lack the medical screening, compensation, healthcare and support they need and deserve. Action for Southern Africa (ACTSA) led a campaign calling on gold companies to provide decent health and compensation in a campaign for justice for Southern African gold mineworkers with silicosis and tuberculosis.  The campaign included: protesting outside the High Court; attending and speaking at many Anglo American AGMs; organising petitions; and producing campaign briefings. On 26 July 2019, the South Gauteng High Court approved a class action settlement worth at least R5 billion (approximately \u00a3268 million). The settlement establishes the Tshiamiso Trust, which will be responsible for paying compensation to eligible gold mineworkers and their dependents in Southern Africa. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Kampala Declaration on cooperation and solidarity for health equity within and beyond aid","field_subtitle":"Medicus Mundi International Network: Kampala, Uganda, January 2020","URL":"https://www.medicusmundi.org/kampaladeclaration/","body":"The authors contend that the priorities of Northern donors dictate the aid agenda, implemented by the non-state and Southern \u2018partners\u2019 they fund. These priorities often clash with the needs and concerns of communities, governments and civil society in many countries around the world. The aid space is dominated by powerful interests, while the voices of those most affected by health inequity are regularly tokenised or excluded from the conversation. The authors argue that many actors within the sector \u2013 even among communities and civil society \u2013 do not question the underlying premise and structures of health aid. Their own ideas and world views have been shaped by, and for, aid and the industry that supports it. Questioning aid poses challenges to the professions, livelihoods and sources of power for those who work within the sector. Furthermore, whilst health aid is important in some situations, on its own aid can never lead to a world where all people can live healthy lives. Signatories of the declaration believe that collective social action in solidarity as one global community, working together to address the root causes of the struggle for health, can transform aid into an equitable means of ensuring health rights. Through the Kampala Initiative, the signatories commit to expose, explore, challenge and transform health aid through dialogue, advocacy, activism and action. They commit to build cooperation and solidarity for health, within and beyond the practice of aid, to build a future where health justice and equity are realised, and aid is no longer a necessity. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Legislative landscape for traditional health practitioners in Southern African development community countries: a scoping review","field_subtitle":"Abrams A; Falkenberg T; Rautenbach C; et al: BMJ Open 10(1) 1-10, 2019","URL":"https://bmjopen.bmj.com/content/10/1/e029958","body":"This study mapped and reviewed traditional health practitioners (THPs) -related legislation among SADC countries. Four of 14 Southern African countries have legislation relating to THPs. South Africa, Namibia and Zimbabwe have acknowledged the roles and importance of THPs in healthcare delivery by creating a council to register and formalise practices, although they have not operationalised nor registered and defined THPs. In contrast, Tanzania has established a definition couched in terms that acknowledge the context-specific and situational knowledge of THPs, while also outlining methods and the importance of local recognition. Tanzanian legislation; thus, provides a definition of THP that specifically operationalises THPs, whereas legislation in South Africa, Namibia and Zimbabwe allocates the power to a council to decide or recognise who a THP is. This council can prescribe procedures to be followed for the registration of a THP. While South Africa, Tanzania, Namibia and Zimbabwe have legislation that provides guidance as to THP recognition, registration and practices, THPs continue to be loosely defined in most of these countries. Not having an exact definition for THPs are argued to hamper the promotion and inclusion of THPs in national health systems, but it may also be something that is unavoidable given the tensions between lived practices and rigid legalistic frameworks.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"NGOs, austerity, and universal health coverage in Mozambique ","field_subtitle":"Pfeiffer J; Chapman R: Globalization and Health 15(Suppl 1) 1-6, 2019 ","URL":"https://tinyurl.com/sro26nx","body":"In many African countries, hundreds of health-related non-government organisations (NGOs) are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country\u2019s structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favoured private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow \u201coff-budget\u201d to NGO \u201cimplementing partners,\u201d with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and re-channelling of aid to public systems building rather than to NGOs.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Non-Communicable Disease (NCD) Research Symposium","field_subtitle":"4 March 2020, Lord Charles Hotel, Somerset West, South Africa","URL":"https://www.cebhc.co.za/research-key-outputs/ncd-research-symposium/","body":"The National NCD Research Symposium is an opportunity to bring together researchers, policymakers and practitioners to exchange knowledge on prevention and treatment of diabetes, hypertension, cardiovascular disease risk factors, and related mental health conditions; identify the gaps in knowledge base; and discuss implications for healthcare policy and practices.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Novel Coronavirus (2019-nCoV) technical guidance","field_subtitle":"World Health Organisation: Geneva, January 2020","URL":"https://tinyurl.com/v98z4v9","body":"On 31 December 2019, WHO was alerted to several cases of pneumonia in Wuhan City, Hubei Province of China. The virus did not match any other known virus. This raised concern because when a virus is new, it is not known how it affects people. One week later, on 7 January, Chinese authorities confirmed that they had identified a new virus. The new virus is a coronavirus, which is a family of viruses that include the common cold, and viruses such as SARS and MERS. This new virus was temporarily named \u201c2019-nCoV.\u201d The World Health Organisation has released a number of guidelines aimed at preventing the spread and proliferation of the virus. \r\n","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Prevalence and determinants of recent HIV testing among older persons in rural Uganda: a cross-sectional study","field_subtitle":"Wandera S; Kwagala B; Maniragaba F: BMC Public Health 20(144) 1-10, 2020","URL":"https://tinyurl.com/srkkhka","body":"This study investigated the socio-demographic determinants of recent HIV testing among older persons in selected rural districts in Uganda using a cross-sectional survey of 649 older men and women age 50\u2009years and older, from central and western Uganda. Prevalence of lifetime HIV testing was 82% and recent HIV testing was 53%. HIV testing in the last 12\u2009months was associated with age, self-reported sexually transmitted infections, male circumcision, and sexual activity in the last 12\u2009months. Recent HIV testing among older persons was associated with younger age, self-reported STIs, male circumcision, and sexual activity among older persons in rural Uganda. The authors propose that HIV testing interventions target persons 70\u2009years and older, who were less likely to test.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Programme Officer, Training, Grants and Fellowships (TGF) Programme","field_subtitle":"Deadline: 15th April 2020","URL":"https://www.codesria.org/spip.php?article3009&lang=en","body":"The Council for the Development of Social Science Research in Africa invites applications from African scholars to fill a vacant position of Programme Officer in its Training, Grants and fellowships Programme at its pan-African Secretariat located in Dakar, Senegal. Candidates wishing to apply for the position should note that they will work under the supervision of the Senior Programme officer and Head of the Training, Grants and Fellowships Programme. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Prolonged health worker strikes in Kenya- perspectives and experiences of frontline health managers and local communities in Kilifi County","field_subtitle":"Waithaka D; Kagwanja N; Nzinga J; Tsofa B; et al: International Journal for Equity in Health 19(23), doi: https://doi.org/10.1186/s12939-020-1131-y, 2020","URL":"https://tinyurl.com/vdykk5k","body":"The authors explored the perceptions and experiences of frontline health managers and community members of the 2017 prolonged health workers\u2019 strikes in Kenya, using informal observations, reflective meetings, individual and group interviews and document reviews, analysed using a thematic approach. In the face of major health facility and service closures and disruptions, frontline health managers enacted a range of strategies to keep key services open, but many were piecemeal, inconsistent and difficult to sustain. Interviewees reported huge negative health and financial impacts on local communities, and especially poor people. They found limited evidence of improved health system preparedness to cope with any future strikes. The 2017 prolonged strikes highlight the underlying and longer-term frustration amongst public sector health workers in Kenya. Reactive responses within the public system and the use of private healthcare led to limited continued activity through the strike, but were not sufficient to confer resilience to the shock of prolonged strikes. To minimise the negative effects of strikes when they occur, the authors suggest that careful monitoring and advanced planning is needed. Planning should aim to ensure that emergency and other essential services are maintained, threats between staff are minimized, health worker demands are reasonable, and that governments respect and honour agreements.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Psychological wellbeing in a resource-limited work environment: examining levels and determinants among health workers in rural Malawi","field_subtitle":"Lohmann J; Shulenbayev O; Wilhelm D; Muula A; et al: Human Resources for Health (2019) 17(85) 1-11, 2019 ","URL":"https://tinyurl.com/wkuuuu2","body":"Ensuring health workers\u2019 psychological wellbeing is critical to sustaining their availability and productivity. This study investigated levels of and factors associated with psychological wellbeing of mid-level health workers in Malawi, using a cross-sectional sample of 174 health workers from 33 primary and secondary level health facilities in four districts of Malawi. Twenty-five percent of respondents had World Health Organsation-5 scores indicative of poor psychological wellbeing. Analyses of factors related to psychological wellbeing showed no association with sex, cadre, having dependents, supervision, perceived co-worker support, satisfaction with the physical work environment, satisfaction with remuneration, and motivation; a positive association with respondents\u2019 satisfaction with interpersonal relationships at work; and a negative association with having received professional training recently. The high proportion of health workers with poor wellbeing scores is concerning in light of the general health workforce shortage in Malawi and strong links between wellbeing and work performance. While more research is needed to draw conclusions and provide recommendations as to how to enhance wellbeing, the results are argued to underline the importance of considering wellbeing as a key concern for human resources for health.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Public Health Care Spending in South Africa and the Impact on Nurses: 25 years of democracy?","field_subtitle":"Valiani S: Agenda, 33 (4) 67-78, 2019","URL":"https://www.academia.edu/41929022/Public_Health_Care_Spending_in_South_Africa_and_the_Impact_on_Nurses_25_years_of_democracy","body":"Nurses in South Africa - as in the rest of the continent - are the backbone and oxygen of public health care though not adequately acknowledged. This article traces the pattern of public health care spending and its impact on nurses since 1994. Given the nature and quantity of demand for public health care in South Africa, deemed the most unhealthy nation in the world in the 2019 Indigo Wellness Index, the article shows that the 25 year record of democratic South Africa registers low public health care expenditure and nurses are at the coal face of this contradiction. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Purchasing reforms and tracking health resources, Kenya ","field_subtitle":"Vilcu I; Mbuthia B; Ravishankar N: Bulletin of the World Health Organisation 98(2), 77-148, 2020","URL":"https://www.who.int/bulletin/volumes/98/2/19-239442.pdf","body":"As low- and middle-income countries undertake health financing reforms to achieve universal health coverage, there is renewed interest in making allocation of pooled funds to health-care providers more strategic. To make purchasing more strategic, countries are testing different provider payment methods. They therefore need comprehensive data on funding flows to health-care providers from different purchasers to inform decision on payment methods. Tracking funding flow is the focus of several health resource tracking tools including the System of Health Accounts and public expenditure tracking surveys. This study explores whether these health resource tracking tools generate the type of information needed to inform strategic purchasing reforms, using Kenya as an example. A qualitative assessment of three counties in Kenya shows that different public purchasers, that is, county health departments and the national health insurance agency, pay public facilities through a variety of payment methods. Some of these flows are in-kind while others are financial transfers. The nature of flows and financial autonomy of facilities to retain and spend funds varies considerably across counties and levels of care. The government routinely undertakes different health resource tracking activities to inform health policy and planning. However, a good source for comprehensive data on the flow of funds to public facilities is still lacking, because these activities were not originally designed to offer such insights. The authors therefore argue that the methods could be enhanced to track such information and hence improve strategic purchasing, and also offer suggestions how this enhancement can be achieved. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Regional Meeting of the Extractives and Health Group","field_subtitle":"TARSC; EQUINET; SATUCC; SAMA; Benchmarks: Meeting report, 1-2 February 2020, Cape Town, South Africa ","URL":"https://www.equinetafrica.org/sites/default/files/uploads/documents/EHG%20Mtg%20Rep%20Feb2020.pdf","body":"EQUINET, SATUCC, SADC CNGO and Benchmarks Foundation have co-operated on regional engagement on extractives and health at the Alternative Mining Indaba, and with the Southern African ex mineworkers Association met in a regional meeting on health literacy in the mining sector in March 2019 to form a mining and health group to strengthen alliances and co-operation in the grassroots to regional and global engagement on the issue. The March 2019 meeting agreed to hold a follow up meeting at the time of the Alternative Mining Indaba (AMI) in February 2020 to follow up on the agreed actions, exchange information and widen the alliances and health literacy activities and processes in the region. The meeting was organised by TARSC / EQUINET and held in co-operation with SATUCC, SAMA and Benchmarks. It was held in Cape Town in the two days before the AMI to enable delegates to also engage in the AMI. It was supported by Medico International and OSF and by TARSC and all the organisations involved who also contributed own resources to their participation. The meeting aimed to  i. Share information on mining and health in the region in terms of the risks, responses, rights and actions ii. Review activities on health literacy in mining and use of the EQUINET health literacy module on Mining and health iii. Review the work of the mining and health working group and its members in various platforms and proposed work on extractives and health equity in the region and identify priorities, alliances, actions and roles for follow up and iv. Identify issues to take forward in the AMI and other regional platforms. This report presents the information shared and discussions at the meeting and the plans for follow up work. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Rights for People, Rules for Corporations - #BindingTreaty","field_subtitle":"Democracy Centre: Film, December 2019","URL":"https://www.youtube.com/watch?v=UdX3Mrhf7pY","body":"#COP25 can barely break into the news cycle - but the public is well aware by now that business-as-usual is not an option if ecological breakdown is to be averted and move to a fairer, safer and more peaceful ways of co-existing on the planet are to be found. Business-as-usual means maintaining trade rules and treaties that give corporations enormous power to endlessly extract natural resources; sacrificing communities and ecosystems in those places to feed rampant consumerism for the profit of a powerful minority. This film\u2019s calls on us to reject business-as-usual and advocate for a #BindingTreaty on Transnational Corporations and Human Rights and are building solidarity across countries and movements to demand Rights for People, Rules for Corporations.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Societal risk factors for overweight and obesity in women in Zimbabwe: a cross-sectional study","field_subtitle":"Mangemba N; Sebastian M: BMC Public Health 20(103) 1-8, 2020","URL":"https://tinyurl.com/yx2oy6jp","body":"This study determined the socioeconomic risk factors for overweight and obesity in non-pregnant adult Zimbabwean women. A cross-sectional study was conducted using the 2015 Zimbabwe Demographic Health Survey data on the adult female population aged 15 to 49. The weighted prevalence of overweight and obesity in adult females was 34% and 12% respectively. The prevalence of overweight and obesity among women in Zimbabwe was high. The key social factors associated were older age, being married, being wealthy and using hormonal contraception. Having a higher education and being Christian also increased the risk of being obese and overweight respectively. The design of multi-faceted overweight and obesity reduction programs for women that focus on increasing physical activity and strengthening of social support systems are argued by the authors to be necessary to combat this epidemic.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Tackling injustices of occupational lung disease acquired in South African mines: recent developments and ongoing challenges","field_subtitle":"Kistnasamy B; Yassi A; Yu J; et al: Globalization and Health 14(60), doi: 10.1186/s12992-018-0376-3, 2018","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022447/","body":"This study aimed to assess developments over the last 5 years in providing compensation, quantify shortfalls and explore underlying challenges for ex mineworkers and their families. Using the database with compensable disease claims from over 200,000 miners, the medical assessment database of 400,000 health records and the employment database with 1.6 million miners, rates of claims, unpaid claims and shortfall in claim filing were calculated for each of the southern African countries with at least 25,000 miners who worked in South African mines, by disease type and gender. Interviews were also conducted in Johannesburg, Eastern Cape, Lesotho and a local service unit near a mine site, supplemented by document review and auto-reflection, adopting the lens of a critical rights-based approach. A myriad of diverse systemic barriers persist, especially for workers and their families outside South Africa. Calculating predicted burden of occupational lung disease compared to compensable claims paid suggests a major shortfall in filing claims in addition to the large burden of still unpaid claims. Despite progress made, our analysis reveals ongoing complex barriers and illustrates that the considerable underfunding of the systems required for sustained prevention and social protection (including compensation) needs urgent attention. With class action suits in the process of settlement, the globalized mining sector is now beginning to be held accountable. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The access paradox: abortion law, policy and practice in Ethiopia, Tanzania and Zambia","field_subtitle":"Blystad A; Haukanes H; Tadele G; Haaland M; et al: International Journal for Equity in Health 18 (126) 1-15, 2019 ","URL":"https://tinyurl.com/qpzldng","body":"This paper explored the relationship between abortion law, policy and women\u2019s access to safe abortion services within the different legal and political contexts of Ethiopia, Tanzania and Zambia. Semi-structured interviews were carried out with study participants differently situated vis-\u00e0-vis abortion, exploring their views on abortion-related legal- and policy frames and their perceived implications for access. The abortion laws have been classified as \u2018liberal\u2019 in Zambia, \u2018semi-liberal\u2019 in Ethiopia and \u2018restrictive\u2019 in Tanzania, but what the authors encountered in the three study contexts was a paradoxical relationship between national abortion laws, abortion policy and women\u2019s actual access to safe abortion services, and that the texts that make up the three national abortion laws are highly ambiguous. While Zambian and Ethiopian laws are more liberal on paper, they in no way ensure access, while the strict Tanzanian law does not prevent young women from seeking and obtaining abortion. The authors observe that the findings demonstrate that the connection between law, health policy and access to health services is complex and dependent on contexts for implementation. They suggest that broad contextualized studies rather than classifications of law along a liberal-restrictive continuum provide better evidence of real access to safe abortion services.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The effects of maternity waiting homes on the health workforce and maternal health service delivery in rural Zambia: a qualitative analysis","field_subtitle":"Kaiser J; Fong R; Ngoma T; McGlasson K; et al: Human Resources for Health 17(93) 1-12; 2019 ","URL":"https://tinyurl.com/ru4csds","body":"This study assessed how maternity waiting homes (MWHs) affect the health workforce and maternal health service delivery at their associated rural health centres. Four rounds of in-depth interviews with district health staff and health centre staff were conducted at intervention and control sites over 24\u2009months. Nearly all respondents expressed challenges with understaffing and overwork and reported that increasing numbers of facility-based deliveries driven by MWHs contributed substantively to their workload. Women waiting at MWHs allow staff to monitor a woman\u2019s final stage of pregnancy and labour onset, detect complications earlier, and either more confidently manage those complications at the health centre or refer to higher level care. District, intervention, and control site respondents passionately discussed this benefit over all time points, describing it as outweighing challenges of additional work associated with MWHs. Intervention site staff repeatedly discussed the benefit of MWHs in providing a space for postpartum women to wait after the first few hours of clinical observation through the first 48\u2009h after delivery. Additionally, intervention site staff perceived the ability to observe women for longer before and after delivery allowed them to better anticipate and plan their own work, adjust their workloads and mindset accordingly, and provide better and more timely care. The authors recommend future studies consider how MWHs impact the workforce, operations, and service delivery at their associated health facilities and strategic selection of  locations for new MWHs.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The mediating role of social capital in the relationship between socioeconomic status and adolescent wellbeing: evidence from Ghana","field_subtitle":" Addae E: BMC Public Health 20(20) 1-11, 2020","URL":"https://tinyurl.com/um5dn7a","body":"This paper presents evidence on the potential for social capital to be a protective health resource by mediating the relationship between socioeconomic status and wellbeing of Ghanaian adolescents. A cross-sectional survey involving a randomly selected 2068 adolescents from 15 schools in Ghana was conducted. Relationships were assessed using multivariate regression models. Three measures of familial social capital were found to protect adolescents\u2019 life satisfaction and happiness against the effects of socioeconomic status. There were variations in how socioeconomic status and social capital related to the different dimensions of adolescents\u2019 wellbeing. Social capital was reported to be a significant mechanism through which socioeconomic status impacts the wellbeing of adolescents. The authors suggest that it can be utilised by public health and that the findings show that the role of the family in promoting adolescents\u2019 wellbeing is superior to that of the school. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Trends in prevalence and correlates of intimate partner violence against women in Zimbabwe, 2005\u20132015","field_subtitle":"Mukamana J; Machakanja P; Adjei N: BMC International Health and Human Rights 20 (2),1-11, 2020","URL":"https://tinyurl.com/r8p95v5","body":"Intimate partner violence (IPV) is a widespread problem affecting all cultures and socioeconomic groups. This study explored the trends in prevalence and risk factors associated with IPV among Zimbabwean women of reproductive age (15\u201349 years) from 2005 to 2015, analysing data from the 2005/2006, 2010/2011 and 2015 Zimbabwe Demographic and Health Surveys. The prevalence of Intimate partner violence was found to have decreased from 45% in 2005 to 41% in 2010, and then increased to 43% in 2015. Some of the risk factors associated with Intimate partner violence were younger age, low economic status, cohabitation and rural residence. Educational attainment of women was not significantly associated with Intimate partner violence. The findings indicate that women of reproductive age are at high and increasing risk of physical and emotional violence. The authors argue that there is a need for an integrated policy approach to address the rise of IPV related physical and emotional violence against women in Zimbabwe.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Tunatazama ","field_subtitle":"An online network for Southern African Communities Living Near Mines","URL":"http://communitymonitors.net","body":"This website is a space for community activists living near mines in southern Africa to share information, resources and experiences. The countries currently participating in this project are: Lesotho, South Africa, Zimbabwe, Zambia, the Democratic Republic of Congo (DRC), Mozambique and Tanzania. Activists in each country document problems they experience and events they participate in and share this on a WhatsApp group. These posts are then shared on this site in the respective country blogs. Each country, in addition, maintains their own country blog.  Additionally, Activists can view the posts on a mobile app called \u201cAction Voices\u201d which can be downloaded on an Android phone from the Google Play store. The activities of this project are managed by the Bench Marks Foundation on behalf of regional organisations.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"User-provider experiences of the implementation of KidzAlive-driven child-friendly spaces in KwaZulu-Natal, South Africa","field_subtitle":"Mutambo C; Shumba K; Hlongwana K: BMC Public Health  20(91) 1-15, 2020","URL":"https://tinyurl.com/vj74m5m","body":"KidzAlive is a child-centred intervention aimed at improving the quality of HIV care for children in South Africa. The authors conducted qualitative interviews with children, their primary caregivers, and KidzAlive trained healthcare workers using and providing child-friendly spaces, respectively. Child-friendly spaces contributed to child-centred care in primary healthcare centres. This was evidenced by the increased involvement and participation of children, increased primary caregivers participation in the care of their children and a positive transformation of the primary healthcare centre to a therapeutic environment for children. Several barriers impeding the success of child-friendly spaces were reported including space challenges; clashing health facility priorities; inadequate management support; inadequate training on how to maximise the child-friendly spaces and lastly the inappropriateness of existing child-friendly spaces for much older children. Child-friendly spaces are observed to promote HIV positive children\u2019s right to participation and agency in accessing care. However, more rigorous quantitative evaluation is required to determine their impact on children\u2019s HIV-related health outcomes.","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"WHO response to WTO member state challenges on tobacco, food and beverage policies","field_subtitle":"Barlow P; Labonte Rl McKee M; Stuckler D: Bulletin of the World Health Organisation 97(1) 846-848, 2019","URL":"https://www.who.int/bulletin/volumes/97/12/19-231985.pdf","body":"In 2013, the World Health Assembly endorsed the World Health Organization\u2019s (WHO) Global action plan for the prevention and control of noncommunicable diseases (NCDs) 2013\u20132020 to achieve a 25% reduction in mortality from NCDs by 2025. WHO\u2019s Global Action Plan is ambitious. In the late 1990s, WHO used its treaty- making powers to address the issue of tobacco use, leading to the Frame-work Convention on Tobacco Control (FCTC). It enabled WHO to have a greater presence at World Trade Organization (WTO) meetings, supporting countries in their efforts to protect their populations against the harms from tobacco. While WHO was present when tobacco trade may conflict with public health concerns, this was not the case in WTO discussions concerning nutrition policy. Even though the Global action plan for the prevention and control of NCDs 2013\u20132020, fully recognizes the need for action on trade in certain foods and beverages, it was not possible to find any evidence of WHO participation in nutrition-related trade challenges, such as those related to unhealthy food high in salt, fat and sugar, alcohol, soft-drinks and infant milk formulae. The authors suggest that WHO can learn from its past successes in championing tobacco control at the WTO. The lack of a treaty similar to the FCTC for nutrition-related diseases may discourage WHO participation because such absence limits the perceived legitimacy of WHO input. Further investigations are necessary to understand why WHO has yet to comment on food and beverage regulations at WTO\u2019s committee. ","php":"","field_issue_date":"2020-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"7th International Conference on the History of Occupational and Environmental Health, 27 \u2013 29 May, Durban, South Africa","field_subtitle":"Abstract submission date extended to 10 December","URL":"https://icohhistory2020.ukzn.ac.za","body":"The theme for the 7th International Conference on the History of Occupational and Environmental Health is \u2018Occupational and Environmental Health: At the Crossroads of Migrations, Empires and Social Movements\u2019. The scientific programme will focus on the migration of workers in various time periods, the interconnections of empires, public health in post-colonial periods, and the role of trade unions and other social movements in occupational and environmental health. The evolution of occupational and environmental health especially in Africa, as well as globally, will be addressed. The conference is intended to promote interconnections among historians, social scientists and occupational and environmental practitioners/researchers. Leading historians in occupational and environmental health have been invited to give keynote lectures. In addition, there will be an open call for abstracts for oral and poster presentations and a pre-conference methods training workshop. Please visit the conference website for instructions on submission of your abstract: You may now register for the Conference at https://icohhistory2020.ukzn.ac.za/registration-information/. Early bird registration will close on 15 January 2020. Early and mid-level academics from African countries are encouraged to apply for the fee waiver. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Adult and young women communication on sexuality: a pilot intervention in Maputo-Mozambique","field_subtitle":"Frederico M; Arnaldo C; Michielsen K; Decat P: Reproductive Health 16(144) 1-12, 2019","URL":"https://tinyurl.com/u2al9gu","body":"With young women increasingly exposed to sexualized messages, they are argued to need clear, trustful and open communication on sexuality more than ever. However, in Mozambique, communication about sexuality is hampered by strict social norms. This paper evaluates an intervention aimed at reducing the generational barrier in talking about sexuality to contribute to better communication within the family context. The intervention consisted of three weekly one-hour coached sessions in which female adults and young people interacted about sexuality. Realist evaluation was used as a framework to assess context, mechanisms and outcomes of the intervention. Interviews were conducted among 13 participants of the sessions. The interaction sessions were positively appreciated by the participants and contributed to a change in norms and attitudes towards communication on sexuality within families. Recognition of similarities and awareness of differences were key in the mechanisms leading to these outcomes. This was reinforced by the use of visual materials and the atmosphere of respect and freedom of speech that characterized the interactions. Limiting factors were related to the long-standing taboo on sexuality and existing misconceptions on sexuality education and talks about sex. By elucidating mechanisms and contextual factors, the study adds knowledge on strategies to improve transgenerational communication about sexuality.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"BAT faces landmark legal case over Malawi families' poverty wages","field_subtitle":"Boseley S: The Guardian, October 2019","URL":"https://tinyurl.com/y4d3xgmr","body":"Human rights lawyers are reported to be preparing to bring a landmark case against British American Tobacco on behalf of hundreds of children and their families forced by poverty wages to work in conditions of gruelling hard labour in the fields of Malawi. Leigh Day\u2019s lawyers are seeking compensation for more than 350 child labourers and their parents in the high court in London, arguing that the British company is guilty of \u201cunjust enrichment\u201d. Leigh Day says it anticipates the number of child labourer claimants to rise as high as 15 000. While BAT claims it has told farmers not to use their children as unpaid labour, the lawyers say the families cannot afford to work their fields, because they receive so little money for their crop. Many of the families are from Phalombe, one of the poorest regions in the south of the country. Children as young as three are involved in tobacco farming, the letter of claim says, often during harvest when the work can be especially hazardous. Children are particularly vulnerable to the effects of toxic pesticides, fertiliser and green tobacco sickness, from nicotine absorption while handling the leaves. Symptoms include breathing difficulties, cramps and vomiting. BAT is one of the most profitable companies in the world, making an operating profit last year of \u00a39.3bn on sales of \u00a324.5bn. Like other big tobacco companies, it has distanced itself from the farmers by commissioning a separate company to buy a stipulated amount of tobacco leaf each year. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Call for abstracts for the Sixth Global Symposium on Health Systems Research (HSR2020)","field_subtitle":"Deadline: 6 February 2020","URL":"https://hsr2020.healthsystemsresearch.org/abstracts","body":"The Sixth Global Symposium on Health Systems Research (HSR2020) is now accepting individual abstracts (including oral presentations and posters), multimedia abstracts and skills-building sessions. You can find out more about key dates and how to submit on the HSR2020 abstracts webpage.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Carnegie African Diaspora Fellowship Program (CADFP)","field_subtitle":"Deadline for applications: 9 December 2019","URL":"https://tinyurl.com/yhelrm3d","body":"The CADFP is a scholar exchange program for African higher education institutions to host a diaspora scholar for 14-90 days for projects in curriculum co-development, research collaboration and graduate student teaching and mentoring. Accredited universities in Ghana, Kenya, Nigeria, South Africa, Tanzania and Uganda and member institutions of the African Research Universities Alliance (ARUA) can submit a project request to host a scholar. Scholars born in Africa, who live in the United States or Canada and work in an accredited college or university in either of those two countries, can apply online to be placed on a roster of candidates for a fellowship. Scholars must hold a terminal degree in their field and may hold any academic rank. Links and information about the African host institution project request application, scholar roster application, and review guidelines are posted on the CADFP website.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Children with hearing impairment in Malawi, a cohort study","field_subtitle":"Mulwafu W; Tataryn M; Polack S; Viste A; et al.: Bulletin of the World Health Organisation 97(10) 654\u2013662, 2019","URL":"https://tinyurl.com/u7jvfgw","body":"This study assessed the outcomes of children diagnosed with hearing impairment 3 years earlier in terms of referral uptake, treatment received and satisfaction with this treatment and social participation. A population-based longitudinal analysis of children with a hearing impairment was conducted in two rural districts of Malawi. Key informants within the community identified the cohort in 2013. Informants clinically screened children at baseline and by questionnaires at baseline and follow-up in 2016. 752 children were diagnosed in 2013 as having a hearing impairment and 307 traced for follow-up in 2016. Referral uptake was low, more likely among older children and less likely for those with an illiterate caregiver. Few of the children who attended hospital received any treatment and 63.6% of caregivers reported satisfaction with treatment. Difficulty making friends and communicating needs was reported for 10.0% and 35.6% of the children, respectively. Lack of school enrolment was observed for 29.5% of children, and was more likely for older children, girls and those with an illiterate caregiver. The authors propose that more widespread and holistic services are required to improve the outcomes of children with a hearing impairment in Malawi.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Corporations\u2019 use and misuse of evidence to influence health policy: a case study of sugar-sweetened beverage taxation","field_subtitle":"Fooks G, Williams S, Box G, Sacks G: BMC Globalization and Health,  15, 56,  doi:10.1186/s12992-019-0495-5, 2019.","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-019-0495-5","body":"Sugar sweetened beverages (SSB) are a major source of sugar in the diet. Although trends in consumption vary across regions, in many countries, particularly LMICs, their consumption continues to increase. In response, a growing number of governments have introduced a tax on SSBs. SSB manufacturers have opposed such taxes, disputing the role that SSBs play in diet-related diseases and the effectiveness of SSB taxation, and alleging major economic impacts. Given the importance of evidence to effective regulation of products harmful to human health, the authors scrutinised industry submissions to the South African government\u2019s consultation on a proposed SSB tax and examined their use of evidence. The findings not only highlight the value of improving the transparency and scrutiny of regulatory impact assessments and consultations in health policy-making, but also other modes of industry political activity. The authors argue that. efforts need to be made to enhance appraisal of industry use of evidence. Ideally, there should be a presumption in favour of in-depth critical appraisal, organised and financially supported by national governments. Beyond this, there is a strong case for closer transnational collaboration between civil society actors and academics that centres on producing real-time appraisals of companies\u2019 use of evidence in both public consultations and other contexts in which they provide information to policy actors and the public.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Crowdsourcing in Health and Health Research: A Practical Guide","field_subtitle":"WHO/TDR and SESH in collaboration with the Social Innovation in Health Initiative: WHO, Geneva, 2019","URL":"https://www.who.int/tdr/publications/year/2018/crowdsourcing-practical-guide/en/","body":"Crowdsourcing tools, such as challenge contests, are increasingly used to improve public health. Crowdsourcing is the process of having a large group, including experts and non-experts, solve a problem and then share the solution with the public. This guide provides practical advice on designing, implementing and evaluating crowdsourcing activities for health and health research \u2013 with descriptions and examples of contests collected through a challenge contest The guide includes: descriptions of and methods for challenge contests for health and health research; how to organize and evaluate contests; practical resources, such as a challenge contest checklist; case studies; and a table of commended challenge contests for health submitted through the report\u2019s challenge contest in 2017. The report was developed by the Social Entrepreneurship to Spur Health (SESH) and the TDR-supported Social Innovation in Health Initiative (SIHI). ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Discussion paper 120: Research that supports health equity: Reflections and learning from EQUINET","field_subtitle":"Loewenson R; Mamdani M; Loewenson T; Dambisya Y; Chitah B; Kaim B; Machemedze R; Gilson L; Zulu A: EQUINET, Harare, 2019","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss120%20Research%20for%20HE%202019%20lfs.pdf","body":"This paper reflects on experience from over two decades of EQUINET research practice to promote health equity in east and southern Africa. The paper was written by members of the EQUINET steering committee and the newsletter team. It draws examples and research features from EQUINET publications available online, a search of publications in the 221 issues of the EQUINET newsletter, and papers, reports, blogs, articles and editorials obtained from key word searches in Google. Despite policy commitments and gains in selected aspects of health, conditions in the region are increasingly driven by a global economy and a regional response that is generating instability, environmental and social costs; intense extraction of natural resources; rising levels of precarious labour, social deficits and weakened public institutions, disrupting social cohesion, solidarity and collective agency. These conditions call for certain features and forms of research. The paper describes diverse research on the costs to health equity of social deficits, inequitable resource outflows and the commodification of public services, as well as research on alternatives and policies on food security, health services, environment and rights that confront these trends. The paper describes specific features of research that respond more directly to the understanding that power relations are central to inequities in health. These research processes explain and show alternatives to disempowering narratives of the inevitability of the status quo and generate knowledge in ways that intend to empower those affected. They pay attention to who defines the research questions, who designs, implements and uses the research. This implies designs and methods that involve people in affirming and validating their realities, generating reflection on causes and building analysis, self-confidence and organisation to act and to learn from action. It presents specific examples of research approaches and the role of a consortium network in advancing them, while noting the ways in which many researchers face the double task of investigating inequities, while also challenging inequity in a global research system.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Disrespectful treatment in primary care in rural Tanzania: beyond any single health issue ","field_subtitle":"Larson E; Mbaruku G; Kujawski A; Mashasi I; et al.: Health Policy and Planning 34(7) 508\u2013513, 2019","URL":"https://academic.oup.com/heapol/article/34/7/508/5542613","body":"Little is known about the prevalence of disrespectful treatment of patients in sub-Saharan Africa outside of maternity care. Data from a household survey of 2002 women living in rural Tanzania was used to describe the extent of disrespectful care during outpatient visits, who receives disrespectful care and the association with patient satisfaction, rating of quality and recommendation of the facility to others. Women were asked about their most recent outpatient visit to the local clinic, including if they were made to feel disrespected, if a provider shouted at or scolded them, and if providers made negative or disparaging comments about them. Women who answered yes to any of these questions were considered to have experienced disrespectful care. The most common reasons for seeking care were fever or malaria, vaccination and non-emergent check-up. Disrespectful care was reported by 14.3% of women and was more likely if the visit was for sickness compared to a routine check-up. Women who did not report disrespectful care were 2.1 times as likely to recommend the clinic. While there is currently a lot of attention on disrespectful maternity care, the authors suggest that this is a problem that goes beyond this single health issue and should be addressed by more horizontal health system interventions and policies.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Ensuring that target-driven funding supports and does not harm comprehensive primary health care in east and southern Africa: Briefs for local, district, regional and international level","field_subtitle":"EQUINET PAROnline community: EQUINET, Harare, 2019","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/PARonline%20brief%20international%202019.pdf","body":"Primary Health Care (PHC) has inspired and galvanized action on health. PHC affirms that health is a state of complete physical, mental and social wellbeing and not merely the absence of disease and that health is a fundamental human right. In the past decade, global institutions have promoted and channeled external funds through performance-based financing (PBF), as a strategy to improve service delivery and access. While there have been studies on whether these particular services targeted under PBF have improved, there has been little systematic evaluation of its system-wide effects, nor of its impacts on comprehensive PHC. In EQUINET, we thus saw it to be important to ask: How is the use of targets in PBF affecting health workers\u2019 professional roles, work and interaction with communities and their ability to deliver comprehensive PHC? In 2018-2019 the PAR involved 21 online participants from seven sites in five ESA countries, including health workers from primary health cent res, community members in HCCs and country site facilitators from seven national health civil society organisations in the region, referred to in this brief collectively as the \u2018online participants\u2019. We also included offline local discussions with an average of 19 community members and 15 health workers per site. Four major areas of action and ten proposals were made within them for PBF to enable and not detract from PHC. These are 4 briefs each of which present the general findings and proposals from the work with separate final points in the first brief for local level; in the second for district and national level; in the third brief for regional level agencies and in the fourth brief for international agencies. The link is to one of the briefs  but all four are on the website.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 222: How can research promote equity and justice in health?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET workshop on health literacy for the mining and extractive sector ","field_subtitle":"1-2 February, 2020, Cape Town, South Africa","URL":"http://www.equinetafrica.org/content/meetings","body":"Most countries in east and southern Africa have rich deposits of a range of mineral reserves that are highly sought after in global trade. Extractive industries (EIs), largely multinationals from all regions of the world, extract these minerals, oil and gas from the earth through mining, dredging and quarrying. Countries in east and southern Africa thus face a challenge to make and implement policy choices that link these natural resources to improved social and economic development, and to ensure that extraction processes do not harm health or environments.  EQUINET is working with trade union partners in the Southern Africa Coordination Council (SATUCC), Ex mineworkers in the Southern Africa Miners Association (SAMA) and civil society through Benchmarks SA on health in the mining sector in east and southern African (ESA) countries. EQUINET are holding a regional meeting on February 1 and 2 2020 in Cape Town South before the Alternative Mining Indaba to share health literacy information on mining and health, distribute the health literacy module on mining and health, and share other materials and experiences in EQUINET\u2019s ongoing programmes and advocacy on mining and health in the region. The workshop is aimed at trade union, ex mineworker and civil society  health organisers. There are very limited sponsored places and self-sponsored places left so those interested, and those attending the AMI who wish to join the meeting, are asked to apply soonest by email.  ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Farmworkers want 67 pesticides banned","field_subtitle":"Hendricks A: Ground up, August 2019","URL":"https://www.groundup.org.za/article/farmworkers-want-67-pesticides-banned/","body":"Over 200 women farm workers from across the Western Cape marched to Parliament on Wednesday demanding that the Department of Agriculture, Forestry & Fisheries (DAFF) and the Department of Labour work together to ban 67 pesticides to protect the health of farm workers. They also want farmers to be held accountable if they disobey labour practices. Research done by the 'Women on Farms' project showed that 73% of women seasonal workers interviewed did not receive protective clothing and 69% came into contact with pesticides within an hour after it had been sprayed. For safety, different pesticides have their own \u201cre-entry period\u201d that has to be adhered to. The WFP campaign to ban pesticides is also being supported by Oxfam South African and Oxfam Germany. With the memorandum, members from Oxfam Germany handed over a placard with 29,302 signatures on it from German consumers supporting the ban.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"From primary health care to universal health coverage\u2014one step forward and two steps back","field_subtitle":"Sanders D, Nandi S, Labont\u00e9 R, Vance C, Van Damme W: The Lancet, Vol 394; 10199, 619-621, 2019","URL":"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31831-8/fulltext","body":"Primary health care (PHC), codified at the historic 1978 Alma Ata Conference, was advocated as the means to achieve health for all by the year 2000.  The principles of PHC included universal access and equitable coverage; comprehensive care emphasising disease prevention and health promotion; community and individual participation in health policy, planning, and provision; intersectoral action on health determinants; and appropriate technology and cost-effective use of available resources. These principles were to inform health-care provision at all levels of the health system and the programmatic elements of PHC that focused primarily on maternal and child health, communicable diseases, and local social and environmental issues. PHC emphasised community participation through a network of workers at all levels who would be trained both \u201csocially and technically\u201d. UHC is concerned with improved access to quality health services and protection from financial risks associated with health care. However, UHC, unlike PHC, is silent on social determinants of health and community participation.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Generating statistics from health facility data: the state of routine health information systems in Eastern and Southern Africa","field_subtitle":"Ma\u00efga A, Jiwani S, Mutua M, et al.: BMJ Global Health; 4:e001849. doi:10.1136/ bmjgh-2019-001849, 2019","URL":"https://www.hst.org.za/publications/NonHST%20Publications/Generating%20Statistics.pdf","body":"Health facility data are a critical source of local and continuous health statistics. Countries have introduced web-based information systems that facilitate data management, analysis, use and visualisation of health facility data. Working with teams of Ministry of Health and country public health institutions analysts from 14 countries in Eastern and Southern Africa, the authors explored data quality using national-level and subnational-level (mostly district) data for the period 2013\u20132017. The focus was on endline analysis where reported health facility and other data are compiled, assessed and adjusted for data quality, primarily to inform planning and assessments of progress and performance.  The analyses showed that although completeness of reporting was generally high, there were persistent data quality issues that were common across the 14 countries, especially at the subnational level. These included the presence of extreme outliers, lack of consistency of the reported data over time and between indicators (such as vaccination and antenatal care), and challenges related to projected target populations, which are used as denominators in the computation of coverage statistics. The authors propose continuous efforts to improve recording and reporting of events by health facilities, systematic examination and reporting of data quality issues, feedback and communication mechanisms between programme managers, care providers and data officers, and transparent corrections and adjustments will be critical. to improve the quality of health statistics generated from health facility data.\r\n","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI)","field_subtitle":"Harvard T.H. Chan School of Public Health, University of Witwatersrand, Johannesburg, and the INDEPTH Network: 2019 ","URL":"https://haalsi.org/about","body":"The Health and Aging Study in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) is led by an interdisciplinary team of collaborators from Harvard School of Public Health, University of Witwatersrand, Johannesburg, and the INDEPTH Network, a global network of health and demographic surveillance systems based in Ghana. By integrating the HAALSI data with cause of death data from the INDEPTH Health and Demographic Surveillance System (HDSS) data at the MRC/Wits Agincourt research site, the authors explored the interrelationships between physical and cognitive functioning, lifestyle risk factors, household income and expenditure, depression and mental health, social networks and family composition, HIV infection and cardio-metabolic disease. In South Africa, the research found that people who were participating in the national HIV treatment programme were more likely to receive care for high blood pressure and achieve control of both blood pressure and blood sugar. This finding suggests that strong primary care systems are an important part of the answer to the disease trends of older adults and that South Africa\u2019s national HIV treatment programme may offer a great platform for expanding primary care for all South Africans. Good health habits formed in childhood and in young adulthood \u2013 including avoiding smoking and alcohol overuse, engaging in physical activity and eating a nutritious diet are identified as being crucial to healthy ageing of the society of a whole.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Health system constraints affecting treatment and care among women with cervical cancer in Harare, Zimbabwe","field_subtitle":"Tapera O; Dreyer G; Kadzatsa W; Nyakabau A:  BMC Health Services Research 19(829) 1-10, 2019 ","URL":"https://tinyurl.com/tfa9dhp","body":"This study investigated health system constraints affecting treatment and care by women with cervical cancer in Harare, Zimbabwe. A sequential explanatory mixed methods design was used. Phase 1 comprised of two surveys namely: patient and health worker surveys with sample sizes of 134 and 78 participants respectively. In phase 2, 16 in-depth interviews, 20 key informant interviews and 6 focus groups were conducted to explain survey results. Health system constraints identified were: limited or lack of training for health workers, weakness of surveillance system for cervical cancer, limited access to treatment and care, inadequate health workers, reliance of patients on out-of-pocket funding for treatment services and lack of back-up for major equipment. The qualitative inquiry found barriers to be: high costs of treatment and care, lack of knowledge about cervical cancer and bad attitudes of health workers, few screening and treating centres located mostly in urban areas, lack of clear referral system resulting in bureaucratic processes and limited screening and treating capacities in health facilities due to lack of resources. The study showed that the health system and its organization present barriers to access of cervical cancer treatment and care among women.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Health systems must go beyond \u2018sick care\u2019 for universal health coverage","field_subtitle":"Bennett S; El-Jardali F: Health Systems Global, September 2019","URL":"https://tinyurl.com/vk5tu5u","body":"Universal Health Coverage (UHC) is normally understood as \u2018people being able to access curative, preventive and palliative health services without incurring financial hardship\u2019. Yet this interpretation is only one part of the overall picture of health. To mitigate and prepare for such environmental and societal changes and the subsequent impact on health the authors suggest that there are at least three major ways in which health systems need to radically transform. Firstly, health systems across the world continue to be predominantly \u2018sick care\u2019 systems. Despite the success of immunization campaigns, the availability of contraceptive services and other preventive interventions, most investment is in healthcare facilities that provide primarily personal, curative health services. The World Health Organization estimates that low- and middle-income countries direct only 11-12 per cent of their total health spending towards preventive services. Secondly, animal and wildlife information systems vary enormously across countries in their objectives and structure but rarely interact with systems for tracking human health. This means that opportunities to identify dangerous viruses and diseases in the animal population before they crossover into humans are frequently missed. Thirdly, at the UN General Assembly (UNGA) the community of academics and activists concerned with non-communicable diseases were vocal, and rightly so. Such diseases now account for 41 out of the world\u2019s 57 million deaths each year. The authors suggest that there is a need to move away from a narrow view of \u2018sick care\u2019 to one that prepares for and acknowledges present day complexities and challenges to achieve UHC.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Health, life and rights: a discourse analysis of a hybrid abortion regime in Tanzania","field_subtitle":"Sambaiga R; Haukanes H; Moland K; Blystad A: International Journal for Equity in Health 18(135) 1-12, 2019","URL":"https://tinyurl.com/swnfsss","body":"This paper explores how major global abortion discourses manifest themselves in Tanzania and indicates potential implications of a hybrid abortion regime. The study combined a review of legal and policy documents on abortion, publications on abortion in Tanzanian newspapers between 2000 and 2015 and 23 semi-structured qualitative interviews with representatives from central institutions and organizations engaged in policy- or practical work related to reproductive health. Tanzania\u2019s abortion law is highly restrictive, but the discursive abortion landscape is diverse and is made manifest through legal- and policy documents and legal- and policy related disputes. The discourses were characterized by diverse frames of reference based in religion, public health and in human rights-based values, reflecting the major global discourses. The paper demonstrates that a hybrid discursive regime relating to abortion is found even in the legally restrictive abortion context of Tanzania. The authors argue that a complex discourse cuts across the restrictive - liberal divide and opens avenues for enhanced access to abortion related knowledge and services.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Hearing and vision screening for preschool children using mobile technology, South Africa","field_subtitle":"Eksteen S; Launer S; Kuper H; Eikelboom R; et al.:  Bulletin of the World Health Organisation 97 (10) 672\u2013680, 2019 ","URL":"https://tinyurl.com/vakbpxl","body":"screening programme for preschool children in the Western Cape, South Africa, supported by mobile health technology and delivered by community health workers. The authors trained four community health workers to provide dual sensory screening in preschool centres of Khayelitsha and Mitchells Plain during September 2017\u2013December 2018. Community health workers screened children aged 4\u20137 years using mobile health technology software applications on smart-phones. Community health workers screened 94.4% of eligible children at 271 centres at a cost of US$5.63 per child. The number of children who failed an initial hearing and visual test was 435 and 170, respectively. Of the total screened, 111 children were diagnosed with a hearing and/or visual impairment. Mobile health technology supported community health worker delivered hearing and vision screening in preschool centres provided a low-cost, acceptable and accessible service, contributing to lower referral numbers to resource-constrained public health institutions. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"HIV self-testing services for female sex workers, Malawi and Zimbabwe","field_subtitle":"Napierala S; Desmond N; Kumwenda M; Tumushime M; et al.: Bulletin of the World Health Organization 97(11) 764\u2013776, 2019","URL":"https://tinyurl.com/ucwuy3a","body":"n Zimbabwe, research was conducted to assess the acceptability and accuracy of human immunodeficiency virus (HIV) self-testing. During implementation, the authors evaluated sex workers\u2019 preferences for and feasibility of distribution of test kits before the programme was scaled-up. In Malawi, the authors conducted a rapid ethnographic assessment to explore the context and needs of female sex workers and resources available, leading to a workshop to define the distribution approach for test kits. Once distribution was implemented, the authors conducted a process evaluation and established a system for monitoring social harm. In Zimbabwe, female sex workers were able to accurately self-test. The preference study helped to refine systems for national scale-up through existing services for female sex workers. The qualitative data helped to identify additional distribution strategies and mediate potential social harm to women. In Malawi, peer distribution of test kits was the preferred strategy. The authors identified some incidents of social harm among peer distributors and female sex workers, as well as supply-side barriers to implementation which hindered uptake of testing. Involving female sex workers in planning and ongoing implementation of human immunodeficiency virus self-testing is essential, along with strategies to mitigate potential harm. Optimal strategies for distribution and post-test support are argued to be context-specific and to need to consider existing support for female sex workers and levels of trust and cohesion within their communities.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"How can research promote equity and justice in health?","field_subtitle":"EQUINET steering committee members","body":"\r\nWhen EQUINET was formed in 1998, all east and southern African countries had public policy commitments to improve health equity.  This was a statement of values, and needed to be protected socially, as much as it demanded information on how to achieve it. As people from government, unions, civil society, parliament, academia from other institutions in the region, we saw that research could inform and reinforce this policy intention. We could expose the extent and forms of avoidable, unfair inequality and their determinants and propose ways of advancing equity in health. With inequalities a reflection of the power people have to direct resources towards their wellbeing, we saw research and knowledge as not neutral in these power relations. \r\n\r\nThis year we reflected on our experience from over two decades of EQUINET research on how, and how far our research practice had achieved these intentions. \r\n\r\nPolicies have been articulated and knowledge generated in our region by many, including ourselves on the inclusive economic policies, comprehensive public services and rights-based approaches to addressing social inequality. Yet our realities are increasingly driven by a global economy and a regional response that is generating instability, environmental and social costs; increasing extraction and export of natural resources; rising levels of precarious labour, social deficits and destruction of cultures. Our public institutions have become weaker and even basic forms of wellbeing commodified, disrupting cohesion, solidarity and collective agency. ESA countries are framed as \u2018under-developed\u2019 and \u2018aid recipients\u2019, with populations undergoing a \u2018development pathway\u2019, despite the economic insecurity, resource depletion and social deficits associated with this pathway. Responding to these trends, people in the network have done work to expose and show the harms and violations in people\u2019s experience of these trends, and to point to opportunities for alternative policy and practice.\r\n\r\nResearch on these issues has involved relationships and dialogue with key constituencies, from the onset and throughout the process, and efforts to ensure rigour, quality, validity and ethical practice. We have shared results in a range of media and interactions. Implementation research, appreciative inquiry, realist review, benefit incidence analysis, policy analysis and other designs have, with the new lenses brought by diverse disciplines in the network, taken us outside biomedical paradigms and the \u2018core curative care business\u2019 that the health sector has retreated to, exploring the choices made in a range of sectors and what this means for the wellbeing of current and future generations.  \r\n\r\nHowever, the battle of ideas and struggle over wealth and power that lies at the heart of the trends generating inequalities in health in our region raise not just WHAT is investigated, but also WHO asks the questions, WHOSE assumptions are brought to bear and HOW the research is done.  Research can explain and show alternatives to disempowering narratives of the inevitability of the status quo and generate knowledge in ways that empower those affected to affirm their reality, to reflect on the causes of their problems and to more directly articulate alternative explanations and build the self-confidence and organisation to produce change and to learn from actions taken.  \r\n\r\nLike others working on social justice, we are on a constant learning curve on how to do this. Participatory action research has, for example, provided a particularly powerful means for people to create counter-narratives to dominant characterizations that ignore or undermine them, transforming people from objects to subjects and strengthening strategic action and review. Yet we are still learning how to embed PAR within the democratic functioning of social organisations as well as testing, such as through online PAR, how to amplify the organisation, consciousness and voice from largely local PAR processes to engage global level drivers of inequity, without losing their authenticity. We\u2019ve been excited by methods and capacities that allow for the complexity of the many overlapping stories in our lives and countries, including narrative research, \u2018fiction\u2019, theatre, photography, and social media, We\u2019ve appreciated how technologies used in research are deeply connected to the processes and interests that use them. \r\nDoing this work excites, reveals, generates energy and many collective \u2018aha\u2019 moments!. But it also exhausts, demands many hours of time and absorbs all those involved in social processes. Many talk about facing the double task of researching on inequities, while also challenging inequity in a global research system that undervalues the cross disciplinary, reflexive and participatory approaches and interactions that are features of equity related research. People in the region, particularly at local level, face travel, visa, cost, gender, class and racial barriers that exclude them from engaging in northern-based global processes. \r\n\r\nIn this context, being in a consortium network and the partnerships with the network have provided support, resources, exchanges and peer review for more self-determined work. The wide range of disciplines, lenses and constituencies in the network have provoked us to be more creative. Yet our region is changing, encountering new opportunities and challenges. We cannot afford to be over-comfortable in old relationships, methods and practice. So the question stays on the agenda: how can our research practice better promote equity and justice in health?\r\n\r\nWe welcome your feedback or queries on the issues raised in this oped \u2013 please send them to the EQUINET secretariat: admin@equinetafrica.org. Please visit http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss120%20Research%20for%20HE%202019%20lfs.pdf  to read the discussions, ideas and examples in the full paper that the editorial draws from. Several papers included in this newsletter also provide interesting experiences and reflections on research for equity and equity in research systems. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Huawei's pitch to African mayors: \u2018Our cameras will make you safe\u2019","field_subtitle":"Allison S: Mail and Guardian, November 2019","URL":"https://mg.co.za/article/2019-11-15-00-our-cameras-will-make-you-safe","body":"A conference organised by the Brenthurst Foundation, a Johannesburg-based think-tank and lobby group gave Huawei a slot to pitch its vision for the future of African cities. It is a vision that revolves around surveillance, artificial intelligence and 5G communication networks, creating a world where your every movement is tracked, recorded and searchable. Human Rights Watch describes this technology, however, as \u201calgorithms of repression\u201d, given a potential for abuse of people\u2019s rights.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"International Conference on Thinking 2020","field_subtitle":"15-18 June 2020, Ekurhuleni, South Africa","URL":"http://www.icot2020.org","body":"The International Conference on Thinking (ICOT2020) will showcase African thinking and its contribution to shaping the progress of societies around the world. ICOT2020 will take place in Ekurhuleni, Johannesburg, South Africa, with the theme of thinking to transform societies. The core focus is education, with environment, business, health, sport and society as the other strands. Sub-themes engage with teaching for better thinking engagement, impact and innovation, fostering an entrepreneurial mindset, breaking from poverty creating, imagining, innovating, promoting an ethic of care towards a sustainable future and exploring African ways of thinking. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"International Health Economics Association (iHEA) Call for Nominations for the 2020 Student Paper Prize","field_subtitle":"Deadline: January 13, 2020","body":"The International Health Economics Association (iHEA) is pleased to invite nominations for the Annual Student Paper Prize in Health Economics. Nominations should include a brief letter of nomination (250 words max) and a copy of the paper (preferably pdf). A student is defined as someone currently studying (full or part time) at a higher education institution, at either Masters or Doctoral level. In addition, students who have completed their studies in the year previous to the announcement qualify as long as the paper was written while registered as a student. Papers can be published or unpublished, but must be in comparable format to a published paper in Journal of Health Economics or Health Economics, of maximum length 8,000 words. Self nomination is acceptable. Papers should be in English. If a submitted paper has more than one author, the student contribution must be at least 75% overall and an accompanying letter must be signed by co-authors to support this, stating the nature of their contribution (conceptualization, analysis, writing etc.). A joint student paper with 50-50 contributions is acceptable. The Prize will be subsidized travel and attendance at the 2021 iHEA Congress in Cape Town to present the paper in a Student Prize Special Organised Session chaired by the iHEA President, or Chair of the Prize Committee; the equivalent of US$1,000; and the offer (if the author wishes, and the paper is unpublished) of potential fast track publication in Health Economics, subject to Editorial approval. The papers in 2nd and 3rd place will receive the equivalent of US$250 each and free registration (but not travel) at the 2021 Cape Town iHEA Congress. They will be invited to give brief presentations at the iHEA Congress Student Prize Special Organized Session.  Applications and inquiries to the email address below. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Key findings from parliamentary meeting on UK Visa refusals for African visitors to the UK ","field_subtitle":"Bailey H: Royal African Society, February 2019","URL":"http://www.royalafricansociety.org/analysis/key-findings-parliamentary-meeting-uk-visa-refusals-african-visitors-uk","body":"In January the All Party Parliamentary Group (APPG) for Africa working in coalition with the APPG for Diaspora, Development and Migration and the APPG for Malawi hosted a meeting in parliament to hear oral evidence on UK visa refusals for African visitors. Participating organisations and individuals gave numerous accounts of conferences, festivals, collaborations and business and trade partnerships that had been undermined due to legitimate African participants being denied visas. Statistics show that UK visa refusals are issued at twice the rate for African visitors than for those from any other part of the world. Evidence strongly demonstrates that the UKVI system lacks consistency, intelligence and any accountability. The immediate cost, needing to access the internet and to pay in a foreign currency all present initial barriers. Other than the practical barriers faced by the applicants, the huge distances between the place of application and where the decisions are made means they are usually made away from local expertise, context and insight that would have previously be held at the High Commissions. The last report on visa services, from the Independent Chief Inspector in 2014 found that over 40% of refusal notices were \u201cnot balanced, and failed to show that consideration had been given to both positive and negative evidence\u201d. The panel heard that applicants are often refused based on a lack of proof or information that was not required or even mentioned under the guidelines for the application. The meeting concluded that the current system was not designed but has organically grown into something that is not fit for purpose. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Maternal determinants of optimal breastfeeding and complementary feeding and their association with child undernutrition in Malawi (2015\u20132016)","field_subtitle":"Walters C;  Rakotomanana H; Komakech J;  Stoecker B: BMC Public Health  19 (1503) 1-12, 2019 ","URL":"https://tinyurl.com/t9xnuj8","body":"The study determined current breastfeeding and complementary feeding practices to identify maternal determinants of each practice, and their association with stunting, underweight, and wasting. The most recent Malawi Demographic Health Survey 2015\u20132016 was used and data for 2294 children aged 0\u201323\u2009months included. A conceptual framework of five maternal domains: sociodemographic, health status, health behaviors, women\u2019s empowerment, and media exposure was used. Among children, 30.8% were stunted, 9.9% were underweight, and 3.7% were wasted. Many were breastfed within the first hour of birth, 89% were breastfed until their first birthday and 40% were not exclusively breastfed to 6 months. Only 32% met minimum dietary diversity, 23% met minimum meal frequency, 12% met minimum acceptable diet and 12% consumed iron-rich foods. Children whose mothers lived in urban areas were less likely to be breastfed within 1 hour of birth but more likely to meet minimum dietary diversity. Children whose mothers listened to radio were more likely to meet minimum meal frequency. Children who met minimum meal frequency and minimum acceptable diet were less likely to be underweight. Optimal breastfeeding and complementary feeding practices in Malawi remain suboptimal and child undernutrition remains problematic. Maternal characteristics from the five domains were significantly associated with optimal breastfeeding and complementary feeding indicators. Knowledge of these maternal determinants were found to assist in improving nutrition policies and interventions that aim to impact breastfeeding and complementary feeding practices and child growth in Malawi.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Household Poverty"}},{"node":{"title":"Measuring progress towards universal health coverage: national and subnational analysis in Ethiopia","field_subtitle":"Eregata G; Hailu A; Memirie S; Norheim O: BMJ Global Health 4:e001843 1-9, 2019  ","URL":"https://tinyurl.com/vchp5xs","body":"his study aimed to estimate the 2015 national and subnational universal health coverage service coverage (UHC) status for Ethiopia. The UHC service coverage index was constructed from indicators of four major categories using survey data and administrative data. The overall Ethiopian UHC service coverage for 2015 was 34.3%, ranging from 52.2% in Addis Ababa city to 10% in the Afar region. The coverage for non-communicable diseases, reproductive, maternal, neonatal and child health and infectious diseases were 35%, 37.5% and 52.8%, respectively. The national UHC service capacity and access coverage was only 20% with large variations across regions, ranging from 3.7% in the Somali region to 41.1% in the Harari region. The 2015 overall UHC service coverage for Ethiopia was low compared with most of the other countries in the region. There was a substantial variation among regions. The authors argue that Ethiopia should rapidly scale up promotive, preventive and curative health services through increasing investment in primary healthcare if it aims to reach the UHC service coverage goals, and to narrow the gap across regions, such as through redistribution of the health workforce, increasing resources allocated to health and providing focused technical and financial support to low-performing regions.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Potential Health Impact of the African Continental Free Trade Area Agreement (AfCTA)","field_subtitle":"Awosusi A: International Health Policies, 2019","URL":"https://tinyurl.com/qpqp4mm","body":"Nearly all African countries have endorsed the continental free trade agreement. Trading is scheduled to commence in 2020 after key negotiations are concluded. Implementation of the agreement is likely to impact health in at least five areas: human capital investments, health innovations, trade for social impact, health security and universal health coverage. The author reccommends that health and development stakeholders take proactive measures to ensure health is protected in policies, programs and negotiations. While the five proposed areas are not exhaustive, they are argued to represent a basic foundation for rigorous research and informed engagement by health and development leaders in AfCFTA and trade-related processes. Other issues such as research and development, biopharmaceutical innovation and intellectual property rights also need to be considered. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Preference and uptake of different community-based HIV testing service delivery models among female sex workers along Malaba-Kampala highway, Uganda, 2017","field_subtitle":"Pande G; Bulage L; Kabwama S; Nsubuga F: BMC Health Services Research 19(799) 1-11, 2019","URL":"https://tinyurl.com/tngmf67","body":"The paper assessed preference and uptake for the enabling environment created to deliver the different community-based HIV testing services to female sex workers along the Malaba-Kampala highway. Malaba \u2013 Kampala high way is one of the major high ways with many different hot spots where the actual buying and selling of sex takes place. The authors defined female sex workers as any female, who undertakes sexual activity after consenting with a man for money or other items/benefits as an occupation or as a primary source of livelihood irrespective of site of operation within the past six months. The authors assessed the preference and uptake of different community-based HIV testing services delivery model among female sex workers based on the proportion of female sex workers who had an HIV counseling and testing in the last 12\u2009months and the proportion of female sex workers who were positive and linked to care. Overall, 86% of the female sex workers had taken an HIV test in the last 12\u2009months. Of the 390 Female Sex workers, 72% had used static facilities, 25% had used outreaches, and 3.3% used peer to peer mechanisms to have an HIV test. Overall, 35% of the female sex workers who had taken an HIV test were HIV positive. Of the 159, 83% were successfully linked into care. Ninety one percent reported to have been linked into care by static facilities. Challenges experienced included; lack of trust in the results given during outreaches, failure to offer other testing services including hepatitis B and syphilis during outreaches, inconsistent supply of testing kits, condoms, STI drugs, and unfriendly health services due to the infrastructure and non-trained health workers delivering KP HIV testing services. Most of the Female Sex workers had HIV counseling and testing services and were linked to care through static facilities. Community-based HIV testing service delivery models are challenged with inconsistent supply of HIV testing commodities and unfriendly services. The authors recommended strengthening of all HIV testing community-based HIV testing service delivery models by ensuring constant supply of HIV testing/AIDS care commodities offering Female Sex workers friendly services, and provision of comprehensive HIV/AIDS health care package.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Recognising and responding to the scars of Cyclone Idai ","field_subtitle":"Itai Rusike, Caiphas Chimhete, Edgar Mutasa and Tafadzwanashe Nkrumah, CWGH, Zimbabwe ","body":"\r\nSix months after Cyclone Idai ravaged the eastern province of Manicaland in Zimbabwe, the devastating effects show that there is need for more work to do for the recovery. The survivors are still in dire straits, psychologically, emotionally and materially. \r\n\r\nThe traumatic events of 15 March 2019 remain etched on the minds of the survivors. Any rumbling sound, even light rain, sends them quaking, as a reminder of the tragic events of that \u2018night of death\u2019, when torrential rains and heavy winds claimed their loved ones and left them scarred. \r\n\r\nCyclone Idai resulted in a massive loss of life and injury, as well as destruction of critical infrastructure, including clinics, schools, roads, bridges, electricity base stations and houses. Manicaland province was the most affected, followed by Masvingo and Mashonaland East. The destruction also affected parts of neighbouring Mozambique and Malawi.\r\n\r\nGovernment statistics indicate that 341 people died, 344 were missing, 183 were injured and 2213 people were displaced. Further, 230 dams burst and 20 000 livestock were lost. The loss of electricity compromised communication systems and hampered search and rescue efforts. The damage to communication networks means that many communities remain cut off from essential services.  Despite government, with assistance from South Africa, having mobilized earth-moving equipment, some roads are still not passable.\r\n\r\nThis situation presented a public health threat of water and vector borne diseases, such as cholera, typhoid and malaria. Malaria deaths have spiked in Manicaland following the Cyclone.   The trauma and loss has certainly led to mental health problems.  The damage to infrastructure has impeded access to health services, raising the risk that people cannot access or default on treatment and care. In addition, local health services are understaffed and lack adequate medicines.\r\n\r\nThe magnitude of the disaster was greater than government alone could cope with. The international community, United Nations agencies, civil society organisations and individuals all contributed. For example, the Community Working Group on Health (CWGH) with Medico International provided relief and aid to 171 households in holding camps in April to June 2019. This interaction also led to input to recommendations to the Civil Protection Unit and other inter-ministerial committees responsible for preventing disease outbreaks and ensuring provision of safe and clean water in the holding camps. Yet the high death toll from Cyclone Idai indicated the lack of disaster preparedness and planned mitigation by government, considering the earlier heavy loss from Cyclone Eline in 2000. Many lives could have been saved had the warnings for Cyclone Idai been widely disseminated in the local media to warn households and a response mobilized to evacuate people from the affected areas. \r\n\r\nThe situation continues to be precarious up to today. Manicaland Provincial Affairs Minister Dr Ellen Gwaradzimba noted that the situation in that province is now worsened by drought, affecting about 1.7 million people, in a situation where food reserves and fields were destroyed. Even while the response moves from an emergency to a recovery phase, the need to both learn from the experience and to sustain intervention is clear, including to respond to continuing vulnerability and to resettle internally-displaced people. \r\n\r\nAt a Provincial All-stakeholder Dialogue Meeting on Cyclone Idai in June concern was raised over the weak execution of the disaster emergency plans for evacuation and rescue and the absence of community-based emergency plans. For example, the reluctance of people to leave their ancestral land, even after being alerted of the disaster, was one factor that impeded evaluation. The dialogue meeting recommended that a government emergency response fund be set up; that communities be educated on first aid and disaster risk management in schools and in the community; and that campaigns be undertaken on disaster preparedness and mitigation. \r\n\r\nWhile much effort has already been made in improving access to public and social services, resources are needed to restore roads, bridges, houses and sanitary facilities. Survivors need counseling and psychosocial support services. Displaced people and affected communities need new land for more rapid permanent resettlement and investments in their livelihoods and social services.\r\n\r\nIn all these inputs the planning, preparations, decisions and responses need to be people-centered. Putting people at the centre of the next steps, including in the planning for any future emergencies, is central to the response.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Repositioning Africa in global knowledge production","field_subtitle":"Fonn S; Ayiro L; Cotton P; Habib A; et al: The Lancet 392 (10153), doi:https://doi.org/10.1016/S0140-6736(18)31068-7, 2018","URL":"https://www-sciencedirect-com.libproxy.ucl.ac.uk/science/article/pii/S0140673618310687","body":"Sub-Saharan Africa accounts for 13.5% of the global population but less than 1% of global research output. In 2008, Africa produced 27\u2008000 published papers\u2014the same number as The Netherlands. Informed by a nuanced understanding of the causes of the current scenario, the authors propose action that should be taken by African universities, governments, and development partners to foster the development of research-active universities on the continent. Sub-Saharan Africa depends greatly on international collaboration and visiting academics for its research output. Many researchers whose publications are associated with sub-Saharan Africa are described as non-local and transitory; they spend less than 2 years at sub-Saharan African institutions. Meanwhile, intra-Africa collaboration remains severely restricted. The authors note that research-intensive universities across sub-Saharan Africa need to be identified, recognised, strengthened, and invested in. These research-intensive universities should focus their resources on graduate training and research. Creating and maintaining research-intensive universities will require consistent investment in human capital, research equipment, and relevant administrative support, at far higher levels than is available under current conditions. New funding mechanisms need to be created to support research-intensive Africa universities. At a minimum, research-intensive universities should commit their own resources to research. African Governments must increase their support for research in general and provide targeted funding for research-intensive universities. They suggest that this  will only succeed and be sustained if there is accountability, transparency, and efficiency in the use of funds at research-intensive universities. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Revenue-raising potential for universal health coverage in Benin, Mali, Mozambique and Togo ","field_subtitle":"Mathauer I; Koch K; Zita S; Alex Murray-Zmijewski A; et al.: Bulletin of the World Health Organ 97(9) 620\u2013630, 2019","URL":"https://tinyurl.com/qkb9dep","body":"Increasing fiscal space is argued to be important for health sector public financing. One strategy is to mobilize additional government revenues through new taxes or increased tax rates on goods and services. The authors illustrate how countries can assess the feasibility and quantitative potential of different revenue-raising mechanisms. The processes and results from country assessments in Benin, Mali, Mozambique and Togo are reviewed and synthesized. The studies analysed new taxes or increased taxes on airplane tickets, phone calls, alcoholic drinks, tourism services, financial transactions, lottery tickets, vehicles and the extractive industries. Study teams in each country assessed the feasibility of new revenue-raising mechanisms using six qualitative criteria. The quantitative potential of these mechanisms was estimated by defining different scenarios and setting assumptions. Consultations with stakeholders at the start of the process served to select the revenue-raising mechanisms to study and later to discuss findings and options. Exploring feasibility was essential, as this helped rule out options that appeared promising from the quantitative assessment. Stakeholders rated stability and sustainability positive for most mechanisms, but political feasibility was a key issue throughout. The estimated additional revenues through new revenue-raising mechanisms ranged from 0.47\u20131.62% as a share of general government expenditure in the four countries. Overall, the revenue raised through these mechanisms was small. The authors advise countries to consider multiple strategies to expand fiscal space for health. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Structural adjustment programmes adversely affect vulnerable populations: a systematic-narrative review of their effect on child and maternal health","field_subtitle":"Thomson M; Kentikelenis A; Stubbs T: Public Health Reviews 38(13), doi: 10.1186/s40985-017-0059-2, 2017","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810102/","body":"Structural adjustment programmes of international financial institutions have typically set the fiscal parameters within which health policies operate in developing countries. Yet, a systematic understanding of the ways in which these programmes impact upon child and maternal health is currently lacking. This article systematically reviews observational and quasi-experimental articles published from 2000 onward in online databases and grey literature from websites of IMF, World Bank and African Development Bank. Studies were considered eligible if they empirically assessed the aggregate effect of structural adjustment programmes on child or maternal health in developing countries. Of 1961 items yielded through database searches, reference lists and organisations\u2019 websites, 13 met the inclusion criteria. The authors found that structural adjustment programmes had a detrimental impact on child and maternal health. In particular, these programmes undermined access to quality and affordable healthcare and adversely impacted upon social determinants of health, such as income and food availability. According to the authors, the evidence suggests that a fundamental rethink is required by international financial institutions if low income countries are to achieve the Sustainable Development Goals on child and maternal health. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The danger of a single story","field_subtitle":"Adichie C: TEDGlobal, 2009","URL":"https://www.ted.com/talks/chimamanda_adichie_the_danger_of_a_single_story/transcript","body":" In this TED talk, Chimamanda Ngozie Adichie warns of \u2018the danger of the single story\u2019.  She describes how impressionable and vulnerable people are in the face of a story, particularly as children.  She notes that stories matter, but also that many stories matter and no single story can portray a reality. Stories have been used to dispossess and to malign, but stories can also be used to empower and to humanize. Stories can break the dignity of a people, but stories can also repair that broken dignity. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The future of African Studies: what we can do to keep Africa at the heart of our research","field_subtitle":"Nolte I: Journal of African Cultural Studies 31(3) 296-313, doi: https://doi.org/10.1080/13696815.2019.1584552, 2019","URL":"https://www.tandfonline.com/doi/full/10.1080/13696815.2019.1584552","body":"Over the past two decades, Africa has returned to academic agendas outside of the continent. At the same time, the field of African Studies has come under increasing criticism for its marginalisation of African voices, interests, and agendas. This article explores how the complex transformations of the academy have contributed to a growing division of labour. Increasingly, African scholarship is associated with the production of empirical fact and socio-economic impact rather than theory, with ostensibly local rather than international publication, and with other forms of disadvantage that undermine respectful exchange and engagement. This discourages engagement with Africa as a place of intellectual production in its own right. By arguing that scholars can and should make a difference to their field, both individually and collectively, the author suggests ways of understanding and engaging with these inequalities.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The pharmaceutical industry in Sub-Saharan Africa: A guide for promoting pharmaceutical production in Africa (UNIDO)","field_subtitle":"White S; Banda G; Chaudhuri S; Chen L; et al.: United Nations Industrial Development Organisation (UNIDO), 2019","URL":"https://tinyurl.com/yf2ze9p2","body":"The authors report that there is consensus that local pharmaceutical production in sub-Saharan Africa in close proximity to where medicines are needed can reduce dependence and improve health outcomes for the population. Many African governments, regional economic communities and the African Union have recognized the need for active support to the development of the sector if these benefits are to be realized. However, concrete action on the ground is reported to have remained hesitant and piecemeal to date. This document contains advice for government policy makers, the private sector especially pharmaceutical manufacturers in sub-Saharan African countries, development partners and finance institutions on how to promote pharmaceutical production. The guide focuses on the key areas of competitiveness, market access, technology and access to finance. It further proposes a path of how governments could embark on and steer a policy development process as well as giving guidance on policy interventions. The document especially emphasizes the interconnectedness of key intervention areas and recommends that promotional measures from key areas should be combined to increase impact.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"The power of action-based dissemination ","field_subtitle":"Ifakara Health Institute Spotlight: Evidence for policy and action 19.01, IHI, Tanzania,  2019","URL":"https://tinyurl.com/vftede2","body":"In 2018, Ifakara Health Institute disseminated results emerging from the formative study for Children In the Mining (CIM) seeking to improve access to social- economic and health services for children living in the mining areas in Bukombe, Songwe and Chunya districts of Tanzania. Using an action-based approach, members of the Kerezia community involved reflected on the findings and developed a plan of action to address the social-economic problems that face children living in the mining areas. The villagers prioritized water, roads and schooling. A while later the villagers reported to the IHI researchers: \"We are happy to tell you that one of our priorities has been implemented and through the efforts of community members, we have constructed a foundation for the primary school here in our village [........] I was really wondering how I could see you and inform you about this progress.\" The Kerezia story is argued to highlight how scientists need to go beyond the traditional methods of sharing research findings and apply action-based dissemination where possible to influence change at the grass roots.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The problem of \u2018trickle-down science\u2019 from the Global North to the Global South","field_subtitle":"Reidpath D; Allotey P: BMJ Global Health 4(4), doi: http://dx.doi.org/10.1136/bmjgh-2019-001719,  2019","URL":"https://gh.bmj.com/content/4/4/e001719","body":"Countries in the Global South continue to struggle to train and retain good researchers and practitioners to address local, regional and global health challenges. As a result, there is an ongoing reliance on the Global North for solutions to local problems and an inability to develop alternative approaches to problem solving that take local (non-northern) contexts into account. Current paradigms of scientific advancement provide no long-term models to challenge the status quo or privilege knowledge that is generated primarily in the Global South. This has major impacts on access to funding which perpetuates the problem. The authors argue that there needs to be a concerted and demonstrable shift to value and promote the development of research and scientific traditions that are borne out of the reality of local contexts that complement knowledge and evidence generated in the Global North.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Translating political commitment to real action to achieve universal health coverage in Africa","field_subtitle":"Badejo O: Health Systems Global, October 2019","URL":"https://tinyurl.com/ros87qu","body":"Following the High-Level Meeting on Universal Health Coverage (UHC) UN member states are expected to show more financial and political commitment to accelerate progress towards UHC.. Different approaches have been taken by different countries in Africa for this. Rwanda has used affordable health finance and insurance mechanisms - financed by both the national government and individuals - as a crucial driver for UHC. In 2018, Kenya also unveiled a plan for reaching UHC by 2022 by piloting UHC in four counties. The prioritization of such policy options and the ways to implement them are seen to require a. context-dependent balancing act that should be grounded in the correct application of evidence in decision-making processes. This is obserbed to demand measures to build individual and institutional capabilities to generate and use evidence to support value-based design and implementation of relevant system-level policy reforms for UHC. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Who are CHWs? An ethnographic study of the multiple identities of community health workers in three rural Districts in Tanzania","field_subtitle":"Rafiq M; Wheatley H; Mushi H; Baynes C: BMC Health Services Research 19(712) 1-15, 2019","URL":"https://tinyurl.com/sg3mkp4","body":"unity health workers (CHWs) possess multiple, overlapping roles and identities, which makes them effective primary health care providers when properly supported with adequate resources. This also limits their ability to implement interventions that only target certain members of their community and prevents them from performing certain duties when it comes to sensitive topics such as family planning. To understand the multiple identities of CHWs qualitative and ethnographic methods involved participant observation, open-ended and semi-structured interviews and focus group discussions with CHWs, their supervisors, and their clients between October 2013 and June 2014 in Rufiji, Ulanga and Kilombero Districts in Tanzania. The findings suggest that it is difficult to distinguish between personal and professional identities among CHWs in rural areas. Important aspects of CHW services such as personalization, access, and equity of health services were influenced by CHWs\u2019 position as local agents. However, the study also found that their personal identity sometimes inhibited CHWs in speaking about issues related to family planning and sexual health. Being local, CHWs were viewed according to the social norms of the area that consider the gender and age of each worker, which tended to constrain their work in family planning and other areas. Furthermore, the communities welcomed and valued CHWs when they had curative medicines; however, when medical stocks were delayed, the community viewed the CHWs with suspicion and disinterest. Community members who received curative services from CHWs also tended to become more receptive to their preventative health care work. Although CHWs\u2019 multiple roles constrained certain aspects of their work in line with prevalent social norms, overall, the multiple roles they fulfilled had a positive effect by keeping CHWs embedded in their community and earned them trust from community members, which enhanced their ability to provide personalized, equitable and relevant services. However, CHWs needed a support system that included functional supply chains, supervision, and community support to help them retain their role as health care providers and enabled them to provide curative, preventative, and referral services.","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"\u201cAfrica Multiple\u201d Cluster of Excellence: Four Junior Research Group Leaders ","field_subtitle":"Deadline for applications: December 31, 2019","URL":"https://tinyurl.com/sous7kd","body":"The Africa Multiple Cluster of Excellence at the University of Bayreuth is establishing four Junior Research Groups commencing on July 1, 2020 and is seeking to appoint Four Junior Research Group Leaders for a funding period of four years. The doctoral students will pursue their degrees within the Bayreuth International Graduate School of African Studies. African women and women of colour are strongly encouraged to apply and applicants with children are highly welcome. ","php":"","field_issue_date":"2019-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":" The toll of the cobalt mining industry on health and the environment","field_subtitle":"CBS News: March 6 2018","URL":"https://www.cbsnews.com/news/the-toll-of-the-cobalt-mining-industry-congo/","body":"This CBS News video reports an investigation of child labour in cobalt mines in the Democratic Republic of Congo, revealing that tens of thousands of children are growing up without a childhood today \u2013 two years after a damning Amnesty report about human rights abuses in the cobalt trade was published. The Amnesty report first revealed that cobalt mined by children was ending up in products from prominent tech companies including Apple, Microsoft, Tesla and Samsung. According to the CDC, \"chronic exposure to cobalt-containing hard metal (dust or fume) can result in a serious lung disease called 'hard metal lung disease'\" \u2013 a kind of pneumoconiosis, meaning a lung disease caused by inhaling dust particles. Inhalation of cobalt particles can cause respiratory sensitization, asthma, decreased pulmonary function and shortness of breath, the CDC says. An estimated two-thirds of children in the region of the DRC that CBS News visited recently are not in school. They're working in mines instead. CBS News' Debora Patta spoke with an 11-year-old boy, Ziki Swaze, who has no idea how to read or write but is an expert in washing cobalt. Every evening, he returns home with a dollar or two to provide for his family.\r\n\r\n","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"2nd Global Symposium on Community Health Workers Evolving Health Systems to Achieve University Health Coverage through Community Health Workers ","field_subtitle":"22-24 Nov 2019, Dhaka, Bangladesh ","URL":"http://chwsymposium2019.icddrb.org","body":"The 2nd International Symposium on Community Health Workers, hosted by the International Centre for Diarrhoeal Disease Research, Bangladesh, in collaboration with Directorate General of Health Services, Government of Bangladesh; James P. Grant School of Public Health, BRAC University, Bangladesh; and Save the Children, Bangladesh; will be held during November 22 \u2013 24, 2019 at Pan Pacific Sonargaon, Dhaka, Bangladesh. The organisers invite the local and international community engaged in research or policy making on Community Health Workers to attend the Symposium on Community Health Workers to discuss past successes and challenges with Community Health Workers in order to formulate strategic pathways for better community based health programme for prevention and control of Non Communicable Diseases further to attain Universal Health Coverage and Sustainable Development Goals targets. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Governments Urged to move with Speed to Address Over-Dependence on Imported Medicines","field_subtitle":"United Nations Economic Commission for Africa: UNECA Addis Ababa, 2019","URL":"https://allafrica.com/stories/201907010731.html","body":"At the two-day Horn of Africa trade forum in Addis Ababa,  organized by the ECA, the Government of Ethiopia, the African Union Commission (AUC), and the European Union, participants agreed that with the African Continental Trade Agreement (AfCFTA) in force, it was time for the continent to increase domestic production of pharmaceutical products and end over-dependence on imported medicines. The AfCFTA, they agreed, provides an opportunity for economies of scale necessary for African pharmaceutical production. The Economic Commission for Africa's (ECA) Director for Regional Integration and Trade, Stephen Karingi, in closing the forum said that domestic policies that can be used to support the industry, including through investment assurances, grants, fiscal incentives and local content requirements. Regional centers of excellence could be used to overcome constraints in human capacities and resources for research and development and testing. The forum also agreed on the need to strengthen regulatory frameworks to develop the pharmaceutical sector; to encourage domestic production with a regional focus; and to ensure efficient and safe logistic chains that can bring down the cost of medicines. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us?","field_subtitle":"Boerma T, Tappis G; Saad-Haddad G; Das J; et al: BMJ Global Health 4, i161\u2013i168, 2019","URL":"https://tinyurl.com/y4x5ffvj","body":"This paper seeks to examine data from national surveys in 13 countries in sub-Saharan Africa with major conflicts during 1990\u20132016, to assess the levels and trends in reproductive, maternal, newborn and child health intervention coverage, nutritional status and mortality in children under 5 years in relation to the trends. The surveys provide substantive evidence of a negative association between these indicators at national level and armed conflict, with some exceptions. Major improvements in these indicators took place post-conflict, except for stunting. The short-term conflict in Congo and the Ethiopian\u2013Eritrea war had limited effects on national trends, even though direct local associations with increased child stunting were \r\nfound in Eritrea.  The authors findings suggest that armed conflict can have negative consequences on reproductive, maternal, newborn and child health. They argue that surveys are a critical data source which, in combination with further analysis of the distinct features of each conflict as well as programme data collected to measure conflict impact, can provide a better assessment of the national impact of armed conflicts on health. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Breaking down the silos of Universal Health Coverage: towards systems for the primary prevention of non-communicable diseases in Africa","field_subtitle":"Oni T; Mogo E; Ahmed A; Davies J: BMJ Global Health 4(4), doi: http://dx.doi.org/10.1136/bmjgh-2019-001717, 2019","URL":"https://gh.bmj.com/content/4/4/e001717","body":"The third sustainable development goal (SDG), ensuring healthy lives and well-being for all at all ages, although comprising multiple components, is often strongly linked with the concept of universal health coverage (UHC) and its underlying principles of equity, quality and financial protection. While addressing the upstream determinants of health is seen as a vital accelerator of progress in achieving the SDGs, in practice, UHC has often been focused on a disease-fighting, healthcare-centric approach. African countries are not on track to achieve global targets for non-communicable disease (NCD) prevention, driven by an insufficient focus on ecological drivers of NCD risk factors, including poor urban development and the unbridled proliferation of the commercial determinants of health. As the risk factors for NCDs are largely shaped outside the healthcare sector, an emphasis on downstream healthcare service provision to the exclusion of upstream population-level prevention limits the goals of UHC and its potential for optimal improvements in (achieving) health and well-being outcomes in Africa. The author argues for a systems for health rather than a solely healthcare-centric approach, that proactively incorporates wider health determinants (sectors)\u2014housing, planning, waste management, education, governance and finance, among others\u2014in strategies to improve health. This includes aligning governance and accountability mechanisms and strategic objectives of all \u2018health determinant\u2019 sectors for health creation and long-term cost savings. Researchers are seen to have a vital role to play, collaborating with policy makers to provide evidence to support implementation and to facilitate knowledge sharing between African countries.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for Papers: Innovations in implementation research in low- and middle-income countries","field_subtitle":"Deadline for manuscripts: 15 October 2019","URL":"https://tinyurl.com/yyrrjxjs","body":"This journal of Health Policy and Planning, and the Alliance for Health Policy and Systems Research are calling for papers on the theme of: \u201cInnovations in Implementation Research in Low- and Middle-Income Countries (LMICs)\u201d. This journal supplement will discuss the concept and usefulness of implementation research in the context of LMICs, and invite contributions to illustrate some of the innovations on this. It will outline trajectories of the development of the field and help to chart the way forward for the further application of implementation research to maximise its impact on policies and programmes in the real world. Articles are sought which speak to innovations in the methods, approaches and governance of research on the implementation of public health policies and programmes in LMICs, including but not limited to the following sub-themes: quantitative assessment of public health policy and programme implementation; multidisciplinary and qualitative approaches and mixed methods assessments of public health policy and programme implementation; health policy implementation analysis, including policy process and power; process evaluation of public health programme implementation; systematic reviews of public health policy and programme implementation; embedding and participatory approaches in implementation research; and governance and ethics of implementation research in LMICs. All papers should clearly identify the specific innovation that it is presenting or illustrating and situate it in the literature. Papers that receive positive reviews but are not deemed suitable for this supplement may be considered for individual publication in Health Policy and Planning. This supplement will be launched to coincide with the Sixth Global Symposium on Health Systems Research, taking place in Dubai from 8-12 November 2020.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Decision-making in district health planning in Uganda: does use of district-specific evidence matter?","field_subtitle":"Henriksson D; Peterson S; Waiswa P; Fredriksson M: Health Research Policy and Systems 17(57), 1-11, 2019 ","URL":"https://tinyurl.com/y3vwunfj","body":"This study investigated how evidence used in the planning process affects decision-making and how stakeholders involved in planning perceived the use of evidence. Quantitative data was collected from district health annual work plans for 2012-2016 and from 'bottleneck analysis reports' for these years. Qualitative data was collected through semi-structured interviews with key informants from the two study districts. District managers reported that they were able to produce more robust district annual work plans when they used district-specific evidence. Approximately half of the prioritised activities in the annual work plans were evidence based. Procurement and logistics, training, and support supervision activities were the most prioritised activities. District-specific evidence and a structured process for its use to prioritise activities and make decisions in the planning process at the district level helped to systematise the planning process. However, the districts also reported having limited decision and fiscal space, inadequate funding and high dependency on external funding that did not always allow for the use of their own district evidence in planning . ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"EQUINET Discussion paper 118: Comparative review: Implementation of constitutional provisions on the right to healthcare in Kenya and Uganda","field_subtitle":"Centre for Health, Human Rights and Development (CEHURD): EQUINET, Uganda, 2019","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20118%20Const%202019.pdf","body":"This discussion paper is produced by the Centre for Human Rights and Development (CEHURD) as part of the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The paper examines the implementation of constitutional provisions on the right to healthcare in Kenya and Uganda, two countries in East Africa. It aims to identify factors and mechanisms that have facilitated implementation of constitutional provisions on the right to healthcare, including how the constitutions were developed and framed. It compares implementation in Kenya, where the right to healthcare is explicit in their 2010 Constitution, and in Uganda, where the right to healthcare is implicit in the National Objectives and Directive Principles of State Policy. The paper draws on two EQUINET case studies on implementation of constitutional provisions on the right to health, one each in Kenya and Uganda, published in 2018, a 2017 regional workshop that discussed the implementation of constitutional provisions on the right to health, and additional review of published literature. It presents a thematic analysis of the findings from the two case studies in terms of the judicial, political and popular implementation mechanisms, exploring further the factors and mechanisms that have facilitated or blocked their implementation. As the two constitutions address the right to healthcare differently, this analysis of their application provides insights into the factors and mechanisms for practice that may be useful in other settings.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 221: Home-grown solutions for the evidence to policy conundrum: Reflections on the ECSA HC Best Practices Forum","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Even Larry Summers Denounces World Bank\u2019s \u201cPEF\u201d Ebola Bonds that Enriched Investors at the Expense of the sick in the Congo","field_subtitle":"Smith. Y: Naked Capitalism, USA, August 2019","URL":"https://tinyurl.com/y27zs6fp","body":"The author reports that Larry Summers, a former World Bank chief economist, viewed the Banks Ebola financing scheme as a problem. As recounted by another former World Bank economist, Olga Jonas, the World Bank involvement of the private sector in funding countries affected by Ebola in the wake of the 2014-2016 outbreak led to the Pandemic Emergency Financing Facility (PEF) as a form of investor scheme for private financing. However, as Jonas points out, the PEF stipulates a payout of $45 million for Ebola if the officially confirmed death toll reaches 250 (which occurred in the DRC [Democratic Republic of the Congo] by mid-December 2018), but only if at least 20 deaths occurred in a second country. Given that the WHO lists only one multi-country outbreak amid more than 30 that occurred in a single country, this requirement is viewed as inappropriate.  Rather than a lack of funds, the author argues that vigilance and public-health capacity have been the main deficiencies. When governments and the World Bank are prepared to respond to infectious-disease threats, money flows within days. The World Bank has said that the PEF is working as intended by offering the potential of \u2018surge\u2019 financing. However its triggers are said to guarantee that payouts will be too little because they kick in only after outbreaks grow large. The author concludes that the best investment of funds and attention is in ensuring adequate and stable financing for core public-health capacities, that the PEF has failed. It should end early \u2014 and that IDA funds should go to poor countries, not investors.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Free online course on Health Systems Strengthening","field_subtitle":"The University of Melbourne, The Nossal Institute for Global Health, UNICEF: FutureLearn. ","URL":"https://tinyurl.com/y363mvae","body":"The Nossal Institute, in collaboration with UNICEF and FutureLearn, has developed a free online course in health systems strengthening. This course aims to develop skills and confidence in policy makers, managers and clinicians working in health systems to analyse system problems and take decisive, evidence-based actions to strengthen their system. It covers health system structures, functions and components, and how they interact. How to use evidence, and analysis of inequity, to drive interventions to strengthen health systems. It also addresses strengthening health systems through action in areas such as health policy, financing, human resources, supply chain management, quality of care and private sector engagement and using complex systems thinking to address health system problems.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health workers\u2019 strikes in low-income countries: the available evidence","field_subtitle":"Russo G; Xu L; McIsaac M; Matsika-Claquin M; et al: Bulletin of the World Health Organisation 97(7) 460\u2013467H, 2019","URL":"https://tinyurl.com/y53qdfcf","body":"In this paper, the authors analysed the characteristics, frequency, drivers, outcomes and stakeholders of health workers\u2019 strikes in low-income countries, using published and grey online sources for 2009 to 2018. They identified 70 unique health workers\u2019 strikes in 23 low-income countries during the period, accounting for 875 strike days. 2018 had the highest number of events, with 170 work days lost. Strikes involving more than one professional category were more frequent, followed by strikes by physicians only. The most commonly reported cause was complaints about pay, followed by protest against the sector\u2019s governance or policies and safety of working conditions. Positive resolution was achieved more often when collective bargaining institutions and higher levels of government were involved in the negotiations. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Healthcare equity analysis: applying the Tanahashi model of health service coverage to community health systems following devolution in Kenya","field_subtitle":"McCollum R; Taegtmeyer M; Otiso L; Mireku M; et al: International Journal for Equity in Health volume 18(65) 1-12, 2019","URL":"https://tinyurl.com/y36djtv4","body":"The authors applied Tanahashi\u2019s equity model to review perceived equity of health services by actors across the health system and at community level, following changes to the priority-setting process at sub-national levels post devolution in Kenya. A qualitative study was implemented between March 2015 and April 2016, involving 269 key informant and in-depth interviews from different levels of the health system in ten counties and 14 focus group discussions with community members in two of these counties. Qualitative data were analysed using the framework approach. The findings revealed that devolution in Kenya has focused on improving the supply side of health services, by expanding the availability, geographic and financial accessibility of health services across many counties. However, there has been limited emphasis and investment in promoting the demand side, and limited efforts to promote acceptability or use of services. Respondents perceived that the quality of health services has typically been neglected within priority-setting to date. The authors suggest that if Kenya is to achieve universal health coverage, then county governments must address all aspects of equity, including quality, including through community health services.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Home-grown solutions for the evidence to policy conundrum: Reflections on the ECSA HC Best Practices Forum","field_subtitle":"Yoswa M Dambisya, ECSA Health Community, Tanzania ","body":"\r\nIn June, at the East, Central and Southern Africa Health Community (ECSA HC) 12th Best Practices Forum held under the theme: Innovation and Accountability in Health Towards Achieving Universal Health Coverage, about 130 participants deliberated for three days and proposed recommendations for policy and practice, including to enhance delivery on existing policy commitments. The recommendations covered diverse areas relating to the theme, covering: improving adolescent and young people\u2019s health; equity in access to eye health; innovative approaches for food safety and improved quality of life; addressing harmful substance use and mental health problems; achieving water and sanitation global health targets; tackling emerging and re-emerging health threats and a regional \u2019One Health Approach\u2019 for managing recurrent outbreaks.  The full recommendations can be found on the ECSA HC website. What is also important, however, is the process by which these proposals are made and reviewed.\r\n\r\nThe East, Central and Southern Africa Health Community (ECSA HC) is a regional inter-governmental organisation. It reports to, and receives guidance from the Conference of Health Ministers (HMC).\r\n\r\nOver the years, ECSA HC has held a Best Practices Forum (BPF). The BPF aims to encourage and strengthen policy dialogue among the diverse stakeholders involved in evidence-based policy decision making. The BPF attracts a wide range of health actors, including senior officials from ministries of health of ECSA-HC member states, the constituent health professions colleges of the ECSA College of Health Sciences, health research institutions, collaborating partners, civil society organisations and other health experts and implementers from the region and beyond.  \r\n\r\nWhile the HMC is the highest policy organ of ECSA HC, the Directors Joint Consultative Committee (DJCC) is its highest technical organ. The DJCC consists of the directors of health services, the deans or heads of health faculties and training institutions, the heads of health research institutions and senior officials in the constituent colleges within the ECSA College of Health Sciences. The DJCC informs the health ministers through persuasive evidence-based recommendations. The BPF, in turn, is a critical step and an important platform for presenting and interrogating findings from the member states, from the region and beyond. It provides a platform for a free participation and open exchange of ideas by technical people, researchers, civil society, partner organisations and ministry of health senior officials. The experience, evidence and analysis from the region presented and debated in this forum inform the recommendations to the DJCC and from there to the health ministers in the HMC. \r\n\r\nAs applied in the recent 12th BPF, the main theme and sub-themes are set by the health ministers at their previous HMC. Submissions are then invited from the countries and from ECSA HC partners, stakeholders and researchers within the thematic areas. Suitable abstracts are then selected for presentation to prime the discussions in these areas at the BPF. It is a unique feature of the BPF that at the start of the meeting there are no draft recommendations tabled for discussion. Rather the participants draft them in an open and free spirit of intellectual engagement, drawing on their collective experience and the evidence presented. These recommendations are then submitted to the DJCC for their consideration. \r\n\r\nTo complete the loop, the recommendations made at the BPF, as validated by the DJCC, are presented to the HMC. For example for the 12th BPF held in June this year followed by the 28th DJCC, the recommendations will be presented to the HMC in October this year. The HMC will be held under the same theme as for the BPF and DJCC, and the recommendations will be tabled for the Ministers to consider as the basis for their resolutions. While the recommendations of the DJCC may be used as a guide to enhance the programming and prioritisation of their activities, until they are affirmed or changed by the HMC, the resolutions of the HMC are binding on member states and on the ECSA HC secretariat. \r\n\r\nMost of the follow up work to implement the recommendations happens within the countries. However, there are also regional approaches that are within the mandate of ECSA HC and in association with partners for some priority areas. The action points are thus directed to both the member states and the ECSA HC Secretariat as appropriate. \r\n\r\nOver the past twelve years by convening the BPF, ECSA HC has developed and institutionalised a mechanism and processes by which it engages both the \u2018consumers\u2019 and \u2018producers\u2019 of research evidence in policy dialogue. This is often done in a demand-driven manner, with the HMC and DJCC identifying gaps and calling for evidence in areas that draw presentations at the subsequent BPF. However, some presentations and research findings also emerge \u2018bottom-up\u2019 from work by stakeholders in the region that raise new evidence and issues within the broad thematic areas under consideration.  Some presentations report on the implementation and findings of work that was mandated in prior DJCCs and HMCs and what it means for the health system. Some also track delivery on prior policy commitments, the outcomes achieved and the barriers faced. \r\n\r\nECSA-HC continues to work towards strengthening this approach in the hope that it helps to close the gaps in evidence for policy dialogue from the region and in channels for researchers and implementers to present their experience and findings in a way that influences policy. In doing this, the organisation hopes that relevant research and policy, which are two sides of the same coin, can be increasingly connected. The BPF model is being replicated in West Africa through the West African Health Organisation (WAHO), suggesting that it is perceived as a worthwhile effort. \r\n\r\nOne major challenge with the BPF approach, however, is in the identification of \u2018best practices\u2019. While this is based on an open call for and submission of abstracts, the ECSA HC does not have the capacity to ensure that all the best practices in each area come to the fore and there may be limited publicity of the BPF as the outlet for relevant research findings. It has also become evident  that a lot of experience and research evidence that is seen to be relevant and useful by policy actors in the DJCC and HMC does not make its way into formal journals for wider dissemination. \r\n\r\nNotwithstanding such challenges, the BPF stands out as a useful and unique home-grown solution to the false divide between researchers and implementers on the one hand, and decision and policy makers on the other. It does so by providing a platform for the free input, exchange of and debate on ideas, embedding this within the policy processes and structures of the organisation. Looking at the journey over the last twelve years, one is justified to suggest that in the next twelve years, the BPF could itself be identified as a \u2018best practice\u2019 for the East, Central and Southern African region.\r\n\r\nPlease send feedback or queries on the issues raised to the EQUINET secretariat: admin@equinetafrica.org. For more information on the ECSA HC BPF please visit https://ecsahc.org/ ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Integrating community health assistant-driven sexual and reproductive health services in the community health system in Nyimba district in Zambia: mapping key actors, points of integration, and conditions shaping the process","field_subtitle":"Zulu J; Kinsman J; Hurtig A; Michelo C; et al: Reproductive Health 16(122) 1-11, 2019","URL":"https://tinyurl.com/y3npydvp","body":"This study aimed to identify the conditions and strategies through which Community Health Assistants gained entry and acceptability into community health systems to provide sexual and reproductive health services services to youth in Nyimba district, Zambia. Community Health Assistants worked with a range of community actors, including other health workers, safe motherhood action groups, community health workers, neighborhood health committees, teachers, as well as political, traditional and religious leaders and took services to health facilities, schools, police stations, home settings, and community spaces. They used their health facility service delivery role to gain trust and entry into the community, and built relationships with other community level actors by holding regular joint meetings, and acting as brokers between the volunteer health workers and the Ministry of Health. They used their existing social networks to deliver sexual and reproductive health services to adolescents, and embedded this into general life skills at community level, the improving its acceptability. Support from community leaders also promoted their legitimacy. The acceptability of their services was limited by a taboo of discussing sexuality issues, a gender discriminatory environment, competition with other providers, and challenges in conducting household visits. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Kader Asmal Fellowship Programme","field_subtitle":"Deadline for applications: 11 September 2019","URL":"https://www.canoncollins.org.uk/apply/scholarship/kader-asmal-fellowship","body":"The Embassy of Ireland in South Africa in partnership with Canon Collins Trust invites applications for scholarships for postgraduate study in Ireland commencing in September 2020. In 2020 fellowships will be offered for postgraduate study in: Agriculture, Environmental Science, Conservation, Rural Development; Food Science, Food Engineering and related; Pharmacy and Biotechnology; Health, Medicine and Health Economics; Development Studies, Peace Studies, Conflict Resolution and Humanitarian Action; Social Policy, Social Research, Community Development and Sociology; Law, Human Rights, Women\u2019s Studies, Gender Studies, Equality Studies; Engineering, Hydrology, Sustainable Technology; Economics, Finance, Accounting, Management and Business; Information Systems and Communications Technology and Tourism. Applicants must be a resident national of South Africa and have a minimum of two years relevant work experience. Applicants already in possession of a Masters degree are not eligible.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Launch of the EAC Regional Contingency Plan for Public Health Emergencies","field_subtitle":"East, Central and Southern African Health Community (ECSA HC): Arusha,  July 2019","URL":"https://tinyurl.com/y3v9mcqu","body":"In 2014, the EAC regional Technical Working Group for Communicable and Non-Communicable Diseases conceived the idea of developing a regional plan for preparedness and response to public health emergencies. ECSA-HC, through the World Bank-funded East Africa Public Health Laboratory Networking Project, supported the drafting and development of the initial version of the plan. This is a multi-hazard preparedness and response plan whose scope includes epidemic prone diseases, and other known and unknown hazards that may have overwhelmed individual countries or are spreading across international border(s) in the EAC region.  The Incident Command System describes teams of stakeholders involved in triggering and managing the preparedness, response and recovery phases of public health emergencies, all implemented in a One Health context.  The command system is triggered by the national disease surveillance system at a point they determine to be in need of regional assistance. The plan was launched on June 11th 2019 at a ceremony in Namanga at the inauguration of the field simulation exercise for a fictitious Rift Valley fever outbreak spreading across the border between Kenya and Tanzania. ECSA-HC provided technical support in the planning and execution of the World Health Organization-led exercise.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Profits Over People: Mining in Malawi","field_subtitle":"Human Rights Watch: Malawi, 2016","URL":"https://www.youtube.com/watch?v=qD4WlqL5fwg","body":"New mining activities are playing an increasing role in Malawi's economy. This video reports on the situation of families in Malawi affected by new mining activities , and the health problems of families living near coal and uranium mining operations. It reports on the gap in health system capacities to diagnose and address these challenges. While the mining company indicates that they test the water used by these communities and provides the results to government, people in the community are not aware of the results. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Public Health Association of South Africa Conference 2019: the Right to Health \u2013 25 years into a Constitutional Democracy","field_subtitle":"16-18 September 2019, College of Cape Town, Athlone, Cape Town","URL":"https://tinyurl.com/y3oswcom","body":"The 2019 Public Health Association of South Africa conference will reflect on the intersections between democracy and health, and the progressive realisation of health care in South Africa. Despite the legislative, economic, social and cultural accomplishments since 1994, South Africa is facing a quadruple burden of diseases; increasing corruption; the grossly inequitable distribution of access between public and private health care sectors and governance crises in provincial health departments. These have seriously compromised the right to health care and many South Africans remain desperately deprived. This year\u2019s conference will focus on the status of health care since 1994 in South Africa and what can be done to move closer to achieving the targets of the National Development Plan and equity in universal health coverage. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Realizing Universal Health Coverage in East Africa: the relevance of human rights","field_subtitle":"Yamin A; Maleche A: BMC International Health and Human Rights 17(21) 1-10, 2019","URL":"https://tinyurl.com/y3d4upmo","body":"The authors propose that applying a robust human rights framework would change thinking and decision-making in efforts to achieve Universal Health Coverage (UHC), and advance efforts to promote women\u2019s, children\u2019s, and adolescents\u2019 health in East Africa, a priority under the Sustainable Development Agenda. Nevertheless, they point to a gap between global rhetoric of human rights and ongoing health reform efforts. This article seeks to fill part of that gap by setting out principles of human rights-based approaches and then applying those principles to questions that countries face in undertaking efforts toward UHC and promoting women\u2019s, children\u2019s and adolescents\u2019 health, particularly to ensure enabling legal and policy frameworks, establish fair financing and priority-setting and provide meaningful oversight and accountability mechanisms. In a region where democratic institutions are weak, the authors argue that the explicit application of a human rights framework could enhance equity, participation and accountability, and in turn the democratic legitimacy of UHC reforms being undertaken in the region.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Reclaiming African knowledge systems - what does it mean?","field_subtitle":"Editor, EQUINET Newsletter","body":"There has been growing engagement around the inequitable benefit from the extraction of minerals, genetic and biological resources from the continent. Attention is now also growing on the exploitation of local and indigenous knowledge, and as captured in some of the articles in this newsletter, the injustice of knowledge systems that extract empirical evidence for analysis in other countries, and impose barriers to those most directly exposed to conditions being able to travel and participate in scientific programmes and forums, to bring direct knowledge on those conditions into global health forums. This international context contrasts with the experience described in this month's editorial of a sustained initiative within east, central and southern Africa to facilitate dialogue between researchers, service implementers, civil society and government policy makers in and from the region, to share and review knowledge for health and health systems within the region. How actively do we use, engage in and benefit from such platforms?  What do we need to do reclaim, build and assert the knowledge systems in the region - and from the region, globally- to advance health equity? We invite you to share your experiences and perspectives as comments, opeds, or links to relevant papers and reports for our next newsletter.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Regional Research\u2013Policy Partnerships for Health Equity and Inclusive Development: Reflections on Opportunities and Challenges from a Southern African Perspective","field_subtitle":"Yeates N; Moeti T;  Luwabelwa M: Institute for Development Studies Bulletin 50(1) 121-142, 2019","URL":"https://tinyurl.com/y3huoqps","body":"This article critically reflects on the experience and lessons from a health-focused social policy research project involving a partnership spanning multiple countries across southern Africa and Europe. It asks what factors condition the efficacy of the partnership\u2013policy nexus. The policy research project Southern African Development Community partnership case study used participatory action research to create a regional indicators-based monitoring toolkit of pro poor health policy and change for the region. The article addresses the partnership drivers, features, methodological context, and process of the project, and the wider implications for constructing partnerships for social change impact. Lessons drawn from this case study underscore the importance of participatory action research -inspired partnership structures and working methods while querying assumptions that the relationship between participatory action research and policy change is seamless. The authors argue that greater focus is needed on the wider institutional context conditioning the work of partnerships when considering the efficacy of a nexus between partnerships and policy.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Remembering women\u2019s struggles against destructive mining","field_subtitle":"Mugari T: Centre for Natural Resource Governance, Zimbabwe, 2019","URL":"https://tinyurl.com/yyh6rrcb","body":"In 1972, disaster struck the coal mining town of Hwange killing 427 workers following an underground explosion at the No.2 Colliery, also known as Kamandama Mine, part of Hwange Colliery. Forty-seven years later, the author reports that the widows of the victims of the Kamandama mine disaster live in neglect and abject poverty. Following the death of their husbands, they were forced out of colliery houses to pave way for new workers and their families. Many who had no relatives in town moved to rural areas. In a commemoration to remember the women\u2019s struggles, convened by Centre for Natural Resource Governance (CNRG) and Greater Hwange Residents Trust, with the support from Open Society Initiative for Southern Africa, the surviving widows said that they are only remembered once per year, in June, when the mining town commemorate the Kamandama mine disaster. The widows called on the government and Hwange Colliery Company to compensate them and ensure they get improved access to health care. The CNRG called on the government of Zimbabwe, as the majority shareholder in Hwange Colliery Company Limited, to compensate the widows and ensure decent housing in the villages for them.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Salaried and voluntary community health workers: exploring how incentives and expectation gaps influence motivation","field_subtitle":"Ormel H; Kok M; Kane S; Ahmed R; et al: Human Resources for Health 17(59) 1-12, 2019","URL":"https://tinyurl.com/y692j4d4","body":"This paper aims to critically analyse how using incentives affected community health worker motivation in six countries was undertaken. The motivational factors were defined as financial, material, non-material and intrinsic and semi-structured interviews and focus group discussions with community health workers, supervisors, health managers and selected community members were used. The authors found that incentives influence motivation in similar and sometimes different way across contexts. Motivation was negatively influenced by gaps between incentives and expectations, including lower than expected financial incentives, later than expected payments, fewer than expected material incentives and job enablers, and unequally distributed incentives across groups of community health workers. Furthermore, it was found that incentives could cause friction in the interface between community health workers, communities and the health sector. Whether they are employed or volunteers has implications for the way incentives influence motivation. Intrinsic motivational factors are important to and experienced by both types of community health workers, yet for many who are salaried, payment does not compensate for the demotivation derived from the perceived low level of financial reward. The authors suggest that managing expectations and consistency in payments may be as important as the absolute level of incentives.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Strengthening ethical community engagement in contemporary Malawi","field_subtitle":"Nyirenda D; Gooding K; Sambakunsi R; et al: Wellcome Open Research, Lilongwe, 2019","URL":"https://wellcomeopenresearch.org/articles/3-115/v2","body":"Although community engagement is increasingly promoted in global health research to improve ethical research practice, the authors observe that there is sometimes a disconnect between the broader moral ambitions for community engagement in the literature and guidelines on the one hand and its rather narrower practical application in health research on the other. In practice, less attention is said to be paid to engaging communities for the \u2018intrinsic\u2019 value of showing respect and ensuring inclusive participation of community partners in research design. Rather, more attention is paid to the use of community engagement for \u2018instrumental\u2019 purposes to improve community understanding of research and ensure successful study implementation. Against this backdrop, the authors reviewed the literature and engaged various research stakeholders at a workshop to discuss ways of strengthening ethical engagement of communities and to develop context-relevant guidelines for community engagement in health research in Malawi. They concluded by proposing a model with three elements that would increase participatory community engagement in health research namely: collaboration, consultation and communication from the onset of research.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The ghost battalion: On the Sudanese Professionals Association (SPA) the organized force behind the revolutionary uprising in Sudan","field_subtitle":"Majdoub S: Africa is a Country, August 2019","URL":"https://tinyurl.com/y528s8qo","body":"In Sudan, the Tajamoo al-mihanyin al-sudaniyin or the Sudanese Professionals Association (SPA) is an alliance of independent professionals shrouded in mystery. Described as the \u201cghost battalion\u201d by the now-deposed president Omar al-Bashir, the contemporary movement led by the SPA exerted influence on mobilizations and protest movements through sustained appeals, and built broad appeal and demonstrated a know-how of protests, applied within the social movement across the country. They initiated civil disobedience, rallies and marches in all parts of the country, focusing on women, displaced and exiled people, and on social justice and life on the margins. Moreover, they have taken the call to protest beyond the limits of major cities like Khartoum and across sectors\u2014from resignation marches in outlying towns and provinces to the mobilization of dock workers in Port Sudan. The For a movement like the SPA there are challenges. Will its spirit remain strong or be exhausted? Will it be the guardian of this transition or its watchdog?","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The problem of \u2018trickle-down science\u2019 from the Global North to the Global South","field_subtitle":"Reidpath D; Allotey P: BMJ Global Health 4(4), doi: http://dx.doi.org/10.1136/bmjgh-2019-001719, 2019","URL":"https://gh.bmj.com/content/4/4/e001719","body":"Ten years ago, Nigel Crisp observed, with respect to the healthcare workforce that \u2018the global health system is characterised by an import\u2013export business in which rich countries export the ideology of Western scientific medicine and aid predicated on this ideology to poor countries. In return, the poor countries export a portion of their preciously limited pool of trained health workers back to the rich countries\u2019. The authors of the paper suggest that a similar situation holds in scientific research.  Many of the very brightest minds from the Global South go to institutions of higher learning in the Global North, either as graduate students or as fully fledged researchers. They are attracted by better pay, resources, engagement and prestige. There are then three broad outcomes: If the move is a permanent one (which is the case 70% of the time) many turn their focus away from the concerns of the south towards the research priorities in the north, where the funding is. Others remain in the north but keep their focus on the issues of the south, albeit often with limited impact, and sometimes compromising their career progression in the north. The third outcome is the return of the researcher to the south, and frustration over the lack of an enabling environment to apply their skills. Trickle-down science as a strategy for advancing knowledge for current and future challenges has enabled an inequity in the distribution of scientific capacities. However the authors observe that there are ways to engage more effectively with the growing, if disempowered, talent in the south to build of enabling environments, leadership and a quality and volume of home grown, contextually driven knowledge. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The visa conundrum in global health","field_subtitle":"Vervoort D: The BMJ Opinion, June 2019","URL":"https://tinyurl.com/yysajrsk","body":"There is a growing push to include local voices in global health initiatives and policies to promote ownership of downstream implementation, but also to get a proper sense of the realities on the ground. Many governments gladly jump on the bandwagon. Yet when it comes to it, visa applications are often rejected on feeble grounds. Physicians and medical students with booked return flights, domestic hospital affiliations, formal invitation letters and even proof that they will not be a financial liability are rejected. Academia increasingly understands the need for local authorship and ownership of global health programmes, and rightfully so. However, a colonial trend persists in the wider community. Policies and resolutions are driven by high income country actors or government officials who are, by definition, detached from what is happening on the ground. Civil society actors who live among the realities of poverty are left behind. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Urban Health Initiative in Accra:  Workshop on planning for climate action, improved air quality and health  ","field_subtitle":"Accra Metropolitan Assembly: Ghana, May 2019","URL":"https://tinyurl.com/y4x3coug","body":"The World Health Organisation, Accra Metropolitan Assembly, Ghana Health Service, Environmental Protection Agency, UN-Habitat and ICLEI hosted a two-day workshop with the Accra Metropolitan Assembly in May 2019 to support action towards healthier urban environments and to engage other municipalities to jointly act on air quality, public health and the reduction of short-lived climate pollutants. With representatives from several assemblies and municipalities, ministries and other relevant institutions, the workshop took participants through working sessions to discuss the health and economic impacts of sectoral policies, to inform the development of Accra\u2019s Climate Action Plan and control of air pollution.","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"We are called the et cetera: experiences of the poor with health financing reforms that target them in Kenya","field_subtitle":"Kabia E;  Mbau R; Oyando R;  Oduor C; et al: International Journal for Equity in Health 18(98) 1-14, 2019","URL":"https://tinyurl.com/y4l7h7o9","body":"This study examined the experiences of poor people with health financing reforms that target them. The authors conducted a qualitative cross-sectional study in two purposively selected counties in Kenya, using focus group discussions and in-depth interviews with people in the lowest wealth quintile and health insurance subsidy programme beneficiaries. Health financing reforms reduced financial barriers and improved access to health services for poor people in the study counties. However, various access barriers limited the extent to which they benefited from these reforms. Long distances, lack of public transport, poor condition of the roads and high transport costs especially in rural areas limited access to health facilities. Continued charging of user fees despite their abolition, delayed insurance reimbursements to health facilities that health insurance subsidy programme beneficiaries were seeking care from, and informal fees exposed the poor to out of pocket payments. Stock-outs of medicine and other medical supplies, dysfunctional medical equipment, shortage of healthcare workers, and frequent strikes adversely affected the availability of health services. Acceptability of care was further limited by discrimination by healthcare workers and ineffective grievance redress mechanisms which led to a feeling of disempowerment among poor people.  ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"When things fall apart: local responses to the reintroduction of user-fees for maternal health services in rural Malawi ","field_subtitle":"Pot H; de Kok B; Finyiza G: Reproductive Health Matters, 26(54) 126-136, 2018","URL":"https://tinyurl.com/yx8h6kw6","body":"This paper analyses power dynamics at play in the implementation of maternal health policies in rural Malawi, a country with one of the world\u2019s highest burdens of maternal mortality. The authors analysed Malawi\u2019s recent experience with the temporary reintroduction of user-fees for maternity services as a response to the suspension of external funding, a shift in political leadership and priorities and unstable service contracts between the government and its implementing partner, the Christian Health Association of Malawi. The authors report that different actors are frustrated about user fees and their impact on poor people, especially because in Malawi non-institutional deliveries have become strongly associated with maternal deaths.  This especially affects women in rural areas, where access to care is already minimal. In addition, the poorest rural women struggle most to pay user-fees, and would have to travel to the district hospital.  User-fees eroded trust between women and health workers. The authors indicate that the fact that local maternity services excluded of the most vulnerable rural women from care rather than address higher level sources reflect the power dynamics involved in this issue. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"\u2018Prejudiced\u2019 Home Office refusing visas to African researchers","field_subtitle":"Grant H: The Guardian, June 2019","URL":"https://tinyurl.com/y5s2x4ao","body":"The UK Home Office is reported to be accused of institutional racism and to be damaging British research projects through increasingly arbitrary and \u201cinsulting\u201d visa refusals for African academics. In April, a team of six Ebola researchers from Sierra Leone were unable to attend vital training in the UK, funded by the Wellcome Trust as part of a \u00a31.5m flagship pandemic preparedness programme. At the LSE Africa summit, also in April, 24 out of 25 researchers were missing from a single workshop. Shortly afterwards, the Save the Children centenary events were marred by multiple visa refusals of key guests. The article refers to a parliamentary inquiry into visa refusals hearing evidence that there is \u201can element of systemic prejudice against applicants\u201d. In a letter in the Observer, 70 senior leaders from universities and research institutes across the UK warn that \u201cvisa refusals for African cultural, development and academic leaders \u2026 [are] undermining \u2018Global Britain\u2019s\u2019 reputation as well as efforts to tackle global challenges\u201d. The system is reported to be so difficult to predict or navigate that meetings, including conferences funded with British government money, are now being held in other countries. ","php":"","field_issue_date":"2019-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":" WHO: Member States adopt resolution on transparency in medicine pricing","field_subtitle":"Third World Network: TWN Information Service on IP and Health, May 2019 ","URL":"https://www.twn.my/title2/health.info/2019/hi190512.htm","body":"The 72nd World Health Assembly (WHA) of health ministers in May 2019 adopted the resolution on \u201cImproving the transparency of markets for medicines, vaccines, and other health products\u201d in what is considered as a first step to improve the transparency on medicine pricing and other factors impacting prices such as clinical trial costs. The resolution urges the WHO Member States in accordance with their national and regional legal frameworks and contexts to take appropriate measures to publicly share information on the net prices of health products. Further, the resolution urges Member States to take measures to disclose the net price i.e. the price received by the manufacturer instead of the price paid by the government or customers. The resolution requires that costs from human subject clinical trials, regardless of outcomes, be made publicly available or be voluntarily provided. Further, the resolution provides a clear mandate to the WHO Secretariat to \u201canalyse the availability of data on inputs throughout the value chain, including on clinical trial data and price information\u201d. Unlike the initial draft, first proposed by Italy and then supported by a group of countries, the resolution does not create any responsibility on the part of Member States to ensure transparency on R&D cost and clinical trial cost.  TWN report that the debate on the resolution brought out out the division within Europe between the countries with pharmaceutical industry such as Germany, France, the United Kingdom, Switzerland, Sweden and Denmark on the one hand, and countries that do not have strong pharmaceutical industry such as Spain, Portugal, the Netherlands, Austria and Norway. The USA supported the resolution, stating the commitment of the Trump Administration\u2019s initiative to legislate to ensure competition in the pharmaceutical market through transparency in pricing. Though the resolution was adopted by consensus i.e. without any objection from the Member States, Germany, Hungary and the UK stated their disassociation from the resolution at the WHA plenary.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A few words on changes in the newsletter","field_subtitle":"Editor, EQUINET newsletter","body":"From July 2019 the EQUINET newsletter will be coming out quarterly in March,  June, September and December of every year. The next issue will thus be in September 2019. After discussion in the EQUINET steering committee we will try where feasible to have a stronger thematic focus on issues, while still keeping a wide range of coverage of resources, announcements and updates and  publications. As a reminder we are keen to share information on and about the region and invite you to share news, information, papers, reports, briefs, announcements and resources of different types and are happy to receive editorials from or on the region. Please submit by visiting the newsletter on the EQUINET site and selecting \"submit news\"  on the online menu. We are also keen to get your feedback on how to improve the newsletter as a resource for you so please do submit your feedback!","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"After the handover: Exploring MSF\u2019s role in the provision of health care to migrant farm workers in Musina, South Africa","field_subtitle":"de Gruchy T; Kapilashrami A: Global Public Health, doi: https://doi.org/10.1080/17441692.2019.1586976, 2019","URL":"https://www.tandfonline.com/doi/full/10.1080/17441692.2019.1586976","body":"Non-state actors, including humanitarian agencies, play a prominent role in providing health care in low- and middle-income countries. Between 2007 and 2009, Musina, a South African municipality bordering Zimbabwe, became the site of several interventions by non-state organisations as an unprecedented number of Zimbabweans crossed the border, putting strain on already burdened local systems. After the initial need for humanitarian relief dissipated, organisations started to implement projects that were more developmental in nature. For example, M\u00e9decins sans Fronti\u00e8res developed a mobile clinic programme to improve health care access for migrant farm workers, a programme that was subsequently integrated into the Department of Health. Since the handover of the programme, it has faced multiple challenges. Using qualitative methodology and a case study approach, this paper traces the development of the programme, exploring the changing relationship between MSF and the state during this time. This research raises questions about the implications of short-term \u2018innovative\u2019 interventions targeting the access that migrants have to care, within a context in which policy and programmatic responses to health are not 'migration aware'. The authors highlight the ways in which the energies and resources of local health department employees were redirected by MSF's involvement in the area.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Are public\u2013private partnerships the future of healthcare delivery in sub-Saharan Africa? Lessons from Lesotho","field_subtitle":"Hellowell M: BMJ Global Health 4(2), doi: http://dx.doi.org/10.1136/bmjgh-2018-001217, 2019","URL":"https://gh.bmj.com/content/4/2/e001217","body":"Many governments in sub-Saharan Africa are seeking to establish public\u2013private partnerships (PPPs) to finance and operate new healthcare facilities and services. While there is a large empirical literature on PPPs in high-income countries, much less is known about their operation in low-income and middle-income countries. This paper seeks to inform debates about the use of PPPs in sub-Saharan Africa by describing the planning and operation of a high-profile case in Maseru, Lesotho. The paper highlights several beneficial impacts of the transaction, including the achievement of high clinical standards, alongside a range of key challenges\u2014in particular, the higher-than-anticipated costs to the Ministry of Health. Governments may use budget-related incentives to promote the use of PPPs which may threaten financial sustainability in the long term. The authors suggest that future proposals for PPPs need to be exposed to more effective scrutiny and challenge, taking into account state capacity to proficiently manage and pay for contracted services.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Assessment of interventions to attract and retain health workers in rural Zambia: a discrete choice experiment","field_subtitle":"Prust M; Kamanga A; Ngosa L; McKay C; et al: Human Resources for Health 17(26)1-12, 2019 ","URL":"https://tinyurl.com/yynjettu","body":"The authors examined whether non-monetary employment incentives were cost-effective in attracting and retaining public sector health workers in rural areas of Zambia. The study consisted of two key phases: Firstly, in qualitative interviews with 25 health workers and focus group discussions with 253 health students, participants were asked to discuss job attributes and potential incentives that would influence their job choices. Based on this exercise and in consultation with policymakers, job attributes were selected for inclusion in a discrete choice experiment. A questionnaire, consisting of hypothetical job \u201cchoice sets,\u201d was presented to 474 practicing health workers and students.  Using administrative data, the authors estimated the cost of implementing potential attraction and retention strategies per health worker year worked. Although health workers preferred urban jobs to rural jobs, employment incentives influenced health workers\u2019 decision to choose rural jobs. If superior housing was offered in a rural area compared to a basic housing allowance in an urban job, participants would be five times as likely to choose the rural job. Education incentives and facility-based improvements also increased the likelihood of rural job uptake. Housing benefits were estimated to have the lowest total costs per health worker year worked, and offer high value in terms of cost per percentage point increase in rural job uptake. The authors note that non-monetary incentives such as housing, education, and facility improvements can be important motivators of health worker choice of location and could mitigate rural health workforce shortages.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Association of Schools of Public Health in Africa Conference and Annual Meeting","field_subtitle":"Deadline for Abstracts: 19 July 2019 ","URL":"http://asphaafrica.net/upcoming-events/","body":"The Association of Schools of Public Health in Africa (ASPHA) welcomes abstract submissions for oral and poster presentations for the 2019 ASPHA Conference and Annual Meeting. The main theme of the conference is \u2018Universal Health Coverage in Africa: The Role of Public Health Workforce.\u2019 The sub-themes of the conference are \u2018Developing Public Health Workforce to expand Universal Health Coverage\u2019, \u2018Innovations to improve Maternal, Newborn, Child and Adolescent Health Care in Africa\u2019, \u2018Current and Emerging Public Health Issues (Non-communicable and Communicable diseases)\u2019, \u2018Evidence to Policy: Financing Healthcare for Universal Health Coverage\u2019 and \u2018Public Health Education\u2019. Consider including the following information in the abstract, when relevant: objective, problem under investigation, hypothesis, or research goal, the description of research methods, summary of findings and statement of how the research advances public health. See the website for further information.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"CODESRIA Social Policy in Africa International Conference Theme: Governance of Africa\u2019s Social Policy: Subverting Development and Democracy?","field_subtitle":"Deadline for Abstracts: 30 August 2019 ","URL":"https://www.codesria.org/spip.php?article2934&lang=en","body":"The 2019 2nd Social Policy in Africa International Conference invites abstracts and papers that address the dynamics of social policymaking in Africa, identify the drivers of policies and their policy preferences, and address the issue of the nature of politics and the constitution of the public sphere necessary for enhanced economic transformation, human flourishing, and new forms of social compact in inclusive development. Presenters are invited to engage with these issues and explore the different national and regional experiences of modes of governance of the African social policy space, the drivers of public policy, and explore the modes of governance and politics necessary for enhanced human wellbeing and development. The conference also invites papers in the broad areas of social policy not directly concerned with the theme of the 2019 conference. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Connecting global debates to local realities at the 2019 World Health Assembly ","field_subtitle":"Michael Ssemakula, People\u2019s Health Movement and Human Rights Research Documentation Center, Uganda  ","body":"\r\nGlobal meetings and processes can seem very distant from the realities at local level, despite the fact that the policies being made in global meetings have profound influence on these local realities. The People\u2019s Health Movement (PHM) has for several years implemented a \u2018WHO watch programme\u2019 to follow and provide information, analysis and critical commentary for people on the global health debates taking place at the World Health Organisation (WHO).  \r\n\r\nIn its Global Health Watch activities, PHM follows range of WHO meetings, including the World Health Assembly (WHA) and the WHO Executive Board (EB) and at regional level in the WHO Regional Committees, such as the one for the AFRO region. The analysis that PHM does explores how far these global processes and resolutions respond to local, regional and global contexts and priorities and how far states and other relevant stakeholders\u2019 implement, comply with and are publicly accountable for the resolutions made. \r\n\r\nThe recently ended \u2018WHA72\u2019 that took place in end May 2019 was one such global meeting.\r\n\r\nThere were many debates at the WHA72, but two merit attention. One was on improving the transparency of markets for medicines, vaccines and other health-related products and technologies. A second was on the Ebola epidemic in the Democratic Republic of Congo (DRC) and the public health emergency response. Both were critical debates for African countries. Both issues need strong intervention from states, by galvanizing comprehensive workforces and capacities for both health systems and emergency responses, to address disease burdens and respond to disease outbreaks. \r\n\r\nAfter the scrutiny and criticism of its response to the Ebola epidemic in West-Africa in 2014, WHO restructured its health emergencies program in 2016 to provide a more effective response. However, the virtual freeze in member state contributions has meant that the core funding for the program has not improved. The current Ebola outbreak in the DRC thus provided an opportunity to assess how successful the measures and resources are for such emergency responses. The DRC outbreak provided a tough test: it has been termed a complex emergency due to its occurrence in a highly volatile and extremely insecure conflict zone, politicizing the epidemic and raising the challenge of dealing with an outbreak in a war zone. At the recent WHA, WHO reported that its use of vaccination strategies enabled it to achieve unprecedented survival rates. It also pointed to other factors that enabled the response and improved survival, including significant investment in planning and capacities for epidemic preparedness, sustained testing for Ebola, improved screening, vaccination of frontline healthcare-workers and training of multidisciplinary teams for a rapid response mechanism. \r\n\r\nWhile this work has been a significant contribution to addressing the Ebola emergency in DRC, there are still issues to address. PHM observe that WHO should mobilise member states and other relevant-stakeholders to find ethical and valid ways of more rapidly testing interventions to combat diseases like Ebola. A rapidly spreading emergency like Ebola calls for an urgent response, including quick advice on the most effective treatments to use.  The concern is that the pace of development of new vaccines, drugs and diagnostics is not meeting the pace of rapid spread of health emergencies, such as that faced in the DRC. The time consuming nature and wide population enrolment of current medicine trials doesn\u2019t match the urgency needed for responding to such rapidly spreading epidemics. This raises debate on what flexibilities can be introduced that do not compromise the quality and safety of trials. \r\n\r\nAt the same time, there is also a more general demand for improved access to medicines. Accessing medicines would have been critical for the approximately 1.6 million Africans who died of malaria, tuberculosis and HIV-related illnesses in 2015. While many of the diseases in Africa can be prevented or treated with timely access to appropriate and affordable medicines, vaccines and other health interventions, less than two percent of medicines consumed in Africa are produced on the continent. Many people cannot access locally produced drugs and many may not afford imported medicines. \r\n\r\nThe WHA discussed a draft roadmap on access to medicines, vaccines and other health products for 2019-2023. The roadmap proposes strategies to support quality, safety, efficacy and equitable access of health-products. The strategies include strengthening regulation, assessing the quality, safety and efficacy or performance of health products, including through market surveillance and investing in research and development (R&D) that meets public health needs. The strategies also include managing intellectual property so that it contributes to innovation and promotes public health, and ensuring evidence-based selection, fair and affordable pricing, procurement and supply chain management and appropriate prescribing, dispensing and rational use of health products.\r\n \r\nThe resolution on transparency of markets for medicines, vaccines, and other health-related products and technologies adopted at this year\u2019s WHA is a substantial stride towards improving the affordability of and access to medicines and other technologies. For example, there is currently an information gap on what different countries pay for medicines and on the actual cost of R&D and manufacture of medicines. The lack of transparency on this gives pharmaceutical corporations a significant advantage and allows them to charge extortionate prices, maximizing profit over human life. \r\n\r\nDespite the obvious benefit of improved transparency in these issues, the resolution received mixed reactions.  Germany, Hungary and the United Kingdom dissociated themselves from the resolution, using a range of procedural reasons. They claimed that the roadmap was \u201crushed through\u201d and breached procedure, with inadequate consultation with all experts. The dissociation raised governance concerns. However the resolution was approved by a majority of states and will support the space for governments in Africa to negotiate medicine prices. Given the current crisis of unaffordable pricing of many medical technologies, the resolution, if implemented, will support greater public disclosure of prices of medicines and other health-related products. This information should help to reduce the prices of these products, now needed also for rising levels of chronic conditions such as cancers, hepatitis and diabetes, many of which are too costly for universal access in low and middle income countries. \r\n.\r\nThe resolution was thus welcomed by African countries. It needs to be further monitored for its implementation to assess if it achieves its purpose and goal in relation to universal health coverage (UHC). At the same time, as raised by PHM during a debate at the WHA on UHC, accessing medicines also depends on investing in comprehensive primary health care. Further, as was the original intention of Alma Ata, we need to apply human rights-based and comprehensive approaches not just to treating disease, but also to ensuring health. As we address issues of transparency and of responsiveness to emergencies, that also depends on a deeper redistribution of power and wealth.\r\n\r\nYou can read more about PHM \u2018watch\u2019 activities and findings in the Global Health Watch at https://www.ghwatch.org/wha72 . Commentaries, statements and policy briefs can be found on the WHO Tracker at  https://who-track.phmovement.org/. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Draft WHO global strategy on health, environment and climate change: the transformation needed to improve lives and well-being sustainably through healthy environments ","field_subtitle":"Director-General: World Health Organization, Geneva, April 2019","URL":"http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_15-en.pdf","body":"This proposed strategy provides a vision and way forward on how the world and its health community need to respond to environmental health risks and challenges until 2030, and to ensure safe, enabling and equitable environments for health by transforming ways of living, working, producing, consuming and governing. The Health Assembly noted the report, and requested the Director-General to report back on progress at the 74th World Health Assembly in 2022. The WHO draft global strategy envisions a world in which sustainable development has eliminated the almost one quarter of the disease burden caused by unhealthy environments, through health protection and promotion, good public health standards, preventive action in relevant sectors and healthy life choices, and which manages environmental risks to health. The strategy sets six strategic objectives. Strategic objective 1 aims towards primary prevention: to scale up action on health determinants for health protection and improvement in the 2030 Agenda for Sustainable Development. Strategic objective 2 calls for cross-sectoral action to act on determinants of health in all policies and in all sectors. Strategic objective 3 concerns a strengthening health sector leadership, governance and coordination roles. Strategic objective 4 aims towards building mechanisms for governance, and political and social support. Strategic objective 5 calls for generating the evidence base on risks and solutions, and to efficiently communicate that information to guide choices and investments. Lastly, strategic objective 6 aims to guide actions by monitoring progress towards the Sustainable Development Goals. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET Discussion paper 119: Critical assessment of different health financing options in east and southern African countries","field_subtitle":"Doherty J: EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Disspaper%20119%20Fin%202019.pdf","body":"EQUINET commissioned this desk review paper. It aims to contribute to a regional understanding of the positive and negative implications of the different domestic health financing options being explored, advocated and implemented in the East and Southern African (ESA) region. It presents issues to be addressed in the implementation of these financing options from the perspective of equitable progression towards universal health coverage (UHC), to inform policy dialogue and decisions on domestic health financing in ESA countries. The paper considers only one aspect of health financing reform, namely, revenue collection. It distinguishes between policy instruments, i.e., the sources of finance, and policy strategies, i.e., how these instruments are deployed to achieve various objectives or to address contextual features. Non-contributory sources (essentially tax-financed) and contributory (employment-based) options are explored. The paper presents: a. A typology of domestic revenue instruments and strategies; b. Domestic financing trends and options in place, or under consideration, in ESA countries; c. A review of low- and middle-income country experiences of domestic financing options; and d. Conclusions on the findings and lessons for ESA countries.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 220: Connecting global debates to local realities at the 2019 World Health Assembly","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Header"}},{"node":{"title":"Facilitators, best practices and barriers to integrating family planning data in Uganda\u2019s health management information system","field_subtitle":"Wandera S; Kwagala B; Nankinga O; Ndugga P; et al: BMC Health Services Research 19(327) 1-13, 2019 ","URL":"https://tinyurl.com/y549v27f","body":"This study sought to investigate the facilitators, best practices and barriers of integrating family planning data into the district and national Health management information systems in Uganda. The authors conducted a qualitative study in Kampala, Jinja, and Hoima Districts of Uganda, based on 16 key informant interviews and a multi-stakeholder dialogue workshop with 11 participants. The technical facilitators of integrating family planning data from public and private facilities in the national and district Health management information systems were user-friendly software; web-based and integrated reporting; and availability of resources, including computers. Organizational facilitators included prioritizing family planning data; training staff; supportive supervision; and quarterly performance review meetings. Key behavioural facilitators were motivation and competence of staff. Collaborative networks with implementing partners were also found to be essential for improving performance and sustainability. Significant technical barriers included limited supply of computers in lower level health facilities, complex forms, double and therefore tedious entry of data, and web-reporting challenges. Organizational barriers included limited human resources; high levels of staff attrition in private facilities; inadequate training in data collection and use; poor culture of information use; and frequent stock outs of paper-based forms. Behavioural barriers were low use of family planning data for planning purposes by district and health facility staff. Family planning data collection and reporting are integrated in Uganda\u2019s district and national health management information systems. Best practices included integrated reporting and performance review, among others. Limited priority and attention is given to family planning data collection at the facility and national levels. Data are not used by the health facilities that collect them. The authors recommend reviewing and tailoring data collection forms and ensuring their availability at health facilities. All staff involved in data reporting should be trained and regularly supervised.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Healthcare equity analysis: applying the Tanahashi model of health service coverage to community health systems following devolution in Kenya","field_subtitle":"McCollum R; Taegtmeyer M; Otiso L; Mireku M; et al: International Journal for Equity in Health 18(65) 1-12, 2019","URL":"https://tinyurl.com/y36djtv4","body":"This paper applied Tanahashi\u2019s equity model to identify the perceived equity of health services by actors across the health system and at community level, following changes to the priority-setting process at sub-national levels post devolution in Kenya. The authors carried out a qualitative study between March 2015 and April 2016, involving 269 key informant and in-depth interviews from different levels of the health system in ten counties and 14 focus group discussions with community members in two of these counties. Qualitative data were analysed using the framework approach. Their findings revealed that devolution in Kenya has focused on improving the supply side of health services, by expanding the availability, geographic and financial accessibility of health services across many counties. However, there has been limited emphasis and investment in promoting the demand side, including restricted efforts to promote acceptability or use of services. Respondents perceived that the quality of health services has typically been neglected within priority-setting to date. The authors observe that achieving universal health coverage means that all aspects of equity need to be addressed, including quality, and that community health services can play a crucial role in this. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Healthcare Innovation Summit Africa (HISA) 2019","field_subtitle":"16-17 October 2019, Johannesburg, South Africa ","URL":"http://www.healthcareinnovationsummit.co.za","body":"This conference will tackle  robotics, electronic health records, delivering personalised healthcare, artificial intelligence, IoT in healthcare, driving down the cost of care with technology, security, legal impact of eHealth, healthcare policy, telemedicine advances, future of healthcare and much, much more. The summit will look at the role technology plays in patient empowerment, disease diagnosis and enhancing operational efficiency in medical facilities. HISA 2019 presents the latest healthcare technologies and showcasing their practical application and integration into existing healthcare infrastructure. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Hypertension control in integrated HIV and chronic disease clinics in Uganda in the SEARCH study","field_subtitle":"Kwarisiima D; Atukunda M; Owaraganise A; Chamie G; et al: BMC Public Health 19(511) 1-10, 2019","URL":"https://tinyurl.com/yy38rwgz","body":"This paper looks at the increasing burden of hypertension across sub-Saharan Africa where HIV prevalence is the highest in the world, but current care models are inadequate to address the dual epidemics. Little data exist on the effectiveness of integrated HIV and chronic disease care delivery systems on blood pressure control over time. Population screening for HIV and hypertension, among other diseases, was conducted in ten communities in rural Uganda as part of the SEARCH study. Individuals with either HIV, hypertension, or both were referred to an integrated chronic disease clinic. Based on Uganda treatment guidelines, follow-up visits were scheduled every 4\u2009weeks when blood pressure was uncontrolled, and either every 3\u2009months, or in the case of drug stock-outs more frequently, when blood pressure was controlled. The authors described demographic and clinical variables among all patients and used multilevel mixed-effects logistic regression to evaluate predictors of hypertension control. Following population screening of 34,704 adults age\u2009\u2265\u200918\u2009years, 4554 individuals with hypertension alone or both HIV and hypertension were referred to an integrated chronic disease clinic. Within 1\u2009year 2038 participants with hypertension linked to care and contributed 15,653 follow-up visits over 3\u2009years. Hypertension was controlled at 15% of baseline visits and at 46% of post-baseline follow-up visits. Hypertension control at follow-up visits was higher among HIV-infected patients than uninfected patients and improved hypertension control was achieved in an integrated HIV and chronic care model. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Incorporating concerns for equity into health resource allocation: A guide for practitioners","field_subtitle":"Love-Koh J; Griffin S; Kataika E; Revill P; et al: CHE Research Paper 160, 2019","URL":"https://ecsahc.org/wp-content/uploads/2019/02/CHERP160.pdf","body":"This report summaries the methods for analyzing health equity available to policymakers regarding the allocation of health sector resources. The authors provide an overview of the major tools that have been developed to measure, evaluate and promote health equity, along with the data required to operationalise them. These are organized into four key policy questions facing decision-makers: What is the current level of inequity in health? Does government health expenditure benefit the worst-off? Can government health expenditure more effectively promote equity? and which interventions provide the best value for money in reducing inequity? Benefit incidence analysis is identified as the principal tool for estimating the distribution of current public health sector expenditure, with geographical resource allocation formulae and health system reform being the main government policy levers for improving equity. Techniques from the economic evaluation literature, such as extended and distributional cost-effectiveness analysis can be used to identify \u2018best buy\u2019 interventions from a health equity perspective. A range of inequality metrics, from gap measures and slope indices to concentration indices and regression analysis, can be applied to these approaches to evaluate changes in equity. Methods from the economics literature can be used to generate novel evidence on the health equity impacts of resource allocation decisions. They provide policymakers with a toolkit for addressing multiple aspects of health equity, from health outcomes to financial protection, and can be adapted to accommodate data commonly available in either high income or low and middle income settings. However, the quality and reliability of the data are crucial to the validity of all methods.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Just Transition: Crowd-Sourcing City Case Studies ","field_subtitle":"Deadline: 7 July 2019","URL":"https://tinyurl.com/y6ykymfo","body":"The United Nations Research Institute for Social Development (UNRISD) is seeking potential case studies for its project Cities in Transition\u2014Urban Struggles for Just Transition(s), run by the Just Transition Research Collaborative (JTRC). This project analyses urban approaches to just transition, exploring the role of cities in implementing progressive and transformative just transition strategies and plans. Building on the theoretical framework and assessment carried out by the Just Transition Research Collaborative and published in the report Just Transition(s) to a Low-Carbon World (2018), the project collects new empirical evidence and stories from several cities, and fosters exchange of experience and mutual learning on the role of cities in just transition. The research contributes a better understanding of the potential of city-level just transition policies and frameworks to influence higher level policy change and climate justice. The case studies will be a major part of a research report which will be presented to decision makers and activists at the United Nations Climate Change Conference COP 25 in Santiago de Chile in December 2019.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Learning Network Video Resources ","field_subtitle":"University of Cape Town, 2019","URL":"https://tinyurl.com/yy24xsvn","body":"This resource provides a range of films which are useful training materials and resources. Films include reflections on community actions towards improving health, such as Community Working Group on Health (CWGH) documentary on \u201cStrengthening Community Feedback Mechanisms for Improved Health Service Delivery\u201d and a documentary film on \u201cHow South Africans are taking food security into their own hands\u201d by a student featuring individuals from Klapmuts, Belhar, and Gugulethu in the Western Cape who are initiating food gardens and other programmes to empower their communities and strengthen food security and sovereignty. A short documentary tells the story of the Network of Community Defenders for the Right to Health, users of healthcare services that have organized themselves to identify problems, engage with authorities for resolutions and demand accountability. Also featured is a training video which explores the role of Health Committees from different perspectives \u2013 from that of a facility manager, a health care provider, health committee members and patients. Two further films from the Community Systems Strengthening (CSS) project reflect on the social determinants of health and the importance of responding to community health issues in a more holistic manner. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Museum of Namibian Music Call for Submissions","field_subtitle":"Museums Association of Namibia ","URL":"https://twitter.com/MuseumsANamibia/status/1126109049085411334","body":"The Museums Association of Namibia is inviting musicians and members of the public to assist by identifying musical instruments, recordings, photographs or stories that might be included in the museum. They are calling on submissions to the development of the museum by Namibian artists and the general public alike, to contribute ideas about what the museum should contain. The museum will be a museum of Namibian music that will endeavour to showcase all forms of Namibian music across all genres, cultures, instruments, uses and time. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995\u20132050","field_subtitle":"Global Burden of Disease Health Financing Collaborator Network: The Lancet, doi: https://doi.org/10.1016/S0140-6736(19)30841-4, 2019","URL":"https://tinyurl.com/y6m9krz3","body":"The authors estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories\u2014government, out-of-pocket, and prepaid private health spending\u2014and estimated development assistance for health (DAH) from 1990 to 2018. Future scenarios of health spending using an ensemble of linear mixed-effects models were estimated, with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. Between 1995 and 2016, health spending grew at a rate of 4% annually, although it grew slower in per capita terms and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries, mainly due to growth in government health spending, and in lower-middle-income countries, mainly from DAH. The decomposition analysis identified governments\u2019 increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Policy brief 45: Features of domestic revenue sources for universal health systems: a contribution to policy dialogue","field_subtitle":" University of the Witwatersrand and Training and Research Support Centre: EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQPolbrief%2045%20financing.pdf","body":"This brief aims to present the positive and negative implications of the different domestic revenue sources being explored, advocated and implemented in the East and Southern African (ESA) region. It presents issues to be considered in choosing between, and implementing, the different non-contributory and contributory options for revenue collection, given the policy commitments in the region to equity and universal health coverage (UHC). The brief draws information from experiences of other low and middle income countries globally, including on the fiscal, revenue, progressiveness and acceptability implications of different options. The brief highlights that revenue collection measures need to be accompanied by measures to strengthen strategic purchasing and access to equitable, effective, quality care. The full report  the brief is drawn from is also being made available on the EQUINET website.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Posting policies don\u2019t change because there is peace or war\u201d: the staff deployment challenges for two large health employers during and after conflict in Northern Uganda","field_subtitle":"Ayiasi R; Rutebemberwa E; Martineau T: Human Resources for Health 17(27)1-10, 2019 ","URL":"https://tinyurl.com/y3g73fzb","body":"In this paper, the authors examine how deployment policies and practices were adapted during the conflict and post-conflict periods with the aim of drawing lessons for future responses to similar conflicts. Qualitative data was collected in a cross-sectional survey to investigate deployment policy and practice during the conflict and post-conflict period in Amuru, Gulu and Kitgum districts in Northern Uganda in 2013. Two large health employers from Acholi were selected, the district local government and Lacor hospital, a private provider. Twenty-three key informants\u2019 interviews were conducted at the national and district level, and in-depth interviews with 10 district managers and 25 health workers. There was no evidence of change in deployment policy due to conflict, but decentralisation from 1997 had a major effect for the local government employer. Health managers in government and those working for Lacor hospital both implemented deployment policies pragmatically, especially because of the danger to staff in remote facilities. Lacor hospital introduced bonding agreements to recruit and staff their facilities. While managers in both organisations implemented the deployment policies as best as they could, some deployment-related decisions were noted as possibly leading to longer-term problems. While it may not be possible to change deployment policies during or after conflict, the authors observe that if given sufficient autonomy, local managers can adapt deployment policies appropriately to need, but that they should also be supported with the necessary management skills to enable this.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Press Statement on Government\u2019s Continued Non-involvement of Botswana Labour Migrants Association (BoLAMA) in TB Programme Management ","field_subtitle":"Botswana Labour Migrants Association (BoLAMA): Gaberone, May 2019","URL":"https://www.twn.my/title2/health.info/2019/hi190512.htm","body":"BoLAMA report in a press statement that it has without much success made all efforts to engage and collaborate with the Government of Botswana on miners\u2019 right to health, specifically for those suffering from TB and other occupational diseases. BoLAMA assert that TB rates in Botswana remain high and a multi-sectoral accountability framework is required. This framework which is aligned with the End TB Strategy and UN Political Declaration on TB requires key populations and civil society to work in collaboration with Governments. The regional TB/Silicosis class action is seen as an opportunity to reduce the economic hardships of ex-miners who due to contracting occupational lung diseases have been rendered redundant and not in gainful employment. The court case, to which BoLAMA has been party, is slated to be finalized in 2019. BoLAMA called on the Government of Botswana to; i) remember her commitments under the WHO EndTB Strategy from which the TB National Strategic Plan is aligned; ii) implement the UN Political Declaration on the fight against TB; iii) ensure an inter-ministerial committee including BoLAMA deal with ex-miners issues; and iv) provide support in the TB/Silicosis regional class suit. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Prevalence of chronic respiratory disease in urban and rural Uganda","field_subtitle":"Siddharthan T: Grigsby M; Morgan B; Kalyesubula R; et al: Bulletin of the World Health Organisation 97(5)318\u2013327, 2019","URL":"https://www.who.int/bulletin/volumes/97/5/18-216523.pdf?ua=1","body":"This paper seeks to determine the prevalence of chronic respiratory diseases in urban and rural Uganda and to identify risk factors for these diseases. The population-based, cross-sectional study included adults aged 35 years or older. All participants were evaluated by spirometry according to standard guidelines and completed questionnaires on respiratory symptoms, functional status and demographic characteristics. The presence of four chronic respiratory conditions was monitored: chronic obstructive pulmonary disease, asthma, chronic bronchitis and a restrictive spirometry pattern. The age-adjusted prevalence of any chronic respiratory condition was 20.2%; the age-adjusted prevalence of chronic obstructive pulmonary disease was significantly greater in rural than urban participants, whereas asthma was significantly more prevalent in urban participants: 9.7% versus 4.4% in rural participants. The age-adjusted prevalence of chronic bronchitis was similar in rural and urban participants, as was that of a restrictive spirometry pattern. For chronic obstructive pulmonary disease, the population attributable risk was 51.5% for rural residence, 19.5% for tobacco smoking, 16.0% for a body mass index over 18.5 kg and 13.0% for a history of treatment for pulmonary tuberculosis. The prevalence of chronic respiratory disease was high in both rural and urban Uganda.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Primary health care is where the battle for health will be won or lost","field_subtitle":"Third World Network: TWN Information Service on Health Issues 19/10, May 2019 ","URL":"https://tinyurl.com/y2vl5gdy","body":"In his address to the 72nd session of the World Health Assembly, Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organisation (WHO) said that strong primary health care is the front-line in defending the right to health, including sexual and reproductive rights. According to WHO, the \u201ctriple billion\u201d targets that are at the heart of its strategic plan for the next five years are: one billion more people benefiting from universal health coverage (UHC); one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being. Dr Tedros cited various initiatives in countries that demonstrate progress and new normative products developed by WHO that are being used globally to protect and promote health. He highlighted three priorities that must guide discussions to make advances in primary health care: health is about political leadership; health is about partnership; and health is about people.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Resolution on States\u2019 Obligation to Regulate Private Actors Involved in the Provision of Health and Education Services ","field_subtitle":"African Commission on Human and People\u2019s Rights: ACHPR, Egypt, 2019","URL":"http://www.achpr.org/sessions/64th_os/resolutions/420/","body":"The African Commission on Human and People\u2019s Rights calls on States Parties to the African Charter to take appropriate policy, institutional and legislative measures to ensure respect, protection, promotion and realization of economic, social and cultural rights, in particular the right to health and education and to fulfil their obligations on this. The Commission calls on States Parties to adopt legislative and policy frameworks regulating private actors in social service delivery and ensure that their involvement is in conformity with regional and international human rights standards. States Parties are invited to ensure that the involvement of private actors in the provision of social services is a result of a participatory policy formulation process and continues to be subject to democratic scrutiny and to the human rights principles of transparency and participation. The Commission considers carefully the risks for the realization of economic, social and cultural rights of public-private partnerships and ensure that any potential arrangements for public-private partnerships are in accordance with their substantive, procedural and operational human rights obligations, and do not violate the norms and principles of the rights contained in the African Charter; and to ensure through regular impact assessments that the involvement of private actors in the provision of health services and education does not create systemic adverse impacts on human rights. Further States Parties are to ensure access to an effective remedy for violations of the right to health and education or other human rights violations by private actors involved in the provision of health and education services. The Commission reminds private actors of their responsibility to respect economic and social rights, particularly the right to health and education and to refrain from infringing on human rights as they engage in the provision of these services.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Rights-based training enhancing engagement of health providers with communities, Cape Metropole, South Africa ","field_subtitle":"Zwama G; Stuttaford M; Haricharan H; London L: Frontiers in Sociology, 1-12 doi: https://doi.org/10.3389/fsoc.2019.00035, 2019","URL":"https://tinyurl.com/y567fa2s","body":"Community participation, the central principle of the primary health care approach, is widely accepted in the governance of health systems. Health Committees (HCs) are community-based structures that can enable communities to participate in the governance of primary health care. Previous research done in the Cape Town Metropole, South Africa, reports that HCs' potential can, however, be limited by a lack of local health providers' (HPs) understanding of HC roles and functions as well as lack of engagement with HCs. This study was the first to evaluate HPs' responsiveness towards HCs following participation in an interactive rights-based training. Thirty-four HPs, from all Cape Metropole health sub-districts, participated in this qualitative training evaluation. Two training groups were observed and participants completed pre- and post-training questionnaires. Semi-structured interviews were held with 10 participants 3\u20134 months after training. Following training, HPs understood HCs to play an important role in the communication between the local community and HPs. HPs also perceived HCs as able to assist with and improve the quality and accessibility of PHC, as well as the answerability of services to local community needs. HPs expressed intentions to actively engage with the facility's HC and stressed the importance of setting clear roles and responsibilities for all HC members. This training evaluation reveals HPs' willingness to engage with HCs and their desire for skills to achieve this. Moreover, it confirms that HPs are crucial players for the effective functioning of HCs. This evaluation indicates that HPs' increased responsiveness to HCs following training can contribute to tackling the disconnect between service delivery and community needs. Therefore, the training of HPs on HCs potentially promotes the development of needs-responsive PHC and a people-centred health system.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"SA just endorsed a draft resolution that could bring Big Pharma to its knees","field_subtitle":"Van Dyk J: Bhekisisa, April 2019","URL":"https://tinyurl.com/yxp2qx4w","body":"A World Health Assembly resolution this year proposed that drug prices could be reduced if countries forced pharmaceutical companies to be open about what it really costs to produce medicines. The plan is to give governments a way to enforce changes in the way medicine prices are set. In South Africa, cancer patients pay exorbitant prices to stay alive. Blood cancer patients are paying over R 800 000 for a year\u2019s worth of one chemotherapy medicine, according to a report by the Cancer Alliance. Loopholes in South African patent laws are said to be one reason medicine prices are this high. Currently, companies that bring new drugs onto the market are awarded market monopolies through being awarded long-term patents that prevent anyone else from manufacturing a similar drug for many years. For example, the company that brought the blood cancer drug in question onto the market has had protection from competitors for 40 years, according to a briefing paper by the Initiative for Medicines, Access and Knowledge. In an overhauled system, it is proposed that market monopolies be capped at 15 years with small rewards offered when new, good drugs enter the market.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Smoke, spies and lies: Should you throw away your e-cigarette?","field_subtitle":"Van Dyk J: Bhekisisa Centre for Health Journalism, April 2019","URL":"https://tinyurl.com/y5n7y8r2","body":"E-cigarettes allow users to inhale solutions that usually contain nicotine in a colourless liquid such as propylene glycol \u2013 an additive typically found in food and cosmetics. This solution is heated in hand-held devices and produces a vapour, which is why smoking e-cigarettes is often called \u201cvaping\u201d. South Africa\u2019s new tobacco control Bill, which was published in July last year, proposes the same harsh regulations for e-cigarettes as their traditional cigarette counterparts. These include advertising restrictions, plain packaging and the banning of smoking areas in restaurants and public buildings. After the Bill\u2019s publication, the Vapour Products Association (VPA), which represents e-cigarette manufacturers and retailers, publicly asserted that e-cigarettes are 95% safer than conventional cigarettes and may even help traditional smokers to quit, quoting an expert review by Public Health England in 2015. The UK study has however been widely criticised with some scientists taking issue with its methodology, arguing the research was based on the opinions of experts, instead of clinical trials. Anthony Westwood, a pulmonologist at the School of Child and Adolescent Health at the University of Cape Town, explains: \u201cOur children cannot afford to find out in 20 years that they\u2019ve got cancer because of e-cigarettes. \u201cWe have a chance to defuse this ticking time bomb.\u201d","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"South African Medical Association (SAMA) Conference","field_subtitle":"8-10 August 2019, Durban, South Africa","URL":"https://www.samedical.org/conference/","body":"The theme of the 2019 SAMA conference is \u201cLeadership and Quality in Healthcare \u2013 Let\u2019s close the Gap\u201d and will cover the future direction of healthcare and various initiatives of the National Health Insurance (NHI). It also resonates with the discussions emanating from the private sector in South Africa. The conference will feature a parallel research track and undergraduate and postgraduate students, as well as colleagues involved in research are invited to attend and participate.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Successes and challenges of the One Health approach in Kenya over the last decade","field_subtitle":"Munyua P;  Njenga K; Osoro E; Onyango C; et al: BMC Public Health 19; 465; Suppl 3; 1-9, 2019 ","URL":"https://tinyurl.com/y6to86t3","body":"More than 75% of emerging infectious diseases are zoonotic in origin and a transdisciplinary, multi-sectoral One Health approach is a key strategy for their effective prevention and control. In 2004, US Centers for Disease Control and Prevention office in Kenya established the Global Disease Detection Division of which one core component was to support, with other partners, the One Health approach to public health science. A Zoonotic Disease Unit has provided Kenya with an institutional framework to highlight the public health importance of endemic and epidemic zoonoses including Rift Valley Fever, rabies, brucellosis, Middle East Respiratory Syndrome Coronavirus, anthrax and other emerging issues such as anti-microbial resistance. The programme is implementing capacity building programs, surveillance, workforce development, research, coordinated investigation and outbreak response. This has led to an improved outbreak response and generated data that has informed disease control programs to reduce the burden of and enhance preparedness for endemic and epidemic zoonotic diseases, enhancing global health security. Since 2014, the Global Health Security Agenda implemented through Centers for Disease Control and Prevention office in Kenya and other partners in the country has provided additional impetus to maintain this effort and Kenya\u2019s achievement now serves as a model for other countries in the region. Significant gaps remain in implementation of the One Health approach at subnational administrative levels. however, with  sustainability concerns, competing priorities and funding deficiencies.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Systematic looting robs Africa of billions of dollars","field_subtitle":"Centre for Natural Resource Governance, 31 May 2019","URL":"https://tinyurl.com/y37va8o6","body":"Natural resource governance activists have called on African leaders and corporates to stop the systematic looting of resources because it deprives the states of meaningful revenue needed for development. The call was made at a regional conference on the political economy of resource looting in the SADC region organized by Centre for Natural Resource Governance (CNRG) Southern Africa Political Economy Series (SAPES Trust) and regional watchdog Southern African Resource Watch (SARW) in Harare in May 2019. Southern Africa is said to be losing tens of billions of American dollars in potential natural resources revenue through systematic looting which includes trade mispricing, tax avoidance, corruption and transnational organized crime involving ruling elites and foreign actors, regional natural resource experts have said.  SADC delegates present at the conference suggested that there is need to harmonise the laws in the region and adopt mineral resource governance and stronger contract negotiations to curb the leakages.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Tech firms to check suppliers after mining revelations in Tanzania","field_subtitle":"Watts J: The Guardian, June 2019","URL":"https://tinyurl.com/y4hbxwct","body":"A network of journalists report that electronics companies, including Canon, Apple and Nokia, are re-evaluating their supply chains following reports they may be using gold extracted from a London listed Tanzanian gold mine that has been criticised for environmental failures.  More recently, the Tanzanian government has imposed penalties on the mine and ordered the operators to build an alternative to its tailings reservoir, which is used to store potentially hazardous by-products of mining. Under Tanzanian law, no mine should operate within 200 metres of a home or 100 metres of a farm, but the mining company reported that it had not been able to meet this requirement. The company has built a wall in some areas, improved security training and introduced a grievance mechanism, which have led to a marked reduction in conflict over the past two years, but locals claimed there were still accidents and violence as a result of incursions, and toxic wastewater continued to seep from the mine into residential areas and waterways nearby. While there is scrutiny of the supply chain there is concern that this focuses on small-scale miners rather than multinationals, that there is not enough attention to environmental standards and local laws, and that responsibility gets diluted along the supply chain.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The IMF should support the financing of universal social protection, health and education","field_subtitle":"International Trade Union Confederation: Geneva,  June 2019","URL":"https://www.ituc-csi.org/the-imf-should-support-the","body":"At the International Labour Conference, IMF Managing Director Christine Lagarde unveiled an institutional view on social spending that will guide Fund staff on social protection, health and education. This responds to an IMF Internal Evaluation Office report noting that the institution was increasingly out-of-step with \u201cthe rights-based approach to social protection espoused by UN agencies including the ILO.\u201d The IMF view is primarily focused on social assistance. These benefits, generally targeted to the poorest, are often advocated by the IMF as a measure to mitigate its conditionality and policy advice including austerity and the expansion of regressive taxation such as Value-Added Taxes. The institutional view argues that regressive taxes can be offset by more progressive social transfers. The Fund\u2019s approach to social assistance and reducing spending has led to the promotion of narrow targeting through proxy means testing in many developing countries that erroneously excludes large numbers of recipients. The difficulties of narrow targeting are acknowledged but do not result in a clear change in policy. The International Labour Conference discussion of the General Survey concerning the Social Protection Floors Recommendation No. 202 highlighted how pressures from the IMF to cut social spending and the wage bill in public sector workers and to reduce the coverage of social protection have impeded the ability of states to deliver on their commitment to deliver adequate, comprehensive social protection systems consistent with ILO standards. In the past, the IMF has been more open to social protection floors, working jointly with the ILO after 2010 to support financing of national floors. Throughout the creation of the institutional view, the ITUC advocated for the IMF to support countries in financing comprehensive social protection systems and close coordination with the ILO. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"When a national referral hospital ceases to be one: Reminding government of its duties","field_subtitle":"Job K: Center for Health, Human Rights and Development (CEHURD), 2019","URL":"https://tinyurl.com/y23konls","body":"The author questions whether Uganda national referral hospitals are performing their function. The author asks why a section of persons should be given special treatment by government in the names of being \u2018Very Important Persons\u2019 to access the best medical services in referral facilities for first line care or in \u2018uptown\u2019 private medical facilities and abroad. The author proposes that government perform its core minimum obligation and ensure that its public health care facilities function effectively. ","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"\u201cWe come as friends\u201d: approaches to social accountability by health committees in Northern Malawi","field_subtitle":"Lodenstein E; Molenaar J; Ingemann C; Botha K; et al: BMC Health Services Research 19(279) 1-14, 2019 ","URL":"https://tinyurl.com/y2sp4j8j","body":"This study explores how health facility committees monitor the quality of health services and how they demand accountability of health workers for their performance in Malawi. Documentary analysis and key informant interviews were complemented by interviews with purposefully selected health facility committees members and health workers regarding their experiences with health facility committees.  The informal and constructive approach that most health facility committees use is shaped both by formal definition and expectations of their role and resource constraints. The primary social accountability role of health facility committees appeared to be co-managing the social relations around the health facility and promoting access to and quality of services. The results suggest that health facility committees can address poor health worker performance and the authors suggest that social accountability approaches with health facility committees be integrated in existing quality of care programs and that accountability arrangements and linkages with upward accountability approaches be clarified.","php":"","field_issue_date":"2019-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":" Investing in health R&D: where we are, what limits us, and how to make progress in Africa","field_subtitle":"Simpkin V; Namubiru-Mwaura E; Clarke L; et al: BMJ Global Health 4(2), doi: http://dx.doi.org/10.1136/bmjgh-2018-001047, 2019","URL":"https://gh.bmj.com/content/4/2/e001047","body":"Global research and development (R&D) pipelines for diseases that disproportionately affect African countries appear to be inadequate, with governments struggling to prioritise investment in R&D. This article provides insights into the sources of investment in health science research, available research capacity and level of research output in Africa. Africa has 15% of the world\u2019s population, yet only accounted for 1.1% of global investments in R&D in 2016. There were substantial disparities within the continent, with Egypt, Nigeria and South Africa contributing 65.7% of the total R&D spending. In most countries of the Organisation for Economic Co-operation and Development, the largest source of R&D funding is the private sector. R&D in Africa is mainly funded by the public sector, with significant proportions of financing in many countries coming from international funding. Challenges that limit private sector investment include unstable political environments and poor governance practices. Evidence suggests various research output and research capacity limitations in Africa in terms of university rankings, number of researchers, number of publications, clinical trials networks and pharmaceutical manufacturing capacity and substantial regional disparities within the continent. The authors propose that incentivising investment is crucial to foster current and future research output and research capacity. This paper outlines some of the initiatives under way for this, including through innovative and collaborative financing mechanisms that stimulate further investment. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"72nd session of the World Health Assembly","field_subtitle":"20-28 May 2019, Geneva","URL":"http://apps.who.int/gb/e/e_wha72.html#informationdocunents","body":"The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. Background reports, daily information can be found at the website shown.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A cross-sectional mixed-methods study of sexual and reproductive health knowledge, experiences and access to services among refugee adolescent girls in the Nakivale refugee settlement, Uganda","field_subtitle":"Ivanova O; Rai M; Mlahagwa W; Tumuhairwe J; et al: Reproductive Health 16 (35) 1-11, 2019","URL":"https://tinyurl.com/y2nw4uxm","body":"Humanitarian crises and migration make girls and women more vulnerable to poor sexual and reproductive health (SRH) outcomes.  This mixed-methods study assessed SRH experiences, knowledge and access to services of 260 refugee girls 13-19 years old in the Nakivale settlement, Uganda between March and May 2018. The majority of girls were born in DR Congo and Burundi. the findings showed weak knowledge of SRH and methods for preventing HIV and pregnancy, school days missed due to menstruation and that 30 of the 260 girls were sexually active, of which 11 had experienced forced sexual intercourse. The latter occurred during conflict, in transit or within the camp. The preferred sources for SRH information was parents or guardians, although participants expressed that they were afraid or shy to discuss other sexuality topics apart from menstruation with parents. Only 30% of the female adolescents had ever visited a SRH service centre, mostly to test for HIV and to seek medical aid for menstrual problems. The authors found that adolescent refugee girls lack adequate SRH information, experience poor SRH outcomes including school absence due to menstruation, sexual violence and FGM and recommend comprehensive SRH services including sexuality education, barrier-free access to SRH services and parental involvement  for refugee communities.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"A qualitative study of the dissemination and diffusion of innovations: bottom up experiences of senior managers in three health districts in South Africa","field_subtitle":"Orgill M; Gilson L; Chitha W; Michel J; et al: International Journal for Equity in Health 18(53) 1-15, 2019","URL":"https://tinyurl.com/y5ugvo6y","body":"The research paper explored, from a bottom up perspective, how efforts by the South African government to disseminate and diffuse innovations were experienced by district level senior managers and why some efforts were more enabling than others. Managers valued the national Minister of Health\u2019s role as a champion in disseminating innovations via a road show and his personal participation in an induction programme for new hospital managers. The identification of a site coordinator in each pilot site was valued as this coordinator served as a central point of connection between networks up the hierarchy and horizontally in the district. Managers leveraged their own existing social networks in the districts and created synergies between new ideas and existing working practices to enable adoption by their staff. Managers also wanted to be part of processes that decide what should be strengthened in their districts and want clarity on the benefits of new innovations, total funding they will receive, their specific role in implementation and the range of stakeholders involved. The authors proposed that those driving reform processes from the top remember to develop well planned dissemination strategies that give lower-level managers relevant information and, as part of those strategies, provide ongoing opportunities for bottom up input into key decisions and processes. Managers in districts should be recognised as leaders of change, not only as implementers who are at the receiving end of dissemination strategies from those at the top. They are integral intermediaries between those at the frontline and national policies, managing long chains of dissemination and natural diffusion.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Accelerating universal health coverage: a call for papers","field_subtitle":"Deadline for submissions: 15 June 2019","URL":"https://www.who.int/bulletin/volumes/97/3/19-230904/en/","body":"In 2020, the world will still have a decade to harness global momentum and advance progress towards UHC by 2030. A special issue of the Bulletin of the World Health Organization will focus on the theme of accelerating progress towards UHC to encourage learning and information sharing on this dimension of the Sustainable Development Goals (SDGs). The issue will explore policy options and country experiences on how to expand population coverage, service coverage and financial protection. Manuscripts that capture knowledge and experience in addressing bottlenecks and root causes of stagnation that hamper successful UHC advancement are welcomed. Analysis of breakthroughs in health systems that have been conducive to rapid expansion of coverage are also encouraged. Papers should focus on, for example, implementation science in health systems, innovative health financing, strategic purchasing, UHC and primary health care, the role of the private sector, policy coherence across government levels (particularly in decentralized health systems), the role of innovative technology and the design and use of health information. Best practices in good governance for health, based on transparency and accountability, would also be useful to learn how vested interests that hamper progress towards UHC are countered in different socioeconomic and political contexts. Comparative cross-country analyses are encouraged.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Are foreigners stealing your jobs and healthcare? Find out","field_subtitle":"Heleta S: NGO pulse, Sangonet, April 2019","URL":"https://tinyurl.com/y6efwjut","body":"Clinic and hospitals in the public sector in South Africa are stretched, but the author argues that this is not because of immigrants as is being proposed in some quarters, but because of understaffing, poor planning and other problems. A 2018 World Bank study showed that between 1996 and 2011, every immigrant worker generated two jobs for South Africans, mostly because their diverse skill sets led to productivity gains and multiplier effects. Immigrants also contribute to the national fiscus through payment of VAT and purchase goods and services, such as rent, from South Africans. The author calls for xenophobic blaming of foreigners to be resisted and for South Africans to see this for what it is: scapegoating of immigrants to hide domestic failures","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Building a tuberculosis-free world: The Lancet Commission on tuberculosis","field_subtitle":"Reid M; Arinaminpathy N; Bloom A; Bloom B; et al: The Lancet Commissions 393(1017b, p1331-1384, 2019","URL":"https://tinyurl.com/y54d73c5","body":"Tuberculosis can be treated, prevented, and cured. Rapid, sustained declines in tuberculosis deaths in many countries during the past 50 years provide compelling evidence that ending the pandemic is feasible. Yet this disease\u2014which has plagued humanity since before recorded history and has killed hundreds of millions of people over the past two centuries\u2014remains a relentless scourge. In 2017, 1.6 million people died from tuberculosis, including 300\u2008000 people with HIV, representing more deaths than any other infectious disease. Moreover, in many parts of the world, drug-resistant forms of tuberculosis threaten struggling control efforts. The world can no longer ignore the enormous pall cast by the tuberculosis epidemic. Going forward, the global tuberculosis response must be an inclusive, comprehensive response within the broader sustainable development agenda. No one-size-fits-all approach can succeed.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Climate costs South Africa 10% of its GDP","field_subtitle":"Kings S: Mail and Guardian, South Africa, April 2019","URL":"https://www.pnas.org/content/116/20/9808","body":"Research suggests that poor countries in the south would have 24% larger economies if it wasn\u2019t for global warming. This is because the world is 1\u00b0C hotter than it was a century ago. That warming means crops fail, economic productivity goes down and people get sick or die because of the heat. South Africa is argued to be between 10% and 20% poorer than it would have been without that warming in the last six decades. Nigeria is 29% poorer and India is 30% poorer. The research, titled  \u201cGlobal warming has increased global inequality'  reports that rich countries have benefited from this warming. By calculating temperature and economic growth between 1961 and 2010, the researchers found that already rich countries, mostly in colder climates, have growth spurts during an unusually hot year. This is because hotter weather moves them closer to what is known as the \u201cempirical optimum\u201d \u2014 the closer a country\u2019s average temperature is to 13\u00b0C, the more its economy thrives. South Africa\u2019s average is around 17\u00b0C and is only increasing with global warming. The researchers concluded that global warming has meant countries are also more unequal. Richer people can insulate themselves from extreme events \u2014 by buying food when the price goes up or by being able to claim from insurance \u2014 and keep functioning. Those with few resources to start with do not have such a buffer. This local and global inequality in the impact of global warming is the topic of fierce international negotiation. While China and India are massively growing their emissions, the authors note that they still represent a fraction of total emissions in the last two centuries, with China has emitted half of what the United States has and India a seventh.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Ebola situation worsening while support lags","field_subtitle":"World Health Organisation: Statement from High-Level Mission to Butembo, DRC, WHO, 2019","URL":"https://tinyurl.com/y4feombf","body":"WHO Director-General Dr Tedros Adhanom Ghebreyesus and WHO Regional Director for Africa, Dr Matshidiso Moeti, visited Butembo, in the Democratic Republic of the Congo. It was in Butembo on 19 April that WHO epidemiologist Dr Richard Mouzoko was killed by armed men while he and colleagues were working on the Ebola response. Dr Tedros and Dr Moeti traveled to Butembo to express their gratitude and show support to WHO and partner organization staff, while also assessing the next steps needed to strengthen both security and the Ebola response effort. They also met with local political, business and religious leaders, and called on them to accelerate their efforts to stabilize the surrounding environment. They urged the international community to step up support to contain the Ebola outbreak, including filling the funding gap that threatens to stymie the Ebola response. Most Ebola response activities, including community engagement, vaccination, and case investigation, have been re-launched following a slowdown in the wake of the attack that left Dr. Mouzoko dead and two people injured. However, they expressed deep concern that a rise in reported cases in recent weeks is straining resources even further. Only half of the currently requested funds have been received, which could lead to WHO and partners rolling back some activities precisely when they are most needed. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 219: Health must not remain a privilege of the powerful alone","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Factors influencing men\u2019s involvement in antenatal care services: a cross-sectional study in a low resource setting, Central Tanzania","field_subtitle":"Gibore N; Bali T; Kibusi S: Reproductive Health 16(52)1-10, 2019","URL":"https://tinyurl.com/y39gnwz4","body":"In this paper the authors sought to determine the level of men\u2019s involvement in antenatal care and the factors influencing their involvement in these services. A cross sectional study of 966 randomly selected men aged 18\u2009years or older was conducted in Dodoma Region, from June 2014 to November 2015. Face to face interviews were conducted using a pretested structured questionnaire. The level of men\u2019s involvement in antenatal care was high and 89% of respondents made joint decisions on seeking antenatal care. More than half of respondents accompanied their partners to the antenatal clinic at least once. Less than a quarter of men were able to discuss issues related to pregnancy with their partner\u2019s health care providers, although 77% of respondents provided physical support to their partners during the antenatal period. Factors influencing men\u2019s involvement in antenatal care were occupation, ethnicity, religion, waiting time, information regarding men\u2019s involvement in antenatal care and men\u2019s perception about the attitude of health care providers. Overall, more than half of respondents reported high involvement in antenatal care services. Access to information on men\u2019s involvement, religion, occupation, ethnicity, waiting time and men\u2019s perception about the attitude of care providers were significant factors influencing men\u2019s involvement in antenatal care services in this study. The authors observe that health promotion is needed to empower men with essential information for meaningful involvement in antenatal care services.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"G20-Africa engagement: Finding a roadmap to shared development","field_subtitle":"van Staden C; Sidiropoulos E:  South African Institute of International Affairs (SAIIA) Occasional Paper No 294, 2019","URL":"https://tinyurl.com/y6acnbb8","body":"The G20 plays an important role in global rule-making. Africa is significantly under-represented in this body, with only South Africa a permanent member. This makes Africa a rule-taker.  At the same time the G20 has started to pay more attention to Africa and the continent\u2019s future development now occupies a somewhat more central position on the grouping\u2019s agenda. The G20 Initiative on Supporting Industrialization in Africa and Least Developed Countries, launched under China\u2019s G20 presidency of 2016, and the 2017 German presidency\u2019s Compact with Africa offered unprecedented moments of engagement. However, the question remains how Africa can use these initiatives to deepen its engagement with the G20 and boost its own development. This paper draws on extensive interviews with key stakeholders to analyse G20\u2013Africa engagement by focusing on three presidencies: China in 2016, Germany in 2017, and Argentina in 2018. It shows how China\u2019s Industrialisation Initiative was crucially informed by its pre-existing African engagement, while Germany\u2019s Compact with Africa both gained and suffered from a more narrowly focused commercial engagement. It then shows how Argentina, despite lacking a similar African initiative, managed to continue G20\u2013Africa engagement through person-to-person diplomacy. The paper points out both the benefits and the limits of these engagements and suggests a series of further initiatives that could allow Africa a more significant say in the G20.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health Literacy training and processes in the Mining Sector ","field_subtitle":"EQUINET: Regional meeting, Harare and follow up work, March 2019","URL":"http://www.equinetafrica.org/content/equinet-feedback-form","body":"From 2016, co-ordinated by Training and Research Support Centre (TARSC), EQUINET has implemented research and policy engagement on extractive industries / mining and health in east and southern Africa (ESA), working with regional partners in East Central and Southern Africa Health Community, the Southern African Trade Union Co-ordinating Council, SADC Council of NGOs, the Alternative Mining Indaba ad others. The work and knowledge shared contributed to the development of a Mining and Health Literacy Module, to provide information and support discussion on advancing public health and implementing the right to health in the mining sector in the ESA region. In March 2019, against this background, TARSC in EQUINET organised a regional meeting on health literacy in the mining sector in Harare, Zimbabwe from 28-29 March 2019 for organisations that had been actively involved in planning and leading work on health in mining to date. The meeting involved delegates from Botswana Federation of Trade Unions, Benchmarks Foundation, Swaziland Migrant Mineworkers Association, Southern African Trade Union co-ordinating conference, Botswana Labour Migrants Association, Zimbabwe Congress of Trade Unions, National Mineworkers Union of Zimbabwe, Southern and East African Trade Information and negotiations Institute and TARSC. The meeting discussed health literacy outreach for workers, communities and ex mineworkers in the mining sector; shared information on the scope of and groups covered in current mining and health capacity building programmes and reviewed the methods for and use of the EQUINET health literacy module on Mining and health. Delegates planned collectively subsequent follow up training activities on mining and health, and discussed co-operation on upcoming regional processes on health in mining. The group agreed to continue to work together as a \u2018Mining and Health\u2019 Working group to take follow up work forward, with each contributing inputs related to their work. A health literacy training of trainers workshop on mining and health  will be held in follow and those interested should please contact EQUINET using the feedback form at the website shown.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Health must not remain a privilege of the powerful alone","field_subtitle":"Professor Asha George, Chair, Health System Global Board and University Western Cape ","body":"\r\nForty years on from the Alma Ata declaration, those who are the most vulnerable are still the least likely to access quality healthcare and to live healthy lives. Research is critical for understanding and addressing the systems of power that undermine health and health equity. Leaders must invest in more inclusive, introspective and innovative research partnerships to strengthen robust, resilient and responsive health systems to achieve \u2018health for all\u2019.\r\n\r\nAt the 2018 Fifth Global Symposium for Health Systems Research in Liverpool, UK, delegates made a strong plea for action to address the \u2018power and privilege\u2019 that continues to undermine global health. In supporting health systems as a key foundation for ensuring the health and wellbeing of citizens and communities world over, this call was repeated to those participating in the 2018Global Conference for Primary Healthcare in Astana, Kazakhstan. The call for Astana to renew and build upon a promise made forty years ago in Alma Ata, Kazakhstan to achieve \u2018health for all\u2019 was a reminder for us to reflect on how far we have come, but also how far we have to go. \r\n\r\nWhile the ambition remains as noble and important as it was in 1978, we are living in a completely different world with unprecedented challenges, with pollution, militarisation, unregulated commercial interests, polarising ideologies, pandemics and ageing populations, to name a few. These challenges are marked by increasing and intersecting inequalities, within countries and between them. We know that the impact of these political threats and social inequities affect those at the bottom of the ladder, if they are on the ladder at all.\r\n\r\nAt the same time, social voice and leverage, including social media initiatives like #MeToo, #TimesUp, and #PeriodPoverty, independent journalism, progressive legislative action and everyday activism by citizens and communities do hold those in positions of power to account. Citizen voice and community participation, a hallmark of Alma Ata, merits further consideration, scrutiny and support. They remain essential for mobilising the broader awareness, engagement and political commitment needed for domestic policies to materialize universal principles and goals, including human rights, gender equality, global solidarity, universal health coverage and the sustainable development goals.\r\n\r\nWe have had many recent historical markers raising the profile of health equity, including the birth of the UK National Health Service (NHS), the Alma Ata declaration for primary health care and the Commission for Social Determinants of Health. But, what does that mean in real terms if we do not learn, or change the power structures that continue to undermine health and equity?\r\n\r\nAs raised at the 2018 Global Symposium on Health Systems Research, the causes of bad (and good) health are multiple, and go beyond the health sector, so must we. Just as people\u2019s lives and needs cannot be neatly divided into categories to match government structures or professional disciplines, our research, policy and practice needs to transcend these boundaries. Supporting effective multi-sectoral action for health needs not just greater technical understanding, but also research on how best to facilitate, monitor and govern multi-sectoral action inclusive of actors for whom health is not a shared starting point.\r\n\r\nEngaging communities in policy, practice and research is essential. While recognizing the importance of community health worker programs, further understanding of the diverse actors that make up community ecosystems and who broker social change is needed through context specific, nationally embedded research. Greater understanding of the multiple social networks and power relations within and outside of communities is needed to ensure equitable partnerships to sustain the social changes that underpin effective health interventions.\r\n\r\nAdvances in commercial products, services, technologies, and business models have generated diverse forms of service provision, expanding the influence of the private sector. These advances have created novel opportunities to expand the reach of the health system, as well as challenges due to the misalignment with commercial interests. We need to invest more in learning how to strengthen various government capacities to effectively steer these opportunities and ensure that vigilance and a healthy critique about private sector engagement remains.\r\n\r\nWhile some benefit from improvements in quality, affordable healthcare, healthy environments, and economic opportunities, others remain marginalized without adequate access or voice. We must continue to include and reach the most marginalized, move beyond polarising social identities, to build social solidarity that address systems and structures of power, otherwise we will be having this same conversation in another forty years. Research must not only continue to identify who is left behind and why, but also support understanding of how best to change that.\r\n\r\nWe often talk about power and privilege in terms of \u2018the other\u2019 or \u2018them\u2019 over there in another space. But in all senses we must look inward and reflect on our own position if we are to truly address the pervasive inequities that continue to shape our society and health. This is no truer than in the field of health policy and systems research. Health policy and systems research is more inclusive of marginalized voices than ever, but certain vulnerable populations, geo-political configurations and planetary concerns remain under-represented. The assessment of power, privilege and positionality remains central to our work in health policy and systems research, and so it be must elsewhere if we are to realize health for all.\r\n\r\nThis oped is updated from a blog that first appeared on the Health System Global site in October 2018 at https://tinyurl.com/y4aoz54g. and builds on discussions held at the Global Symposium on Health Systems Research in October 2018. Asha George is supported by the South African Research Chair's Initiative of the Department of Science and Technology and National Research Foundation of South Africa (Grant No 82769). Any opinion, finding and conclusion or recommendation expressed in this material is that of the author and the NRF does not accept any liability in this regard.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya","field_subtitle":"Genberg B; Wachira J; Kafu C; Wilso I; et al: Journal of the International Association of Providers of AIDS Care 18, 1-10, 2019","URL":"https://tinyurl.com/y3zee9f8","body":"This study examined the experiences of HIV care providers in a high patient volume HIV treatment and care program in Western Kenya on health system factors that impact patient engagement in HIV care. Results from thematic analysis demonstrated that providers perceive a work environment that constrained their ability to deliver high-quality HIV care and encouraged negative patient\u2013provider relationships. Providers described their roles as high strain, low control and low support. The study revealed that health system strengthening must include efforts to improve the working environment for providers tasked with delivering antiretroviral therapy to increasing numbers of patients in resource-constrained settings.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"How can we achieve UHC in Africa by 2030?: Reflection on Africa Health Agenda International Conference (AHAIC) 2019","field_subtitle":"Saha S; Kavattur P; Goheer A: Health Systems Global blog, April 2019","URL":"https://tinyurl.com/y36oveha","body":"Health should not be like playing the lottery - but that is what it has become in Africa. If you\u2019re born rich you win, if you are born poor, you lose.\u2019 This statement was made by Dr Githinji Gitahi, Group CEO of Amref Health Africa at the opening ceremony of the Africa Health Agenda International Conference (AHAIC) which took place in Kigali, Rwanda in March 2019. The conference was focused on Multi-Sectoral Action to achieve Universal Health Coverage (UHC) in Africa by 2030.  The conference delegates observed that technology and data are needed to achieve UHC but that most of the technology available is focused on secondary and tertiary sectors and on curative care, rather than at community level. There is also need for regulation of new generation actors that are technology-focused. The authors propose that cross-regional dialogue and knowledge sharing is needed where countries can learn from each other, avoiding traditional silos and engaging multi-stakeholder and multi-sectoral partnerships and shifting the paradigm from a view of health as an investment rather than an expenditure. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Hundreds march in Cape Town for National Health Insurance","field_subtitle":"Gonstana M-A: GroundUp, April 2019","URL":"https://tinyurl.com/yypyswuk","body":"Hundreds of people marched through Cape Town to Parliament in April to demand that government implement the National Health Insurance (NHI) system, including members of Sonke Gender Justice; Movement for Change and Social Justice (MCSJ) and the People\u2019s Health Movement South Africa. They sang and danced holding banners and placards. MCSJ founder Mandla Majola, described the NHI as the \u201cfirst step to better our public healthcare system\u201d. He said the NHI was a fund that would ensure the implementation of proper healthcare for all and would bridge the gap between private and public sectors. Before the march, the MCSJ identified ten private hospitals and sent a small group of people to each hospital to picket outside to try and get help for one member in each group who was struggling to get help at a public clinic. In a memorandum, addressed to Minister of Health Aaron Motsoaledi, the MCSJ highlights structural problems in public clinics and hospitals, such as overcrowding and bed shortages; understaffing and maladministration, such as the disappearance of patient folders and staff shortages; the rural and urban divide, such as the long commutes to and from facilities; and the disparities between private and public sectors, such as drug shortages and long queues. The marchers demanded that NHI be implemented rapidly and adequately; that national government widen the awareness of NHI through initiatives like road shows and campaigns and that there be transparency in the NHI process.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"International Studies Association International Conference 2019: Exploring the agency of the Global South in International Studies (Practices) ","field_subtitle":"1-3 August 2019, Legion Center for International Affairs & Diplomacy, University of Ghana, Accra","URL":"https://www.isanet.org/Conferences/ISA-Accra-2019","body":"Representing over 100 countries, the International Studies Association (ISA) has more than 6,500 members worldwide and is the most respected and widely known scholarly association in this field. Endeavouring to create communities of scholars dedicated to international studies, the ISA is divided into 7 geographic subdivisions of ISA (Regions), 29 thematic groups (Sections) and 4 Caucuses which provide opportunities to exchange ideas and research with local colleagues and within specific subject areas. This year\u2019s conference explores the theme of the agency of the Global South in International Studies (Practices).","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Knowledge, attitudes and practices of cervical cancer prevention among Zambian women and men","field_subtitle":"Nyambe A; Kampen J; Baboo S; Van Hal G: BMC Public Health 19(508)1-15, 2019","URL":"https://tinyurl.com/y4kz78e2","body":"This paper addresses the relationship between knowledge about cervical cancer, attitudes, self-reported behavior, and immediate support system, towards screening and vaccination of cervical cancer of Zambian women and men, as a basis for improving and adjusting existing prevention programs. A cross-sectional mixed methods study was conducted with women and men residing in Chilenje and Kanyama, Zambia. Less than half of the respondents had heard of cervical cancer, 20.7% of women had attended screening and 6.7% of the total sample had vaccinated their daughter. Knowledge of causes and prevention was very low. There was a strong association between having awareness of cervical cancer and practicing screening and vaccination. Social interactions were also found to greatly influence screening and vaccination behaviors. The low level of knowledge of causes and prevention of cervical cancer suggests a need to increase knowledge and awareness among both women and men. The authors note that interpersonal interactions have great impact on practicing prevention behaviors.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Maternal overweight and obesity and the risk of caesarean birth in Malawi ","field_subtitle":"Nkoka O; Ntenda P; Senghore T; Bass P: Reproductive Health 16(40) 1-10, 2019","URL":"https://tinyurl.com/yyv4q4wf","body":"This paper investigated the association between maternal overweight and obesity and caesarean births in Malawi. The authors utilised cross-sectional population-based Demographic Health Surveys data collected from mothers aged 18\u201349\u2009years in 2004/05, 2010, and 2015/16 in Malawi.  The results showed that maternal overweight in 2015/16 and from 2004 to 2015 were risk factors for caesarean births in Malawi. Women who had one parity, and lived in the northern region were significantly more likely to have undergone caesarean birth. In order to reduce non-elective caesarean birth in Malawi, the authors propose that public health programs focus on reducing overweight and obesity among women of reproductive age. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"PhD position in social sciences or humanities or related fields ","field_subtitle":"Deadline for applications: 12 June 2019","URL":"https://tinyurl.com/y5u7ww9m","body":"The position is being offered in the context of the Swiss National Science Foundation (SNSF) and the French Agence Nationale de la Recherche's (ANR) co-funded project, \u201cSelf-Accomplishment and Local Moralities in East Africa\u201d (SALMEA). The selected candidate will serve as a full member of the project and will be fully integrated into the team's activities.   Possible research topics are therefore varied and may cover a wide range of issues related to violence, kinship (including family formation and identity), religion, and wealth (including land ownership) in Eastern Africa. The PhD candidate will be attached to IMAF (Institut des Mondes Africains) in Aix en Provence. Based in Paris and Aix en Provence, the institute brings together scholars with an interest in Africa who are affiliated with the CNRS, IRD, EHESS, EPHE, the University of Paris 1, and Aix Marseille University. The successful candidate will be allowed to write his/her doctoral dissertation either in French or English. He/she will be enrolled at the Aix Marseille University Doctoral School. The candidate must have obtained, or be close to obtaining, an MA or an equivalent degree in a relevant field (demography, history, geography, anthropology, political science etc.). The candidate is expected to demonstrate sufficient skills in both French and English so as to adapt quickly to the working and research environment in Aix and in East Africa. Selection will involve a two-stage process, starting with the consideration of submitted application, and followed by interviews with selected candidates on July 1st 2019. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Postgraduate training support","field_subtitle":"The Special Programme for Research and Training in Tropical Diseases, World Health Organisation","URL":"https://www.who.int/tdr/capacity/strengthening/postgraduate/en/","body":"The Special Programme for Research and Training in Tropical Diseases (TDR) postgraduate training scheme provides a full academic scholarship in collaboration with universities in LMICs to train MSc students. The training is specifically focused on subjects or disciplines relevant to implementation research. Items covered by the scholarship include full time tuition and board, cost of dissertation research / field work, return air travel from home country to institution and contribution towards the purchase of essential textbooks / learning materials. Candidates must apply to institutions in their respective regions (Africa, Asia, Latin America or Middle East) to be eligible for consideration. Prospective candidates are advised to contact the institution directly for details on eligibility and academic requirements for admission. They should also familiarise themselves with the field of implementation research / implementation science which is the focus of this scheme. The participating universities are: James P Grant School of Public Health, BRAC University, Bangladesh, Universidad de Antioquia, National School of Public Health, Colombia, University of Ghana, School of Public Health, Ghana, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia, American University of Beirut, Faculty of Health Sciences, Lebanon, University of the Witwatersrand, School of Public Health, South Africa, and University of Zambia, Department of Public Health, Zambia.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Setting the global research agenda for community health systems: literature and consultative review","field_subtitle":"Agarwal S; Kirk K; Sripad P; Bellows B; et al: Human Resources for Health 17(22), doi: https://doi.org/10.1186/s12960-019-0362-8, 2019","URL":"https://tinyurl.com/yyhfq2xk","body":"Globally, there is renewed interest in and momentum for strengthening community health systems. Recent reviews have identified factors critical to successful community health worker (CHW) programs but pointed to significant evidence gaps. This systematic review identifies areas for a global research agenda to strengthen CHW programs. Research gap areas that were identified in the literature and validated through expert consultation include selection and training of CHWs and community embeddedness, institutionalisation of CHW programs (referrals, supervision, and supply chain), CHW needs including incentives and remuneration, governance and sustainability of CHW programs, performance and quality of care, and cost-effectiveness of CHW programs. Priority research questions included queries on effective policy, financing, governance, supervision and monitoring systems for CHWs and community health systems, implementation questions around the role of digital technologies, CHW preferences, and drivers of CHW motivation and retention over time. As international interest and investment in CHW programs and community health systems continue to grow, the authors propose that it becomes critical not only to analyse the evidence that exists, but also to clearly define research questions and collect additional evidence to ensure that CHW programs are effective, efficient, equity promoting, and evidence based. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Sociodemographic inequities in cervical cancer screening, treatment and care amongst women aged at least 25 years: evidence from surveys in Harare, Zimbabwe","field_subtitle":"Tapera O; Kadzatsa W; Nyakabau A; Mavhu W; et al: BMC Public Health 19(428)1-12, 2019","URL":"https://tinyurl.com/y54rvp94","body":"This paper investigated socio-demographic inequities in cervical cancer screening and utilization of treatment among women in Harare, Zimbabwe. Two cross sectional surveys were conducted in Harare with a total sample of 277 women aged at least 25\u2009years from high, medium, low density suburbs and rural areas. Only 29% of women reported ever screening for cervical cancer. Cervical cancer screening was less likely in women affiliated to major religions and those who never visited health facilities or doctors or visited once in previous 6\u2009months. Ninety-two of selected patients were on treatment. Women with cervical cancer affiliated to protestant churches were 68 times more likely to utilize treatment and care services compared to those in other religions. Province of residence, education, occupation, marital status, income, wealth, medical aid status, having a regular doctor, frequency of visiting health facilities, sources of cervical cancer information and knowledge of treatability of cervical cancer were not associated with cervical cancer screening and treatment respectively. The authors recommend strengthening health education in communities, including in churches, to improve uptake of screening and treatment of cervical cancer.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"South African Health Review (SAHR) 2019 Emerging Public Health Practitioner Award","field_subtitle":"Deadline for Applications: 31 July 2019","URL":"http://www.hst.org.za/media/Pages/EPHPA2019.aspx","body":"This call invites practitioners to submit a completed manuscript to the South African Health Review (SAHR) to apply for the 2019 Emerging Public Health Practitioner Award. The successful candidate will have their paper published in the 2019 edition of the SAHR. The winner will also receive a cash prize and access to wider networks of practising public health practitioners and researchers in the field. Preference will be given to papers that take cognisance of the World Health Organisation\u2019s six building  blocks for an effective, efficient and equitable health system. The SAHR aims to advance the sharing of knowledge, to feature critical commentary on policy implementation, and to offer empirical understandings for improving South Africa\u2019s health system. To be eligible for the award, the applicant must be a South African citizen or permanent resident, with a valid South African ID number, currently registered for a Master\u2019s degree in health sciences/medicine or public health at a South African tertiary institution. The applicant must be the sole author of the paper. Any other contributions may only be recognised as acknowledgements. Entries will be assessed by a panel of public health experts. The official prize-giving ceremony will take place at the launch of the 22nd edition of the SAHR.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The C-Word: Tackling the enduring legacy of colonialism in global health","field_subtitle":"Saha S; Kavattur P; Goheer A: Health Systems Global blog, April 2019","URL":"https://tinyurl.com/y33lcpfq","body":"The authors write that definitions of \u201cglobal health\u201d are generally depoliticized and invoke trans-national health issues and collaboration. Yet they argue that global health is only the newest iteration of what was formerly \u201cinternational health\u201d, \u201ctropical medicine\u201d and \u201ccolonial medicine\u201d, with historical roots lie in colonial endeavours and imperial interests.  They report a widespread frustration with how global health is taught in universities in ways that create and perpetuate neo-colonial relations; and a desire for alternative conceptualizations of the \u201cglobal\u201d that fundamentally tackle structures of power.  The authors observe in the paper the various issues that need to be tackled if  there is an intent to 'decolonise' global health, commenting that it is not a one-day event or a checkbox. It is a process that leads to futures that are unknown, but that one should dare to imagine. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The impact and cost-effectiveness of community-based HIV self-testing in sub-Saharan Africa: a health economic and modelling analysis","field_subtitle":"Cambiano V; Johnson C; Hatzold K; Terris-Prestholt F; et al: Journal of the International AIDS Society 22(51), doi: https://doi.org/10.1002/jia2.25243, 2019","URL":"https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25243","body":"This study assessed the epidemiological impact and cost-effectiveness of community-based HIV self-testing (CB-HIVST) in different sub-populations and across scenarios characterized by different adult HIV prevalence and antiretroviral treatment programmes in sub-Saharan Africa, using a synthesis model.  In the base case, targeting adult men with CB-HIVST offered the greatest impact, averting 1500 HIV infections and 520 deaths per year in the context of a simulated country with nine million adults, and impact could be enhanced by linkage to voluntary medical male circumcision. However, the approach was only cost-effective if the programme was limited to five years or the undiagnosed prevalence was above 3%. CB-HIVST to women having transactional sex was the most cost-effective. To maximize population health within a fixed budget, the authors argue that CB-HIVST needs to be targeted on the basis of the prevalence of undiagnosed HIV, sub-population and the overall costs of delivering this testing modality.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Special Programme for Research and Training in Tropical Diseases (TDR) Global launches crowdfunding challenge to help researchers fund their own research future","field_subtitle":"Deadline for submissions: 30 June 2019","URL":"http://www.seshglobal.org/Crowdfunding","body":"TDR Global is partnering with SESH to build capacity for crowdfunding among a group of low- and middle-income country researchers focused on infectious diseases. Crowdfunding for infectious diseases research is both a science and an art \u2013 one must have both a compelling research question and also a clear way to effectively communicate this with the public. The team will identify selected individuals and build their capacity to use crowdfunding related to infectious diseases in low- and middle-income countries(LMICs). Submissions should be less than 1200 words of text in English that describe the: scientific question and hypothesis; significance of the project; relevance to the public; personal motivation for research and personal connection to the disease and geographic location; areas for mentorship. The project has three stages. The first is an open challenge contest to solicit infectious diseases research ideas in LMICs, followed by a capacity building workshop to help individuals gain skills and hone their message. Lastly there will be a crowdfunding pilot to seek a limited amount of money (10,000 USD \u2013 50,000 USD) for local research projects. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Understanding factors influencing linkage to HIV care in a rural setting, Mbeya, Tanzania: qualitative findings of a mixed methods study","field_subtitle":"Sanga E; Mukumbang F; Mushi A; Lerebo W; et al: Biological Medical Central Public Health 19(383), 1-15, 2019","URL":"https://tinyurl.com/y43d9gzz","body":"This study explored facilitators and barriers to linkage to HIV care at individual/patient, health care provider, health system, and contextual levels to inform the design of interventions to improve linkages to HIV care. The authors conducted a descriptive qualitative study nested in a cohort study of 1012 newly diagnosed HIV-positive individuals in Mbeya region Tanzania between August 2014 and July 2015. The authors identified multiple factors influencing linkage to care. HIV status disclosure, support from family/relatives and having symptoms of disease were reported to facilitate linkage at the individual level. Fear of stigma, lack of disclosure, denial and being asymptomatic, belief in witchcraft and spiritual beliefs were barriers identified at individual\u2019s level. At providers\u2019 level; support and good patient-staff relationship facilitated linkage, while negative attitudes and abusive language were reported barriers to successful linkage. Clear referral procedures and well-organized clinic procedures were system-level facilitators, whereas poorly organized clinic procedures and visit schedules, overcrowding, long waiting times and lack of resources were reported barriers. Distance and transport costs to HIV care centres were important contextual factors influencing linkage to care. The authors argue that interventions must address issues around stigma, denial and inadequate awareness of the value of early linkage to care.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"When ethics and politics collide in donor-funded global health research","field_subtitle":"Storeng K; Palmer J: The Lancet, doi: https://doi.org/10.1016/S0140-6736(19)30429-5, 2019","URL":"https://tinyurl.com/yyyfltgu","body":"In this paper, the authors share their experience of censorship in evaluation research for global health. Their experience shows a broader trend of external funders and implementing partners who deliberately use ethical and methodological arguments to undermine essential research. In a context of chronic underfunding of universities and their growing dependence on externally-driven research grants, the authors propose several structural and cultural changes to prevent manipulation of research governance systems and to safeguard the independence of research. While they acknowledge censorship to be a strong word, they justify its use in situations found where researchers in commissioned research-based evaluations are asked by funders to omit important results from their final report. The authors note that universities' provide methodological and subject area expertise and strong systems of research ethics and governance, but also observe that current systems are ill equipped to deal with these challenges.","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"WHO Watch","field_subtitle":"Peoples Health Movement, 2019","URL":"https://phmovement.org/who-watch/","body":"PHM follows closely the work of WHO, both through the World Health Assembly and the Executive Board. A team of PHM volunteers attends WHO bodies\u2019 meetings \u2013 following the debate, talking with delegates and making statements to the EB. The PHM\u2019s commentaries covers most of the agenda items of the WHO bodies\u2019 meetings and includes a note on the key issues in focus at the meeting, a brief background and critical commentary. Reports on key issues are also prepared. PHM is part of a wider network of organizations committed to democratizing global health governance and working through the WHO-Watch project.  Information from PHM on the proceedings of the May 2019 World Health Assembly can be found at the website provided. ","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"World Health Organisation (WHO) Guideline Recommendations on digital interventions for health system strengthening","field_subtitle":"World Health Organisation: WHO, Geneva, 2019","URL":"https://tinyurl.com/y57qurwa","body":"Digital health, or the use of digital technologies for health, has become a salient field of practice for employing routine and innovative forms of information and communications technology (ICT) to address health needs. The World Health Assembly Resolution on Digital Health unanimously approved by WHO Member States in May 2018 demonstrated a collective recognition of the value of digital technologies to contribute to advancing universal health coverage (UHC) and other health aims of the Sustainable Development Goals (SDGs). This guideline presents recommendations on emerging digital health interventions that are contributing to health system improvements, based on an assessment of the benefits, harms, acceptability, feasibility, resource use and equity considerations. This guideline urges readers to recognize that digital health interventions are not a substitute for functioning health systems, and that there are significant limitations to what digital health is able to address. It presents a subset of prioritized digital health interventions accessible via mobile devices, and will gradually include a broader set of emerging digital health interventions in subsequent versions. It includes the following topics: birth notification via mobile devices; death notification via mobile devices; stock notification and commodity management via mobile devices; client1-to-provider telemedicine; provider-to-provider telemedicine; targeted client communication via mobile devices; digital tracking of patients\u2019/clients\u2019 health status and services via mobile devices; health worker decision support via mobile devices; provision of training and educational content to health workers via mobile devices (mobile learning-mLearning).","php":"","field_issue_date":"2019-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"'You often get sick': the deadly toll of illegal gold mining in South Africa","field_subtitle":"Clark C: The Guardian, April 2019","URL":"https://tinyurl.com/yxzrdhsa","body":"According to a 2015 report by the South African Human Rights Commission, South Africa\u2019s burgeoning illicit gold trade has been fuelled by the formal mining industry\u2019s decline combined with the failure of government to regulate the informal mining sector. The report estimated 30,000 illegal miners were operating across South Africa; about 75% are believed to be undocumented migrants, primarily from Zimbabwe, Mozambique and Lesotho. The authors indicate that hundreds have died due to collapsing mine shafts, gas explosions and turf wars between the criminal syndicates that have seized control of the illegal industry. On Johannesburg\u2019s outskirts, cut off from support networks and services, women are bearing the brunt of the violence and lawlessness associated with illicit mining. With the vast majority of people in the area living off the proceeds of illicit mining, fear of arrest or deportation prevents many women from going to the police or seeking help at overstretched local medical clinics.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A panel discussion how to base country health priorities on the Sustainable Development Goals. Zambia and other country cases. ","field_subtitle":"Byskov J; Zulu J; Silumbwe A; et al: Summary of presentation in International Conference on Priorities in Health, Link\u00f6ping, September 2018","URL":"https://tinyurl.com/y48aspt9","body":"The ever increasing evidence and technical developments supporting population health have not yet reached the goal of health for all. The decision making for population health has not led to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. This presentation discusses Zambia as a case study country, finding that national governance results in policy based choices are not necessarily helpful at implementation and community levels.  The authors present evidence that if one comprehensively addresses a particular disease burden it does decrease, but limits other action. The Sustainable Development goals included democratic cross sector processes in their formulation, but the targets applied in health still tend to receive funding from competing sectors and programs. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Association between the Human Development Index and Millennium Development Goals 6 Indicators in Sub-Saharan Africa from 2000 to 2014: Implications for the New Sustainable Development Goals","field_subtitle":"Mabaso M; Zama T; Mlangeni L; Mbiza S; et al: Journal of Epidemiology and Global Health 8(1-2), 77-81, 2018","URL":"https://www.atlantis-press.com/journals/jegh/125905568/view","body":"It is important to assess whether regional progress toward achieving the Millennium Development Goals (MDGs) has contributed to human development and whether this has had an effect on the triple burden of disease in Africa. This analysis investigates the association between the human development index (HDI) and co-occurrence of HIV/AIDS, tuberculosis (TB), and malaria as measured by MDG 6 indicators in 35 selected sub-Saharan African countries from 2000 to 2014. The analysis used secondary data from the United Nations Development Programme data repository for HDI and disease data from WHO Global Health observatory data repository. Generalized Linear Regression Models were used to analyze relationships between HDI and MDG 6 indicators. HDI was observed to improve from 2001 to 2014, and this varied across the selected sub-regions. There was a significant positive relationship between HDI and HIV prevalence in East Africa and Southern Africa. A significant positive relationship was observed with TB incidence and a significant negative relationship was observed with malaria incidence in East Africa. Observed improvements in HDI from the year 2000 to 2014 did not translate into commensurate progress in MDG 6 goals. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Clean water and sanitation: Why it matters","field_subtitle":"NGO pulse, Sangonet, March 2019","URL":"https://tinyurl.com/y4kw6t3j","body":"Worldwide, more than two million people die every year from diarrhoeal diseases. Poor hygiene and unsafe water are responsible for nearly 90 per cent of these deaths and mostly affect children. A study by the World Bank Group, UNICEF and the World Health Organization estimates that extending basic water and sanitation services to unserved households would cost US$28.4 billion per year from 2015 to 2030, or 0.1 per cent of the global product of the 140 countries included in its study. The economic impact of not investing in water and sanitation costs 4.3 per cent of sub-Saharan African GDP. The paper recommends that civil society organizations work to keep governments accountable, invest in water research and development, and promote the inclusion of women, youth and indigenous communities in water resources governance. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Climate change adaptation in South Africa: a case study on the role of the health sector","field_subtitle":"Chersich M; Wright C: Globalisation and Health 15(22), doi: https://doi.org/10.1186/s12992-019-0466-x, 2019","URL":"https://tinyurl.com/yyf9mp36","body":"In this systematic review the authors assessed progress with climate change adaptation in the health sector in South Africa, providing useful lessons for other African countries. Very few of the studies found presented findings of an intervention or used high-quality research designs. Several policy frameworks for climate change have been developed at national and local government levels. These, however, pay little attention to health concerns and the specific needs of vulnerable groups. Systems for forecasting extreme weather, and tracking malaria and other infections appear well established. Yet, there is little evidence about the country\u2019s preparedness for extreme weather events, or the ability of the already strained health system to respond to these events. Seemingly, few adaptation measures have taken place in occupational and other settings. To date, little attention has been given to climate change in training curricula for health workers. Overall, the authors note that the volume and quality of research is disappointing, and disproportionate to the threat posed by climate change in South Africa. This is surprising given that the requisite expertise for policy advocacy, identifying effective interventions and implementing systems-based approaches rests within the health sector. They suggest that more effective use of data, a traditional strength of health professionals, could support adaptation and promote accountability of the state. With increased health-sector leadership, climate change could be reframed as a health issue, one necessitating an urgent, adequately-resourced response. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Commercial determinants of health: advertising of alcohol and unhealthy foods during sporting events","field_subtitle":"Ireland R; Bunn C; Reith G; Philpott M; et al: Bulletin of the World Health Organisation 97(4), 290-295, 2019","URL":"https://www.who.int/bulletin/volumes/97/4/18-220087/en/","body":"Tobacco, alcohol and foods that are high in fat, salt and sugar generate much of the global burden of noncommunicable diseases.  A better understanding is needed of how these products are promoted. The promotion of tobacco products through sporting events has largely disappeared over the last two decades, but advertising and sponsorship continues by companies selling alcohol, unhealthy food and sugar-sweetened beverage. The sponsorship of sporting events such as the Olympic Games, the men\u2019s FIFA World Cup and the men\u2019s European Football Championships in 2016, has received some attention in recent years in the public health literature, as have global football events with which transnational companies are keen to be associated, to promote their brands to international markets. Despite this the marketing and sponsorship portfolio of these events have received very little scrutiny from public health advocates. The authors call for policy-makers and the public health community to formulate an approach to the sponsorship of sporting events, one that accounts for public health concerns.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Determinants of paying national health insurance premium with mobile phone in Ghana: a cross-sectional prospective study","field_subtitle":"Boaheng J; Amporfu E; Ansong D; Osei-Fosu A: International Journal for Equity in Health 18 (50) 1-9, 2019","URL":"https://tinyurl.com/y2y97wux","body":"This study investigated the determinants of renewing membership and paying the National Health Insurance Scheme premium through a mobile phone. The prospective cross-sectional survey was used to solicit information from 1192 respondents living in Kumasi Metropolis, Atwima Nwabiaya and Sekyere Central Districts of Ghana to estimate the determinants of paying the National Health Insurance Scheme premium with the mobile phone. The study found that residing in an urban area, senior high education, tertiary education and informal employees are the determinants of paying the NHIS premium with the mobile phone. It was recommended that the NHIS consider making the mobile payment as simple as possible for the less educated and for rural members to access it.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"East, Central and Southern Africa Health Community Best Practices Forum Conference: \u2018Theme: Innovation and Accountability in Health Towards achieving Universal Health Coverage\u2019","field_subtitle":"19-21 June 2019, Arusha, Tanzania, Deadline for submission of abstracts: 3rd May 2019 ","URL":"https://ecsahc.org/news/the-12th-ecsa-bpf-and-28th-djcc-meeting/","body":"The East, Central and Southern Africa Health Community (ECSA-HC) is an inter- governmental organisation, which was established to foster regional cooperation to address priority health problems, in order to attain the highest possible standards of health for the people of the region.  In pursuit of its mandate, ECSA-HC facilitates the convening of regional meetings namely; the Best Practices Forum (BPF) and the Directors Joint Consultative Committee (DJCC). The aim of the BPF and DJCC meetings is to share best practices and research evidence, identify relevant health policy issues and making recommendations to the Health Ministers Conference, towards the improvement of health programming and outcomes in the region. The upcoming conference will provide a forum for health scientists, policy makers, development partners and other stakeholders in health, food and water and sanitation for health to present their best practices and research evidence that inform policies and programming in the ECSA region. The Conference will be organised in two parts as follows; The Regional Forum on Best Practices from 19 to 20 June 2019 and the  Directors Joint Consultative Committee from 21 June 2019. The theme for the 12th BPF is Innovation and Accountability in Health Towards achieving Universal Health Coverage. The theme will be addressed through the following sub-themes: Efforts to improve adolescent and young people\u2019s health; Opportunities for achieving water and sanitation health global target; Equity and access to eye healthcare in the ECSA region; Innovative approaches towards achieving food safety and improving quality of life; Prioritising substance use and mental health challenges in the ECSA Region; Tackling emerging and re-emerging health threats: A regional One Health approach to managing recurrent outbreaks in the region. ECSA-HC invites submission of abstracts for best practices and scientific papers that are relevant to the conference theme or sub themes.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET Discussion paper 117: Pathways to urban health equity: Report of multi-method research in east and Southern Africa","field_subtitle":"Loewenson R; Masotya M: TARSC, Working with Harare and Lusaka youth, Civic Forum on Human Development and Lusaka District Health Office, EQUINET, Harare, 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20117%20%20UHsynth2018.pdf","body":"By 2050, urban populations in Africa will increase to 62%. The World Health Organization (WHO) and UN-Habitat in their 2010 report \u2018Hidden Cities\u2019 note that this growth in the urban population constitutes one of the most important global health issues of the 21st century. In 2016-2018, Training and Research Support Centre (TARSC) in the Regional Network for Equity in Health in East and Southern Africa (EQUINET) explored the social distribution of health in urban areas and the opportunities for and practices promoting urban health and well-being. It focused on youth 15-24 years of age as an important group for both current and future well-being. The paper synthesises and reports evidence from a programme of work that unfolded iteratively over two years. The work involved desk reviews of published literature and analysis of data from international databases for east and southern African countries, and international evidence on practices supporting urban well-being in areas prioritised by urban youth. The findings were subject to cycles of participatory review and validation by young people from diverse urban settings and socio-economic groups in Harare and Lusaka. These methods were applied with an intention to draw on different disciplines, concepts and variables from different sectors and on the lived experience and perceptions of the youth directly affected by different urban conditions. Separate publications produced in the project give more detail on particular methods, and findings and are cited in this paper. A series of dissemination and dialogue activities have been carried out with youth, local authority and policy actors, supported by shorter briefs and technical reports.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Discussion paper 118: Comparative review: Implementation of constitutional provisions on the right to healthcare in Kenya and Uganda","field_subtitle":"Centre for Health, Human Rights and Development (CEHURD): CEHURD, EQUINET: Uganda and Harare, 2019","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20118%20Const%202019.pdf","body":"This discussion paper is produced by the Centre for Human Rights and Development (CEHURD) as part of the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The paper examines the implementation of constitutional provisions on the right to healthcare in Kenya and Uganda, two countries in East Africa. It aims to identify factors and mechanisms that have facilitated implementation of constitutional provisions on the right to healthcare, including how the constitutions were developed and framed. It compares implementation in Kenya, where the right to healthcare is explicit in their 2010 Constitution, and in Uganda, where the right to healthcare is implicit in the National Objectives and Directive Principles of State Policy. The paper draws on two EQUINET case studies on implementation of constitutional provisions on the right to health, one each in Kenya and Uganda, published in 2018, a 2017 regional workshop that discussed the implementation of constitutional provisions on the right to health, and additional review of published literature. It presents a thematic analysis of the findings from the two case studies in terms of the judicial, political and popular implementation mechanisms, exploring further the factors and mechanisms that have facilitated or blocked their implementation. As the two constitutions address the right to healthcare differently, this analysis of their application provides insights into the factors and mechanisms for practice that may be useful in other settings.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 218: It\u2019s not enough to tweak old models: Urban health calls for new approaches","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evidence map of knowledge translation strategies, outcomes, facilitators and barriers in African health systems","field_subtitle":"Edwards A; Zweigenthal V; Olivier J: Health Research Policy and Systems 17(16) 1-14, 2019","URL":"https://tinyurl.com/y2h6ybtf","body":"This paper provides a systematic overview of the literature on knowledge translation strategies employed by health system researchers and policy-makers in African countries. An evidence mapping methodology was adapted from the social and health sciences literature and used to generate a schema of knowledge translation strategies, outcomes, facilitators and barriers.The knowledge translation literature in African countries is found to be widely distributed, problematically diverse and growing. Significant disparities exist between reports on knowledge translation in different countries, and there are many settings without published evidence of local knowledge translation characteristics. Commonly reported knowledge translation strategies include policy briefs, capacity-building workshops and policy dialogues. Barriers affecting researchers and policy-makers include insufficient skills and capacity to conduct knowledge translation activities, time constraints and a lack of resources. Availability of quality locally relevant research was the most reported facilitator. Limited knowledge translation outcomes reflect persisting difficulties in outcome identification and reporting.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Gender equity in the health workforce: Analysis of 104 countries","field_subtitle":"Boniol M; McIsaac M; Xu Lihui; Wuliji T; et al: Health Workforce Working paper 1, World Health Organisation, 2019","URL":"https://tinyurl.com/y3jfcdyz","body":"The health and social sector, with its 234 million workers, is one of the biggest and fastest growing employers in the world, particularly of women. Women comprise seven out of ten health and social care workers and contribute US$ 3 trillion annually to global health, half in the form of unpaid care work. While gender issues have been at the top of the global agenda, few comprehensive studies on gender in the health and social workforce have been conducted at the global level. This brief is based on an analysis of WHO NHWA data5 for 104 countries over the last 18 years. The analysis confirms previous findings that women\u2019s share of employment in the health and social sector is high, with an estimated 67% of the health workforce in the 104 countries analysed being female. Analysis based on median wages from 21 countries showed health workers face gender-related gaps in pay, with female health workers earning, on average, 28% less than males. This is slightly greater than global estimates of gender pay gap data, showing that women are paid approximately 22% less than men. Data from 56 countries showed higher average working hours per week for men than women for most occupations and regions. This likely reflects different type of contracts, with more part-time jobs occupied by women. Women represent around 70% of the health workforce, but earn on average 28% less than men. Occupational segregation (10%) and working hours (7%) can explain most of this gap, but even when considering \u201cequal work\u201d an \u201cequal pay\u201d gap of 11% remains. The authors note that it must be recognized that much of the work in health done by women is unpaid work and that investments in creating decent work in the health sector are needed to support the translation of informal work into formal sector employment. \r\n","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Health System Factors Constrain HIV Care Providers in Delivering High-Quality Care: Perceptions from a Qualitative Study of Providers in Western Kenya","field_subtitle":"Genberg B; Wachira J; Kafu C:  Journal of the International Association of Providers of AIDS Care 18, 1-10, 2019","URL":"https://tinyurl.com/y3zee9f8","body":"This study examined the experiences of sixty HIV care providers in a high patient volume HIV treatment and care program in eastern Africa. The authors conducted in-depth interviews focused on providers\u2019 perspectives on health system factors that impact patient engagement in HIV care. Results from thematic analysis demonstrated that providers perceive a work environment that constrained their ability to deliver high-quality HIV care and encouraged negative patient\u2013provider relationships. Providers described their roles as high strain, low control, and low support. The authors suggest that health system strengthening must include efforts to improve the working environment and easing burden of care providers tasked with delivering antiretroviral therapy to increasing numbers of patients in resource-constrained settings.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Implementing prevention policies for mother-to-child transmission of HIV in rural Malawi, South Africa and United Republic of Tanzania, 2013\u20132016 ","field_subtitle":"Jones H; Wringe A; Todd J; Songo J; et al: Bulletin of the World Health Organisation 97(3) 200\u2013212, 2019","URL":"https://tinyurl.com/yy8vz8uh","body":"This study assessed the adoption of World Health Organization guidance into national policies for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus and monitored implementation of the guidelines at facility level in rural Malawi, South Africa and the United Republic of Tanzania. The authors summarized national PMTCT policies and World Health Organization guidance for 15 indicators across the cascades of maternal and infant care over 2013\u20132016. Two survey rounds were conducted in 46 health facilities serving five health and demographic surveillance system populations. Structured questionnaires were administered to facility managers to describe service delivery.  In all countries, national policies influencing the maternal and infant prevention of mother-to-child transmission cascade of care aligned with World Health Organization guidelines by 2016; most inter-country policy variations concerned linkage to routine human immunodeficiency virus care. The proportion of facilities delivering post-test counselling, same-day antiretroviral therapy initiation, antenatal care and antiretroviral therapy provision in the same building, and Option B+ increased or remained at 100% in all sites. Progress in implementing policies on infant diagnosis and treatment varied across sites. Stock-outs of human immunodeficiency virus test kits or antiretroviral drugs in the past year declined overall, but were reported by at least one facility per site in both rounds. Progress has been made in implementing prevention of mother-to-child transmission policy in these settings. However, persistent gaps across the infant cascade of care and supply-chain challenges, risk undermining infant human immunodeficiency virus elimination goals.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Is the Urban Child Health Advantage Declining in Malawi? Evidence from Demographic and Health Surveys and Multiple Indicator Cluster Surveys","field_subtitle":"Lungu E; Biesma R; Chirwa M; Darker C: Journal of Urban Health 96(1) 131\u2013143, 2019 ","URL":"https://tinyurl.com/y4j43xxj","body":"Considerable evidence has emerged that some population groups in urban areas may be facing worse health than rural areas and that the urban advantage may be waning in some contexts. The authors used a descriptive study undertaking a comparative analysis of 13 child health indicators between urban and rural areas using seven data points provided by nationally representative population based surveys\u2014the Malawi Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Rate differences between urban and rural values for selected child health indicators were calculated to denote whether urban-rural differentials showed a trend of declining urban advantage in Malawi. The results show that all forms of child mortality have significantly declined between 1992 and 2015/2016 reflecting successes in child health interventions. Rural-urban comparisons, using rate differences, largely indicate a picture of the narrowing gap between urban and rural areas albeit the extent and pattern vary among child health indicators. Of the 13 child health indicators, eight show clear patterns of a declining urban advantage particularly up to 2014. However, U-5MR shows reversal to a significant urban advantage in 2015/2016, and slight increases in urban advantage are noted for infant mortality rate, underweight, full childhood immunization, and stunting rate in 2015/2016. The findings suggest the need to rethink the policy viewpoint of a disadvantaged rural and much better-off urban in child health programming. Efforts should be dedicated towards addressing determinants of child health in both urban and rural areas.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"It\u2019s not enough to tweak old models: Urban health calls for new approaches","field_subtitle":"R Loewenson, M Masotya, Training and Research Support Centre (TARSC)","body":"\r\nIsaac is a 20 year old with aspirations of a better life. He came to urban Harare a few years ago after finishing school to start a new life. In his life in the city he has done this in ways he didn\u2019t predict. He lives as a lodger in a small, smoky backyard shack and earns money from gathering and selling plastic waste. His most prized possession is a smart phone that is his link to friends, humour and, when he can afford data, to social media and market ideas. Behind a \u2018healthy\u2019 appearance he hides stress, hunger, worry about his future and frustration that he cannot afford the food, services, entertainment and life that he sees around him in the city. \r\n\r\nOur growing cities are full of such young people, in urban areas that concentrate opportunities, information, social connections, ideas, enterprise, wealth, technology and services together with substandard living environments, pollution, food and income insecurity, violence and exclusion. \r\n\r\nPublished evidence shows that these risks and benefits are unequally distributed amongst urban residents. Recent migrants, residents of informal settlements and those living in informal housing, as lodgers or \u2018backyard shacks\u2019 have a vastly different experience of urban life than wealthier, more secure groups. These urban conditions pose particular challenges for people at different stages of life, whether as children, adolescents, adults or elderly people. We have for decades measured and implemented measures to address the social gap between urban and rural areas, with the disadvantage in the latter. However the growth in poverty and disadvantage and rising inequality within urban areas now demand attention. Published evidence appears to chase, lag behind or miss the rapid, diverse changes taking place in urban areas and is often silent on the features of urbanisation and social assets that promote wellbeing.\r\n\r\nIn 2016-18 we gathered and analysed diverse forms of evidence and experience on the social distribution of health in urban areas and on the opportunities for promoting health and wellbeing. In Harare, with the Civic Forum on Human Development and Harare youth, and in Lusaka, with the District Health Office and Lusaka youth, we listened to the perceptions and experiences of young people (18-25 year olds) from diverse settings and socio-economic groups in these two cities. We explored how far their experiences were captured in the evidence we collect across the countries in the region.\r\n\r\nFor young people in Harare and Lusaka, \u2018health\u2019 was a biomedical concept, linked to \u2018absence of disease\u2019, and to the various problems they see their health services treating. Indeed, the \u2018health\u2019 data we routinely collect in our region also commonly focuses on mortality, morbidity and negative indicators such as suicide and obesity, and on immediate determinants of these diseases such as food, water, sanitation, education and health care. This is problematic for young people like Isaac. They appear to be in \u2018good health\u2019, despite lacking decent standards of many of these immediate determinants, but this hides the mental and social challenges they experience, and ignores conditions and determinants that have longer term effects across their lives, including for the rising burden of chronic conditions and the growing challenge this poses to our urban health services.\r\n\r\nFor young people in Harare and Lusaka, having secure incomes, opportunities for entrepreneurship, education, shelter, public spaces, participation in government decisions and self-esteem were important for them to be and remain healthy. They believed these issues would become more challenging in the future, envisaging that as the city grew, it would become more competitive and overcrowded, threatening resources for health, including green spaces. Cities would demand even more of young people\u2019s capacities for innovation and entrepreneurship, with a diminishing, rather than an increasing level of social solidarity. \r\n\r\nHow ready are we to address these concerns? The indicators we collect across the countries of the region provide a picture of disconnected facets and fragments that weakly reflect the combined current and future impact of these features of urban life on the different groups in the city. Not surprisingly, therefore, the systems and services that respond to them are also segmented and silo\u2019ed. In 2016, the World Health Organisation (WHO) and UN Habitat suggested that we need to reclaim a more multidimensional understanding of equity to address the challenges in urban areas. \r\n\r\nSo what would such a more holistic, integrated and affirmative approach look like? One starting point may be to go back to the first principle of the WHO Constitution, that health is not merely the \u2018absence of disease or infirmity\u2019, it is \u201ca state of complete physical, mental and social wellbeing. A concept of \u2018wellbeing\u2019  \u2013 or \u2018buen vivir\u2019 as applied in some countries \u2013 holds the potential to integrate psychosocial, social, time use, political, material, economic, service, governance and ecological determinants, all of which are affecting urban health.  \r\nBy bringing them together, the concept draws attention to what balance (and imbalances) we are generating between these different dimensions of wellbeing and the current and future consequences of imbalances. The structural adjustment programmes exposed the inequalities that grow when economic strategies pursue growth at the cost of social deficits. The recent global student school strikes over climate justice point to young people\u2019s concern that decisions made globally are dominated by certain economic interests to the cost of the degradation of nature and extinction of species. Achieving equity in wellbeing takes us beyond measuring and closing gaps between different groups of people to the strategies needed and assets we have to use to redress the imbalances that are generating these gaps and that have long term consequences. \r\nThe health sector has tried, through \u2018health in all policies\u2019 approaches, to persuade other sectors to adopt policies that promote health. To some extent this is still seen as a \u2018health sector\u2019 campaign, often taking place in parallel with increasingly biomedical personal care services and declining investment in public health capacities and authority.  \r\n\r\nIn contrast, we found many integrated, collaborative approaches addressing these imbalances and the issues raised by Harare and Lusaka youth in different cities globally, from participatory urban planning in Kenya, to strengthening community safety in Honduras, environmental regeneration and urban agriculture in Brazil and urban youth collaborative engagement on school reforms in the USA. They point not only to the importance of public spaces for bringing together diverse services and interventions in area-based approaches, but also to the opportunities that exist in urban areas for encouraging local competencies and innovation and for facilitating the involvement of affected residents, like Isaac, as knowledge producers and participants in planning and action for health and wellbeing.  \r\n\r\nMore detailed information on the evidence and processes referred to in this oped and the different people involved in this work can be found in EQUINET Discussion paper 117  Responding to inequalities in health in urban areas:  Report of multi-method research in east and southern Africa, http://tinyurl.com/y3dv4pvm and other reports referred to in that document. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Landmark Jurisdiction case won by Zambian farmers at Supreme court","field_subtitle":"Foil Vedanta; Lusaka Times, April 2019","URL":"https://tinyurl.com/y3d5jhae","body":"The Supreme Court in the United Kingdom announced in April a verdict in the landmark case of the Zambian communities consistently polluted by Konkola Copper Mines (KCM), a subsidiary of British miner Vedanta Resources Plc, allowing them to have their case against the parent company and its subsidiary tried in the UK. The ruling sets a strong legal precedent which will allow people with claims against subsidiaries of British multinationals to sue the parent company in the UK. The judgment by Chief Justice Lady Hale, and four further judges, re-affirms the rulings of the Court of Technology and Construction in 2016 and the Court of Appeal in 2017. Lady Hale refused Vedanta\u2019s pleas in appealing the former judgments stating that, contrary to the claims of Vedanta\u2019s lawyers the claimants do have a bona fide claim against Vedanta; the company does owe a duty of care to the claimants, especially in view of the existence of company-wide policies on environment and health and safety. The judgement noted that the size and complexity of the case, and the lack of funding for claimants at \u2018at the poorer end of the poverty scale in one of the poorest countries of the world\u2019 means that they do not have substantive access to justice in Zambia. This has wider implications for other communities affected by multinational mining. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Large-scale health insurance for the informal sector in Sub-Saharan Africa: Six years field experience on creating a large scale health insurance in rural Senegal ","field_subtitle":"Docrat S; Lund C; Chisholm D: International Journal of Mental Health Systems 13(4) https://doi.org/10.1186/s13033-019-0260-4, 2019","URL":"https://www.itg.be/files/docs/shsop/shsop34.pdf","body":"From 2012 to 2017, the Belgian governmental cooperation and the Senegalese authorities implemented a project aimed at organising health insurance for rural poor  people (\u2018PAODES\u2019) to fund basic health care services at local and district level. It aimed to develop a health insurance model that had been tested long enough on a large enough scale to scale it up. PAODES intervened in four health districts with 480 000 people. The report found that health insurance coverage after two years was at 64% (more than 300,000 people). The health insurance scheme was reported to be financially viable at 30% coverage. Utilisation of primary care was up from 0.6 to 1.2 consultations per person per year for insured people.  The authors report that large-scale health insurance for the informal sector can be efficient if it is operated by professional teams, if it is significantly subsidised by government so as to allow poor people to adhere, and if it is embedded in a nation-wide institution with a public purpose. The authors report that the credibility of a health system depends on the quality and packages of care offered. It is argued that large-scale health insurance cannot exist and function without the government addressing at least technical and procedural matters with regard to governance, such as a uniform and government-regulated fee-paying system and a digitalised accounting system for all health facilities and districts. ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Local solutions can boost healthier food choices in South Africa","field_subtitle":"Ndlovu N: The Conversation, March 2019","URL":"http://tinyurl.com/y7dedamz","body":"In this article, Ndlovu asks, how should countries like South Africa go about making sure that people \u2013 particularly poor people where the burden of non-communicable diseases is highest \u2013 have access to healthy food?  Recent research from the Wits School of Public Health, the Health Systems Trust and the University of KwaZulu-Natal sheds fresh light on the problem, showing a proliferation of unhealthy food, particularly in poorer communities. The research set out to assess differences in food environment based on socio-economic status. It focused on grocery stores and fast-food restaurants only, with full service restaurants excluded. The analysis used a tool called the \u201cmodified retail food environment index\u201d and show the proportion of food retailers in Gauteng that were \u201chealthy\u201d and what proportion were \u201cunhealthy\u201d. The results showed how fast-food outlets and the unhealthy foods they serve, vastly outnumbered formal grocery stores. In November 2016, there were 1559 unhealthy food outlets in Gauteng compared to only 709 healthy food outlets. Strikingly, the distribution of these outlets are income-based. Most of the poorer wards had only fast-food retailers with no healthy food outlets. Conversely, grocery stores are concentrated in wealthy areas.  The research shows that many wards in Gauteng have high concentrations of unhealthy food \u2013 in other words, they have \u201cobesogenic\u201d food environments. This means the type of food available in this environment promote obesity, leaving their residents little choice. Local as well as national government structures have the authority to license and control food retailers. Alternatively, national level policies can better guide implementation at a local level. This would require governments to adapt existing business licensing and planning frameworks to take into account the lack of healthy food retailers in a particular area. Additionally, municipalities could streamline the process for licensing healthy food retailers, making it easier and faster for them to open in areas most in need. The authors indicate that there is a plethora of options to select from if municipalities want to improve their food environments and can facilitate the right to access to healthy foods for the poorest and most vulnerable.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"New app takes African short stories to the world","field_subtitle":"NGO pulse, Sangonet, March 2019","URL":"https://tinyurl.com/y3rtxb92","body":"Anew local app hopes to give African writers global exposure by connecting them with literature fanatics in SA, US and the UK. Storytelling app BookBeak says it is the first African app-based platform to aggregate African short stories from published, unpublished and self-published writers and serve them to a global audience. The app, available on Android and iOS app stores, was founded by three young South Africans, Kamo Sesing, Cam Naidoo and Louis Enslin, and registered under their business Atheneum. Africans have been telling stories for centuries, passing nuggets of cultural knowledge and heritage from one generation to the next through fables, folktales and narrations. BookBeak aims to make it possible for those new and old African stories to be shared with the world in the form of e-books and audio books, while bridging the gap between traditional and digital reading experiences.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Noncommunicable disease burden among HIV patients in care: a national retrospective longitudinal analysis of HIV-treatment outcomes in Kenya, 2003-2013","field_subtitle":"Achwoka D; Waruru A; Chen T; Masamaro K; et al: Biological Medical Central Public Health 19(372) 1-10, 2019","URL":"https://tinyurl.com/y3qpshom","body":"This paper sought to estimate the burden of noncommunicable diseases (NCDs) among people living with HIV (PLHIV) enrolled in HIV care and treatment in Kenya between 2003 and 2013. The authors conducted a nationally representative retrospective medical chart review of HIV-infected adults aged \u226515\u2009years enrolled in HIV care in Kenya from October 1, 2003 through September 30, 2013. The authors estimated proportions of four NCDs categories among PLHIV at enrolment into HIV care, and during subsequent HIV care visits from 3170 records of PLHIV, 2115 of whom were women and just over half from PLHIVs aged above 35\u2009years. Close to two-thirds of PLHIVs were on ART. The proportion of any documented NCD among PLHIV was 11.5%, with elevated blood pressure as the most common NCD. Despite this observation, only 17 patients had a corresponding documented diagnosis of hypertension in their medical record. Overall NCD incidence rates for men and women were and 31.6%, slightly more in men than in women but with no differences in NCD incidence rates by marital or employment status. At one year of follow up 43.8% of PLHIV not on ART had been diagnosed with an NCD compared to 3.7% of patients on ART; at five years the proportions with a diagnosed NCD were 88.8 and 39.2%, respectively.\u2003PLHIV in Kenya are thus noted to have a high prevalence of NCD, but in the absence of systematic, effective screening, the NCD burden is likely to be underestimated in this population. The authors recommend that systematic screening and treatment for NCDs using standard guidelines be integrated into HIV care and treatment programs in sub-Saharan Africa.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Prevention and control of noncommunicable diseases: lessons from the HIV experience","field_subtitle":"Abimbola S; Thomas E; Jan S; McPake B; et al: Bulletin of the World Health Organisation 97(3), 169-244, 2019","URL":"https://www.who.int/bulletin/volumes/97/3/18-216820/en/","body":"In many low- and middle-income countries, the challenges of scaling up successful localized projects to achieve national coverage are well recognized. The wide success of efforts to scale up interventions to prevent and control human immunodeficiency virus (HIV) infection mean that it is now managed as a chronic condition. Lessons from the HIV experience may thus be transferable to the rollout and scale-up of effective interventions for noncommunicable diseases in low- and middle-income countries.  WHO\u2019s best buys for reducing noncommunicable diseases in low-resource settings suggest several such interventions. They include measures to improve tobacco control, increase public awareness of the health benefits of physical activity, multidrug therapy for people at high risk of cardiovascular disease and the screening and treatment of cervical cancer. While there is much to learn from the HIV experience, noncommunicable diseases have peculiarities that may limit the transferability of learning or require significant adaptation of such learning, while there are also issues to address in transfering learning on noncommunicable disease prevention and control between high-income and low- and middle-income countries. The authors call for the development of research and practice platforms that allow for progressive and systematic accumulation and sharing of field learning from scale-up efforts of HIV interventions and from the scale-up of noncommunicable disease interventions between settings","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Public Health Association of South Africa (PHASA) Conference 2019","field_subtitle":"16-18 September 2019, College of Cape Town, Athlone, Cape Town, South Africa","URL":"https://tinyurl.com/y3oswcom","body":"The 2019 Public Health Association of South Africa conference reflects on the intersections between democracy and health, and the progressive realisation of health care in South Africa.  This year\u2019s conference will focus on the status of health care since independence in South Africa and what can be done to move the country closer to achieving the targets of the National Development Plan, achieving equity within universal health coverage and the global Sustainable Developmental Goals by 2030. Through this Conference and its other activities, the Association is working to increase recognition of the importance of maintaining and improving the health of populations by 2030 that is based on the principles of social justice, human rights, equity, evidence-informed policy and practice, and addressing the underlying determinants of health.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Public Spending on Health: A Closer Look at Global Trends","field_subtitle":"Xu K; Soucat A; Kutzin J; Brindley C; et al: World Health Organisation, Geneva, 2018","URL":"http://tinyurl.com/y5vkvblq","body":"The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. This report presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage. The key messages include that global trends in health spending confirm the transformation of the world\u2019s funding of health services. Domestic spending on health is central to universal health coverage, but there is no clear trend of increased government priority for health. The report further shows that primary health care is a priority for expenditure tracking. Further, allocations across disease and interventions differ between external and government sources. The report indicates that performance of government spending on health can improve.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Repositioning Africa in global knowledge production","field_subtitle":"Fonn S; Ayiro L; Cotton P; Habib et al: The Lancet 392(10153), 1163-1166, 2018","URL":"https://tinyurl.com/yybhxlyu","body":"Sub-Saharan Africa accounts for 13\u00b75% of the global population but less than 1% of global research output. In 2008, Africa produced 27\u2008000 published papers\u2014the same number as The Netherlands. Informed by a nuanced understanding of the causes of the current scenario, the authors propose action that should be taken by African universities, governments, and development partners to foster the development of research-active universities on the continent. Since the 1990s, African universities have sought to regain their role as agents of transformation. On a per capita basis, African universities remain severely underfunded in view of increasing enrolment, the establishment of new universities, and the declining purchasing power of African currencies.  Part of the explanation is that Africa contributes less than 1% of the global expenditure on research and development. By comparison, Latin America and the Caribbean account for 3%; Europe for 27%; Asia for 31%, and North America for 37%. Sub-Saharan Africa depends greatly on international collaboration and visiting academics for its research output. In 2012, southern Africa, east Africa, and west and central Africa produced 79%, 70%, and 45% of all their research output, respectively, through international collaborations. African Education ministers have met several times recently to address challenges in higher education. The authors argue that research-intensive universities across sub-Saharan Africa need to be identified, recognised, strengthened, and invested in through new sources of funding. Creating and maintaining research-intensive universities will require consistent investment in human capital, research equipment, and relevant administrative support, at far higher levels than is available under current conditions. To ensure that designated research-intensive universities do not become complacent and to allow for the entry of upcoming high-achieving universities, the authors propose on-going peer review every 3\u20135 years. At a minimum, the authors propose that research-intensive universities commit their own resources to research and that African governments increase their support for research in general and provide targeted funding for research-intensive universities\u2014in addition to the usual operational funds and tuition income currently available to these institutions.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"South African Health Review (SAHR) 2019 Emerging Public Health Practitioner Award","field_subtitle":"Deadline for Applications: 31 July 2019","URL":"http://www.hst.org.za/media/Pages/EPHPA2019.aspx","body":"This call invites practitioners to submit a completed manuscript to the South African Health Review (SAHR) to apply for the 2019 Emerging Public Health Practitioner Award. The successful candidate will have their paper published in the 2019 edition of the SAHR. The winner will also receive a cash prize and access to wider networks of practising public health practitioners and researchers in the field. Preference will be given to papers that take cognisance of the World Health Organisation\u2019s six building  blocks for an effective, efficient and equitable health system. The SAHR aims to advance the sharing of knowledge, to feature critical commentary on policy implementation, and to offer empirical understandings for improving South Africa\u2019s health system. To be eligible for the award, the applicant must be a South African citizen or permanent resident, with a valid South African ID number, currently registered for a Master\u2019s degree in health sciences/medicine or public health at a South African tertiary institution. The applicant must be the sole author of the paper. Any other contributions may only be recognised as acknowledgements. Entries will be assessed by a panel of public health experts. The official prize-giving ceremony will take place at the launch of the 22nd edition of the SAHR.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The future of African Studies: what we can do to keep Africa at the heart of our research","field_subtitle":"Nolte I: Journal of African Cultural Studies (Forthcoming Special Issue: Ethical Collaboration), doi: https://doi.org/10.1080/13696815.2019.1584552, 2019","URL":"https://www.tandfonline.com/doi/full/10.1080/13696815.2019.1584552","body":"Over the past two decades, Africa has returned to academic agendas outside of the continent. At the same time, the field of African Studies has come under increasing criticism for its marginalisation of African voices, interests, and agendas. This article explores how the complex transformations of the academy have contributed to a growing division of labour. Increasingly, African scholarship is associated with the production of empirical fact and socio-economic impact rather than theory, with ostensibly local rather than international publication, and with other forms of disadvantage that undermine respectful exchange and engagement. This article suggests ways of understanding and engaging with these inequalities.","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The Mandela Institute for Development Studies: Diamond Empowerment Fund Scholarship","field_subtitle":"Deadline for applications: Friday, 31 May, 2019","URL":"https://tinyurl.com/yb4bpwmo","body":"The Mandela Institute for Development Studies has partnered with the Diamond Empowerment Fund to establish the first in a series of Diamond Empowerment Fund Scholarships. The Fund was inspired by Nelson Mandela who encouraged Diamond Empowerment Fund\u2019s co-founders to tell the world the positive impact Africa\u2019s diamonds were having in building healthy and educated communities on the continent. The Mandela Institute for Development Studies, Diamond Empowerment Fund Scholarship will be earmarked for students from a diamond producing country whose chosen post-graduate study will be in a field that meets the needs for improving the quality of life for Africans. Preference will be given to students who want to gain critical skills in short supply on the continent. Applications are invited from qualifying students in eligible countries, namely Angola, Botswana, Central African Republic, Democratic Republic of Congo, Lesotho, Liberia, Namibia, Sierra Leone, South Africa, Tanzania and Zimbabwe.  ","php":"","field_issue_date":"2019-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A systematic review on occupational hazards, injuries and diseases among police officers worldwide: Policy implications for the South African Police Service","field_subtitle":"Mona G; Chimbari M; Hongoro C: Journal of Occupational Medicine and Toxicology 14(2), doi: https://doi.org/10.1186/s12995-018-0221-x, 2019","URL":"https://occup-med.biomedcentral.com/articles/10.1186/s12995-018-0221-x","body":"Occupational hazards, injuries and diseases are a major concern among police officers, including in Sub-Saharan Africa. However, there is limited locally relevant literature for guiding policy for police services. A review was done to describe the occupational hazards, injuries and diseases affecting police officers worldwide, in order to benchmark policy implications for local police services. Police officers\u2019 exposure to accident hazards may lead to acute or chronic injuries such as sprains, fractures or fatalities. These hazards may occur during driving, patrol or riot control. Physical hazards such as noise induced hearing loss (NIHL) arise due to exposure to high levels of noise. Exposure to high concentrations of carbon dioxide and general air pollution was associated with cancer, while physical exposure to other chemical substances was linked to dermatitis. There is a risk of exposure to blood borne diseases from needle stick injuries (NSIs) or cuts from contaminated objects. Musculoskeletal disorders can result from driving long distances and lifting heavy objects, while there is also a risk of post-traumatic stress disorder (PTSD), stress and burnout. ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Abantu Book Festival as an archive of the future","field_subtitle":"Coetzee C: Africa is a Country, 2019","URL":"https://tinyurl.com/yxpakyvq","body":"Abantu, South Africa, celebrates black intellectual labour and reading cultures. Abantu inter-connects reading and activist work. The third edition of the Abantu Book Festival took place in Soweto in December 2018 adds to a growing collection of images, videos, blog posts, Facebook (Abantu Book Festival) and Twitter updates (@abantu) of a vibrant black literary culture with long histories.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Accelerating universal health coverage: a call for papers","field_subtitle":"Deadline for submissions: 15 June 2019 ","URL":"https://www.who.int/bulletin/volumes/97/3/19-230904/en/","body":"This issue of the Bulletin of the World Health Organisation will explore policy options and country experiences on how to expand population coverage, service coverage and financial protection. The editors welcome manuscripts that capture knowledge and experience in addressing bottlenecks and root causes of stagnation that hamper successful UHC advancement. Papers which present an analysis of breakthroughs in health systems that have been conducive to rapid expansion of coverage are encouraged. Papers should focus on, for example, implementation science in health systems, innovative health financing, strategic purchasing, UHC and primary health care, the role of the private sector, policy coherence across government levels (particularly in decentralized health systems), the role of innovative technology and the design and use of health information. Best practices in good governance for health, based on transparency and accountability, would also be useful to learn how vested interests that hamper progress towards UHC are countered in different socioeconomic and political contexts. Comparative cross-country analyses are encouraged.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Diaspora Support to African Universities: Call for Senior African Diaspora Academics to serve in the Council for the Development of Social Science Research in Africa College of Mentors","field_subtitle":"Deadline for applications: 30 April 2019  ","URL":"https://tinyurl.com/y6722a7f","body":"The Council for the Development of Social Science Research in Africa (CODESRIA), with support from the Carnegie Corporation of New York is implementing an African Academic Diaspora Support to African Universities Program. In the early part of 2019, Council for the Development of Social Science Research in Africa intends to recruit 50 doctoral students in the social science and humanities from accredited public universities in Africa and place them under the College to benefit from the mentorship program. As part of this initiative, CODESRIA intends to recruit 15 senior academics from the Diaspora to complement existing academics who are already serving in the College of Mentors. Selected mentors and mentees will be brought together at a \u2018College of mentors\u2019 summer institute scheduled to take place in August 2019. The institute will provide the opportunity for mentors and mentees to get to interact directly learn more about each other\u2019s research interests and get to establish supervisory unions on the basis of shared interests. The call specifically targets senior African Diaspora in the social sciences, humanities and higher education studies based at universities in North America, Europe or Asia. African academics based at universities or other higher education and research institutions in Africa but outside of their own countries may also apply. Mentors will be compensated with a modest honorarium after a midterm review of the project. African academics in the Diaspora wishing to be considered should send detailed current CV\u2019s and a brief note expressing interest to serve in the College.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Assessing changes in social determinants of health inequalities in South Africa: a decomposition analysis","field_subtitle":"Omotoso K; Koch S: International Journal for Equity in Health17(181) 1-13, 2018 ","URL":"https://tinyurl.com/ybpzefdy","body":"This paper examines how changes in the social determinants of health have impacted health inequalities over the last decade, the second since the end of apartheid. Data was drawn from information on social determinants of health and on health status in the 2004, 2010 and 2014 South African General Household Surveys. The results show that inequalities in ill-health are consistently explained by socio-economic inequalities relating to employment status, while provincial differences in ill health narrowed considerably over the studied periods. Disability inequalities were largely explained by socio-economic inequalities relating to racial groups, educational attainment and provincial differences. The authors indicate that the extent of employment, location and education inequalities suggests the need for improved health care management and further delivery of education and job opportunities.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Call for abstracts: Special issue of Critical Public Health \u2018Public health activism in changing times: Re-locating collective agency\u2019 ","field_subtitle":"Deadline for applications: 1 May 2019  ","URL":"http://tinyurl.com/y3an6pew","body":"The special issue will examine emerging new forms of public health activism, and associated novel sources of collective agency, that are evolving in the fight for health-enabling conditions. Attention to structural forms of power, and the strengths and weaknesses of individual agency have long been cornerstones of critical public health, rooted in a long-established structure-agency binary. The editors seek to disrupt this binary by calling for papers that draw attention to alternative, distributed, networked, disruptive, bottom-up sources of agency that characterise emerging new forms of activism. New and resurgent social movements include attention to issues of anti-austerity, disability rights, new feminisms, defence of public services, housing justice, urban regeneration, anti-racism and advocacy targeting commercial determinants of health. Alternative forms of health-enhancing agency and efforts to connect grassroots collective agency to traditional axes of power are emerging. Papers on any of these, or other, locations of collective agency with potential for innovative public health activism would all be suited to the special issue. The editors invite papers from the full range of public health disciplines, exploring the possibilities of public health activism in contemporary conditions, especially papers with strong empirical bases in studies of recent/contemporary activism. Creative responses to crisis are most often generated in practice rather than theory, and papers rooted in activist and collaborative praxis are particularly welcome.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Challenges to hypertension and diabetes management in rural Uganda: a qualitative study with patients, village health team members, and health care professionals","field_subtitle":"Chang H; Hawley N; Kalyesubula R; Siddharthan T; et al: International Journal for Equity in Health 18(38) 1-14, 2019","URL":"https://tinyurl.com/y2tpt78d","body":"This study aimed to understand the challenges in managing hypertension and diabetes care in rural Uganda. The authors conducted semi-structured interviews with 24 patients with hypertension and/or diabetes, 11 health care professionals, and 12 community health workers in Nakaseke District, Uganda. Data were coded using NVivo software and analyzed using a thematic approach. The results included patient knowledge gaps regarding the preventable aspects of hypertension and diabetes, mistrust in the Ugandan health care system rather than in individual health care professionals and skepticism from both health care professionals and patients regarding a potential role for village health team members in hypertension and diabetes management. In order to improve hypertension and diabetes management in this setting, the authors recommend taking actions to help patients to understand non communicable diseases as preventable, for health care professionals and patients to advocate together for health system reform regarding medication accessibility, and promotion of education, screening and monitoring activities at community level in collaboration with village health team members.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Distribution of out of pocket health expenditures in a sub-Saharan Africa country: evidence from the national survey of household standard of living, C\u00f4te d\u2019Ivoire","field_subtitle":"Attia-Konan A; Oga A; Tour\u00e9 A: BMC Research Notes 12(25), doi: https://doi.org/10.1186/s13104-019-4048-z, 2019","URL":"https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-019-4048-z","body":"This research aimed to identify the determinants of out of pocket (OOP) health expenditures in the Ivory Coast population in Abidjan, a rural and an urban area. The authors used data from the 2015 standard households living survey conducted by the National Institute of Statistics. About 13.3% of the participants experienced OOP expenditures on health with a mean expenditure of US$29. There were significant differences in the self-reported OOP between the three areas. People in Abidjan spent an average of 1.6 and 1.5 times more than those in the rural and urban areas respectively. Hospitalisation is the highest expenditure item in terms of money spent, while medicines are the most common item of expenditure in terms of frequency, regardless of the place of residence. Female gender, high social economic status and large household size increase OOP health expenditure significantly in all areas of residence while having insurance reduces it.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 217: Global health is anything but healthy \u2013 we have to reshape our own future ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Header"}},{"node":{"title":"Factors affecting the acceptability of isoniazid preventive therapy among healthcare providers in selected HIV clinics in Nairobi County, Kenya: a qualitative study","field_subtitle":"Wambiya E; Atela M; Eboreime E: Infectious Diseases 8(12), doi: 10.1136/bmjopen-2018-024286, 2018 ","URL":"https://bmjopen.bmj.com/content/8/12/e024286","body":"Despite being globally recommended as an effective intervention in tuberculosis (TB) prevention among people living with HIV, isoniazid preventive therapy (IPT) implementation remains limited,  especially in sub-Saharan Africa. This study explored the factors influencing the acceptability of IPT among healthcare providers in selected HIV clinics in Nairobi County, Kenya, a high HIV/TB burden country. A qualitative study was conducted using in-depth interviews with healthcare providers in selected HIV clinics in Nairobi County, Kenya.  Provider acceptability of IPT was influenced by the organisational context, provider training, perceptions of its efficacy, the clarity of IPT guidelines and procedures and the work environment. Inadequate high-level commitment and support for the IPT programme by programme managers and policy-makers were found to be the major barriers to successful IPT implementation. The authors argue for expanded engagement by policy-makers and IPT programme managers with providers and patients, as well as on-the-job design specific actions to support providers in implementation. ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"French Institute for Research in Africa: Fieldwork Grants 2019","field_subtitle":"Deadline for applications: 28 April 2019","URL":"http://ifra-nairobi.net/2801","body":"IFRA-Nairobi invites applications for fieldwork grants from Masters and PhD students who conduct research in social sciences and humanities in the East African region (Kenya, Uganda, Tanzania, Burundi, Rwanda, and Eastern Congo). IFRA will prioritize support to the following research themes: workers, labour, and employment; decolonizing knowledge and practices in the social sciences; and gender & LGBT in words and in practice. These research areas target studies on workers in industries, in factories and on plantations in East Africa, focusing on working conditions, workers relations (considering gendered issues), workers/employers relations, organized protest or consent, the growth of a working class culture, entertainment and reading practices, political consciousness, etc. Both case-study approaches and comparative approaches are welcome. Read more at the website.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global health is anything but healthy \u2013 we have to reshape our own future  ","field_subtitle":"Barbara Kaim, Training and Research Support Centre, Zimbabwe, Wilson Asibu, Country Minders for People\u2019s Development, Malawi","body":"\r\nA little over 20 years ago the health and social inequities within our region and the opportunity to act on them motivated the founders of EQUINET to come together as an \u2018equity catalyst\u2019. The intention was to bring together our collective knowledge and experiences and to explore the challenges and possible solutions to the broad range of economic, social and environmental factors that determine the opportunities for and deficits in health in our region. Since then, we have built evidence, analysis and dialogue in different communities across the region on where and how to reclaim the resources for health, including through comprehensive, primary health care oriented, people-centred and publicly-led health systems.\r\n\r\nParticipating for EQUINET at the fourth People\u2019s Health Assembly (PHA4) in Savar, Bangladesh  in November last year we found that the People\u2019s Health Movement (PHM) and the over 1200 participants from 80 countries raised the same demands that we are raising in our region.  Yes, there has been growing wealth in the world over the last 20 years, improved access to information and technological innovations, and some people have seen improved life expectancy and falling infant mortality. But the reality is that health is anything but \u2018healthy\u2019 at a global level.  \r\n\r\nAs PHM\u2019s Amit Sengupta succinctly put it: \u201cEight people in the world have more wealth than 50% of the world population.  Medicines exist, but only for some. We are seeing massive migration of populations in search of a more secure life. Our planet stands on the edge of destruction, while our health is for sale in the market.\u201d   We shared evidence at PHA4 of how the majority of people are not even able to meet their most basic needs for health and of how inequality within and between countries and regions in the world has grown and not fallen over the past decades. .\r\n\r\nWhy is this? Delegate after delegate at the PHA4 answered this question with a scathing critique of the neoliberal policies that have dominated the world order for the last four decades.   From different countries people pointed to how a neoliberal ideology, which favours the unrestricted flow of capital between countries globally, drives minimal government social spending and limits regulations on the activities of private transnational corporations, has massively impacted on the health of people throughout the world. \r\n\r\nThis situation makes having a strong, vocal World Health Organisation (WHO) important.  But in a plenary session at PHA4, David Legge explained the crisis in the WHO.  When it was formed in 1948, its main funding came from its member states, who paid \u2018assessed contributions\u2019 according to the size of their population and their economy. Since a 1980 vote in the World Health Assembly to freeze assessed contributions, today only 20% of WHO\u2019s budget is from member states \u2013 barely enough to cover their administrative costs \u2013 while the remaining 80% comes from voluntary contributions from member states, intergovernmental bodies and to a large extent from philanthrocapitalists like the Gates Foundation, often tied to particular programmes. \r\n\r\nAs a consequence, David raised that WHO\u2019s work is controlled by these external funders rather than by its assembly of member states, affecting its independence and distorting its priorities and the coherence of its programmes. This has had a profound impact on WHO\u2019s ability to support the implementation of comprehensive primary health care as set out in the Alma Ata Declaration and adopted by 134 countries in 1978. \r\n\r\nIt has also weakened the protection of health by other global actors. Many conversations in the PHA4 were about the impact of trade agreements on health. Jane Kelsey, a New Zealand lawyer, gave a shocking expose on how new generation agreements between countries and multinational investors are often negotiated in secret, preventing legislatures and the public from getting information on or regulating the health impacts of these corporate activities. She cautioned that this practice could lead to longer monopolies for medicines, to kerbing restrictions on standards for food and alcohol and for tobacco labelling, and to limits on governments\u2019 ability to regulate private hospitals. Such agreements have led to situations where foreign investors can sue governments if state regulation in areas such as patents, mining licenses, privatised water contracts and health insurance substantially affect their profits. In 2017 alone 65 such claims were laid against 48 countries, with the sums claimed ranging from USD15million to USD1.5billion. These court cases can act as a form of intimidation of governments who try to put the health and wellbeing of their citizens ahead of corporate interests.  \r\n\r\nWhile this situation can leave us feeling despondent, in contrast PHA4 left us energised as we shared experiences of action and resistance from local to international level.  At PHA4 we found a growing understanding that if we want change we will have to shape our own future, building alliances between community and civil society groups, academics, civil servants, journalists, international organisations and others.  \r\n\r\nWe have seen evidence of this in our region. The successful campaign for universal access to antiretrovirals undertaken by the Treatment Action Campaign in South Africa in the 1990s, for example, saw such an alliance challenging the ethical basis for restricting global access to medicines. We heard at PHA4 about similar national and global struggles to campaign and litigate on critical issues related to the quality of and access to healthcare, to stop mining interests harming health and to advocate for more democratically led global health governance.  These struggles for health are struggles for a more caring world. \r\n\r\nEQUINET is taking forward and is part of this in our region. We are building collective ideas and action in a range of areas, including on the health effects of our extractive industries, on food security, on living and social conditions, on comprehensive primary health care and our laws and rights in health.  PHA4 showed us how many activists there are in the same struggles in all corners of the world and that working at all levels, locally, nationally, regionally and with our comrades internationally is more important than ever.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. Read more about  PHA4 at https://phmovement.org/peoples-health-assembly-dhaka-3/ ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Maternal and newborn health needs for women with walking disabilities; \u201cthe twists and turns\u201d: a case study in Kibuku District Uganda","field_subtitle":"Apolot R; Ekirapa E; Waldman L; Morgan R:  International Journal for Equity in Health 18(43) 1-10, 2019","URL":"https://tinyurl.com/yxpakyvq","body":"In Uganda 13% of persons have at least one form of disability. This study explores the maternal and newborn health related needs of women with walking disabilities in Kibuku District Uganda. A qualitative study was carried out in September 2017 in three sub-counties of Kibuku district. Four In-depth Interviews among purposively selected women who had walking disabilities and who had given birth within two years from the study date were conducted.  The thematic areas explored during analysis included psychosocial, mobility, health facility and personal needs of women with walking disabilities. Data was analyzed manually using framework analysis. The authors found that women with walking disabilities had psychosocial, mobility, special services and personal needs. Psychosocial needs included, partners, communities, families\u2019 and health workers\u2019 acceptance. Mobility needs were associated with transport unsuitability, difficulty in finding transport and high cost of transport. Health facility needs included; infrastructure and responsive health services needs while personal maternal and newborn health needs were; personal protective wear, basic needs and birth preparedness items. Communities, and health workers need to be sensitized on these needs to meet them.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Mixed-methods evaluation of mental healthcare integration into tuberculosis and maternal-child healthcare services of four South African districts","field_subtitle":"Lovero K; Lammie S; van Zyl A: BMC Health Services Research 19(83), doi: https://doi.org/10.1186/s12913-019-3912-9, 2019","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-3912-9","body":"The South African National Mental Health Policy Framework and Strategic Plan 2013\u20132020 was adopted to address the country\u2019s substantial burden and inadequate treatment of mental illness. It outlines measures for full integration of mental health services into primary care by 2020. To evaluate progress and challenges in implementation, the authors conducted a mixed-methods assessment of mental health service provision in tuberculosis and maternal-child healthcare services of forty clinics in four districts in South Africa, interviewing district-level program managers (DPMs) and clinic nurses and mental health practitioners (MHPs). DPMs indicated that nurses should screen for mental illness at every patient visit, but only 73% of nurses reported conducting universal screening and 44% reported using a specific screening tool. For patients who screen positive for mental illness, DPMs described a stepped-care approach in which MHPs diagnose patients and then treat or refer them to specialised care. However, only 41% of MHPs indicated that they diagnose mental illness and 82% offer any treatment for mental illness. The challenges to current integration efforts include insufficient funding and material resources, poor coordination at the district administrative level, and low mental health awareness in district administration and the general population. Though some progress has been made toward integration of mental health services into primary care settings, the authors observe that implementation calls for improved district-level administrative coordination, mental health awareness, and financial and material resources.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"More talk than action: gender and ethnic diversity in leading public health universities","field_subtitle":"Khan M; Lakha F; Tan M; Singh S; et al: The Lancet 393 (1071), 594-600, 2019","URL":"http://tinyurl.com/y5qrruew","body":"Improving the career progression of women and ethnic minorities in public health universities has been a longstanding challenge. The authors believe it might be addressed by including staff diversity data in university rankings. In this study, findings from a mixed methods investigation of gender-related and ethnicity-related differences in career progression at the 15 highest ranked social sciences and public health universities in the world are presented. The study revealed that clear gender and ethnic disparities remain at the most senior academic positions, despite numerous diversity policies and action plans reported. In all universities, representation of women declined between middle and senior academic levels, despite women outnumbering men at the junior level. Ethnic-minority women might have a magnified disadvantage because ethnic-minority academics constitute a small proportion of junior-level positions and the proportion of ethnic-minority women declines along the seniority pathway.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Policy review on the management of pre-eclampsia and eclampsia by community health workers in Mozambique","field_subtitle":"Macu\u00e1cua S; Sharma S; Val\u00e1 A; Vidler M; et al: Human Resources for Health 17(15) 1-9, 2019","URL":"https://tinyurl.com/y2v99z57","body":"This review identified health policies related to the role of CHWs in the management of pre-eclampsia and eclampsia in Mozambique. It used three methods - policy document review, key informant interview and literature review. Three main themes were identified from the qualitative review as establishment of the community health worker programme and early challenges, revitalization of the community health workers programme and the integration of maternal health in the community health tasks. In 1978, following the Alma Alta Declaration, the Mozambique government brought in legislation establishing primary health care and the community health worker programme. Between the late 1980s and early 1990s, this programme was scaled down due to several factors including a prolonged civil war; however, the decision to revitalise the programme was made in 1995. In 2010, a revitalised programme was re-launched and expanded to include the management of common childhood illnesses, detection of warning signs of pregnancy complications, referrals for maternal health and basic health promotion. The study observe that the role of community health workers has evolved over the last 40\u2009years to include care of childhood diseases and basic maternal health counselling, but do not yet include some possible areas, like management of emergency conditions of pregnancy including pre-eclampsia and eclampsia. ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Regional EQUINET meeting on health literacy in the mining sector","field_subtitle":"Harare, Zimbabwe 28-29 March 2019","body":"The Regional EQUINET meeting on health literacy in the mining sector is being held on March 28 and 29 2019 in Harare to discuss health literacy outreach for workers, communities and ex mineworkers in the mining sector. We will be sharing information on the scope of and groups covered in current mining and health capacity building programmes; the methods for and use of the EQUINET health literacy module on Mining and health and co-operation on key upcoming regional processes on health in mining. The meeting involves EQUINET (TARSC, SEATINI);  Botswana Federation of Trade Unions; Zimbabwe Congress of Trade Unions, Southern African Trade Union Co-ordinating Council, Benchmarks Foundation South Africa, Swaziland Migrant Mineworkers Association, Eswatini and BoLAMA Botswana. For those interested in further follow up health literacy  training in the Mining sector being held later in 2019 please contact the EQUINET secretariat.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Stakeholders\u2019 perceptions of policy options to support the integration of community health workers in health systems","field_subtitle":"Ajuebor O; Cometto G; Boniol M; Akl E: Human Resources for Health 17(13) 1-13, 2019 ","URL":"https://tinyurl.com/y64tucgg","body":"This study assesses stakeholders\u2019 valuation of acceptability and feasibility of policy options considered for the CHW guideline development. A cross-sectional mixed methods study targeting stakeholders involved directly or indirectly in country implementation of community health workers programmes was conducted in 2017. Data was collected from 96 stakeholders from five World Health Organization regions using an online questionnaire. A Likert scale was used to grade participants\u2019 assessments of the outcomes of interest, and the acceptability and feasibility of policy options were considered. All outcomes of interest were considered by at least 90% of participants as \u2018important\u2019 or \u2018critical\u2019. Most critical outcomes were \u2018improved quality of community health workers health services\u2019 and \u2018increased health service coverage. Out of 40 policy options, 35 were considered as \u2018definitely acceptable\u2019 and 36 \u2018definitely feasible\u2019 by most participants. The least acceptable option was the selection of candidates based on age. The least feasible option was the selection of community health workers with a minimum of secondary education. ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"STAR: supporting authors in emerging regions to access journals for free","field_subtitle":"Taylor and Francis, 2019","URL":"https://authorservices.taylorandfrancis.com/star/","body":"Special Terms for Authors and Researchers (STAR) is a Taylor and Francis initiative developed to provide authors and researchers in emerging regions with free access to articles from their leading international and regional journals across subject areas. Those in eligible countries can register for one voucher, per person, per year. Free access will expire after the fiftieth article or twelve months after registration. It is possible to request more accesses after the fiftieth article","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Sustainable financing options for mental health care in South Africa: findings from a situation analysis and key informant interviews","field_subtitle":"Docrat S; Lund C; Chisholm D: International Journal of Mental Health Systems 13(4) https://doi.org/10.1186/s13033-019-0260-4, 2019","URL":"https://ijmhs.biomedcentral.com/articles/10.1186/s13033-019-0260-4","body":"South Africa faces a need to understand how existing reforms may be leveraged to incorporate the objectives of the National Mental Health Policy Framework and Strategic Plan (MHPF) and financed in a context of fiscal constraint. The authors conducted a situational analysis followed by in depth interviews with a range of expert national stakeholders. Although the MHPF is said to be consistent with ongoing efforts toward the implementation of National Health Insurance (NHI), there is clear evidence of discordance between the MHPF and the NHI. The most promising strategies for sustainable mental health financing call for increased decentralization of resources to primary and community mental health services and active integration of mental health into ongoing NHI implementation in district hospitals. The authors suggest several ways in which existing reforms may be leveraged to incorporate the objectives of the MHPF and achieve better mental health outcomes for South Africans, but this needs a costed investment case, projecting potential resource requirements and returns on investment of a strong service platform. In the longer-term, they argue that the NHI benefit package must be expanded to include comprehensive mental health services at all levels, with measures to incentivise quality of care. ","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The health impacts of extractive industry transnational corporations: a study of Rio Tinto in Australia and Southern Africa","field_subtitle":"Anaf J; Baum F; Fisher M; London L: Globalization and Health 15(13) 1-20, 2019 ","URL":"https://tinyurl.com/y2g3nrbv","body":"This research on extractive industries examined Rio Tinto in Australia and Southern Africa to test methods for assessing the health impacts of corporates in high and middle income jurisdictions with different regulatory frameworks. The authors adapted existing Health Impact Assessment methods. Data identifying potential impacts were sourced through media analysis, document analysis, company literature and semi-structured interviews. The data were mapped against a corporate health impact assessment framework which included Rio Tinto\u2019s political and business practices, productions and workforce, social, environmental and economic conditions. Both positive and detrimental aspects of Rio Tinto\u2019s operations were identified. Positive impacts include provision of direct employment under decent working conditions, but countered by an increase in precariousness of employment. Commitments to upholding sustainable development principles are undermined by limited site remediation and other environmental impacts. Positive contributions are made to national and local economies but then undermined by business strategies that include tax minimisation. This study confirmed that it is possible to undertake a corporate health impact assessment on an extractive industry transnational corporation. The different methods provided sufficient information to understand the need to strengthen regulations that are conducive to health; the opportunity for Rio Tinto to extend corporate responsibility initiatives and support their social licence to operate; and for civil society actors to inform their advocacy towards improving health and equity outcomes from transnational corporations operations.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi ","field_subtitle":"Crehan C, Kesler E, Nambiar B, Dube Q; et al: British Medical Journal of Global Health.  4(e000860) 1-12, 2019 ","URL":"https://tinyurl.com/y6osvq3b","body":"An integrated mHealth solution was developed to improve quality of newborn care and survival in a district hospital in Malawi. The NeoTree application described in this paper focused on newborn care in low-income facilities, combining data collection by healthcare workers themselves, with interactive decision support and education for improving quality of care. Focus groups explored the acceptability and feasibility of digital health solutions before and after implementation of the NeoTree in the clinical setting. Healthcare workers perceived the NeoTree to be acceptable, feasible and clinically usable. Healthcare workers reported high perceived improvements in quality of newborn care after using the NeoTree on the ward. They described improved confidence in clinical decision-making, clinical skills, critical thinking and standardisation of care. The authors suggest that such an interactive co-development with healthcare workers can create a highly usable interactive admission platform, providing a teaching resource and improving the perceived quality of care delivered by healthcare workers involved in newborn care.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Universal Health Coverage, Primary Health Care and the role of the Private Sector","field_subtitle":"Ozano K; Simkhada P; Porcellato L; Khatri R: Health Systems Global, 2019","URL":"https://tinyurl.com/y26p38cp","body":"This report provides an overview of the discussions around Primary Health Care (PHC) and the private sector, which took place during the 5th Global Symposium on Health Systems Research 2018: Advancing health systems for all in the SDG era. Universal Health Coverage (UHC) and how health systems are working to deliver this global goal by 2030 was a major theme of the conference. Discussions were captured through session data capture and semi-structured interviews. 26 conference rapporteurs captured data in 93 sessions; and 21 interviews were conducted with policy makers, implementers and practitioners from the public and private sector.  The discussions referred to initiatives to better engage, train and support small private providers such as community pharmacists to broaden their role and regulate their prescribing to develop safer PHC services. Urgent policy level exploration was called for on public-private links to achieve comprehensive PHC and UHC and clear mechanisms and legal frameworks for strategic purchasing and regulation that consider the power of purchasing medicines and supplies across countries within geographic regions.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Urban Studies Foundation International Fellowships","field_subtitle":"Deadline for applications: 7 May 2019 ","URL":"https://urbanstudiesfoundation.org/funding/international-fellowships/","body":"Applications are invited for an International Fellowship for early to mid-career urban scholars from the Global South, on any theme pertinent to a better understanding of urban realities in the Global South. The Fellowship covers the costs of a sabbatical period at a university of the candidate\u2019s choice in the Global North or South for the purpose of writing up the candidate\u2019s existing research findings in the form of publishable articles or a book under the guidance of a chosen mentor in their field of study. Funding is available for a period ranging between 3-9 months. Applicants must be early to mid-career urban scholars with a PhD obtained within the preceding 10 years who currently work in a university or other research institution within the Global South. Candidates must also be nationals of a country in the Global South, defined here as countries on the OECD\u2019s current ODA recipient list (2018-2020). Preference may be given to candidates from least or low-income countries but middle-income countries on the list are not excluded if the need for support is justified. The candidate must make suitable arrangements to be mentored by a suitably experienced senior urban scholar at the candidate\u2019s chosen research institution.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"What do the implementation outcome variables tell us about the scaling-up of the antiretroviral treatment adherence clubs in South Africa? A document review.","field_subtitle":"Mukumbang F; Zaida Orth Z; van Wyk B: Health Research Policy and Systems 17(28) 1-12, 2019","URL":"https://tinyurl.com/y6bq5vzg","body":"This study reviewed the effectiveness of the rollout of the antiretroviral adherence clubs in South Africa. The authors did a thematic analysis of 32 documents on the adherence clubs programme found in various databases from December 2017 to July 2018. The analysis showed that adherence clubs were highly acceptable as they decongested clinics, increased social support for patients and had a low cost of implementation. Evidence suggests that the model was effective in improving adherence to antiretroviral treatment and retention in care. Based on the success of the clubs in the Western Cape, adherence clubs are currently being implemented in all of the other South African provinces. The challenges include acquiring additional resources and support and the efficient use of available resources. They can be addressed by increasing communication between stakeholders and fostering a culture of learning between facilities, and the authors recommend this as the programme expands.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Why the world needs an African ecofeminist future","field_subtitle":"Kelleher F: African Arguments, March 2019","URL":"http://tinyurl.com/y2xxwbhj","body":"The author points to how women and feminist activists are on the front line of the battle for ecological sustainability on the continent. Their everyday struggles, commitment, and willingness to envision a future in which justice, equity and rights harmonise with environmental sovereignty is said to have the potential to save us all. Wangari Maathai and her Green Belt Movement are said to epitomise the essence of African ecofeminism and the collective activism that defines it. As the first environmentalist to win the Nobel Peace Prize, in 2004, Maathai highlighted the close relationship between African feminism and African ecological activism, which challenge both the patriarchal and neo-colonial structures undermining the continent. Lesser -known activists, however, have also long been at the intersection of gender, economic, and ecological justice. Ruth Nyambura of the African Eco Feminist Collective, for example, uses radical and African feminist traditions to critique power, challenge multinational capitalism, and re-imagine a more equitable world. Organisations like African Women Unite Against Destructive Resource Extraction (WoMin) campaign against the devastation of extractive industries. Meanwhile, localised organising is also resisting ecologically-damaging corporatisation: in South Africa, Women Mapella residents fought off land grabs by mining companies; in Ghana, the Concerned Farmers Association, led largely by women, held mining companies accountable for pollution of local watersheds; and in Uganda, women of the Kizibi community seed bank are preserving local biodiversity in the face of the commercialisation of seeds by corporate multinationals. From Ghana to South Africa and beyond, women-organised seed-sharing initiatives continue to resist corporatisation. Activists like Mariama Sonko in Senegal continue to lead on agroecological farming initiatives for localised and sustainable food production. The author argues that the crisis of Africa\u2019s current trajectory is a crisis of visioning: the inability of the continent\u2019s leaders to imagine a process of development less destructive, more equitable, less unjust, more uniquely African, and \u2013 quite simply \u2013 more exciting. The positions, passions, and holistic approaches offered by African ecofeminism are argued to provide key ingredients for an alternative to the capital-centric ideals of economic growth that have defined progress so far.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"\u2018Soda taxes work\u2019","field_subtitle":"Green A: Health-E News, February 2019","URL":"https://www.health-e.org.za/2019/02/26/soda-taxes-work/","body":"South Africa\u2019s version of a soda tax, called the Health Promotion Levy, will turn one-year-old in April. It was introduced to fight soaring rates of costly health conditions like obesity and diabetes. According to the Healthy Living Alliance\u2019s (Heala) Sbongile Nkosi, excessive consumption of sugary beverages is \u201ca major cause of obesity\u201d and \u201calso increases the risk of diabetes, liver and kidney damage, heart disease and some cancers\u201d. Nkosi also criticised the beverage industry which, she said, \u201chave specifically targeted poor communities who have the least access to quality health services\u201d. In his budget speech, Finance Minister Tito Mboweni announced that the local tax on sugary drinks would be increased slightly in order to account for inflation. But Heala is pushing for the taxation rate to be doubled to bring the country in line with WHO guidelines.","php":"","field_issue_date":"2019-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Africa Health Agenda International Conference","field_subtitle":"5-7 March 2019, Kigali, Rwanda","URL":"https://ahaic.org","body":"The Africa Health Agenda International Conference 2019 (Africa Health 2019) in Kigali, Rwanda is geared to be one of the largest health convenings in Africa, with over 1,500 participants expected. Africa Health 2019 will serve as a platform to foster new ideas and home-grown solutions to the continent\u2019s most pressing health challenges, with a focus on achieving universal health coverage (UHC) in Africa by 2030. The conference will be a key opportunity to map a pathway from commitment to action on UHC and to build momentum among diverse stakeholders, including policymakers, civil society, technical experts, innovators, the private sector, thought leaders, scientists and youth leaders.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Health Economics and Policy Association (AfHEA) 5th scientific conference","field_subtitle":"11-14 March 2019, Accra, Ghana","URL":"https://afhea.org/en/conferences/afhea-2019","body":"The African Health Economics and Policy Association (AfHEA) is hosting the fifth Scientific Conference in Accra, Ghana from 11 to 14 March, 2019. The broad theme of the conference is: Securing PHC for all: the foundation for making progress on UHC in Africa. This broad theme acknowledges the important role of PHC in the achievement of UHC. Strengthening PHC improves equity, accessibility and quality of care. Similarly, UHC ensures access to needed good quality health services irrespective of ability to pay. The two are therefore closely related. PHC is the main gateway to healthcare for the majority of the population, especially for those living in rural and underserved communities. A well-functioning PHC system will be able to respond to the health care needs of most of the population, including preventive, promotive and non-specialist clinical care, at a much lower cost than if similar services were provided at higher levels of the health care system. The conference will explore how securing PHC for all is a more cost-effective way to move towards the UHC agenda of any country, particularly for low income and lower middle income countries (LICs/LMICs) where the resource constraints are more severe.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Applying an intersectionality lens to examine health for vulnerable individuals following devolution in Kenya","field_subtitle":"McCollum R; Taegtmeye M; Otiso L; Tolhurst R; et al: International Journal for Equity in Health18(24) 1-15, 2019 ","URL":"https://tinyurl.com/yyfablta","body":"This paper examines health for vulnerable individuals following devolution in Kenya through a qualitative study between March 2015 and April 2016, involving 269 key informant and in-depth interviews from across the health system in ten counties, 14 focus group discussions with community members in two of these counties and photovoice participatory research with nine young people. The authors adopted an intersectionality lens to reveal how power relations intersect to produce vulnerabilities for specific groups in specific contexts, and to identify examples of the tacit knowledge about these vulnerabilities held by priority-setting stakeholders. The authors identified a range of ways in which longstanding social forces and discriminations limit the power and agency individuals can exercise. These are mediated by social determinants of health, their exposure to risk of ill health from their living environments, work, or social context, and by social norms relating to their gender, age, geographical residence or socio-economic status. While a range of policy measures have been introduced to encourage participation by typically \u2018unheard voices\u2019, devolution processes have yet to adequately challenge the social norms and power relations which contribute to discrimination and marginalisation. The authors conclude that if key actors in devolved decision-making structures are to ensure progress towards universal health coverage, there is need for intersectoral action to address these social determinants and to identify ways to challenge and shift power imbalances in priority-setting processes.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Call for Expressions of Interest: Universities and Social Inequalities in the Global South","field_subtitle":"Deadline for Submission of Proposals: 10 March 2019, 23:59 CET ","URL":"https://tinyurl.com/y3fxgu4t","body":"UNRISD invites expressions of interest from researchers to prepare papers that will feed into the development of a research proposal for a project on the relationship between universities and social inequalities in low- and middle-income countries. With the persistent and rising inequalities of present day encompassing not only income and wealth but also inequalities across race, gender, ethnicity and geographic region, it is critical to reinvent, reimagine and strengthen a wide range of policies and institutions that can play a role in overcoming inequalities. This call and the subsequent research project to be developed focuses on universities as one such institution. The project proposal will focus on the role of universities in reinforcing or lessening social inequalities in low- and middle-income countries. It will explore the following questions: What potential does higher education have today to increase social mobility, reduce inequality and contribute to the advancement of society through the production of knowledge and skills? Are institutions of higher education contributing to inequality rather than equality, and if so, through what specific actions and mechanisms? How can the transformative potential of such institutions be fully harnessed for overcoming inequality?","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Can social network analysis help to include marginalised young women in structural support programmes in Botswana? A mixed methods study","field_subtitle":"Loutfi D; Andersson N; Law S; Salsberg J; et al: International Journal for Equity in Health 18(12) 1-11, 2019 ","URL":"https://tinyurl.com/yyr9y2af","body":"This paper investigated social networks of young women in Botswana to see if an approach based on an understanding of these networks could help with recruitment into support programmes. A national HIV trial was testing an intervention to assist young women to access government programs for returning to education and improving livelihoods. Structural factors such as poverty, poor education, strong gender inequalities and gender violence render many young women unable to act on choices to protect themselves from HIV. Social network analysis was used to identify key young women in four communities and to describe the types of people that marginalised young women turn to for support. In discussion groups, the same young women helped explain results from the network analysis. Most marginalised young women went to other women, usually in the same community and with children, especially if they had children themselves. Rural women were better connected with each other than women in urban areas, though there were isolated young women in all communities. Peer recruitment contributed most in rural areas; door-to-door recruitment contributed most in urban areas. The authors argue that since marginalised young women seek support from others like themselves, outreach programs could use networks of women to identify and engage those who most need help from government structural support programs. while this alone may be insufficient, a combination of approaches, including, for instance, peers, door-to-door recruitment and key community informants could be explored as a strategy for reaching marginalised young women for supportive interventions.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"e-Learning Course on Health Financing Policy for universal health coverage (UHC)","field_subtitle":"Osseiran N: World Health Organisation, Geneva, Switzerland, 2019","URL":"https://tinyurl.com/y3xa3368","body":"The first e-learning course on health financing policy for universal health coverage has now been launched. This e-learning course comprises six modules which cover the core functions of health financing policy. Each module is divided into a number of sub-topics. This is a foundational course which targets participants of various levels of experience and expertise. The course is designed to be used in a variety of ways: as preparation for those who will attend a WHO face-to-face course, for those who are for various reasons unable to attend a face-to-face course, and for those who have already attended courses and wish to refresh their knowledge. Individual modules can also be used as part of a programme of blended capacity building. Module 1 provides an overview. Module 2 addresses revenue raising and policy objectives. Module 3 looks to pooling and policy objectives, while module 4 and 5 address purchasing and benefit package design. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"EQUINET Diss 117: Pathways to urban health equity: Report of multi-method research in east and southern Africa","field_subtitle":"Loewenson R; Masotya M: TARSC, Working with Harare and Lusaka youth, Civic Forum on Human Development and Lusaka District Health Office, EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20117%20%20UHsynth2018.pdf","body":"By 2050, urban populations in Africa will increase to 62%. The World Health Organization (WHO) and UN-Habitat in their 2010 report \u2018Hidden Cities\u2019 note that this growth in the urban population constitutes one of the most important global health issues of the 21st century. In 2016-2018, Training and Research Support Centre (TARSC) in the Regional Network for Equity in Health in East and Southern Africa (EQUINET) explored the social distribution of health in urban areas and the opportunities for and practices promoting urban health and well-being. It focused on youth 15-24 years of age as an important group for both current and future well-being. The paper synthesises and reports evidence from a programme of work that unfolded iteratively over two years. The work involved desk reviews of published literature and analysis of data from international databases for east and southern African countries, and international evidence on practices supporting urban well-being in areas prioritised by urban youth. The findings were subject to cycles of participatory review and validation by young people from diverse urban settings and socio-economic groups in Harare and Lusaka. These methods were applied with an intention to draw on different disciplines, concepts and variables from different sectors and on the lived experience and perceptions of the youth directly affected by different urban conditions. Separate publications produced in the project give more detail on particular methods, and findings and are cited in this paper. A series of dissemination and dialogue activities have been carried out with youth, local authority and policy actors, supported by shorter briefs and technical reports.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 216: The Price of Life \u2013 WHO\u2019s efforts to justify health protection","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Global Network of Public Health Nursing 5th International Conference","field_subtitle":"14-16 May 2019, Nairobi, Kenya","URL":"http://www.gnphn.com/kenya-2019/","body":"This conference aims to provide delegates with an opportunity to present and learn about new evidence-based knowledge concerning health systems/services/practice to enable public health nursing to contribute to the achievement of the targets of Goal 3 of the UN Sustainable Goals. Because of their global significance and relevance to Public Health Nursing, it was agreed to explore the contribution of public health nursing to achieving Goal 3 of the UN Sustainable Development  Goals \u2018good health and well being\u2019 as a working title for the conference. The sub themes will focus on the role of public health nursing in achieving the targets of Goal 3 at every aspect and every population group including the elderly, maternal and child groups, people with disabilities, health care systems and safe environments. The focus is on; HIV/AIDS testing, disclosure, access and adherence to care; adolescent reproductive health; public health leadership and governance; health systems integration; rural, county and national levels; infectious disease management; community health strategy; public health workforce, labour relations and mental health.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"How climate change is undermining the war against HIV in Africa","field_subtitle":"Lazareva I: Business Day, January 2019","URL":"https://tinyurl.com/y5z96u3q","body":"In a study looking at the link between climate change and HIV infection since antiretroviral (ARV) treatment drugs became widely available in Sub-Saharan Africa, researchers found that severe drought threatens to drive new HIV infections. In the urban areas of Lesotho researchers looked at, droughts were linked to an almost five-fold increase in the number of girls selling sex and a three-fold increase in those being forced into sexual relations. Such findings mean climate shocks \u2014 which can bring displacement, loss of income and other problems \u2014 threaten to undermine progress made in HIV treatment, said Andrea Low, an assistant professor of epidemiology at the International Centre for AIDS Care and Treatment Programmes at Columbia University. \u201cI think the real concern is that we have gained a lot in terms of epidemic control ... but there is always a possibility of  losing all those gains if a lot of people are displaced due to climate extremes [and] forced migration.\u201d People forced to migrate as a result of drought may no longer have easy access to the support of family and friends or to HIV treatment. The researchers indicate that  said ways of reducing HIV risk associated with climate shocks include providing easier access to medical care, distributing HIV self-testing kits and offering cash transfers to pay school fees for drought-hit families forced to migrate.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Incorporating concerns for equity into health resource allocation: A guide for practitioners ","field_subtitle":"Love-Koh J; Griffin S; Kataika E; Revill P: CHE Research Paper 160, 1-25, 2019 ","URL":"http://ecsahc.org/wp-content/uploads/2019/02/CHERP160.pdf","body":"This paper summaries the methods for analysing health equity available to policymakers regarding the allocation of health sector resources. The authors provide an overview of the major tools that have been developed to measure, evaluate and promote health equity, along with the data required to operationalise them. These were organised into four key policy questions facing decision-makers: (i) what is the current level of inequity in health; (ii) does government health expenditure benefit the worst-off; (iii) can government health expenditure more effectively promote equity; and (iv) which interventions provide the best value for money in reducing inequity? Benefit incidence analysis is identified as the principal tool for estimating the distribution of current public health sector expenditure, with geographical resource allocation formulae and health system reform being the main government policy levers for improving equity. Techniques from the economic evaluation literature, such as extended and distributional cost-effectiveness analysis can be used to identify \u2018best buy\u2019 interventions from a health equity perspective. A range of inequality metrics, from gap measures and slope indices to concentration indices and regression analysis, can be applied to these approaches to evaluate changes in equity. Methods from the economics literature can be used to generate novel evidence on the health equity impacts of resource allocation decisions. They provide policymakers with a toolkit for addressing multiple aspects of health equity, from health outcomes to financial protection, and can be adapted to accommodate data commonly available in either high income or low and middle income settings. However, the quality and reliability of the data are crucial to the validity of all methods.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Initiating a participatory action research process in the Agincourt health and socio\u2013demographic surveillance site","field_subtitle":"Wariri O; D\u2019Ambruoso L; Twine R: Journal of Global Health 7(1), doi: 10.7189/jogh.07.010413, 2017 ","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475314/","body":"Despite progressive health policy, disease burdens in South Africa remain patterned by deeply entrenched social inequalities. The authors suggest that accounting for the relationships between context, health and risk can provide important information for equitable service delivery. This research used a participatory research process with communities in a low income setting in the Agincourt health and socio\u2013demographic surveillance site (HDSS) in rural north\u2013east South Africa. Three village\u2013based discussion groups were convened and consulted about conditions to examine, one of which was under\u20135 mortality. A series of discussions followed in which routine HDSS data were presented and participants\u2019 subjective perspectives were elicited and systematized into collective forms of knowledge using ranking, diagramming and participatory photography. The process concluded with a priority setting exercise. Visual and narrative data were thematically analysed to complement the participants\u2019 analysis. Participants identified a range of social and structural root causes of under\u20135 mortality: poverty, unemployment, inadequate housing, unsafe environments and shortages of clean water. Despite these constraints, single mothers were often viewed as negligent. A series of mid\u2013level contributory factors in clinics were also identified: overcrowding, poor staffing, delays in treatment and shortages of medications. However, blame and negativity were directed toward clinic nurses in spite of the systems constraints identified. Actions to address these issues were prioritized as: expanding clinics, improving accountability and responsiveness of health workers, improving employment, providing clean water, and expanding community engagement for health promotion. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Integrating noncommunicable disease services into primary health care, Botswana","field_subtitle":"Tapela N; Tshisimogo G; Shatera B; et al: Bulletin of the World Health Organisation 97(2), 142-153, 2018","URL":"https://www.who.int/bulletin/volumes/97/2/18-221424/en/","body":"Despite the rising burden of noncommunicable diseases, access to quality decentralized noncommunicable disease services remain limited in many low- and middle-income countries. The authors describe strategies that were employed to drive the process from adaptation to national endorsement and implementation of the 2016 Botswana primary healthcare guidelines for adults. The strategies included detailed multilevel assessment with broad stakeholder inputs and in-depth analysis of local data; leveraging academic partnerships; facilitating development of policy instruments and embedding noncommunicable disease guidelines within broader primary health-care guidelines in keeping with the health ministry strategic direction. At facility level, strategies included developing a multi-method training programme for health-care providers, leveraging on the experience of provision of human immunodeficiency virus care and engaging health-care implementers early in the process. Through the strategies employed, the country\u2019s first national primary health-care guidelines were endorsed in 2016 and a phased three-year implementation started in August 2017. Provision of primary health-care delivery of noncommunicable disease services was included in the country\u2019s 11th national development plan (2017\u20132023). During the guideline development process, the authors learnt that strong interdisciplinary skills in communication, organisation, coalition building and systems thinking, and technical grasp of best-practices in low- and middle-income countries were important. They found that delays and poor communication emerged from the misaligned agendas of stakeholders, exaggerated by a siloed approach to guideline development, underestimation of the importance of having policy instruments in place and weak initial coordination of the processes outside the health ministry. The authors share this experience for its relevance to other countries interested in developing and implementing guidelines for evidence-based services for noncommunicable diseases.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Kenya\u2019s Health in All Policies strategy: a policy analysis using Kingdon\u2019s multiple streams","field_subtitle":"Mauti J; Gautier L; De Neve J et al: Health Research Policy and Systems 17(15) 1-12, 2019 ","URL":"https://tinyurl.com/y36cjlu6","body":"This paper assesses the extent to which Health in All Policies (HiAP) is being translated into the process of governmental policy-making and is supported by international development partners and non-state actors. A qualitative case study was performed, including a review of relevant policy documents and 40 key informants with diverse backgrounds. Kenya is facing major health challenges that are influenced by various social determinants, but the implementation of intersectoral action focusing on health promotion is still arbitrary. On the policy level, little is known about HiAP in other government ministries. Many health-related collaborations exist under the concept of intersectoral collaboration, which is prominent in the country\u2019s development framework of Vision 2030, but with no specific reference to HiAP. The paper highlights that political commitment from the highest office would facilitate mainstreaming the HiAP strategy, for example by setting up a department under the President\u2019s Office. The budgeting process and planning for the Sustainable Development Goals were found to be potential windows of opportunity. While HiAP is being adopted as policy in Kenya, it is still perceived by many stakeholders as the business of the health sector, rather than a policy for the whole government and beyond. The authors propose that Kenya\u2019s Vision 2030 use HiAP to foster progress in all sectors with health promotion as an explicit goal.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"O'Neill Institute for National and Global Health Law guide to Health Equity Programs of Action","field_subtitle":"Call for collaboration","URL":"https://tinyurl.com/yy2da52w","body":"The O'Neill Institute for National and Global Health Law at Georgetown University Law Center (Washington, DC) has launched a guide to Health Equity Programs of Action. The Institute offers a systematic, systemic, and inclusive approach to reduce unjust health gaps between populations. It aims to empower the people who experience these inequities and help to establish a sustained national focus on health equity. This implementation framework is based on seven principles: Empowering participation and inclusive leadership; maximizing health equity;\r\nhealth systems and beyond: social determinants of health; every population counts; actions, targets and timelines; comprehensive accountability; and sustained high-level political commitment.  The O'Neill Institute is interested to discuss collaborations and opportunities for taking this approach forward.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Perceptions of and support for national health insurance in South Africa's public and private healthcare sectors","field_subtitle":"Booysen F; Hongoro C: The Pan African Medical Journal 30(277), doi: doi:10.11604/pamj.2018.30.277.14147, 2018","URL":"http://www.panafrican-med-journal.com/content/article/30/277/full/","body":"For the purpose of effective implementation of a National Health Insurance (NHI) policy the authors argue that it is necessary to have an understanding of the awareness and perceptions of and support for such policy among clients using the healthcare system. The South African National Health and Nutrition Examination Survey asked household heads a series of questions on healthcare utilisation and access and collected information on knowledge and perceptions of and support for national health insurance. Comparisons are drawn between private sector healthcare users with medical aid and public sector healthcare users without medical aid, using descriptive and regression analysis. Inequalities in access to quality healthcare remain stark. Only 8.5% of private users had postponed seeking healthcare compared to 23.9% of public users. Only 11.9% of public users were very satisfied with the quality of healthcare services compared to 50.2% of private users. More than eighty percent of healthcare users however were of the opinion that NHI is a top priority. The findings suggest that this requires a national health insurance that provides better quality healthcare, increasing the probability of support for an NHI with lower cost and full coverage by 10.1%. The authors suggest that it is imperative to provide better quality healthcare services in the public sector for private sector users to be supportive of national health insurance. Concerted efforts are also required to develop a proper communication strategy to disseminate information on and garner support for national health insurance, both in the public and private healthcare sectors.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Responding to inequalities in health in urban areas in east and southern Africa: Brief 5: What does the evidence indicate for advancing urban health and wellbeing?","field_subtitle":"Loewenson R; Masotya M: TARSC, EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Urban%20health%20brief%205%20Dec2018.pdf","body":"Training and Research Support Centre (TARSC) as cluster lead of the \u201cEquity Watch\u201d work in EQUINET implemented a multi-methods approach to gather and analyse diverse forms of evidence and experience on inequalities in health and its determinants within urban areas. We explored current and possible responses to these urban conditions, from the health sector and the health promoting interventions of other sectors and of communities. We aimed to build a holistic understanding of the social distribution of health in urban areas and the distribution of opportunities for and practices promoting health and wellbeing from different perspectives and disciplines. We worked with Harare and Lusaka youth, the Civic Forum on Human Development and Lusaka District Health Office for the participatory validation This brief, the fifth in the series on urban health, reports on the combined findings and their implications for improving equity in urban health and wellbeing.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Re\ufb02ections of an Engaged Economist: An Interview with Thandika Mkandawire","field_subtitle":"Meagher K: Development and Change 0(0), doi: https://doi.org/10.1111/dech.12481, 2019","URL":"https://tinyurl.com/y4fgokpp","body":"This article reports an interview with Professor Thandika Mkandawire, a leading development economist of Malawian origin specializing in the comparative study of Africa. The interview explores how growing up under colonialism in Zimbabwe meant that huge decisions were being made that had profound effect on one's life, that he saw in the experience of his father as a  unionised worker on a mine and a tailor at home. He recounts the conversations on politics and working conditions on the mines that took place while people waited for their garments, as people tried to  make sense of policies they had no contribution to. As a school student in Malawi doing is 'O levels'  at a time of anti-colonial struggles, he was involved in demonstrations that exposed the brutality of the police. After school and working on a weekly paper his experience of being arrested exposed the facade of rule of law in a trial that he called a farce. His study of economics was initially to be a better journalist. Studying in Latin America he saw the hostility of Latin Americans to the USA as a 'more naked' form of the 'new imperialist order'. The interview traces him to his life in exile from Malawi, living in Sweden, where the thinking of Amartya Sen and others exposed the deeply social and political nature of economics, while the writing of African nationalists exposed the tension between class and nation as the overriding concern, a debate he posits as continuing until today. Living in Sweden at that time provided an experience of a democratic state that could \"tame the structural power of capital\", reinforcing but also moderating his \"leftist inclinations\". The interview continues to track how his life experiences and work at institutions such as CODESRIA and UNRISD influenced his thinking on developmental states, his views on strategic responses to the structural adjustment programmes in Africa, of the role of intelligent, capable and democratic states as the only viable instrument for development, and of  social investment as a developmental tool. The interview explores his views on the implications for the current African political economy and for African scholarship. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Scholarship updates for African students and researchers","field_subtitle":"Strohm R, February 2019","URL":"https://tinyurl.com/y286k4ts","body":"This resource provides a list of scholarships for African students, and research funding for African academics. There are three lists of scholarships and grants for African academics: one for MA and PhD study in Anglophone countries, one for Francophone countries, and one for post-doctoral and research funding. In addition, there are resources for research and travel grants for African professors.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Sociodemographic patterns of health insurance coverage in Namibia","field_subtitle":"Allcock S; Young E; Sandhu M: International Journal for Equity in Health 18(16) 1-11, 2019","URL":"https://tinyurl.com/y2ye3l6z","body":"This paper aimed at assessing the prevalence of health insurance, the relation between health insurance and health service utilisation and to explore the sociodemographic factors associated with health insurance in Namibia. Such findings may help to inform health policy to improve financial access to healthcare in the country. Using data on 14,443 individuals, aged 15 to 64\u2009years, from the 2013 Namibia Demographic and Health Survey, the association between health insurance and health service utilisation was investigated using multivariable mixed effects Poisson regression analyses. Just 17.5% of this population were insured. In fully-adjusted analyses, education was significantly positively associated with health insurance, independent of other sociodemographic factors. Female sex and wealth were also independently associated with insurance. There was a complex interaction between sex, education and wealth in the context of health insurance. With increasing education, women were more likely to be insured and education had a greater impact on the likelihood of health insurance in lower wealth quintiles. In this population, health insurance was associated with health service utilisation but insurance coverage was low, and was independently associated with sex, education and wealth. Education may play a key role in health insurance coverage, especially for women and the less wealthy. The authors suggest that the findings may help to inform the targeting of strategies to improve financial protection from healthcare-associated costs in Namibia.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH ","field_subtitle":"Agyepong  I; Lehmann  U; Rutembemberwa E: Health Policy and Planning 33 (1) (suppl 2), ii35-ii49, 2018 ","URL":"https://academic.oup.com/heapol/article/33/suppl_2/ii35/5050012","body":"Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally, but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consortium of institutions in Sub-Saharan Africa, UK and North America have embarked on a collaboration to develop and implement a pan-African DrPH. This paper presents findings of research to verify relevance, identify competencies and support programme design and customisation. A mixed methods cross sectional multi-country study was conducted in Ghana, South Africa and Uganda. Data collection involved a non-exhaustive desk review, 34\u2009key informant (KI) interviews with past and present health sector leaders and a questionnaire with closed and open ended items administered to 271 potential DrPH trainees. Most study participants saw the concept of a pan-African DrPH as relevant and timely. Strategic leadership competencies identified by KI included providing vision and inspiration for the organisation, core personal values and character qualities such as integrity and trustworthiness, skills in adapting to situations and context and creating and maintaining effective change and systems. There was consensus that programme design should emphasise learning by doing and application of theory to professional practice. Short residential periods for peer-to-peer and peer-to-facilitator engagement and learning, interspaced with facilitated workplace based learning, including coaching and mentoring, was the preferred model for programme implementation. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Success of a South-South collaboration on Human Resources Information Systems (HRIS) in health: a case of Kenya and Zambia HRIS collaboration","field_subtitle":"Were V; Jere E; Lanyo K; et al: Human Resources for Health 17(6), doi: https://doi.org/10.1186/s12960-019-0342-z, 2019","URL":"https://tinyurl.com/y2e34beh","body":"This paper is a road map of using a South-South collaboration to develop a Human Resources Information System (HRIS) to inform scale-up of the health workforce. In the last decade, Kenya implemented one of the most comprehensive HRIS in Africa. It was funded by the US President\u2019s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) and implemented by Emory University. The Kenyan team collaborated with the Zambian team to establish a similar HRIS in Zambia. This case study describes the collaboration activities between Zambia and Kenya which included needs assessment, establishment of project office, stakeholders\u2019 sensitization, technical assistance and knowledge transfer, software reuse, documents and guidelines reuse, project structure and management, and project formative evaluation. Furthermore, it highlights the need for adopting effective communication strategies, collaborative planning, teamwork, willingness to learn and having minimum technical skills from the recipient country as lessons learned from the collaboration. As a result of the collaboration, while Kenya took 5\u2009years, Zambia was able to implement the project within 2\u2009years which is less than half the time it took Kenya. This case presents a unique experience in the use of South-South collaboration in establishing a HRIS. It illustrates the steps and resources needed while identifying the successes and challenges in undertaking such collaboration.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Sudanese Women at the Heart of the Revolution","field_subtitle":"Gaafar R; Shawkat O: African Feminism, 2019","URL":"https://www.who.int/bulletin/volumes/97/2/18-221424/en/","body":"Country-wide peaceful demonstrations against the regime in Sudan have involved women as organised activists. Women in marginalized areas of conflict such as Darfur, South Sudan, the Nuba Mountains and the Blue Nile have lost their children, family and livelihood to war and famine. In addition to their experience of socio-economic deprivation, many of those who fled to the capital Khartoum have been abandoned by their husbands who are unable to support their families. The women\u2019s group No To Women\u2019s Oppression provides legal aid, advocacy and awareness campaigns and monitors violations of human rights, a solid and active component of the resistance. Women activist in the Central Committee for Doctors and other organisations  has, however, made them particularly prone to arrests and harassment. Women have also played a vital part in documenting the movement from the inside, especially in providing footage and proof of women's experiences of activism and of their conditions and the brutality they face.  ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The Global Commission on the Future of Work calls for fundamental changes in health at work","field_subtitle":"Osseiran N: World Health Organisation, Geneva, Switzerland, 2019","URL":"https://tinyurl.com/y3m5jgxw","body":"The ILO Global Commission on the Future of Work called for fundamental changes in the way people work in the wave of globalisation, rapid technological development, demographic transition and climate change, according to its report Work for a Brighter Future published in January 2019. The report examines how to achieve a better future of work for all at a time of un\u00adprecedented change and exceptional challenges in the world of work. These changes require placing health higher on the agenda of the world of work. Everybody has the right to health, which is defined by WHO as a state of complete physical and mental wellbeing and not only the absence of disease and infirmity. Working people have the right to health and to health care as close as possible to where they live and work. In 2018, WHO and ILO established a global coalition on occupational safety and health as multi-partner initiative of international and national agencies to create common solutions for the challenges for health and safety at work and to stimulate joint actions by health and labour sectors in countries. WHO welcomed the attention given by the Global Commission on the care economy and healthcare is a major part of it. WHO is also working with ILO and OECD to implement a five-year \u2018Working for Health\u2019 global action plan to create new and decent job opportunities in health care, to ensure the necessary workforce for universal health coverage and at the same time for stimulating economic growth.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The International Conference on (Re-) Emerging Infectious Diseases (ICREID)","field_subtitle":"The African Union Commission Conference Center, Addis Ababa, Ethiopia, 13-15 March 2019","URL":"http://www.icreid.com","body":"Organized by the Africa Centres for Diseases Control and Prevention (Africa CDC) and Virology Education, ICREID is a global platform that will bring together experts from around the world involved in emerging diseases in an interactive conference setting. Being the first to be held on the continent, the organisers invite healthcare professionals, researchers, public health experts and policy makers involved in treatment, research, discovery and development of drugs and vaccines in the field of re-emerging infectious diseases. Presentations include reflections on 100 years of Pandemic Flu and other Emerging Infections and analyses of the World Bank and Pandemic Preparedness. There are also talks on lassa fever, cholera and Rift Valley fever, on health economics in outbreak management and on the standardisation of research ethics during public health emergencies in Africa. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Politics of Resource Bargaining, Social Relations and Institutional Development in Zimbabwe Since Independence","field_subtitle":"Saunders R: United Nations Research Institute for Social Development, Working Paper 1, UNRISD, Geneva, 2019 ","URL":"https://tinyurl.com/yyoutwuf","body":"This paper examines evolving models and experiences of domestic resource mobilisation in Zimbabwe since independence in 1980. Grounded in UNRISD\u2019s Politics of Domestic Resource Mobilization and Social Development project, the study explores key questions around the nature and dynamics of resource bargaining over revenue mobilisation and allocation; the changes in relationships among key actors; and the forms and outcomes of institutional development surrounding resource bargaining processes. It adopts a historical approach to explore the balance of forces among actors and institutional constraints in the formulation of successive resource mobilisation strategies. Three case studies in the paper of divergent resource mobilisation innovations underscore the complexity of challenges faced by governments whose actions are shaped by uneven state capacity and policy autonomy; a weak formal sector in which established business actors wield significant power and influence; and growing contestation over legitimacy and participation by political and social actors. The Zimbabwean experience underscores the critical importance of political undercurrents and contesting interests in resource bargaining. It highlights the uneven nature of social actors\u2019 access to and influence in bargaining processes; and of the state itself in the wake of neoliberal austerity, state capture and intra-elite competition. At the same, the author argues that the evidence from Zimbabwe points to the benefits of more transparent, inclusive and capacitated forms of revenue mobilisation involving a wider array of social actors. ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Price of Life \u2013 WHO\u2019s efforts to justify health protection","field_subtitle":"Leslie London, University of Cape Town, Sofia Gruskin, University of Southern California, Sharon Fonn, Witwatersrand University, South Africa","body":"\r\nIn the same month that it reaffirmed the 1978 Alma Ata Declaration\u2019s commitment to \u201cthe fundamental right of every human being to the enjoyment of the highest attainable standard of health\u201d in its October 2018 Declaration of Astana, the World Health Organisation (WHO) launched, with much fanfare and hubris, its \u201cfirst investment case\u201d for 2019-2023, as a proposal that could \u201csave up to 30 million lives\u201d. \r\n\r\nDespite the rhetoric of the Astana Declaration, the WHO appears to be in a political moment where it is under pressure to justify, in economic terms, its existence as a global governance structure for health. To convince the doubting reader, the investment case promised \u201ceconomic gains of US$ 240 billion\u201d as the return to be made on increasing annual country contributions by US$10 billion to enable the WHO to meet its annual budget of US$14 billion. \r\n\r\nTwo things are striking. Firstly, the investment case purports to lay the basis for \u201ca stronger, more efficient, and results-oriented WHO \u2026and \u2026 highlights new mechanisms to measure success, ensuring a strict model of accountability and sets ambitious targets for savings and efficiencies.\u201d  This is the language of the private sector. \r\n\r\nThere is nothing wrong with working more efficiently, but the WHO should be placing health equity and human rights at the centre of its work and should guard against efficiency and managerialism coming at the expense of equity and social justice.  The bureaucracy and inefficiency of the WHO needs addressing, but the idea that the solution lies in the application of New Public Management is a political choice, rather than a necessary outcome of clear analysis.\r\n\r\nSecondly, the parlous state of WHO funding is not a coincidence. It is the result of a systematic decline in assessed contributions by member states, particularly the United States, over past decades. Whereas assessed contributions were 75% of WHO\u2019s budget in 1971, the Peoples Health Movement and others showed in 2017 that this is now about 25% of the institution\u2019s budget and that countries that do pay, choose to put most funding into voluntary contributions. Voluntary contributions can be tied to particular programmes, meaning countries can determine the work of WHO through funding dependence. WHO\u2019s budget has also been stagnant for the past eight years, which is why the organisation now has to go cap-in-hand, clutching a seemingly miraculous investment case argument, to beg for the budgets it has been starved of for the past decade. \r\n\r\nIt is astonishing, but deeply revealing, that the WHO has to justify human life in monetary or investment\u2019 terms. Who would have thought the Constitution of the World Health Organization which 70 years ago heralded the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being would end up in such abysmal decline? \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  The WHO Investment case referred to in the editorial can be found at https://tinyurl.com/yavqzjvk ","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"The Second Africa Health Forum","field_subtitle":"26-28 March 2019, Praia, Cabo Verde","URL":"https://tinyurl.com/yy95ofya","body":"The Government of Cabo Verde and the World Health Organization Regional Office for Africa will jointly host The Second WHO Africa Health Forum on the theme: Achieving Universal Health Coverage and Health Security in Africa: The Africa people want to see. The WHO Africa Health Forum Organizing team, also take this opportunity to call on partners to report on what they have been doing in delivering on the Call-to-Action from The First WHO Africa Health Forum - Putting People First: The Road to Universal Health Coverage in Africa.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Therapeutic citizens and clients: diverging healthcare practices in Malawi's prenatal clinics","field_subtitle":"Zhou A: Sociology of Health and Illness (Epub ahead of print), doi: https://doi.org/10.1111/1467-9566.12841, January 2019 ","URL":"https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12841","body":"This article examines how HIV policies and the funding priorities of global institutions affect practices in prenatal clinics and the quality of healthcare women receive. Data consist of observations at health centres in Lilongwe, Malawi and 37 interviews with providers. The author argues that a neoliberal ideology structuring global health produces a fragmented healthcare system on the ground. He found two kinds of healthcare practices within the same clinic: firstly externally funded non government organisations (NGOs) took on HIV services while government providers focused on prenatal care. NGO practices were defined by surveillance, where providers targeted a limited number of pregnant HIV positive women and intensively monitored their adherence to drug treatment. In contrast, state-led practices were defined by inclusion and rationing. Government providers worked with all pregnant women, but with staff and resource shortages, they limited time and services for each patient in order to serve everyone. The author concludes that global health priorities produce different conditions, practices and outcomes between externally funded NGO and state-led care.","php":"","field_issue_date":"2019-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"A health policy analysis reader: The politics of policy change in low- and middle-income countries","field_subtitle":"Gilson L; Orgill M; Shroff Z: Alliance for Health Policy and Systems Research, 2018","URL":"https://tinyurl.com/yd3dscn5","body":"This reader aims to encourage and deepen health policy analysis work in low- and middle-income countries (LMICs). It presents the range of health policy analysis studies that have been conducted in LMICs, highlights relevant theory, and points to new directions for such work. It also includes methodological and analytical pointers, and considers how to use health policy analysis prospectively to support health policy change. The Reader\u2019s primary audience includes all those with an interest in understanding and influencing health policy change, including researchers and educators, as well as policy advocates, managers, and policy-makers. The Reader will also be of interest to those who have specialist policy studies or public administration backgrounds, and also to those with limited prior engagement with relevant social science perspectives.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Accrediting private providers with National Health Insurance to better serve low-income populations in Kenya and Ghana: a qualitative study","field_subtitle":"Suchman L: International Journal for Equity in Health 17(179) 1-18, 2018","URL":"https://tinyurl.com/y86thh5f","body":"This paper pulled together data collected from private providers, patients, and social health insurance (SHI) officials in Kenya and Ghana to answer the question: does participation in an SHI scheme affect private providers\u2019 ability to serve poorer patient populations with quality health services? In-depth interviews were held with 204 providers over three rounds of data collection in Kenya and Ghana. The authors also conducted client exit interviews in 2013 and 2017 for a total of 106 patient interviews. Ten focus group discussions were conducted in Kenya and Ghana respectively in 2013 for a total of 171 FGD participants. A total of 13 in-depth interviews also were conducted with officials from the Ghana National Health Insurance Agency and the Kenya National Hospital Insurance Fund across four rounds of data collection. Provider interviews covered reasons for enrollment in the health insurance system, experiences with the accreditation process, and benefits and challenges with the system. Client exit interviews covered provider choice, clinic experience, and SHI experience. Focus Group Discussions covered the local healthcare landscape. Interviews with SHI officials covered officials\u2019 experiences working with private providers, and the opportunities and challenges they faced both accrediting providers and enrolling members. Private providers and patients agreed that SHI schemes are beneficial for reducing out-of-pocket costs to patients and many providers felt they had to become SHI-accredited in order to keep their facilities open. The SHI officials in both countries corroborated these sentiments. However, due to misunderstanding of the system, providers tended to charge clients for services they felt were above and beyond reimbursable expenses. Services were sometimes limited as well. Significant delays in SHI reimbursement in Ghana exacerbated these problems and compromised providers\u2019 abilities to cover basic expenses without charging patients. While patients recognized the potential benefits of SHI coverage and many sought it out, a number of patients reported allowing their enrollment to lapse for cost reasons or because they felt the coverage was useless when they were still asked to pay for services out-of-pocket at the health facility. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Africa Health Agenda International Conference 2019, 2030 Now: Multi-sectoral Action to Achieve Universal Health Coverage in Africa","field_subtitle":"Youth Pre-Conference 3-4 March 2019, General Admission 5-7 March 2019, Kigali, Rwanda","URL":"https://ahaic.org","body":"Every iteration of AHAIC builds on the success of the previous one to bring more nuance and action to conversations on health in Africa. The 2017 conference, which was held in Nairobi, Kenya, brought together over 1000 stakeholders to discuss systems and innovations needed to enable Africa to achieve the Sustainable Development Goals. AHAIC 2019 will convene stakeholders from across sectors and around the world to take forward critical conversations initiated in Nairobi to explore what it will take for Africa to achieve Universal Health Coverage (UHC) by 2030. Confirmed speakers include Dr Diane Gashumba, Minister of Health, Republic of Rwanda, Dr. Githinji Gitahi, Group CEO, Amref Health Africa and Dr. Matshidiso Moeti, Regional Director for Africa, World Health Organization. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Civil Society Statement on Universal Health Coverage ","field_subtitle":"People\u2019s Health Movement: PHM, December 2018","URL":"https://tinyurl.com/y7xuyhdt","body":"This statement from the People\u2019s Health Movement (PHM) asserts a commitment to Comprehensive Primary Health Care and addressing the Social, Environmental and Economic Determinants of Health. To make health care accessible to all, African governments are considering or have implemented policy reforms with a focus on achieving Universal Health Coverage (UHC). Examples include, the Community Based Health and Planning Services (CHPS) and National Health Insurance Scheme in Ghana; National Health Insurance Scheme in Uganda, expansion of the National Hospital Insurance Fund in Kenya, National Health Insurance in South Africa and Health Financing Policy and Strategy in Zimbabwe. These policy reforms in different ways aim to provide health financing to protect populations from impoverishing health care costs. Despite this momentum, many African countries still provide limited access to quality health services and only a small percentage of the population is protected from financial risks associated with health care costs. PHM identify that the dialogue on UHC in Africa is strongly influenced by the World Bank and other multilateral and bilateral donors, which promote UHC as predominantly a health financing mechanism. Issues of health equity, including a focus on access for the \u2018uncovered\u2019 poor, community participation and the strengthening of public health systems are largely ignored. Where UHC is framed as a health financing issue, rather than a human right or public good, and supports charging the poor for health coverage and the creation of health markets (privatisation). Instead PHM assert that PHC is the key to achieving health for all. Efforts to achieve UHC should prioritise reviving and strengthening public health systems in African countries within the Primary Health Care framework which permeates all levels of health care including addressing social determinants of health. The statement identifies actions needed towards addressing the social determinants of health, including: that policies for UHC need to clearly prioritise PHC at the primary and community levels. They argue that a whole of government approach must be applied to support UHC, including Health in All Policies, so that all ministries and departments of government are coordinated in promoting healthier working and living conditions and healthy lifestyles, preventing causes of disease and mortality, and supporting equitable access to health services. Further, governments should increase health sector spending to at least 15% of national budgets, as agreed in the 2001 Abuja Declaration. The PHM call for increased fiscal space by expanding and improving current tax collection measures; as well as implementing new taxes that ensure progressiveness and sustainability and strengthening prepayment mechanisms that pool resources.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Air pollution and child health: prescribing clean air","field_subtitle":"World Health Organisation: WHO, Geneva, 2018 ","URL":"https://www.who.int/ceh/publications/air-pollution-child-health/en/","body":"This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children\u2019s health from exposure to air pollution, a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013. This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines. More than one in every four deaths of children under 5 years is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under 5 years in 2016.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Assessing changes in social determinants of health inequalities in South Africa: a decomposition analysis","field_subtitle":"Omotoso K; Koch S: International Journal for Equity in Health 17(181) 1 -13, 2018","URL":"https://tinyurl.com/ybpzefdy","body":"This study examines how changes in the social determinants of health have impacted health inequalities in South Africa over the last decade, the second since 1994. Information collected on social determinants of health and on health status was obtained from the 2004, 2010 and 2014 questionnaires in the South African General Household Surveys. The health indicators considered include ill-health status and disability. Concentration indices and Oaxaca-Blinder decomposition of change in a concentration index methods helped to unravel changes in socio-economic health inequalities and their key social drivers over the studied time period. The results show that inequalities in ill-health are consistently explained by socio-economic inequalities relating to employment status. Provincial differences narrowed considerably over the studied periods. Relatedly, disability inequalities are largely explained by shrinking socio-economic inequalities relating to racial groups, educational attainment and provincial differences. The extent of employment, location and education inequalities suggests the need for improved health care management and further delivery of education and job opportunities.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Call for contributions to the journal Justice Spatiale | Spatial Justice","field_subtitle":"Deadline for Applications: 15 May 2019","URL":"http://www.jssj.org/appel-a-contributions/","body":"As part of its editorial programming for 2019-2021, the journal Justice Spatiale | Spatial Justice is opening a permanent call for contribution to its different sections : 1) Focus for peer review papers ; 2) Public Spaces for general interventions, interviews or position papers on issues related to spatial justice; 3) JSSJ Reviews for books reviews. Justice Spatiale | Spatial Justice is an international electronic journal whose concept was born in Nanterre, France, precisely where Henri Lefebvre taught, and this is in no way a coincidence as there is a strong relation between the concept of spatial justice and the Lefebvrian concepts of production of space (\u201cproduction de l\u2019espace\u201d) and right to the city (\u201cdroit \u00e0 la ville\u201d).  The journal Justice Spatiale | Spatial Justice is committed to interdisciplinary approaches and encourages cross-cutting research. Another primary objective is to create sustained linkages between the English-speaking and the French-speaking scientific communities. The journal is therefore completely bilingual. The electronic medium also has the potential to expand the traditional definition of the academic article since it enables the combination of text, images (static and animated) and sounds.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Challenges to tuberculosis control in Angola: the narrative of medical professionals","field_subtitle":"Brady P; Vita D: Journal of Public Health 40(4) 820\u2013826, 2018","URL":"https://tinyurl.com/yc5nzvau","body":"This study interviewed healthcare workers involved in tuberculosis (TB) control on what they consider to be the drivers of the TB epidemic in Angola. Twenty four in-depth qualitative interviews were conducted with medical staff working in this field in the provinces of Luanda and Benguela. The healthcare professionals see the migrant working poor as a particular problem for the control of TB. Migrants are constructed as \u2018Rural People\u2019 and are seen as non-compliant and late-presenting. This is a stigmatized and marginal group contending with the additional stigma associated with TB infection. The healthcare professionals interviewed also see the interruption of treatment and self-medication generally as a better explanation for the TB epidemic than urbanization or lack of medication. The local narrative is in contrast to explanations used elsewhere. To be effective policy must recognize the local issues of the migrant workforce, interruption of treatment and the stigma associated with TB in Angola.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Clinton Health Access Initiative (CHAI) \u2013 South Africa, Programme Manager: Sexual and Reproductive Health and Congenital Syphilis Programs ","field_subtitle":"Deadline for Applications: 28 February, 2019","URL":"https://tinyurl.com/y93g5eyh","body":"The Clinton Health Access Initiative (CHAI) is seeking a highly motivated individual with outstanding technical and managerial capabilities to play a key role in either the Sexual and Reproductive Health and/or Congenital Syphilis programs in South Africa.  The Program Manager will shape strategy, manage and provide technical input to a large and growing CHAI team. CHAI works in a fast-paced and results-driven environment. This individual would manage a growing team, at national and provincial levels, and shape CHAI\u2019s engagement. Thus, they should have exceptional communication and analytical skills, be a strong strategic thinker and be able to adapt to differing program needs. CHAI places great value on commitment to excellence, resourcefulness, responsibility, tenacity, flexibility, independence, energy, work ethic and humility. The Manager will be based in Pretoria, South Africa and report to CHAI South Africa\u2019s leadership team. The Manager\u2019s key responsibilities include, but are not limited to support NDoH in all areas ranging from either sexual reproductive health and/or congenital syphilis; with respect to planning and implementation, ensuring CHAI\u2019s ongoing alignment with the DoH strategic goals and priorities, oversee the translation of objectives provided by the government, donors, and other partner organizations into clear activity plans, and provide guidance to a team and DoH on prioritization of initiatives, manage and establish collaborative relationships with the DoH, suppliers, partner organizations and other relevant stakeholders. The qualifications and requirements for the position will include an advanced degree in a related field such as health economics, public health, financial management, business preferred, 5 to 7 years of professional experience in demanding, results-oriented environments in the public sector and/or private sector, excellent problem solving, analytical and quantitative skills, including attention to detail and experience in modeling using Microsoft Excel among others. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Clinton Health Access Initiative (CHAI) \u2013 South Africa, Senior Programme Manager: Sexual and Reproductive Health, Maternal and Neonatal Health (SRMNH)","field_subtitle":"Deadline for Applications: 28 February, 2019","URL":"https://tinyurl.com/y7nuclco","body":"The Clinton Health Access Initiative (CHAI) is seeking a highly motivated individual with outstanding technical and managerial capabilities to play a leadership role in the SRMNH program in South Africa.  The Senior Program Manager will shape strategy, manage and provide technical input to a large and growing CHAI team across the areas of Sexual Reproductive Health, Maternal Neonatal Health. S/he will work with a range of partners and subject matter experts and report into CHAI South Africa\u2019s leadership team.  The Manager will be based in Pretoria, South Africa and report to CHAI South Africa\u2019s leadership team. The key responsibilities will not be limited to the following supervise a team of CHAI staff working at the national and provincial level providing strategic direction, managerial and technical support as well as quality assurance for the portfolio, work with CHAI staff and the government in program areas ranging from sexual reproductive health and maternal and neonatal health, work with CHAI staff and the government in the scale-up of a health services including strategy and  design, development and implementation of evidence-based strategic and operational plans, manage senior level stakeholder relationships; coordinate and participate in technical working groups. The qualifications and requirements for the position will include an advanced degree in a related field such as health economics, public health, financial management, business preferred; a clinical background is an added advantage but not required, 7-10 years of professional experience in demanding, results-oriented environments in the public sector and/or private sector, entrepreneurial mindset; demonstrated ability to work independently on complex projects and solve challenging problems, in a high-pressure, fast-paced environment among others. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Coming Full Circle: How Health Worker Motivation and Performance in Results-Based Financing Arrangements Hinges on Strong and Adaptive Health Systems ","field_subtitle":"Kane S; Gandidzanwa C; Mutasa R; et al: International Journal of Health Policy and Management 8(2), doi: 10.15171/ijhpm.2018.98, 2018","URL":"https://www.ijhpm.com/article_3557_bd535847eb91a6ca69a79c78980ed2b3.pdf","body":"This paper presents findings from a study which sought to understand why health workers working under the results-based financing (RBF) arrangements in Zimbabwe reported being satisfied with the improvements in working conditions and compensation, but paradoxically reported lower motivation levels compared to those not working under RBF arrangements. A qualitative study was conducted amongst health workers and managers working in health facilities that were implementing the RBF arrangements and those that were not. Through purposeful sampling, 4 facilities in RBF implementing districts that reported poor motivation and satisfaction, were included as study sites. Four facilities located in non-RBF districts which reported high motivation and satisfaction were also included. Data was collected through in-depth interviews and analyzed using the framework approach. Findings reveal that insufficient preparedness of people and processes for this change, constrained managers and workers performance. Results based financing arrangements introduce explicit and tacit changes, including but not limited to, incentive logics, in the system. Findings show that unless systematic efforts are made to enable the absorption of these changes in the system: eg, through reconfiguring the decision space available at various levels, through clarification of accountability relationships, through building personnel and process capacities, before instituting changes, the full potential of the RBF arrangements cannot be realised. This study demonstrates the importance of analysing existing institutional, management and governance arrangements and capabilities and taking these into account when designing and implementing RBF interventions. Introducing RBF arrangements cannot alone overcome chronic systemic weaknesses. For a system wide change, as RBF arguably is, to be effected, explicit organisational change management processes need to be put in place, across the system. The authors argue that carefully designed processes, which take into account the interest and willingness of various actors to change, and which are cognizant of and constructively engage with potential bottlenecks and points of resistance, should accompany any health system change initiative.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Courts deliver big wins for environment","field_subtitle":"Sipho Kings: SangoNet Pulse, 2018","URL":"https://tinyurl.com/ydbcxnhl","body":"South Africa\u2019s environment law has a strange loophole. In theory, every activity that would harm the environment falls under the National Environmental Management Act (Nema) and the Acts linked to it. This allows the government to uphold everyone\u2019s constitutionally guaranteed right to a healthy environment. Nema is what should give the environment department teeth. But mining is exempt because of a 2014 takeover by the mineral resources department of most environmental oversight for mining. Now, far-reaching court decisions are pulling apart the way in which the mining department discharges its job of looking after the environment, and questioning how positive a development this has been. In a stinging rebuke last week, the high court ruled in defence of a wetland in Mpumalanga. This has created a precedent that rights groups say they will use to challenge other cases when mines threaten the environment. This decision follows a judgment earlier this month by the Constitutional Court in a case between residents of villages that fall under the Bakgatla Ba Kgafela tribal administration, near Rustenberg in the North West, and a would-be mining company. Read together, the environmental and land rights judgments are argued by the author to be a serious blow to the carte blanche attitude of the minerals department and its mandate to expand mining. Mining companies will now have to consult all residents. The minerals department will also have to do more than tick boxes based on information given by mines when it comes to looking after the environment.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 215: Include a gender and equity lens to effectively tackle antimicrobial resistance","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Header"}},{"node":{"title":"HIV prevalence in young people and children living on the streets, Kenya","field_subtitle":"Braitstein P; Ayuku D; DeLong A; Makori D; et al: Bulletin World Health Organisation 97(1) 33\u201341, 2019 ","URL":"https://www.who.int/bulletin/volumes/97/1/18-210211.pdf?ua=1","body":"This paper seeks to obtain an estimate of the size of and human immunodeficiency (HIV) prevalence among, young people and children living on the streets of Eldoret, Kenya. The authors counted young people and children using a point-in-time approach, ensuring the authors reached a target population by engaging relevant community leaders during the planning of the study. The authors acquired point-in-time count data over a period of 1 week between the hours of 08:00 and 23:00, from both a stationary site and by mobile teams. Participants provided demographic data and a fingerprint and were encouraged to speak with an HIV counsellor and undergo HIV testing. Of the 1419 eligible participants counted, 1049 were male with a median age of 18 years. Of the 1029 who spoke with a counsellor, 1004 individuals accepted HIV counselling and 947 agreed to undergo an HIV test. Combining those who were already aware of their HIV-positive status with those who were tested during this study resulted in an overall HIV seroprevalence of 4.1%. The seroprevalence was 2.7% for males and 8.9% for females. The authors observed an increase in seroprevalence with increasing age for both sexes, but of much greater magnitude for females. By counting young people and children living on the streets and offering them HIV counselling and testing, the authors could obtain population-based estimates of HIV prevalence.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Housing impacts health: New WHO Guidelines on Housing and Health","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"https://tinyurl.com/y7rt6lzl","body":"The quality of housing has major implications for people\u2019s health. Poor housing is associated with a wide range of health conditions such as respiratory diseases including asthma, cardiovascular diseases, injuries, mental health and infectious diseases including tuberculosis, influenza and diarrhoea.  Housing is becoming increasingly important to public health due to demographic and climate changes, according to the latest WHO Housing and health guidelines re\u00acleased today.  The guidelines provide new evidence-based recommendations on how to reduce major health risks associated with poor housing conditions in 4 areas:  Inadequate living space (crowding); low and high indoor temperatures; injury hazards in the home; and accessibility of housing for people with functional impairments.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Include a gender and equity lens to effectively tackle antimicrobial resistance","field_subtitle":"Sarah Simpson and Victoria Saint","body":"\r\nAntimicrobial resistance (AMR) is one of the most serious current threats to global public health, food security and thus development.  It may make standard treatments ineffective for many communicable diseases, including pneumonia, tuberculosis, malaria and HIV/AIDS.  Without effective antibiotics, chemotherapy and everyday dental and surgical procedures become increasingly dangerous, due to the risk of complications from infection.  \r\n\r\nAMR refers to the ability of microorganisms such as bacteria, viruses, and some parasites to stop antimicrobial medicines such as antibiotics, antivirals and antimalarials from controlling them.   \r\n\r\nOne of the reasons for this resistance across all countries is the overuse of antimicrobials, or use when they are not needed or suitable. This may happen in various sectors beyond the use of medicines in health services. It may happen, for example, in agriculture and aquaculture, such as to prevent infection and increase growth in chickens, cows or fish, and in the environment, where antibiotic residues may be found in waste water from humans and farms, together with unused medicines that are not properly disposed of.  \r\n\r\nSupporting this drive for change, a global action plan to tackle AMR was endorsed in 2015. The 2015 World Health Assembly set the goal of this global action plan as  \u201cto ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.\u201d\r\n\r\nThere is an urgent need for the world to change the way it prescribes and uses antibiotics to address AMR, rather than only relying on the development of more powerful antimicrobials. AMR is often talked about in terms of \u2018drugs and bugs\u2019. We need to move beyond this focus to think about how AMR and interventions to address it affect people in their day to day lives, at home, at work and in their communities. This is important if we are to ensure the reach, effectiveness and impact of the strategies used, so that they leave no one behind. We need to understand how men, women and different groups in society may have different levels of exposure to and risk of AMR, or different levels of impact from AMR, to identify ways of addressing them.  \r\n\r\nFor example, increasing antibiotic resistance and inadequate safe water and sanitation in health care institutions may raise women\u2019s risk during pregnancy and childbirth.  Women and men may have different levels of exposure and vulnerability to diseases that have already shown signs of AMR, such as tuberculosis, HIV, malaria, gonorrhea and urinary tract infections. The World Health Organization (WHO) observed that men who have sex with men may be at greater risk of getting drug-resistant strains of gonorrhea, as some may not seek treatment given the stigma they face. \r\n\r\nWomen make up 67% of the global health and social sectors workforce and are often concentrated in lower-level, lower-paid jobs, with unsafe working conditions. For example, health workers and cleaners may not be provided with gloves, masks and other protective clothing, leaving them exposed to resistant microbes through their work. Likewise in agricultural settings, people working without protective equipment or cleaning facilities with cattle, pigs and poultry that are infected with drug resistant bacteria may also be exposed to these strains. Workers infected with these resistant bacteria in their work may then spread them to family members and friends.\r\n\r\nThere are also different levels of knowledge and different attitudes and practices relating to the use of antibiotics amongst people, prescribers, policy makers and pharmacists. For example, younger people and those with less education may not have correct information and knowledge on what illnesses antibiotics work for. In 2014 in Spain, researchers found, for example, that young men were more likely to believe that antibiotics are effective against viruses such as flu (they are not) and to incorrectly seek prescriptions for antibiotics to manage such conditions. \r\n\r\nGiven that AMR is occurring everywhere in the world, it is critical to effectively cover all these negative effects. This means that in sectors with a known risk of AMR, there are measures to monitor which groups in the population may be experiencing higher exposures to and rates of AMR, or may not have sufficient access to quality-assured and affordable medicines when needed. Monitoring such health impacts thus needs not only to be undertaken by the health sector, but also by other sectors such as agriculture and environment. \r\n\r\nAs the examples in this editorial indicate, a strategy for effective coverage would need to pay attention to the differences in exposure, risk and impact between males and females and between different socioeconomic groups, taking features such as occupation and working conditions into account. It would need to analyse equity and gender differentials to ensure that no one is left behind.  \r\n\r\nA WHO working paper, \u2018Tackling antimicrobial resistance (AMR) together \u2013 Working Paper 5.0: Enhancing the focus on gender and equity\u2019 (https://tinyurl.com/yakxvzqo) addresses this issue. It explores how to include a focus on gender and equity in efforts to tackle AMR.\r\n\r\nIt highlights the need to better understand how gender and other social determinants affect the exposure and behavior of different groups in the population in relation to their use of antibiotics and to prescribing practices.   For example, it points to use of existing studies to tailor health campaigns and messages to better reach key groups such as young men or doctors or to reach settings where antimicrobials are mis- or over-prescribed, making use of diverse media. These include, for example, social media, YouTube videos and an interactive game on AMR. These resources can be found at http://apps.who.int/world-antibiotic-awareness-week/activities/en. The WHO paper also provides some guidance for countries on how to explore and manage gender and equity considerations in AMR in their national action plans.  The WHO secretariat is encouraging review, dissemination and feedback to the secretariat at whoamrsecretariat@who.int on this working paper, to support its use in practice.  \r\n\r\nIn July 2018 a WHO survey found that 100 of 194 member state countries had national action plans for AMR in place and 51 countries had plans under development. There is demand, scope and information now available to improve how these action plans are designed and implemented so that no one is left behind.  \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Mapping the constitutional provisions on the right to health and the mechanisms for implementation in Kenya","field_subtitle":"Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN): Case study report, KELIN, EQUINET, Kenya, 2018","URL":"https://tinyurl.com/yc83hf82","body":"This case study is produced by the Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN), working with Charles Dulo as a contributor, in the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). This Paper\u2019s objective is to answer the question, \u201cWhat difference have constitutional rights to health made in practice and what have been the issues affecting the capacity to claim and deliver on the rights in Kenya?\u201d It is a follow up on the results of work on the right to health that highlighted a need to do further studies in countries that do not have expressed provision on the rights to health. It is a desk review of literature that explores the historical background on the right to health before the current constitution that was promulgated in 2010. This is followed by a review of the legislative framework after 2010 and jurisprudence on the right health, and concludes by highlighting key challenges in the realization of the right to health in Kenya.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Moving to a strong(er) community health system: analysing the role of community health volunteers in the new national community health strategy in Malawi","field_subtitle":"Angwenyi V; Aantjes C; Kondowe K; Mutchiyeni J; et al:  British Medical Journal Global Health 3(e000996) 1-10, 2018 ","URL":"https://gh.bmj.com/content/bmjgh/3/Suppl_3/e000996.full.pdf","body":"This paper reviews Malawi\u2019s strategy, with particular focus on the interface between health surveillance assistants (HSAs), volunteers in community-based programmes and the community health team. The authors analysis identified key challenges that may impede the strategy\u2019s implementation inadequate training, imbalance of skill sets within community health team (CHT) and unclear job descriptions for community health volunteers (CHVs); proposed community-level interventions require expansion of pre-existing roles for most CHT members; and district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is argued to be needed on the appropriate CHV support, CHT composition with possibilities of co-opting trained CHVs from existing volunteer programmes into CHTs, review of CHT competencies and workload and strengthening coordination and communication across all community actors. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"New research chairs program will expand research and innovation in Africa","field_subtitle":"International Development Research Centre, South Africa\u2019s National Research Foundation (NRF): IRDC, December 2018","URL":"https://tinyurl.com/y8jjdulj","body":"IDRC and South Africa\u2019s National Research Foundation (NRF) have announced a new research chairs initiative. The OR Tambo Africa Research Chairs Initiative, named after Oliver Reginald Tambo, the pre-eminent South African leader and advocate of science and technology, will support up to 10 top researchers from across Africa over the next five years. Through international and regional strategic partnerships, the Chairs will contribute to the development of long-term mutually beneficial research collaborations on the continent. They will focus on world-class research in diverse fields and on training graduate students at leading universities in the 15 sub-Saharan African countries that make up the Science Granting Councils Initiative (SGCI), a collaboration between IDRC, NRF, the Swedish International Development Cooperation Agency, and the UK\u2019s Department for International Development. The application and selection process will be conducted using a two-phase approach coordinated by NRF, which will also manage the Chairs once awarded. The call for institutional expressions of interest was launched in December 2018 and the call for detailed chair-holder applications will be launched in May/June 2019. Councils participating in SGCI are expected to play a key role in the research and grants management, implementation, and sustainability of the Chairs.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Oral cholera vaccination in hard-to-reach communities, Lake Chilwa, Malawi","field_subtitle":"Grandesso F; Rafael F; Chipeta S; et al: Bulletin of the World Health Organization 96(12), doi: http://dx.doi.org/10.2471/BLT.17.206417, 2018","URL":"https://www.who.int/bulletin/volumes/96/12/17-206417/en/","body":"This study aimed to evaluate vaccination coverage, identify reasons for non-vaccination and assess satisfaction with two innovative strategies for distributing second doses in an oral cholera vaccine campaign in 2016 in Lake Chilwa, Malawi, in response to a cholera outbreak. The authors performed a two-stage cluster survey. The population interviewed was divided in three strata according to the second-dose vaccine distribution strategy: (i) a standard strategy in 1477 individuals (68 clusters of 5 households) on the lake shores; (ii) a simplified cold-chain strategy in 1153 individuals (59 clusters of 5 households) on islands in the lake; and (iii) an out-of-cold-chain strategy in 295 fishermen (46 clusters of 5 to 15 fishermen) in floating homes, called zimboweras. Vaccination coverage with at least one dose was 79.5%, on the lake shores, 99.3% on the islands and 84.7%  on zimboweras. Coverage with two doses was 53.0%  91.1%  and 78.8%  in the three strata, respectively. The most common reason for non-vaccination was absence from home during the campaign. Most interviewees liked the novel distribution strategies. Vaccination coverage on the shores of Lake Chilwa was moderately high and the innovative distribution strategies tailored to people living on the lake provided adequate coverage, even among hard-to-reach communities. Community engagement and simplified delivery procedures were critical for success. Off-label, out-of-cold-chain administration of oral cholera vaccine should be considered as an effective strategy for achieving high coverage in hard-to-reach communities. Nevertheless, coverage and effectiveness must be monitored over the short and long term.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Public Spending on Health: A Closer Look at Global Trends","field_subtitle":"Xu K; Soucat A; Kutzin J; et al: World Health Organisation, Geneva, 2018","URL":"https://tinyurl.com/y9fph8cb","body":"The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. This report also presents, for the first time, spending on primary health care and specific diseases and looks closely at the relationship between spending and service coverage. The report presents key messages: Global trends in health spending confirm the transformation of the world\u2019s funding of health services; domestic spending on health is central to universal health coverage, but there is no clear trend of increased government priority for health. Primary health care is a priority for expenditure tracking but Government spending accounts for less than 40% of primary health care spending. Allocations across disease and interventions differ between external and government sources. External funding to combat HIV/AIDS does not have a clear relationship with national prevalence or income level. The report argues that  the extent of financial protection of individuals is closely associated with government spending on health.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"SADC Member States participate in 16 Days of Activism Against Gender Based Violence Campaign","field_subtitle":"Dambuza K: SADC Secretariat Monthly Newsletter 12, December 2018","URL":"https://tinyurl.com/y9emyljb","body":"The Southern African Development Community (SADC) Member States joined the global community to raise their voices against gender based violence (GBV) during the 16 Days of Activism against GBV Campaign. This global Campaign runs from the 25 November to the 10 December of every year. For 2018, this Campaign was implemented under the global theme Orange Your World: #HearMeToo. The SADC Member States commemorated the 16 Days Campaign through localized themes and different activities involving stakeholders and the community. Key messages from some Members States are as follows: Botswana commemorated this Campaign day under the theme: \u201c#HearMeToo; End Violence Against Women and Children\u201d. His Excellency the President of Botswana Mokgweetsi Eric Keabetswe Masisi highlighted Botswana\u2019s commitment to various gender instruments among which is SADC Protocol on Gender and Development. Namibia used this Campaign to bring to the forefront the voices of women and girls who have survived violence and those who are defending women\u2019s rights. The Ministry of Family Affairs launched the 16 Days of Activism against GBV under a local theme of: \u201cOrange Seychelles: Say NO to Gender-Based Violence\u201d. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Temporal trends in the nutritional status of women and children under five years of age in sub-Saharan African countries: ecological study","field_subtitle":"Humbwavali J; Giugliani C; Silva I; Duncan B: Sao Paulo Medical Journal 136(5), 454-463, 2018","URL":"https://tinyurl.com/y9knm3tn","body":"This paper seeks to describe obesity trends among women of childbearing age over recent decades, along with trends in over and under nutrition among children under five years of age, in sub-Saharan African countries. An ecological study with temporal trend analysis in 13 sub-Saharan African countries was carried out covering trends in nutritional status such as adult obesity, childhood overweight, low height-for-age, low weight-for-height, low weight-for-age and low birth weight. Publicly available data from repeated cross-sectional national surveys were used. The authors chose 13 sub-Saharan African countries from which at least four surveys conducted since 1993 were available. The authors investigated women aged 15-49 years and children under five years of age. In multilevel linear models, the prevalence of obesity increased by an estimated 6 percentage points over 20 years among women of childbearing age, while the prevalence of overweight among children under 5 years old was stable. A major decrease in stunting and, to a lesser extent, wasting accompanied these findings. The upward trend in obesity among women of childbearing age in the context of highly prevalent childhood undernutrition suggests that the focus of maternal and child health in sub-Saharan Africa needs to be expanded to consider both nutritional deficiencies and nutritional excess.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The First FAO/WHO/AU International Conference on Food Safety: \u2018The Future of Food Safety: Transforming knowledge into action for people, economies and the environment\u2019","field_subtitle":"Addis Ababa, Ethiopia, 12-13 February, 2018","URL":"https://www.who.int/food-safety/international-food-safety-conference/","body":"Ongoing changes in climate, global food production and supply systems affect consumers, industry and the planet itself. These changes can have an impact on food safety systems and pose sustainability and development challenges. This is a pivotal moment demanding urgent reflection on actions needed to bolster food safety -the impetus for the two international meetings. At the Addis Ababa Conference, priorities will be discussed so that food safety strategies and approaches can be aligned across sectors and borders, reinforcing efforts to reach the SDGs and supporting the UN Decade of Action on Nutrition. Strategic actions will be defined through Ministerial panels involving health, trade and agriculture officials and experts thematic sessions covering the topics of: the burden of foodborne diseases and the benefits of investing in safe food; safe and sustainable food systems in an era of accelerated climate change; science, innovation and digital transformation at the service of food safety; empowering consumers to make healthy choices and support sustainable food systems. The conference will result in a high-level political statement advocating for increased and better coordinated collaboration and support to improve food safety globally.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Trade, investment and public health: compiling the evidence, assembling the arguments","field_subtitle":"Labont\u00e9 B: Globalisation and Health 15(1), doi: https://doi.org/10.1186/s12992-018-0425-y, 2019","URL":"https://tinyurl.com/yccxqlo2","body":"Trade has long been an axiomatic characteristic of globalization, although international rules governing trade are of more recent vintage. In the post-World War II period, an increasing number of countries began negotiating treaties to reduce, first, tariff barriers and, later, non-tariff barriers (government measures of any sort) that could impede the cross-border flow of goods. The rationale, in part, was that countries that became more entwined economically would be less likely to go to war with each other. It wouldn\u2019t be in their own economic interests to do so, or at least that of the firms based within their borders but engaged in transnational trade and dependent upon global supply chains. At first primarily an undertaking in high-income countries, low and middle-income countries slowly enjoined in what, in 1995, became the World Trade Organization. The WTO locked in scheduled declines in tariffs (border taxes), albeit with lesser obligations on low income country members. Importantly, a slew of new agreements that coincided with the establishment of the WTO also sought to liberalize trade in services and not just goods in the General Agreement on Trade in Services, with new rules for agricultural trade,  expanded intellectual property rights protections and other agreements ensuring that government food, health, or environmental regulations would not pose an unnecessary barrier to trade. Outside of the WTO system, bilateral or regional investment treaties grant special rights to foreign investors to sue governments for actions perceived to affect the value of their investment similarly exploded in number, dispute frequency, and the size of monetary claims. The breadth and depth of these post-1995 Agreements meant that few areas of general public health concern are potentially untouched. Given mounting evidence that trade and investment liberalization was creating and globally diffusing new health risks, public health researchers began focusing on the specific measures in trade and investment treaties that created such risks, primarily but not exclusively through constraining the \u2018policy space\u2019 for new public health regulations. Globalization processes affect health through multiple pathways and not simply through those more directly linked via changes in health systems.  This issue explores the methods and issues that this poses for research on globalisation and health.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Treatment Action Campaign celebrates two decades of fighting against the odds \u2014 and winning","field_subtitle":"Ho U: Daily Maverick, December 2018","URL":"https://tinyurl.com/yazxx8fe","body":"December 2018 marked the 20th anniversary of the birth of the Treatment Action Campaign (TAC); a story that began with a T-shirt with the slogan \u201cHIV-positive\u201d and came to be a thorn in government\u2019s side, a symbol of hope for people dying from HIV/Aids and an icon of activism still needed in an age of democracy. Days before the protest that founded the TAC, co-founder Zackie Achmat had spoken at the funeral of Aids activist Simon Nkoli. He vowed to fight for access to treatment, knowing from his own experience that if the right medicines were affordable and accessible people would not be dying. Four days after that protest action, activist Gugu Dlamini, who had disclosed her HIV status publicly, speaking on radio in Zulu on World Aids Day, was beaten to death in KwaMashu. \u201cThose two events created the anger and passion that would become the momentum for organising and mobilising,\u201d says co-founder Mark Heywood. As one more person put on an \u201cHIV-positive\u201d T-shirt and stood to challenge HIV stigma, more people joined. Recruitment and empowerment came through a strong treatment literacy programme rooted in spreading the word from neighbour to neighbour, patient to patient. This patient-driven, community activism would become a hallmark of the movement. It meant that people could see the power and the purpose in marching to the opening of Parliament each year, taking part in in civil disobedience campaigns and joining rallies for AZT for pregnant women and pushing big pharmaceutical companies to make drugs available. ","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"United Towards Achieving Health For All in Kenya","field_subtitle":"Kariuku S; Chatterjee S: Reliefweb, 2018","URL":"https://reliefweb.int/report/kenya/united-towards-achieving-health-all-kenya","body":"Of all the Sustainable Development Goals, few would rival good health as the definition of a country that has a sustainable, inclusive, peaceful and prosperous future. The authors observe that the launch in December 2018 of the pilot phase of Kenya\u2019s journey towards Universal Health Coverage (UHC) heralds a major step towards that future. In Kenya, health-related expenses are driving about one million into poverty every year, and health care is second only in demand on family spending to food in family budgets. Kenya announced that UHC will involve scaling up immunization, prevention of water borne, vector borne, TB, HIV and sexually transmitted diseases, improving maternal and child health as well as nutrition of pregnant women. Kenya will also focus on prevention of non-communicable diseases like diabetes and hypertension. With Kenya\u2019s Vision 2030 ambition of providing a high quality of life to all its citizens, the most urgent need is argued to be that of ensuring that everyone stays healthy to participate in economic development.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Using Health Committees to Promote Community Participation as a Social Determinant of the Right to Health: Lessons from Uganda and South Africa ","field_subtitle":"Mulumba M; London L; Nantaba J; Ngwena C: Health and Human Rights Journal 20(2), PMID: 30568398, 2018","URL":"https://tinyurl.com/y9s24oeg","body":" This paper provides perspectives from a three-year intervention whose general objective was to develop and test models of good practice for health committees in South Africa and Uganda. It describes the aspects that the authors found critical for enhancing the potential of such committees in driving community participation as a social determinant of the right to health.  Interventions in South Africa and Uganda indicate that community participation is not only a human right in itself but an essential social determinant of the right to health. The interventions show that health committees provide a mechanism that enables communities to be active and informed participants in the creation of a responsive health system that serves them efficiently. The results are argued to confirm the effectiveness of rights-based trainings and exchanges in strengthening committee members\u2019 sense of agency, their capacity to engage the health system, and their ability to exercise claims to health rights. They also contribute evidence of health committees\u2019 potential to play a critical role in advancing community participation as a social determinant of the right to health.\r\nThese participatory spaces are observed to bridge the gap between communities and health facilities, making services responsive to community needs and contributing to the realization of health as a human right.","php":"","field_issue_date":"2019-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A Healthier Humanity: The WHO Investment Case for 2019-2023","field_subtitle":"World Health Organisation: WHO, Geneva, 2018 ","URL":"https://tinyurl.com/yavqzjvk","body":"This investment case describes how a stronger, more efficient and results oriented WHO can serve and guide governments and partners in their efforts to improve the health of their populations and to achieve Sustainable Development Goal 3. The five years to 2023 will determine whether the world will achieve the health- related SDGs. WHO aims to achieve: One billion more people benefiting from Universal Health Coverage through improving access to quality essential health services, ensuring sustainable financing and availability of essential medicines, through qualified workforces, better governances and monitoring; One billion more people better protected from Health Emergencies through increasing preparedness, prevention, detection and response; One billion more people enjoying Better Health and Well-Being. Further, WHO commits to address specific health challenges through; improving human capital across the life course, noncommunicable disease prevention and mental health promotion, elimination and eradication of high-impact communicable diseases, tackling antimicrobial resistance and ensuring a healthy environment. WHO needs US$ 14.1 billion for 2019\u2013 2023 to deliver on the Triple Billion target, and drive impact in countries. This includes 2.5 billion for humanitarian and emergencies, 1.6 billion for polio eradication and 10.0 billion for the WHO base budget. Over the last decade WHO has seen a rise of earmarked voluntary contributions. Partners are requested to increase flexible sources available to WHO, including funding for strategic priorities and regional funding. \r\n","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"A longitudinal review of national HIV policy and progress made in health facility implementation in Eastern Zimbabwe","field_subtitle":"Tlhajoane M; Masoka T; Mpandaguta E; Rhead R; et al: Health Research Policy and Systems 16 (92) 1-13, 2018 ","URL":"https://tinyurl.com/y9s59dqy","body":"In this longitudinal study from 2013 to 2015 the authors sought to establish how World Health Organization (WHO) HIV guidelines changes have been translated into national policy in Zimbabwe and to measure progress in implementation within local health facilities. National HIV programme policy guidelines published between 2003 and 2013 and 2014 and 2015 were reviewed to assess adoption of WHO recommendations on HIV testing services, prevention of mother-to-child transmission of HIV, and provision of antiretroviral therapy (ART). Changes in local implementation of these policies over time were measured in two rounds of a survey conducted at 36 health facilities in Eastern Zimbabwe in 2013 and 2015. High levels of adoption of WHO guidance into national policy were recorded, including adoption of new recommendations made in 2013\u20132015. New strategies to implement national HIV policies were introduced such as the decentralisation of ART services from hospitals to clinics and task-shifting of care from doctors to nurses. The proportions of health facilities offering free HIV testing and counselling, prevention of mother-to-child transmission and ART services increased substantially from 2013 to 2015, despite reductions in numbers of health workers. Provision of provider-initiated HIV testing remained consistently high. At least one test-kit stock-out in the prior year was reported in most facilities. Stock-outs of first-line ART and prophylactic drugs for opportunistic infections remained low. Repeat testing for HIV-negative individuals within 3 months decreased. Laboratory testing remained low across both survey rounds, despite policy and operational guidelines to expand coverage of diagnostic services. Good progress has been made in implementing international guidance on HIV service delivery in Zimbabwe. The authors suggest that further novel implementation strategies may be needed to achieve the latest targets for universal ART eligibility.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Africa Health","field_subtitle":"28 May- 30 May, Johannesburg, South Africa","URL":"https://tinyurl.com/y9fa87dt","body":"Africa Health gathers innovations in healthcare, from state-of-the-art imaging equipment to the most cost-effective disposables; developments in surgery to advances in prosthetics, coming in from more than 40 countries. The show is free to visit if one registers before 28 May 2019. Accompanying the exhibition is a number of business, leadership and Continuing Professional Development (CPD) conferences and workshops providing the very latest updates and insights into cutting edge procedures, techniques and skills. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for contributions \"Pesticide Politics in Africa\" ","field_subtitle":"Conference 29th-31st May 2019, Tropical Pesticide Research Institute (TPRI), Arusha, Tanzania","URL":"http://iris.ehess.fr/index.php?4187","body":"The current economic boom in many sub-Saharan countries is accompanied by an unprecedented increase in noncommunicable diseases (NCDs) due to industrial pollution, including pesticides. While local and international mobilizations call for more stringent pesticide control measures, African governments often refrain from adopting and enforcing strict regulations \u2013 considered as potential obstacles to \u201cdevelopment\u201d. This interdisciplinary conference aims at laying the foundations for a long-term scientific cooperation between African and European scholars on the management of pesticide-related occupational and environmental health hazards in Africa. It aims at exploring the trade-offs between production and prevention that underlie the expansion of chemical-intensive agriculture on the continent, to understand the relations between technique, knowledge and power that condition the inclusion of African populations in the globalized economy, and to grasp the resulting health and environmental inequalities. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Diabetes to be South Africa's leading killer by 2040, study shows","field_subtitle":"Kahn T: BusinessDay, 2018","URL":"https://tinyurl.com/y8urwbzt","body":"South Africans are likely to live, on average, seven years longer in 2040 than they do now, but the country will see only modest improvement in its global ranking as longevity increases worldwide, according to a study published in the Lancet. SA had an average life expectancy of 62.4 years in 2016, and ranked 171 among 195 countries. If recent health trends continue, SA could see life expectancy increasing to 69.3 years. But it will only rise two places in the global rankings, to 169, as life expectancy is expected to increase in most countries. The authors of the study forecast a range of scenarios for each country, which for SA show that life expectancy could increase by as much as 12.9 years to 75.3 years if the country stepped up its efforts to improve the health of the nation. But in the worst-case scenario, life expectancy could fall by as much as 8.1 years. The study forecast a large global shift in deaths from infectious diseases to deaths from noncommunicable diseases such as diabetes, chronic obstructive pulmonary disease, kidney disease and lung cancer. The top 10 causes of death in SA in 2016 were HIV/Aids, lower respiratory infections, road injuries, interpersonal violence, tuberculosis, diabetes, ischemic heart disease, diarrhoeal diseases, stroke and premature birth complications. By 2040, however, diabetes will be the leading cause of death, followed by road injuries, lower respiratory infections, HIV/AIDS, interpersonal violence, ischemic heart disease, tuberculosis, chronic kidney disease, stroke and diarrhoeal diseases.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Empowering frontline providers to deliver universal primary healthcare using the Practical Approach to Care Kit","field_subtitle":"Fairall L; Cornick R; Bateman E: BMJ, doi: https://doi.org/10.1136/bmj.k4451, 2018","URL":"https://www.bmj.com/content/363/bmj.k4451","body":"Global efforts to strengthen primary healthcare are observed by the authors to have generally not focused on the critical interface between provider and patient but rather on policy, financing and infrastructure. Over the past two decades the Knowledge Translation Unit at the University of Cape Town has worked with government, academic, and non-governmental organisation partners to develop and evaluate health systems innovations that empower frontline providers. The unit developed the Practical Approach to Care Kit (PACK), a programme that covers primary healthcare needs across the life course. At the centre of the programme are concise clinical decision support tools (guides) comprising standardised and user friendly algorithms and checklists that provide a comprehensive and integrated approach to screening, diagnosing, and treating common symptoms and chronic conditions in adults, adolescents, and children. The accompanying training programme uses case-based, short training sessions delivered by existing health staff to support frontline providers and their teams. PACK provides decision support tools and training to support frontline providers in low and middle income countries. It prompts primary care health workers to claim \u201csystem agency\u201d based on an intervention that resonates with their primary identity as clinicians. The authors suggest that delivering on universal primary healthcare requires a change in investments to prioritise comprehensive approaches that can meet the changing burden of disease","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 214: Wishing you a creative, collaborative, healthy 2019","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evaluating health research priority-setting in low-income countries: a case study of health research priority-setting in Zambia","field_subtitle":"Kapiriri L; Schuster-Wallace C and Chanda-Kapata P: Health Research Policy and Systems 16(105) 1-12, 2018 ","URL":"https://tinyurl.com/ycp63b9p","body":"This paper describes and evaluates health research priority-setting in Zambia from the perspectives of key stakeholders using an internationally validated evaluation framework. This was a qualitative study based on 28 in-depth interviews with stakeholders who had participated in the priority-setting exercises. An interview guide was employed. Emerging themes were, in turn, compared to the framework parameters. Although there is apparent commitment to health research in Zambia, health research priority-setting is limited by lack of funding, and consistently used explicit and fair processes. The designated national research organisation and the availability of tools that have been validated and pilot tested within Zambia provide an opportunity for focused capacity strengthening for systematic prioritisation, monitoring and evaluation. The authors observe that the utility of the evaluation framework in Zambia could indicate potential usefulness in similar low-income countries.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Exploring power and privilege through photovoice","field_subtitle":"Ardrey J: Liverpool School of Tropical Medicine and Health Systems Global, UK","URL":"http://healthsystemsresearch.org/hsr2018/news/exploring-power-and-privilege-through-photovoice/","body":"At the recent HSR2018 Symposium delegates explored how to challenge embedded power dynamics in health systems research through participatory methodologies. One of the innovations that the Local Organising Committee (LOC) introduced for HSR2018 was the inclusion in the programme of a multi-project Photovoice exhibition. Photovoice is a participatory action research methodology that involves the taking of images by individuals, the discussion and analysis of these images and the use of the images to communicate the lived experiences, strengths and challenges of the photographers. Colleagues commented that this was the largest health based Photovoice exhibition to date but more significant was the scope of the material displayed. The author argues that Photovoice exhibition activities are a great representation of the strength and challenges of using this visual participatory methodology. Using photos can promote the voice of the less powerful seems such a laudable and simple aim but it is important not to overlook the underlying power shifting aims of the methodology. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Free online course: Global Health and Disability: Leaving no one behind","field_subtitle":"International Centre for Evidence in Disability: UK, 2018","URL":"https://www.futurelearn.com/courses/global-disability/4%C2%A0","body":"Around 15% of the world\u2019s population, or 1 billion people, live with some form of disability, with numbers continuing to rise over the coming decades. People with disabilities are often overlooked in national and international development, and can face widespread barriers in accessing services, including health and rehabilitation services, even though simple initiatives are available to enable access. This three week course aims to raise awareness about the importance of health and well-being of people with disabilities in the context of the global development agenda: Leaving no one behind. \r\n","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Government resource contributions to the private-not-for-profit sector in Uganda: evolution, adaptations and implications for universal health coverage","field_subtitle":"Ssennyonjo A, Namakula J, Kasyaba R et al.: International Journal for Equity in Health https://doi.org/10.1186/s12939-018-0843-8, 2018","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0843-8","body":"This case study examined government resource contributions (GRCs) to private-not-for-profit (PNFP) providers in Uganda. It focuses on Primary Health Care (PHC) grants to the largest non-profit provider network, the Uganda Catholic Medical Bureau (UCMB), from 1997 to 2015. The framework of complex adaptive systems was used to explain changes in resource contributions and the relationship between the Government and UCMB. Documents and key informant interviews with the important actors provided the main sources of qualitative data. Trends for GRCs and service outputs for the study period were constructed from existing databases used to monitor service inputs and outputs. The case study\u2019s findings were validated during two meetings with a broad set of stakeholders. Three major phases were identified in the evolution of GRCs and the relationship between the Government and UCMB: 1) Initiation, 2) Rapid increase in GRCs, and 3) Declining GRCs. The main factors affecting the relationship\u2019s evolution were: 1) Financial deficits at PNFP facilities, 2) advocacy by PNFP network leaders, 3) changes in the government financial resource envelope, 4) variations in the \u201cgood will\u201d of government actors, and 5) changes in donor funding modalities. Responses to the above dynamics included changes in user fees, operational costs of PNFPs, and government expectations of UCMB. Quantitative findings showed a progressive increase in service outputs despite the declining value of GRCs during the study period. The authors concluded that GRCs in Uganda have evolved influenced by various factors and the complex interactions between government and PNFPs. The Universal Health Coverage (UHC) agenda should pay attention to these factors and their interactions when shaping how governments work with PNFPs to advance UHC. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"How courts are failing the mentally ill","field_subtitle":"Kwagala P: New Vision, Uganda, 2018","URL":"https://www.newvision.co.ug/new_vision/news/1480232/courts-failing-mentally-ill","body":"The author outlines a court case in which the judgment raises concerns that some judicial officers hold deeply misguided notions regarding people with mental health issues, which deprives them of access to justice. Such attitudes are noted to not be restricted to judicial practitioners and discrimination to be nationwide. The judiciary as protectors of the rule of law are argued to be held to a higher standard. In 2014, Mental Health Uganda and Validity (formerly the Mental Disability Advocacy Centre \u2013 MDAC) published research uncovering widespread abuse, ill-treatment and appalling conditions in Uganda\u2019s regional mental health facilities as well as Butabika. The research also investigated the experiences of people in their communities. The report found that most people with mental health issues experience high levels of violence and neglect at the hands of community members and public officials. The lack of local community mental health and psychosocial support services meant that many found themselves pushed towards unregulated traditional and faith-based healers. Many people recounted having endured unspeakably cruel practices including chaining, cutting the skin, being tied to trees, beatings and daily, casual prejudice. The author argues that the law needs to ensure people can access consensual mental health treatment in the community, with the aim of supporting independence and social inclusion. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Mandela Institute for Development Studies Scholarship Programme: Fellowships and Scholarships","field_subtitle":"There is no deadline for submission","URL":"https://minds-africa.org","body":"Mandela Institute for Development Studies is looking for individuals with a Pan-African outlook, strong leadership potential and a track record of academic excellence. Applications must demonstrate these elements convincingly. Mandela Institute for Development Studies encourages applicants to consider universities that are outside of South Africa. There are two scholarships available for South African citizens wishing to study elsewhere in Africa for studies that relate to Actuarial Sciences, Business Sciences and Accounting. Applicants who wish to conduct such studies at any of the South African, Kenyan and Nigerian institutions that are on the preferred list are encouraged to apply. There is no deadline for submission. Applicants - who meet the criteria - should apply as soon as they have all supporting documents needed submit the application. Mandela Institute for Development Studies will review applications as they are submitted and aim to award scholarships per different university cycles on the continent.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Oral cholera vaccine coverage during a preventive door-to-door mass vaccination campaign in Nampula, Mozambique. ","field_subtitle":"Sema  Baltazar C; Rafael F; Langa J; Chicumbe S; et al: PLoS ONE 13(10) 1-13, 2018 ","URL":"https://tinyurl.com/yc434jc5","body":"In October 2016, the Mozambique Ministry of Health implemented a mass vaccination campaign using a two- dose regimen of the ShancholTM OCV in six high-risk neighborhoods of Nampula city, in Northern Mozambique. Overall 193,403 people were targeted by the campaign, which used a door-to-door strategy. During campaign follow-up, a population survey was conducted to assess oral cholera vaccine coverage, frequency of adverse events following immunization, vaccine acceptability and reasons for non-vaccination. In the absence of a household listing and clear administrative neighborhood delimitations, the authors used geospatial technology to select households from satellite images and used the support of community leaders. One person per household was randomly selected for interview. In total, 636 individuals were enrolled in the survey. The overall vaccination coverage with at least one dose was 69.5% and the two-dose coverage was 51.2%. The campaign was well accepted. Among the 185 non-vaccinated individuals, 83 did not take the vaccine because they were absent when the vaccination team visited their houses. Among the 451 vaccinated individuals, 47 reported minor and non-specific complaints, and 78 mentioned they did not receive any information before the campaign.  In spite of overall coverage being slightly lower than expected, the use of a mobile door-to-door strategy remains a viable option even in densely-populated urban settings. The authors\u2019 results suggest that campaigns can be successfully implemented and well accepted in Mozambique in non-emergency contexts in order to prevent cholera outbreaks.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Participatory meetings in Harare on health and wellbeing of urban youth, 2016-7","field_subtitle":"Training and Research Support Centre (TARSC), Civic Forum on Human Development (CFHD): EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/UH%20Lusaka%20Mtg%20Rep%20June2018%20fw_0.pdf","body":"TARSC as cluster lead of the \u201cEquity Watch\u201d 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.\r\n","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Ready to deliver maternal and newborn care? Health providers\u2019 perceptions of their work context in rural Mozambique","field_subtitle":"Mocumbi S; McKee K; Munguambe K; Chiau R; et al: Global Health Action, 11(1) 1-13, 2018","URL":"https://tinyurl.com/ycl9wwa7","body":"In this paper, the authors investigated the comprehensibility and the internal reliability of Context Assessment for Community Health and its use to describe the healthcare context as perceived by health providers involved in maternal care in Mozambique. The cross-sectional survey using Context Assessment for Community Health, which contains 49 items assessing eight dimensions, was administered to 175 health providers in 38 health facilities within six districts in Mozambique. Analysis of the survey data indicated that items on all dimensions were rated highly, revealing positive perception of context. Significant differences between districts were found for the work culture, leadership, and Informal payment dimensions.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Receding Malawi lake lays bare cost of climate change","field_subtitle":"AFP: Times Live, South Africa, 2018","URL":"https://www.timeslive.co.za/news/africa/2018-11-27-receding-malawi-lake-lays-bare-cost-of-climate-change/","body":"Just four months ago, the fishing harbour at Kachulu on the western shores of Lake Chilwa in Malawi was bustling with fishermen and traders haggling over the catch of the day. Today hundreds of fishing boats sit marooned on cracked, dry mud as vultures fly above the shores of the once productive fishing zone 30 kilometres (19 miles) east of the southern African country's old capital Zomba. Julius Nkhata, a local villager, says the increasingly dramatic seasonal dry-out of the lake -- blamed by experts on man-made climate change -- has displaced local people and increased joblessness. One-and-a-half million people live in the areas on the Lake Chilwa basin, which is one of the most densely populated areas in southern Africa. Nixon Masi, a government fishery official at Chilwa, said a women's fish-drying cooperative that depends on the lake had been devastated. \"There is no fish. This has resulted in a big problem as the women from the cooperative have no source of income,\" he said. Of the initial 38 members, 21 have left to rebuild their lives elsewhere.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The International Health Regulations and health systems strengthening in east and southern Africa: A desk review","field_subtitle":"Machemedze R: EQUINET discussion paper 116, SEATINI, TARSC, EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20IHR%20Diss%20116.pdf","body":"This review paper examines the extent to which the core, public health capacities developed for the 2005 International Health Regulations (IHR) are also being applied in a manner that supports health systems strengthening (HSS). Produced under the Regional Network for Equity in Health in East and Southern Africa (EQUINET), the paper reviews evidence on the IHR 2005 design, capacities and implementation on HSS in east and southern African countries, particularly in relation to: a. Capacities of community health and primary-level health personnel and service capacities, including health information systems to this level; b. Public health system capacities and functioning relevant to food safety; and c. Ensuring laboratory and pharmaceutical personnel capacities. The paper explores the synergies and opportunities being generated, or not, between investments in IHR implementations and these three areas of HSS in the 16 ESA countries covered by EQUINET. It identifies key weaknesses and challenges and highlights case studies of good practice within the region.","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Transforming the workplace environment to prevent non-communicable chronic diseases: participatory action research in a South African power plant","field_subtitle":"Schouw D, Mash R, Kolbe-Alexander T: Global Health Action, 11:1, DOI: 10.1080/16549716.2018.1544336, 2018","URL":"https://www.tandfonline.com/doi/full/10.1080/16549716.2018.1544336","body":"The workplace is an important setting for the prevention of non-communicable diseases (NCDs). Policies for transformation of the workplace environment for occupational health and safety in South Africa have focused more on what to do and less on how to do it. There are no guidelines and little evidence on workplace-based interventions for NCDs. This study aimed to learn how to transform the workplace environment in order to prevent and control cardio-metabolic risk factors for NCDs amongst the workforce at a commercial power plant in Cape Town, South Africa. The study used participatory action research in the format of a cooperative inquiry group (CIG). The researcher and participants engaged in a cyclical process of planning, action, observation and reflection over a two-year period. The group used outcome mapping to define the vision, mission, boundary partners, outcomes and strategies required. At the end of the inquiry the CIG reached a consensus on their key learning. Substantial change was observed in the boundary partners: catering services (78% of progress markers achieved), sport and physical activities (75%), health and wellness services (66%) and managerial support (65%). Highlights from a 10-point consensus on key learning included the need for: authentic leadership; diverse composition and functioning of the CIG; value of outcome mapping; importance of managerial engagement in personal and organizational change; and making healthy lifestyle an easy choice. Transformation included a multifaceted approach and an engagement with the organization as a living system. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"What Are Governments Spending on Health in East and Southern Africa?","field_subtitle":"Piatti-F\u00fcnfkirchen M; Lindelow M; Yoo K: Health Systems and Reform, doi: 10.1080/23288604.2018.1510287, 2018","URL":"https://www.tandfonline.com/doi/full/10.1080/23288604.2018.1510287","body":"This article reviews trends and patterns of government spending in the East and Southern Africa region. It points out methodological challenges with interpreting data from the World Health Organization\u2019s (WHO) Global Health Expenditure Database (GHED) and other sources. Government expenditure for health has increased for most countries, albeit at a slower rate than gross domestic product (GDP). In most countries there has been a prioritization away from health in government budgets, putting the onus on the private sector and external funders to fill the gap. Reliance on external funding is important in the region but argued to be inconsistent with countries\u2019 stated ambitions of universal health coverage. A number of methodological challenges with estimating health expenditures are identified. Capturing health expenditures adequately across agencies and levels of decentralization can be challenging, and off-budget funds and arrears are evasive. Measurement error can be significant because actual expenditure information can be hard to come by and is often dated and unreliable. Furthermore, how external financing is captured will affect government health expenditure estimates. These factors have contributed to differences in expenditure estimates between WHO and country-specific public expenditure reviews and complicate interpretation. The article concludes that it is critical to strengthen national data capacity and international efforts to promote quality and consistency of data. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Wishing you a creative, collaborative, healthy 2019","field_subtitle":"Editor, EQUINET  newsletter","body":"\r\nWe are starting a new year as the old one ended with a stark warning from Tedros Ghebreyesus, the WHO director-general. \u201cWe cannot delay action on climate change. We cannot sleepwalk through this health emergency any longer.\u201d\r\n\r\nA Lancet Countdown on Health and Climate Change reports that global warming is affecting every aspect of human life, not only in terms of extremes of weather but in terms of falling food security and  access to safe drinking water and clean air. \r\n\r\nIn our region, where people are highly dependent on agriculture, vulnerable to drought and flooding and already facing a deficit in food security, safe water and clean energy, the impact is reported to be increasing already intense social inequality.  WHO estimates that almost one in four premature deaths in Africa have environmental causes, and that climate change is likely to increase the number of health emergencies and disease outbreaks.\r\n\r\nIn November this year, African ministers for health and environment adopted a ten-year framework to direct funds toward joint health and environment initiatives. The Strategic Action Plan to Scale Up Health and Environmental Interventions in Africa 2019-2029 is expected to promote government investment in addressing environmental problems that affect human health, such as air pollution, contamination of water sources, and ecosystem damage.\r\n\r\nThese are important commitments. But in our region most governments are not yet fulfilling the commitment they made in 2011 to allocate 15% of domestic government spending on health. Underfunded health sectors struggle to balance the demand for promotion, prevention and medical care and often retreat into the latter. \r\n\r\nClimate change demands global co-operation and resources. During the COP 16, the world's high income countries agreed to mobilize 100 billion US dollars per year by the year 2020 for adaptation and mitigation in low income countries, through a Green Climate Fund (GCF). We are nearly at 2020 and it is reported by IPS that only 10 billion US dollars has been mobilized so far since the establishment of the Fund in 2006.\r\n\r\nRaising the health consequences of climate change is an important lever for attention and action on these concerns. It should also be a means to put people, social justice and solidarity at the centre of this. The opposite is feared to be happening. For example, at the November World Innovation for Health Summit it was noted that effects such as \u2018environmental migrancy\u2019, as people move away from harsh conditions, and the competition for resources can generate self-protection and discrimination. Vandana Singh, author and professor urges that these challenges not make us surrender \u201cour imaginations, our creativity, our wonderful human capacity to work together, to negotiate and argue and brainstorm\u2014on the altar of fear\u201d.  The solutions to these complex issues are not simply technical. They are inherently social and thus political.\r\n\r\nSo on this and the many other challenges that will certainly confront us in 2019, we wish you righteous anger, imagination and creativity and deepening opportunities to work together, negotiate,  argue and brainstorm in the interest of our collective health and wellbeing. ","php":"","field_issue_date":"2019-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":" CATCH","field_subtitle":"Rees-Roberts D; Cooke P: 2016","URL":"http://www.catchshortfilm.com","body":"CATCH is a fictional short film about a father and daughter quarantined in their home in a post-antibiotic world. CATCH is set in a near future world where antibiotic resistance has made antibiotics useless. Although that is a real potential future, the producers argue that it is possible to work now to stop that future from happening. There are lots of simple things people can all do to try to avoid the post-antibiotic future portrayed in CATCH: Always wash hands when handling and preparing food to avoid cross-contamination, especially between raw and ready-prepared food. Never pressure a doctor for antibiotics, as antibiotics can only treat bacterial infections. Never take unprescribed antibiotics. Always finish a prescribed course of antibiotics. Never stop taking antibiotics before the course is finished as prescribed - even if one starts feel better, see it through to the end. Raise awareness about the issue of antibiotic resistance, and what communities can do to combat it. Talk to friends, family, colleagues, and local politicians!","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"An analysis of the nutrition status of neighboring Indigenous and non-Indigenous populations in Kanungu District, southwestern Uganda: Close proximity, distant health realities","field_subtitle":"Sauer J; Berrang-Ford L; Patterson K; Donnelly B: Social Science & Medicine 217, 55-64, 2018","URL":"https://tinyurl.com/ybhknqqx","body":"This paper analyzed the estimated prevalence, and modeled possible determinants of, moderate acute malnutrition and severe acute malnutrition (SAM) for Indigenous Batwa and non-Indigenous Bakiga of Kanungu District in Southwestern Uganda. The authors characterize possible mechanisms driving differences in malnutrition. Retrospective cross-sectional surveys were administered to 10 Batwa communities and 10 matched Bakiga Local Councils during April of 2014. Individuals were classified as moderate acute malnutrition and SAM based on middle upper-arm circumference for their age-sex strata. Malnutrition is high among Batwa children and adults, with nearly half of Batwa adults and nearly a quarter of Batwa children meeting moderate acute malnutrition criteria. SAM prevalence is lower than moderate acute malnutrition prevalence, with SAM highest among adult Batwa males. SAM prevalence among children was higher for Batwa males compared to Bakiga males. Models that incorporated community ethnicity explained the greatest variance in middle upper-arm circumference values. This research demonstrates inequality in malnutrition between the Indigenous Batwa and non-Indigenous Bakiga of Kanungu District, Uganda, with model results suggesting further investigation into the role of ethnicity as an upstream social determinant of health.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Antibiotic resistance has a language problem","field_subtitle":"Mendelson M;  Balasegaram M; Jinks T: Nature, May 2017","URL":"https://tinyurl.com/y74aaesz","body":"Clinicians have long known that microbes such as bacteria, viruses and fungi are becoming alarmingly resistant to the medicines used to treat them. But a global response to this complex health threat \u2014 commonly termed 'antimicrobial resistance' \u2014 requires engagement from a much broader array of players, from governments, regulators and the public, to experts in health, food, the environment, economics, trade and industry. The authors argue that people from these disparate domains are talking past each other. Many of the terms routinely used to describe the problem are misunderstood, interpreted differently or loaded with unhelpful connotations. In 2017, the United Nations formed an interagency group to coordinate the fight against drug resistance urging that, as one of its first steps, the group coordinate a review of the terminology used by key actors. They proposed that drug-resistant infection be the overarching term used (in English) to describe infections caused by organisms that are resistant to treatment, including those caused by bacteria that do not respond to antibiotics. They also noted that a blame narrative is unhelpful, failing to acknowledge symbiotic relationships with bacteria. Because terminology has geographic, disciplinary and societal variations that affect understanding and interpretation, research is argued to be needed to optimize the lexicon across different countries and languages. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Botswana Labour Migrants Association (BoLAMA) ","field_subtitle":"BoLAMA: Botswana, 2018","URL":"https://www.youtube.com/watch?v=CguTMeTcusg","body":"Botswana Labour Migrants Association (BoLAMA) is a non-profit organization registered in accordance with the laws of Botswana. The organization is comprised of former migrant mineworkers and their beneficiaries. The organization provides assistance to ex-miners and their beneficiaries by facilitating their access to social security benefits most of which involves occupational compensation from mines. Among other issues BoLAMA works to address social determinants of TB in mining communities. TB is the leading cause of death among ex-miners and it contributes to the socio-economic status of ex-miners. BoLAMA\u2019s mandate is in line with various prescribes and targets set in global, continental, regional and national mining sector related instruments, protocols and frameworks. BoLAMA carries out its work under three (3) thematic areas:- extractives, labour migration and economic empowerment.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Call for contributions \"Pesticide Politics in Africa\" ","field_subtitle":"Conference 29th-31st May 2019, Tropical Pesticide Research Institute (TPRI), Arusha, Tanzania","URL":"http://iris.ehess.fr/index.php?4187","body":"The current economic boom in many sub-Saharan countries is accompanied by an unprecedented increase in non-communicable diseases (NCDs) due to industrial pollution, including pesticides. While local and international mobilizations call for more stringent pesticide control measures, African governments often refrain from adopting and enforcing strict regulations \u2013 considered as potential obstacles to \u201cdevelopment\u201d. This interdisciplinary conference aims at laying the foundations for a long-term scientific cooperation between African and European scholars on the management of pesticide-related occupational and environmental health hazards in Africa. It aims to explore the trade-offs between production and prevention that underlie the expansion of chemical-intensive agriculture on the continent, to understand the relations between technique, knowledge and power that condition the inclusion of African populations in the globalized economy, and to grasp the resulting health and environmental inequalities. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Calling for a New Global Economic Order","field_subtitle":"PHM, Wemos: Astana, November 2018","URL":"https://vimeo.com/297147040","body":"In 1978, the Alma-Ata International Conference on Primary Health Care stated, in its final declaration, that \u201ceconomic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all.\u201d In Astana at the Cafe Session this video shares why this call is still relevant today and why it should be recalled and renewed now the world celebrates the 40th Anniversary of the Alma-Ata Declaration at the Global Conference on Primary Health Care in Astana, on 25-26 October. The film reminds that Primary Health Care is more than basic health care and some sort of financial protection but rather a radical comprehensive concept based on economic justice. The video calls for a new economic global order as was called for in 1978.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"CODESRIA 15th General Assembly. Theme: Africa And the Crisis of Globalization","field_subtitle":"17\u201321 December,2018, Dakar, Senegal","URL":"https://codesria.org/generalassembly15/","body":"The CODESRIA General Assembly is a triennial gathering of scholars and academics drawn from the Social Sciences and Humanities in Africa and its Diaspora. On the back of the scientific sessions of the Assembly, a meeting of members who are in good standing will be held to review the functioning of the Council in the period since the 14th Assembly and decide the broad agenda to be pursued for the subsequent three years. Broad themes for the General Assembly include: Globalisation, its itinerary and iterations, Africa in the iterations of globalisation, Pan-Africanism and African regional integration, The African nation-state and globalization, Peace, security and Africa\u2019s geopolitics, Planning, policy processes and Africa\u2019s globalization, Globalisation and Africa\u2019s economic transformation and Globalization and Africa\u2019s changing ecology, amongst others. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Contracting-out primary health care services in Tanzania towards UHC: how policy processes and context influence policy design and implementation","field_subtitle":"Maluka S; Chitama D; Dungumaro E; et al: International Journal for Equity in Health 17(118) 1-13, 2018","URL":"https://tinyurl.com/y95ocexr","body":"This paper reports on the design and implementation of service agreements between local governments and non-state providers for the provision of primary health care services in Tanzania. The authors used qualitative analytical methods to study the Tanzanian experience with contracting- out. Data were drawn from document reviews and in-depth interviews with 39 key informants, including six interviews at the national and regional levels and 33 interviews at the district level. The institutional frameworks shaping the engagement of the government with non-state providers are rooted in Tanzania\u2019s long history of public-private partnerships in the health sector. Demand for contractual arrangements emerged from both the government and the faith-based organizations that manage non-state providers facilities. Development partners provided significant technical and financial support, signalling their approval of the approach. Although districts gained the mandate and power to make contractual agreements with non-state providers, financing the contracts remained largely dependent on external funds via central government budget support. Delays in reimbursements, limited financial and technical capacity of local government authorities and lack of trust between the government and private partners affected the implementation of the contractual arrangements. The authors indicate that Tanzania\u2019s central government needs to further develop the technical and financial capacity necessary to better support districts in establishing and financing contractual agreements with non-state providers for primary health care services; and that forums for continuous dialogue between the government and contracted non-state providers be fostered to clarify the expectations of all parties and resolve any misunderstandings.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Data value and care value in the practice of health systems: A case study in Uganda","field_subtitle":"Hutchinson E; Nayiga S; Nabirye C; et al: Social Science & Medicine (211) 123-130, 2018","URL":"https://tinyurl.com/ycj8obej","body":"This paper interrogated the relationship between data collection and the delivery of patient care in Kayunga, Uganda in five public health centres. The authors undertook ethnographic research from July 2015 to September 2016 in health centres, at project workshops, meetings and training sessions. This included three months of observations by three fieldworkers, in-depth interviews with health workers and stakeholders and six focus group discussions with health workers. The authors observed that the attempt to improve data collection within health facilities transferred data-value into health centres with little consideration among project staff for its impact on care, and noted both acquiescence and resistance to data-value by health workers. The authors also described the rare moments when senior health workers reconciled these two forms of value, where care-value and data-value were enacted simultaneously. The authors suggest that those seeking to make changes in health systems must take into account local forms of value and devise health systems interventions that reinforce and enrich existing ethically driven practice.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 213: The African Continental Free Trade Agreement \u2013 what will it mean for our health?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Establishing Standards to Evaluate the Impact of Integrating Digital Health into Health Systems","field_subtitle":"Labrique A; Vasudevan L; Weiss W; et al: Global Health: Science and Practice 6(Supplement 1) S5-S17, 2018","URL":"https://tinyurl.com/ybvgusbs","body":"In this commentary, the authors summarize the key milestones in the rise of digital health, illustrating efforts to bridge gaps in the evidence base, a shifting focus to scale-up and sustainability, growing attention to the precise costing of these strategies, and an emergent implementation science agenda to better characterize the necessary ecosystem of scale\u2014the social, political, economic, legal, and ethical context that supports digital health implementation.  In 2016, WHO established a guidelines development group to assess current evidence and recommendations for digital strategies. The guidelines development process recommends strategies that are adequately supported by sufficient evidence but also highlights promising strategies that currently have a low threshold of evidence that require future research, with a particular eye toward health system integration of these strategies. The evidence base of digital health approaches that have been successfully scaled up is growing, and new technology and shared standards provide a framework that can decrease the risk and amplify the promises of digital health investments. The authors argue that digital health innovations are increasing accessibility, promoting transparency, and have the capacity to increase accountability\u2014all necessary facets of lasting health systems strengthening. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Government resource contributions to the private-not-for-profit sector in Uganda: evolution, adaptations and implications for universal health coverage","field_subtitle":"Ssennyonjo A; Namakula J; Kasyaba R; et al: International Journal for Equity in Health 17(130) 1-12, 2018","URL":"https://tinyurl.com/ycbq3zqr","body":"In this paper, the authors examine government resource contributions (GRCs) to providers in Uganda focusing on Primary Health Care (PHC) grants to the largest non-profit provider network, the Uganda Catholic Medical Bureau (UCMB), from 1997 to 2015. The framework of complex adaptive systems was used to explain changes in resource contributions and the relationship between the Government and UCMB. Documents and key informant interviews with the important actors provided the main sources of qualitative data. Trends for government resource contributions (GRCs) and service outputs for the study period were constructed from existing databases used to monitor service inputs and outputs. The case study\u2019s findings were validated during two meetings with a broad set of stakeholders. Three major phases were identified in the evolution of GRCs and the relationship between the Government and UCMB initiation, rapid increase in GRCs, and declining GRCs. The main factors affecting the relationship\u2019s evolution were: financial deficits at private-not-for-profit (PNFP) facilities, advocacy by PNFP network leaders, changes in the government financial resource envelope, variations in the \u201cgood will\u201d of government actors, and changes in donor funding modalities. Responses to the above dynamics included changes in user fees, operational costs of PNFPs, and government expectations of UCMB. Quantitative findings showed a progressive increase in service outputs despite the declining value of GRCs during the study period. GRCs in Uganda have evolved influenced by various factors and the complex interactions between government and PNFPs. The authors argue that the Universal Health Coverage (UHC) agenda should pay attention to these factors and their interactions when shaping how governments work with PNFPs to advance UHC. GRCs could be leveraged to mitigate the financial burden on communities served by PNFPs. They further suggest that governments seeking to advance UHC goals should explore policies to expand GRCs and other modalities to subsidize the operational costs of PNFPs.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Heads of State commit to lead response to beat noncommunicable diseases, promote mental health","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"https://tinyurl.com/y9brxbkd","body":"Heads of state and government in September 2018 committed to 13 new steps to tackle non-communicable diseases including cancers, heart and lung diseases, stroke, and diabetes, and to promote mental health and well-being. World leaders agreed to take responsibility themselves for their countries\u2019 effort to prevent and treat NCDs. They also agreed that these efforts should include robust laws and fiscal measures to protect people from tobacco, unhealthy foods, and other harmful products, for example by restricting alcohol advertising, banning smoking, and taxing sugary drinks. They committed to implement a series of WHO-recommended policies to prevent and control of NCDs - such as public education and awareness campaigns to promote healthier lifestyles, vaccinating against HPV virus to protect against cervical cancer and treating hypertension and diabetes. WHO estimates that implementing all these policies could generate US$ 350 billion in economic growth in low and lower-middle-income countries between now and 2030. Other specific commitments focus on halting the rise of childhood obesity, promoting regular physical activity, reducing air pollution and improving mental health and wellbeing. The political declaration reaffirms WHO\u2019s global leadership of the fight to beat NCDs and promote mental health, and urges the Organization to continue working closely with key partners, including government, civil society and the private sector. In particular, it calls on food manufacturers to take several actions. These include reformulating products to reduce salt, free sugars and saturated and industrially produced trans fats, using nutrition labelling on packaged food to inform consumers, and restricting the marketing of unhealthy foods and beverages to children.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Health system reforms in five sub-Saharan African countries that experienced major armed conflicts (wars) during 1990\u20132015: a literature review","field_subtitle":"Chol C; Negin J; Garcia-Basteiro; et al: Global Health Action 11(1), doi: https://doi.org/10.1080/16549716.2018.1517931, 2018","URL":"https://www.tandfonline.com/doi/full/10.1080/16549716.2018.1517931","body":"Sub-Saharan Africa (SSA) has had more major armed conflicts (wars) in the past two decades \u2013 including 13 wars during 1990\u20132015 \u2013 than any other part of the world, and this has had an adverse effect on health systems in the region. This study aimed to understand the best health system practices in five SSA countries that experienced wars during 1990\u20132015, and yet managed to achieve a maternal mortality reduction \u2013 equal to or greater than 50% during the same period \u2013 according to the Maternal Mortality Estimation Inter-Agency Group (MMEIG). The study showed three general health system reforms across all five countries that could explain MMR reduction: health systems decentralisation, the innovation related to the WHO workforce health system building block such as training of community healthcare workers, and governments-financing reforms. Restoring health systems after disasters is an urgent concern, especially in countries that have experienced wars. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"IIEP-UNESCO Call for Expressions of Interest for National Researchers in Sub-Saharan Africa","field_subtitle":"Deadline for applications: 31 December 2018","URL":"http://www.iiep.unesco.org","body":"IIEP, UNESCO\u2019s International Institute for Educational Planning, has issued a call for expressions of interest for national researchers in Sub-Saharan Africa to collaborate in a research project on Use of Learning Assessment Data in the Planning Cycle. The project will explore how countries in this region use learning data produced by large-scale international, regional and national assessments; see how they are used in different phases of the education planning cycle; examine the intended use of these data as foreseen in regulatory documents and the discrepancies between this and observed uses; and explore factors that influence the use of assessment data with a particular focus on elements linked to the political economy of actors. It will take a wider look at the information ecosystem that surrounds learning data, analysing how it is interpreted and considered together with other evidence. IIEP-UNESCO will conduct a number of case studies in Sub-Saharan Africa countries to provide a qualitative comparative analysis and to generate knowledge and recommendations that would inform the work of national officers and international partners. The Institute has put out a call for expressions of interest to work with national researchers from Sub-Saharan Africa universities and institutes in the implementation of this project in conducting a case study in one of the countries in the region. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Moving towards universal health coverage: engaging non-state providers","field_subtitle":"Rao K; Paina L; Ingabire M; et al: International Journal for Equity in Health 17(127) 1-9, 2018","URL":"https://tinyurl.com/ycb8ca5y","body":"This paper provides a unique opportunity to understand the dynamics of non-state providers (NSP) engagement in different contexts. A standard template was developed and used to summarize the main findings from the country studies. The summaries were then organized according to emergent themes and a narrative built around these themes. Governments contracted NSPs for a variety of reasons \u2013 limited public sector capacity, inability of public sector services to reach certain populations or geographic areas, and the widespread presence of NSPs in the health sector. Underlying these reasons was a recognition that purchasing services from NSPs was necessary to increase coverage of health services. Yet, institutional NSPs faced many service delivery challenges. Like the public sector, institutional NSPs faced challenges in recruiting and retaining health workers, and ensuring service quality. Properly managing relationships between all actors involved was critical to contracting success and the role of NSPs as strategic partners in achieving national health goals. Further, the relationship between the central and lower administrative levels in contract management, as well as government stewardship capacity for monitoring contractual performance were vital for NSP performance. The authors suggest that for countries with a sizeable NSP sector, making full use of the available human and other resources by contracting NSPs and appropriately managing them, offers an important way for expanding coverage of publicly financed health services and moving towards universal health coverage.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"New Global Commitment to Primary Health Care for all at Astana Conference","field_subtitle":"Fernandez M: UNICEF, New York, 2018 ","URL":"https://tinyurl.com/y8tjdw7f","body":"In October 2018, United Nations Member States unanimously agreed to the Declaration of Astana, vowing to strengthen their primary health care systems as an essential step toward achieving universal health coverage. The Declaration of Astana reaffirms the historic 1978 Declaration of Alma-Ata, the first time world leaders committed to primary health care. The Declaration of Astana comes amid a growing global movement for greater investment in primary health care to achieve universal health coverage. Health resources have been overwhelmingly focused on single disease interventions rather than strong, comprehensive health systems \u2013 a gap highlighted by several health emergencies in recent years. The author reports that UNICEF and WHO will help governments and civil society to act on the Declaration of Astana and encourage them to back the movement and will support countries in reviewing the implementation of this Declaration, in cooperation with other partners.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"New resources added to the PAR portal","field_subtitle":"EQUINET pra4equity network","URL":"http://www.equinetafrica.org/content/portal-resources-participatory-action-research","body":"New resources have been added to the Participatory Action Research Portal. The portal has resources on Participatory Action Research (PAR) with a growing number of resources on PAR related to training courses, training guides and reports of training activities; methods, tools and ethics; PAR work and journal publications on PAR. The portal is a resource for all those working with PAR and includes resources in any language. There is a form for people to send videos, photojournalism, organisations, journal papers, training guides and other resources for the portal. The url link shown here is in English but there is also a Spanish version at http://www.equinetafrica.org/content/portal-de-recursos-para-la-investigaci%C3%B3n-acci%C3%B3n-participativa-iap","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Policy brief on the implementation of devolution in Zimbabwe: recommendations on the structure / composition, functions and funding of Provincial and Metropolitan Councils (PMCs)","field_subtitle":"Centre for Community Development In Zimbabwe, Harare Residents Trust: Harare, November 2018","URL":"https://tinyurl.com/ya57gllb","body":"This brief was developed in consultation with key local government stakeholders. It provides an outline of key concerns and issues regarding devolution and proffers recommendations for consideration by government and parliament in crafting the new legislation to guide the implementation of devolution in Zimbabwe. The issue of devolution is topical and government has indicated its commitment to implementing it. However, the delay in the crafting of legislation to guide devolution is a serious cause for concern for citizens and other local government stakeholders. The devolution of power to local and provincial councils helps to achieve fair and balanced development through provincial and metropolitan councils, which are allowed by the Constitution to set local development priorities. The authors argue that governmental powers must be devolved to the local people so that there is increased transparency and accountability in governance and decision-making as well as management of public affairs and resources by local authorities. Provincial governments must be fully in control of their local authorities whilst central government plays an oversight role to ensure that public resources are used in a transparent manner.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda","field_subtitle":"Musoke D; Ssemugabo C; Ndejjo R; et al: Human Resources for Health 16(41) 1-9, 2018 ","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-018-0306-8","body":"This paper explores the differential roles of male and female Community health workers (CHWs)in rural Wakiso district, Uganda, using photovoice, a community-based participatory research approach. The authors trained ten CHWs on key concepts about gender and photovoice. The CHWs took photographs for 5 months on their gender-related roles which were discussed in monthly meetings. The discussions from the meetings were recorded, transcribed, and translated to English, and emerging data were analysed using content analysis. Although responsibilities were the same for both male and female CHWs, they reported that in practice, CHWs were predominantly involved in different types of work depending on their gender. Social norms led to men being more comfortable seeking care from male CHWs and females turning to female CHWs. Due to their privileged ownership and access to motorcycles, male CHWs were noted to be able to assist patients faster with referrals to facilities during health emergencies, cover larger geographic distances during community mobilization activities, and take up supervisory responsibilities. Due to the gendered division of labour in communities, male CHWs were also observed to be more involved in manual work such as cleaning wells. The gendered division of labour also reinforced female caregiving roles related to child care, and also made female CHWs more available to address local problems. CHWs reflected both strategic and conformist gendered implications of their community work. The authors argue that the differing roles and perspectives about the nature of male and female CHWs while performing their roles should be considered while designing and implementing CHW programmes, without further retrenching gender inequalities or norms.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Results-based financing in health: from evidence to implementation","field_subtitle":"McIsaac M: Kutzin J: Dale E; Soucat A: Bulletin of the World Health Organization 96(11), 729-796, 2018","URL":"http://www.who.int/bulletin/volumes/96/11/18-222968/en/","body":"Results-based financing for health programmes are being piloted in many low- and middle-income countries. While the term results-based financing refers to demand- and supply-side incentives to increase output \u2013 that is, improved access to and quality of health care \u2013 this editorial focuses on the incentives that target service providers, also referred to as performance-based financing or pay-for-performance.  A study in Zambia concluded that the pay-for-performance intervention was cost\u2013effective. However, cost\u2013effectiveness is not the most interesting point of this study, as four policy relevant lessons emerge. First, any output-based provider payment method requires some method of verification. In Zambia, setting up verification mechanisms required new investments, as before the pilot, providers were paid based on inputs. The estimates of the costs of the programme in Zambia, although annualized, are based on only 2.3 years of experience. Given that it is a new programme, one would expect that pay-for-performance verification costs would decline over time. Second, approaching pay-for-performance as an either-or choice of financing is no longer the only frame of reference. The substantive question is how to integrate elements of performance into the mixed provider payment system. Third, as described in the overall evaluation of the project, the direct disbursement of funds to facility bank accounts in the pay-for-performance group was a key ingredient for ensuring better service delivery. Fourth, facility financial autonomy supported by pay-for-performance was found to be key for ensuring progress towards strategic purchasing in Zambia. If balanced with clear accountability for both good results and the use of funds, it should be promoted. In shifting towards mixed provider payment methods with timely disbursement of funds and greater financial autonomy by front-line providers, the budgeting processes need to be considered. In countries such as Zambia, where budgets are mainly formulated, approved and executed based on detailed input lines, the authors argue that shifting to payments based on performance could be challenging. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Role of maternity waiting homes in the reduction of maternal death and stillbirth in developing countries and its contribution for maternal death reduction in Ethiopia: a systematic review and meta-analysis","field_subtitle":"Dadi T; Bekele B; Kasaye H; et al: BMC Health Services Research 18(748)1-10, 2018 ","URL":"https://tinyurl.com/y8ko8l55","body":"This study synthesised the best available evidence on effectiveness of maternity waiting homes on the reduction of maternal mortality and stillbirth in developing countries. In developing countries, maternity waiting homes users were 80% less likely to die than non-users and there was 73% less occurrence of stillbirth among users. In Ethiopia, there was a 91% reduction of maternal death among maternity waiting homes users unlike non-users and it contributes to the reduction of 83% stillbirth unlike non-users. Maternity waiting home contributes more than 80% to the reduction of maternal death among users in developing countries and Ethiopia. Its contribution for reduction of stillbirth is good. More than 70% of stillbirth is reduced among the users of maternity waiting homes. In Ethiopia maternity waiting homes contributes to the reduction of more than two third of stillbirths.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Seeds of Resistance, Harvests of Hope: Farmers halt a land grab in Mozambique","field_subtitle":"Wise T: Food Tank, 2018","URL":"https://tinyurl.com/ya8fedo7","body":"On July 26, 2018, farmers in Xai-Xai, Mozambique, achieved a milestone. They met to formalize their new farmers\u2019 association, elect leaders, and prepare a petition to the local government for land. The association, christened Tsakane, which means \u201chappy\u201d in the local Changana language, was the culmination of six years of resistance to a Chinese land grab that had sparked protest and outrage. The association now has a request pending for its own land. The difference between a large-scale agricultural development project and a land grab is consultation and consent, and this one had neither. Some 7,000 farmers had moved onto the irrigated lands along the Lower Limpopo River in the 1980s after a state farm ceased operations. Farmers reported that they were encouraged to do so by the local government. Mozambique\u2019s Land Law is one of the most progressive in Africa, recognizing the land rights of peasant farmers whether or not they can show formal title, as long as they have been farming the land for 10 years or more. That applies not only to community or village land, it applies to estate land for which the government holds the formal land title. Instead of giving all the best land and infrastructure\u2014particularly irrigation\u2014to foreign investors who then displace local farmers, they ask why not give the land to those farmers? Help them organize into marketing cooperatives, water use associations, and credit unions. With the formal recognition of the Tsakane Farmers\u2019 Association, the Xai-Xai farmers are planning to do just that. They hope to get collective land title to 750 acres of good land for their 300 members.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"South African Health Review 2019 Call for Abstracts","field_subtitle":"Deadline for submission of abstracts: 14 December 2018","URL":"https://tinyurl.com/yadryovh","body":"The South African Health Review (SAHR) is an accredited peer reviewed publication.  The aims of the SAHR are to advance the sharing of knowledge, to feature critical commentary on policy implementation, and to offer empirical understandings for improving South Africa's health system. The editors are pleased to announce that the call for abstracts for the 2019 edition of the SAHR is now open.  Abstracts providing fresh insights into health systems strengthening efforts supporting the realisation of universal health coverage in South Africa are particularly sought.  Preference will be given to manuscripts that take cognisance of the World Health Organization's six building blocks for an effective, efficient and equitable health system. In addition to a primary call for abstracts, there are two other opportunities for potential authors. The first is the launch of the inaugural Healthcare Workers Writing Development Programme offering writing skills training and ongoing coaching throughout the publication process for identified first time authors. Healthcare workers who are interested in contributing to the SAHR and sharing their insights into the challenges and successes of implementation are encouraged to submit an abstract. Further details about this call will be available in January 2019. The second is the annual Emerging Public Health Care Practitioner Award (EPHPA) which is open to South African citizens under the age of 35, who are at Masters' level or below.  Applications for this award will open in February 2019.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The African Continental Free Trade Agreement \u2013 what will it mean for our health?","field_subtitle":"Rangarirai Machemedze, SEATINI","body":"\r\nIn March 2018, when African Union leaders in Rwanda signed the African Continental Free Trade Agreement (AfCFTA), there was much talk about it being a new chapter for the continent in furthering the socio-economic integration enshrined in the 1991 Abuja Treaty. It\u2019s important therefore to ask- what implications does it have for health equity?\r\n\r\nThe agreement establishes a free trade area between African countries, liberalising 90% of trade in goods between countries, removing import duties on goods originating from African countries to enhance trade between them. On the one hand this can potentially promote sustained economic progress, with potential health gains if it offers benefits to all local producers, including small scale producers, and if the economic benefits are equitably distributed. On the other hand it can lead to risks to health if the laws and institutional mechanisms protecting health in cross border trade are not adequate.\r\n\r\nOne way to predict what the impacts of the AfCFTA may be on health is to examine what happened in previous trade liberalization experiences, specifically those in the International Monetary Fund and World Bank led Structural Adjustment Programmes. These trade liberalisation policies were implemented across Africa in a context of weak safety nets and protection of public sector services, including in health, education and agriculture. The decline of these services and economic inequality that arose after that experience raise questions on how the AfCFTA will be implemented. \r\n\r\nSupporting a health sector calls for a range of areas of value-added production, such as for medicines and technologies. Our economies have still weak development of these areas of production and tend to import them, while exporting more or less the same products.  So will the AfCFTA be accompanied by measures to promote investment for value added production in an organised collaborative manner, such as for infrastructures, equipment, technology and medicines for the health sector? Given that prior liberalisation policies have been accompanied by cost escalation for the ordinary person, will it assess and take as a measure of its progress a fall for the population in the price of essential medicines, commodities and services for health? \r\n\r\nMost African countries have porous borders and many have weak capacities to check the quality and safety of goods crossing borders. When unsafe food products, chemicals, alcohol and other products that could harm health are poorly checked at borders there is a risk to public health. So too is the risk to health of cross border movement of substandard medicines. There are already reports by WHO of such medicines appearing in markets in some of our countries. Competition and wider markets provide a potentially health incentive for reducing prices of goods,  so the AfCFTA could enhance access to low cost generic drugs from efficient producers within the continent. This benefit and the control of public health risk from harmful products and unsafe foods calls, however for significantly improved port health capacities in all our countries to accompany the flow of goods. Will the AfCFTA thus include specific measures to enhance these capacities in line with the International Health Regulations, and apply them at all the various points where goods cross borders?\r\n\r\nIf the AfCFTA promotes the freer movement of personnel, it could enhance availability and possibly accessibility of skilled personnel, including health workers, especially for countries experiencing acute shortages. But it could also do the opposite, as we have already experienced in our countries, where skilled health professionals are pushed or pulled to higher income areas and services, further deepening existing inequalities in their distribution. And the movement of people itself has the potential to spread disease across countries. So will the AfCFTA be introduced together with measures for training and resourcing personnel to manage the cross border spread of infection and to enhance equity within the continental access to skilled health workers?\r\nThe liberalisation of trade holds the promise of wider access to new goods and services, and to the spread of innovation across the continent. This can be very positive for health. At the same time changes in dietary patterns, employment conditions, physical environments and lifestyles can change consumption patterns in ways that are not always healthy. We have seen the consequences of this in the negative effect of consumption of processed foods and sweetened products in levels of obesity and diabetes for example. Our countries need strong public health laws and capacities and good communication capacities to manage such issues and avoid the epidemic of non-communicable diseases that has been witnessed in other regions. \r\n\r\nThe AfCFTA will certainly lead to changes in production and industries with implications for incomes and public revenues. As tariffs that protect domestic industries are removed, they are exposed to competition. If they have the capital and capacity to manage the change they may succeed, but if not they may close. For the public the question may thus be \u201cwhat will happen to my job and my income?\u201d Without adequate social security schemes in the continent, any significant negative shifts in jobs and incomes for countries who become net importers rather than net producers could be very harmful for health. \r\n\r\nGiven that import duties will be eliminated on 90% of goods traded between countries the public sector will lose the revenues generated from these import duties. Countries will thus need to diversify their sources of revenue. For some the growth in production may generate new tax revenue, for others that do not see the same production growth, their tax revenues may fall.  As we have seen in the structural adjustment programmes, when this happens public health budgets are cut, with increasing dependency on external funders for the right to health care. As our countries intend to mobilise domestic financing for universal health coverage, what plans are there associated with the AfCFTA to make sure that it doesn\u2019t lead to widening inequality in achieving this across the continent?\r\n\r\nThe AfCFTA could be a tool for fostering south-south cooperation on the continent, with a range of potential benefits for health. Countries could provide mutual support to strengthen areas of inadequacies and reduce inequalities across the continent. However, the issues raised above indicate that trade alone cannot achieve this without complementary measures to ensure wider benefits within and between countries, cooperation on production of health commodities and technologies, and strengthened capacities and measures to protect public health. As the negotiations to finalise the texts and implementation continue, it is imperative that the health sector takes an active role, not only to understand the implications of the AfCFTA, but to negotiate for measures in it that will safeguard the health of the people.\r\n\r\nPlease send feedback or queries on the issues raised to the EQUINET secretariat: admin@equinetafrica.org. For more information on the AfCFTA text see https://www.tralac.org/documents/resources/african-union/1964-agreement-establishing-the-afcfta-consolidated-text-signed-21-march-2018-1/file.html","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"The health system accountability impact of prison health committees in Zambia","field_subtitle":"Topp S; Sharma A; Chileshe C; et al: International Journal for Equity in Health 17(74) 1-13, 2018 ","URL":"https://tinyurl.com/yad62xyr","body":"From 2013, the Zambian Corrections Service (ZCS) worked with partners to strengthen prison health systems and services. One component of that work led to the establishment of facility-based Prison Health Committees (PrHCs) comprising of both inmates and officers. The authors present findings from a nested evaluation of the impact of eight PrHCs 18 months after programme initiation. In-depth-interviews were conducted with 11 government ministry and Zambia Corrections Service officials and 6 facility managers. Sixteen focus group discussions were convened separately with Prison Health Committees members and non-members in 8 facilities. Memos were generated from participant observation in workshops and meetings preceding and after implementation. The authors sought evidence of Prison Health Committees impact, refined with reference to Joshi\u2019s three domains of impact for social accountability interventions in state, society, and state-society relations. Further analysis considered how project outcomes influenced structural dimensions of power, ability and justice relating to accountability. Data pointed to a compelling series of short- and mid-term outcomes, with positive impact on access to, and provision of, health services across most facilities. Inmates reported being empowered via a combination of improved health literacy and committee members\u2019 newly-given authority to seek official redress for complaints and concerns. Inmates and officers described committees as improving inmate-officer relations by providing a forum for information exchange and shared decision making. Contributing factors included more consistent inmate-officer communications through committee meetings, which in turn enhanced trust and co-production of solutions to health problems. Nonetheless, long-term sustainability of accountability impacts may be undermined by permanently skewed power relations, high rates of inmate turnover, variable commitment from some officers in-charge, and the anticipated need for more oversight and resources to maintain members\u2019 skills and morale. The authors showed that Prison Health Committees do have potential to facilitate improved social accountability in both state and societal domains and at their intersection, for an extremely vulnerable population. However, sustained and meaningful change will depend on a longer-term strategy that integrates structural reform and is delivered through meaningful cross-sectoral partnership.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The problem or the solution? Early fertility and parenthood in the transition to adulthood in Khayelitsha, South Africa","field_subtitle":"Swartz A; Christopher C; Harrison A: Reproductive Health Matters 16(32), doi: https://doi.org/10.1080/09688080.2018.1537417, 2018","URL":"https://tinyurl.com/ycvts56c","body":"This article draws on ethnographic data collected between 2014 and early 2016 with young adults (17-25 years) in Town Two, Khayelitsha. Participant observation was the primary data collection method. Narratives and experiences of 15 young people are presented here. The authors argue that in addition to immediate fertility desires, young people\u2019s contraceptive decision-making was significantly shaped by gendered ideals and social norms. Young women\u2019s fertility operated as both an aspiration and a threat within partnerships. Some couples partially achieved relationship stability or longevity through having a child. Entering parenthood in the context of a seemingly stable relationship was perceived as a movement towards an accepted, albeit tenuous, form of social adulthood. Although living up to the ideal of good parent was challenging, it was partially achieved by young mothers who provided care and young fathers who provided financially for children. The authors argue that in the absence of other accepted markers of transition to adulthood and within a context of deprivation and exclusion, early fertility, though clearly a public health problem, can become a solution to social circumstances.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The use of low-cost Android tablets to train community health workers in Mukono, Uganda, in the recognition, treatment and prevention of pneumonia in children under five: a pilot randomised controlled trial","field_subtitle":"O\u2019Donovan J; Taylor C; Chukhina M; et al: Human Resources for Health 16(49) 1-9, 2018  ","URL":"https://tinyurl.com/yafr6rv7","body":"This pilot study compares traditional training with using locally made videos loaded onto low-cost Android tablets to train community health workers (CHWs)on the pneumonia component of Integrated Community Case Management (iCCM). The authors conducted a pilot randomised controlled trial with CHWs in the Mukono District of Uganda. The unit of randomisation was the sub-county level, and the unit of analysis was at the level of the individual CHW. Eligible CHWs had completed basic iCCM training but had not received any refresher training on the pneumonia component of iCCM in the preceding 2 years. CHWs in the control group received training in the recognition, treatment, and prevention of pneumonia as it is currently delivered, through a 1-day, in-person workshop. CHWs allocated to the intervention group received training via locally made educational videos hosted on low-cost Android tablets. The primary outcome was change in knowledge acquisition, assessed through a multiple-choice questionnaire before and after training, and a post-training clinical assessment. The secondary outcome was a qualitative evaluation of CHW experiences of using the tablet platform. In the study, 129 CHWs were enrolled, 66 and 63 in the control and intervention groups respectively. CHWs in both groups demonstrated an improvement in multiple choice question test scores before and after training; however, there was no statistically significant difference in the improvement between groups. There was a statistically significant positive correlation linking years of education to improvement in test scores in the control group, which was not present in the intervention group. The majority of CHWs expressed satisfaction with the use of tablets as a training tool; however, some reported technical issues. The authors note that tablet-based training is comparable to traditional training in terms of knowledge acquisition. It also proved to be feasible and a satisfactory means of delivering training to CHWs. They argue that further research is required to understand the impacts of scaling such an intervention.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Toolkit for International Universal Health Coverage Day ","field_subtitle":"UHC2030 & 12.12 Coordination Group: December 2018","URL":"http://universalhealthcoverageday.org/","body":"Universal health coverage (UHC) ensures all people, everywhere, can access the quality health services they need without suffering financial hardship.  World leaders have agreed: every person\u2014no matter who they are, where they live, or how much money they have\u2014should be able to access quality health services without suffering financial hardship. To achieve this vision of universal health coverage by 2030, there is a need for collective action now to build strong, equitable health systems in every country. The UHC2030 & 12.12 Coordination Group have built a toolkit to use to promote these goals. It provides actions for policy makers, civil society and individuals, resources to share in communities around the world and key messages to share on social media. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"UN International Day For Older Persons Celebrated In Marondera, Zimbabwe","field_subtitle":"263 Chat: Marondera, Zimbabwe, November 2018,","URL":"https://263chat.com/un-international-day-for-older-persons-celebrated-in-marondera/","body":"The United Nations International Day for Older Persons falls on 1 October every year. This year it was commemorated under the theme celebrating older human rights champions. Belated commemorations were held on Friday 23 November 2018 at Mahusekwa district hospital in Marondera, Zimbabwe.  Representatives from the District Administrator\u2019s office, the Ministry of Public Service Labour and Social Services, Ministry of Health and Child Care, the National Age Network of Zimbabwe (NANZ), chiefs, the private sector, NGOs, older people representative organisations and older people champions among others were in attendance. In line with celebrating older human rights champions the event was run and owned by older persons with Gogo Mufuta and Gogo Nyamande sharing the master of ceremonies platform.  Speeches centred on the important role that older people play in society emphasising their role as custodians of culture. Older people were also noted to be key carers of orphaned and vulnerable children. Dr Guvheya, the former chairman of the Zimbabwe Older Persons Association (ZOPO) praised the constitution which enshrines the rights of older people. He challenged government to operationalize provisions of the constitution and other pieces of legislation to enable older people to enjoy their rights. Dr Guvheya also spoke about the challenges faced by older people, including witchcraft accusations and property grabbing.  He lamented on the current environment where pharmacies are demanding payment in foreign currency for medicines. This point was emphasised throughout the day as older people are in need of holistic health care and support as many are living with diseases including HIV, cancer, diabetes and dementia yet they have lost the capacity to generate income to access health services.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts","field_subtitle":"Reynolds Z; Gottert A; Luben E; et al: PLOS One, doi: https://doi.org/10.1371/journal.pone.0203208, 2017","URL":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203208","body":"Adolescent girls and young women (AGYW, ages 15\u201324) are at high risk of HIV in Swaziland and understanding more about their male sexual partners can inform HIV prevention efforts for both. Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20\u201334 were surveyed between December 2016-February 2017. Surveys were conducted at 182 venues identified by community informants as places where AGYW and men meet/socialize. In multivariate analyses, men who reported three or more AGYW partners in the last year were more likely to be HIV-positive. Men were also less likely to disclose their HIV status to adolescent versus older partners and partners more than 5 years younger than themselves. Results also revealed relatively high unemployment and mobility, substantial financial responsibilities, and periodic homelessness. Most men identified through community venues reported relationships with AGYW, and these relationships demonstrated substantial HIV risk. Challenging life circumstances suggest structural factors may underlie some risk behaviours. Engaging men in HIV prevention and targeted health services is argued to be critical, and informant-identified community venues are suggested to be promising intervention sites to reach high-risk male partners of AGYW.","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Willingness to Pay for Condoms in Five Countries Kenya, Nigeria, South Africa, Zambia, and Zimbabwe","field_subtitle":"Ramakrishnan G; Tuchman J; Hartel L: Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project, 2018 ","URL":"https://tinyurl.com/yb72plpw","body":"Though condom use is now higher than ever before, key gaps remain in countries and in certain populations, where use has stagnated or even decreased. This survey comprised five standalone national cross-sectional surveys carried out in randomly selected geographical areas. Quantitative data were collected from adult men who purchased or obtained a condom in the three months preceding the surveys. A minimum of 1,200 participants was enrolled for each country, with quotas for urban and rural respondents; and brand types that a user most often used (i.e., free, socially marketed (SM), and commercial). The AIDSFree team identified important differences in each of the countries\u2019 condom markets. The team noted many overarching themes: Supplies of free condoms appear to significantly exceed use of such condoms; SM brands should set prices based ability-to-pay trends in country, rather than on trends in costs or available subsidies; It is not just price\u2014brand appeal and availability are important factors in men\u2019s choice of condom brands; Low-priced commercial condom brands are emerging, at the same or lower price than SM brands. However, lower awareness and availability appear to limit their market share.; Introducing a single pack of condom brands does not appear to change the market structure significantly. ","php":"","field_issue_date":"2018-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"African Health Economics and Policy Association (AfHEA) conference, 11-14 March, Accra Ghana","field_subtitle":"October 31, 2018 is final deadline for individual abstract submission ","URL":"https://afhea.org/en/conferences/afhea-2019/call-for-abstracts","body":"The co-chairs of the Scientific Committee and Management of African Health Economics and Policy Association (AfHEA) take this opportunity to politely remind practitioners and researchers in the areas of health economists and financing, health systems and policy, public health, implementation science, including policy makers and advocates etc. that the deadline for individual abstract submissions to AfHEA\u2019s 5th scientific conference (to take place from 11-14 March 2019 in Accra, Ghana) will expire on 31st October 2018 at midnight. The broad theme : Securing Primary Health Care (PHC) for all: the foundation for making progress on Universal Health Coverage (UHC) in Africa. Sub-Themes are: Health system strengthening; The effectiveness of aid in the building of health systems; PHC and Healthcare financing; Factors affecting access to healthcare and efforts/challenges in securing PHC; Key methodological changes in health economics and policy analysis specific to Africa; The role of research institutions and donors in building capacity in health economics and policy analysis. Abstracts may be submitted in English or French . Authors should submit individual abstracts online by October 31 at http://afhea.org/en/conferences/afhea-2019/submit-individual-abstracts. Proposals  for organised sessions can be submitted by November 30 at http://afhea.org/en/conferences/afhea-2019/organised-session-abstract. \r\n","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Alternative Civil Society Astana Statement on Primary Health Care","field_subtitle":"Public interest civil society organisations and social movements: open for endorsements up to 15 November","URL":"http://phmovement.org/draft-alternative-civil-society-astana-statement-on-primary-health-care/","body":"Members of public interest civil society organisations and social movements, some of whom are participants at the Global Conference on Primary Health Care, produced this statement to re-affirm a commitment to primary health care (PHC) in pursuit of health and well-being for all, aiming to achieve equity in health outcomes.  The statement is a re-affirmation of the Alma Ata declaration, which to PHM and others remains the ultimate declaration on primary health care; the principles are clear and remain relevant. This authors invite organisations who agree with the views expressed to  sign on to the statement.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Associations between health systems capacity and mother-to-child HIV prevention program outcomes in Zambia","field_subtitle":"Price J; Chi B; Phiri W: PLOS ONE 13(9), doi: https://doi.org/10.1371/journal.pone.0202889, 2018","URL":"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203043","body":"In this study, the authors investigated the association between health system capacity and use of prevention of mother-to-child HIV transmission (PMTCT) services in Zambia. They analyzed data from two studies conducted in rural and semi-urban Lusaka Province in 2014\u20132015. Among 29 facilities, the median overall facility score was 72. Median domain scores were: patient satisfaction 75; human resources 85; finance 50; governance 82; service capacity 77; service provision 60. The programmatic outcome was measured from 804 HIV-infected mothers. Median community-level antiretroviral use at 12 months was 81%. Patient satisfaction was the only domain score significantly associated with 12-month maternal antiretroviral use. When the authors excluded the human resources and finance domains, a positive association between composite 4-domain facility score and 12-month maternal antiretroviral use in peri-urban but not rural facilities was found. In these Zambian health facilities, patient satisfaction was positively associated with maternal antiretroviral 12 months postpartum. The association between overall health system capacity and maternal antiretroviral drug use was stronger in peri-urban versus rural facilities. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Beyond Familiar Territories: 5th South Africa International Conference on Educational Technologies 2019","field_subtitle":"Deadline for submission of abstracts: 15 January 2019","URL":"http://aa-rf.org/saicet2019","body":"The South Africa International Conference on Educational Technologies from 7 \u2013 9 April 2019 (SAICET) 2019 is an international refereed conference that is dedicated to the advancement of research on Educational Technologies. The conference is organised by an African Academic Research Forum under the auspices for Association of Academics and Researchers in Africa. SAICET 2019 aims to offer a platform for academics and researchers in educational technologies to deliberate, network and present a wide range of perspectives, scholarship, and expertise in the pursuit of excellence in education. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Breathing life into constitutional rights to health in Uganda ","field_subtitle":"Jacqueline Nassimbwa and Mulumba Moses, CEHURD, Uganda","body":"\r\nIn 2011 civil society petitioned the Uganda Constitutional Court (Petition 16 of 2011) for its failure to put in place systems to prevent maternal deaths in public health facilities. This failure was argued to be a violation of the right to the highest attainable standard of health guaranteed in the country\u2019s constitution.\r\n\r\nIn response the judgement stated \r\n\r\n\u201c\u2026Much as it may be true that government has not allocated enough resources to the health sector and in particular the maternal health care services, this court is\u2026\u2026\u2026reluctant to determine the questions raised in this petition. The Executive has the political and legal responsibility to determine, formulate and implement polices of Government\u2026\u2026\u2026.. This court has no power to determine or enforce its jurisdiction on matters that require analysis of the health sector government policies\u2026\u201d \r\n\r\nThe court argued that it had no role in reviewing or commenting on government policies or on how they are operationalized. It stated that  judging on the issues raised in the petition implied taking over the role of the government executive, and that the injustice was not a constitutional but a political issue. \r\n\r\nThe Constitutional court thus dismissed the case. However, in an appeal to Uganda\u2019s High Court the dismissal was struck down, with a ruling that the Constitutional Court had erred and that it indeed had a mandate to hear the case. The case has since gone back to the Constitutional court with a date for the hearing still pending. \r\n\r\nThe to and fro on this case reflects the challenges arising when claiming a right to health that is implicit within a national constitution.  Clearly stating the right to health in the constitution is important for it to be promoted, enforced and safeguarded. If not stated in the constitution, its implementation depends on the actions of politicians, state officials, the courts and civil society. In particular, the preamble, \u201cWe the people\u2026\u201d in the constitution mandates the citizenry to advance these provisions.\r\n\r\nWhile some countries in east and southern Africa do explicitly provide the right to health care, the right to health is often not explicitly stated. In Uganda, the 1995 Constitution, currently in force, has provisions on rights to life, privacy, freedom from torture and education amongst others. It does not, however, explicitly provide for the right to health. This right is rather found in the national objectives and directive principles of state policy. It thus depends on a mix of political, judicial and social action. \r\n\r\nIn an EQUINET case study by CEHURD (https://tinyurl.com/y6uppusb), we reviewed how this less explicitly provided right to health in the Uganda Constitution is being implemented through political, judicial and popular mechanisms. \r\n\r\nPolitically, the government executive has made international commitments to the Sustainable Development Goals in line with a Uganda Vision 2040. This policy vision aligns government initiatives to fulfilling duties and responsibilities, including for health care. It commits government to ensure policies and laws and build state capacities to implement programmes to realise health rights. In the health sector, for example, the ministry of health has a policy commitment and plans to ensure universal health coverage to realise the right to health care. \r\n\r\nSuch positive political intentions draw attention to how far they are being implemented. Parliamentarians as political actors have passed progressive laws to reflect changing social perspectives on health rights. However, there are gaps that need to be addressed. For example, old, colonial laws are still in force that do not reflect human rights principles, such as those governing the control of sexually transmitted diseases (termed \u2018venereal diseases\u2019 in the law). \r\n\r\nFurther, a gap in delivery on political intentions can be seen through the disparities in service coverage for particular social groups and  lack of a clear co-ordinating mechanism for different sectors to address health determinants. It can also be assessed from how far policies are being framed for and services delivered to address controversial issues, such as abortion, access to contraceptives and education on sexuality for sexually active adolescents. \r\n\r\nBeyond these political measures, there is an option for judicial implementation of the right to health. Indeed, there has been some increase in litigation on the right to health in Uganda, although with still few cases filed, and even less with favourable judgements. In a 2009 case the court dismissed a petition on the potential toxicity of chemicals sprayed for malaria prevention as not violating constitutional provisions on the right to health.    In contrast in 2010 the court declared female genital mutilation, being practiced in certain Ugandan cultures, as a violation of the constitution, and specifically a violation of the rights of women and the right to health. \r\n\r\nThese poor outcomes could be explained by a lack of understanding of the human rights doctrine amongst judicial officers and lawyers. This may, for example, be a reason for the dismissal of Petition 16 cited earlier, later overturned by the High Court. It could explain the caution in the courts over litigation on social rights. This suggests a need for advocacy and capacity building with these key judicial stakeholders on their role in taking forward the right to health and the use of appeal processes to take up cases where the outcome may be seen to be unfair. \r\n\r\nBeyond the political and judicial routes to implementation of the right to health, there is also the possibility of social action advancing these rights. There has been a rise in popular implementation of the right to health as implicitly provided in the Constitution in Uganda, more commonly through the actions of organized groups. In our review, we found experiences of campaigns, demonstrations, coalition formation and industrial action. \r\n\r\nFor example, in the  \u2018Walk to Work\u2019 campaign in 2011, people were encouraged to walk to work daily to protest increasing prices of fuel, food, and transportation and poor social service delivery. The campaign, identified as political opposition due to its leadership, met police suppression and incarceration of campaigners and was banned in 2012. \r\n\r\nMore specifically focused on the health sector, in late 2017 the Uganda Medical Association (UMA), launched an industrial action over poor salaries, poor working and living conditions and inadequate medical supplies preventing medical personnel from performing their duties. This too met an immediate government response in a court challenge to the legality of UMA, an order by the Minister of Health for the workers to return to work and deployment of military doctors to hospitals. Later, however, government negotiated with the medical workers, improving their welfare and salaries. This measure for popular implementation yielded more positive results on health rights, perhaps given its less partisan political nature.\r\n\r\nThese diverse experiences found in Uganda, further detailed in the case study report, point to the fact that applying a right to health that is not explicitly provided in the constitution is possible. It calls for and generates political, judicial and popular measures, and possibly demands a mix of all.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. Please visit the EQUINET website to read the case study report and other publications on health rights. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Calling for a New Global Economic Order","field_subtitle":"Peoples Health Movement; Medicus Mundi International; G2H2: Astana 2018","URL":"https://vimeo.com/297147040","body":"In 1978, the Alma-Ata International Conference on Primary Health Care stated, in its final declaration, that \u201ceconomic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all.\u201d This video raises why this call is still relevant today and why it should be recalled and renewed now we celebrate the 40th Anniversary of the Alma-Ata Declaration at the Global Conference on Primary Health Care in Astana, on 25-26 October 2018.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"COPASAH Global Symposium on Citizenship, Governance and Accountability in Health","field_subtitle":"15-18 October 2019, New Delhi, India","URL":"http://www.copasahglobalsymposium2019.net/why-participate.html","body":"The practitioner centred COPGS 2019 on Citizenship, Governance and Accountability in Health is designed as meeting point of practice, think-tanks and policy in community centred health systems. Participating in COPGS 2019 will provide a unique opportunity for researchers, policy makers, donors, development and policy experts to interact and dialogue with the 'foot-soldiers' of community-centred accountability practice from around the world. As a participant one will get the opportunity to witness, engage with and experience the following: open sharing and learning on diverse social accountability practices and approaches through practical examples; debates on evolving paradigms and political economy of policy making in global health and its impact on the accountability ecosystem; new insights around the principles and practice of social accountability to achieve global health goals, especially as articulated in SDGs. There are five over-arching themes to the symposium; community action, indigenous people, reproductive health, private health sector and health care workers. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET Case study: Review of Constitutional Provisions on the Right to Health in Uganda","field_subtitle":"Centre for Human Rights and Development (CEHURD)","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/CEHURD%20Constitutional%20Review%20Sep2018.pdf","body":"This case study is produced by the Centre for Human Rights and Development (CEHURD) in the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). It examines how the right to health is enforced in Uganda, how it was implemented, and how health rights advocates have suggested the provision be constitutionally interpreted. It is a follow up on the results of work on the right to health that highlighted a need to do further studies in countries that do not have expressed provision on the rights to health. While the right to health is yet to be explicitly incorporated in the Ugandan constitution, the case study points to a number of ways to implement it within judicial, political and popular measures. Several issues merit future attention to support this, including: developing increased measures and capacities for accountability; integrating a rights based approach in a multi-sectoral response; ensuring adequate resources to the health system; strengthening judicial understanding and implementation of health rights; and strengthening issue based civil society groups and processes that are focused on advancing the right to health with the intention to realize positive public and policy outcomes.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 212: Breathing life into constitutional rights to health in Uganda ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Header"}},{"node":{"title":"Feasibility, acceptability and potential sustainability of a \u2018diagonal\u2019 approach to health services for female sex workers in Mozambique","field_subtitle":"Lafort Y; de Melo M; Lessitala F; et al: BMC Health Services Research 18(752) 1-11, 2018 ","URL":"https://tinyurl.com/y7gk93gk","body":"Female sex workers in many settings have restricted access to sexual and reproductive health services. This paper tested a diagonal intervention which combined strengthening of female sex workers targeted services with making public health facilities more female sex worker-friendly. It was piloted over 18 months and then its performance assessed. The intervention, as designed, was considered theoretically feasible by all informants, but in practice the expansion of some of the targeted services was hampered by insufficient financial resources, institutional capacity and buy-in from local government and private partners, and could not be fully actualised. In terms of acceptability, there was broad consensus on the need to ensure that female sex workers have access to sexual reproductive health services, but not on how this might be achieved. Targeted clinical services were no longer endorsed by the national government, which now prefers a strategy of making public services more friendly for key populations. Stakeholders judged that the piloted model was not fully sustainable, nor replicable elsewhere in the country, given its dependency on short-term project-based funding, lack of government endorsement for targeted clinical services, and viewing the provision of community activities as a responsibility of civil society. In the current Mozambican context, a \u2018diagonal\u2019 approach to ensure adequate access to sexual and reproductive health care for female sex workers is not fully feasible, acceptable or sustainable, because of insufficient resources and lack of endorsement by national policy makers for the targeted, vertical component.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Gendered norms of responsibility: reflections on accountability politics in maternal health care in Malawi","field_subtitle":"Lodenstein E; Pedersen K; Botha K; et al: International Journal for Equity in Health 17(131) 1-15, 2018 ","URL":"https://tinyurl.com/y9emy5qe","body":"This paper aims to provide insights into the role of traditional authorities in two maternal health programmes in Northern Malawi. Among strategies to improve maternal health, these authorities issue by-laws that are local rules to increase the uptake of antenatal and delivery care. The study uses a framework of gendered institutions to critically assess the by-law content, process and effects and to understand how responsibilities and accountabilities are constructed, negotiated and reversed, in a qualitative study in five health centre catchment areas in Northern Malawi. In the study district, traditional leaders introduced three by-laws that oblige pregnant women to attend antenatal care; bring their husbands along and; and to give birth in a health centre. If women fail to comply with these rules, they risk being fined or denied access to maternal health services. The findings show that responsibilities and accountabilities are negotiated and that by-laws are not uniformly applied. Whereas local officials support the by-laws, lower level health cadres\u2019 and some community members contest them, in particular, the principles of individual responsibility and universality. The study adds new evidence on the understudied phenomenon of by-laws. From a gender perspective, the by-laws are problematic as they individualise the responsibility for maternal health care and discriminate against women in the definition and application of sanctions. Through the by-laws, supported by national policies and international institutions, the authors argue that women bear the full responsibility for failures in maternal health care, suggesting a form of \u2018reversed accountability\u2019 of women towards global maternal health goals. This can negatively impact on women\u2019s reproductive health rights and obstruct ambitions to achieve gender inequality and health equity. It is suggested that contextualised gender and power analysis in health policymaking and programming as well as in accountability reforms could help to identify these challenges and potential unintended effects.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Healthcare service delivery to refugee children from the Democratic Republic of Congo living in Durban, South Africa: a caregivers\u2019 perspective","field_subtitle":"Meyer-Weitz A;  Oppong Asante K; Lukobeka B: BMC Medicine 16(163), doi: https://doi.org/10.1186/s12916-018-1153-0, 2018","URL":"https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1153-0","body":"This study explored refugee caregivers\u2019 perceptions of their children\u2019s access to quality health service delivery to their young children in Durban, South Africa. This study used an explanatory mixed methods design, purposively sampling 120 and 10 participants for the quantitative and qualitative phases, respectively. The majority (89%) of caregivers were women, with over 70% of them aged between 30 and 35 years. Over 74% of caregivers visited public clinics for their children\u2019s healthcare needs. The majority of caregivers (95%) were not satisfied with healthcare services delivery to their children due to the long waiting hours and the negative attitudes and discriminatory behaviours of healthcare workers, particularly in public healthcare facilities. These findings underscore the need to address health professionals\u2019 attitudes when providing healthcare for refugees. The authors suggest that attitudinal change may improve the relationship between service providers and caregivers of refugee children in South Africa, which may improve the health-related outcomes in refugee children.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"High rates of smoking in people with HIV in sub-Saharan Africa","field_subtitle":"Carter M: Aidsmap, September 2018","URL":"https://tinyurl.com/ybjpc3ky","body":"This research analysed data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 25 sub-Saharan African countries to determine prevalence of cigarette smoking and use of smokeless tobacco according to HIV status. Cross-sectional data were collected between 2005 and 2015 from adults aged between 15 and 59 years. As well as HIV status, data were also collected on gender, marital/relationship status, level of education, income, area of residence (rural/urban) and employment status. These factors were taken into account in statistical analyses of the association between HIV status and tobacco use. Turning to HIV, the prevalence of smoking was higher among HIV-positive than HIV-negative individuals (10.6% vs 8.1%). Analysis by gender showed that 25.9% of HIV-positive men and 1.2% of HIV-positive women smoked, significantly higher than the 16.1% and 0.7% prevalence seen in HIV-negative men and women, respectively. Country-level analyses showed considerable variability in tobacco use between individual countries. The prevalence of smoking ranged from 2.4% in Ghana to 19.9% in Lesotho. Over half of countries (14 of 25) showed a higher smoking prevalence among people with HIV. The difference was significant in five countries: Gambia, Niger, Swaziland, Zambia and Zimbabwe. But in Ethiopia and Namibia, HIV-positive participants were less likely to smoke than HIV-negative ones. The investigators acknowledge a number of limitations, including the cross-sectional design of their study, failure to collect data on frequency and intensity of tobacco use and a lack of data on use of antiretroviral therapy.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"HIV partner services in Kenya: a cost and budget impact analysis study","field_subtitle":"Cherutich  P; Farquhar C; Wamuti B; et al: BMC Health Services Research 18(721) 1-11, 2018 ","URL":"https://tinyurl.com/ya3cpo5c","body":"This paper focuses on elicitation of contact information, notification and testing of sex partners of HIV infected patients (aPS). Using study data and time motion studies, the authors constructed an Excel-based tool to estimate costs and the budget impact of aPS in selected facilities in Kisumu County. The authors report the annual total and unit costs of HTS, incremental total and unit costs for aPS, and the budget impact of scaling up aPS over a 5-year horizon. The average unit costs for HIV testing among HIV-infected index clients was US$ 25.36 per client and US$ 17.86 per client using nurses and CHWs, respectively. The average incremental costs for providing enhanced aPS in Kisumu County were US$ 1 092 161 and US$ 753 547 per year, using nurses and CHWs, respectively. The average incremental cost of scaling up aPS over a five period was 45% higher when using nurses compared to using CHWs. Over the five years, the upper-bound budget impact of nurse-model was US$ 1,8mn, 63% and 35% of which were accounted for by aPS costs and ART costs, respectively. The CHW model incurred an upper-bound incremental cost of US$ 1,3mn which was 71% lower than the nurse-based model. The budget impact was sensitive to the level of aPS coverage and ranged from US$ 28 547 for 30% coverage using CHWs in 2014 to US$ 1,3mn for 80% coverage using nurses in 2018. Scaling aPS using nurses has minimal budget impact but not cost-saving over a five-year period. Targeting aPS to newly-diagnosed index cases and task-shifting to community health workers is recommended by the authors.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"How a change in US abortion policy reverberated around the globe","field_subtitle":"Bearak M; Morello C: The Washington Post, October 2018","URL":"https://tinyurl.com/yc4tvo5z","body":"In January 2017, President Trump signed an executive order that denied U.S. assistance to any foreign-based organization that performs, promotes or offers information on abortion. A similar policy was in effect under past Republican presidents. In 2017 it was expanded exponentially to apply not just to around $600 million in overseas family-planning funds, but to the entire $8.8 billion in annual U.S. global health aid. It will take years to gauge the full impact of the policy, which will affect aid groups as they renew grants or seek new U.S. funding. More broadly, the policy has created a wave of uncertainty in aid-dependent countries. For the first time, groups that treat HIV, malaria and other illnesses will also have to pledge to have no role in promoting abortion \u2014 or forgo American aid. Academics have questioned whether the policy effectively decreases abortions. A 2011 study by Stanford University researchers suggested the policy has actually been \u201cassociated with increases in abortion rates in sub-Saharan African countries.\u201d One possible reason the researchers gave for this was that some organizations that had provided contraceptives lost funding, which may have led to more unwanted pregnancies. While most foreign health groups have committed to following the new rules., a small group , including the International Planned Parenthood Federation and Marie Stopes, have refused to sign. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"How do gender and disability influence the ability of the poor to benefit from pro-poor health financing policies in Kenya? An intersectional analysis","field_subtitle":"Kabia E; Mbau R; Muraya K; et al: International Journal for Equity in Health 17(149) 1-12, 2018 ","URL":"https://tinyurl.com/y7qdzcd2","body":"This study employed an intersectional approach to explore how gender disability and poverty interact to influence how poor women in Kenya benefit from pro-poor financing policies that target them. The authors applied a qualitative cross-sectional study approach in two purposively selected counties in Kenya. The authors collected data using in-depth interviews with women with disabilities living in poverty who were beneficiaries of the health insurance subsidy programme and those in the lowest wealth quintiles residing in the health and demographic surveillance system. Women with disabilities living in poverty often opted to forgo seeking free healthcare services because of their roles as the primary household providers and caregivers. Due to limited mobility, they needed someone to accompany them to health facilities, leading to greater transport costs. The absence of someone to accompany them and unaffordability of the high transport costs, for example, made some women forgo seeking antenatal and skilled delivery services despite the existence of a free maternity programme. The layout and equipment at health facilities offering care under pro-poor health financing policies were disability-unfriendly. The latter in addition to negative healthcare worker attitudes towards women with disabilities discouraged them from seeking care. Negative stereotypes against women with disabilities in the society led to their exclusion from public participation forums thereby limiting their awareness about health services. Intersections of gender, poverty, and disability influenced the experiences of women with disabilities living in poverty with pro-poor health financing policies in Kenya. Addressing the healthcare access barriers they face could entail ensuring availability of disability-friendly health facilities and public transport systems, building cultural competence in health service delivery, and empowering them to engage in public participation.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Identifying health policy and systems research priorities for the sustainable development goals: social protection for health","field_subtitle":"Mary Qiu M; Jessani N; Bennett S: International Journal for Equity in Health 17(155) 1-14, 2018 ","URL":"https://tinyurl.com/y7gl8uoh","body":"This paper sought to identify potential research priorities concerning social protection and health in low and middle-income countries, from multiple perspectives. Priority research questions were identified through research reviews on social protection interventions and health, interviews with 54 policy makers from Ministries of Health, multi-lateral or bilateral organizations, and NGOs. Data was collated and summarized using a framework analysis approach. The final refining and ranking of the questions were completed by researchers from around the globe through an online platform. The overview of reviews identified 5 main categories of social protection interventions: cash transfers; financial incentives and other demand side financing interventions; food aid and nutritional interventions; parental leave; and livelihood/social welfare interventions. Policy-makers focused on the implementation and practice of social protection and health, how social protection programs could be integrated with other sectors, and how they should be monitored/evaluated. A collated list resulted in 31 priority research questions. Scale and sustainability of social protection programs ranked highest. The top 10 research questions focused heavily on design, implementation, and context, with a range of interventions that included cash transfers, social insurance, and labour market interventions. The authors observe that there is potentially a rich field of enquiry into the linkages between health systems and social protection programs, but research within this field has focused on a few relatively narrowly defined areas. The SDGs provide an impetus to the expansion of research of this nature, with priority setting exercises such as this helping to align funder investment with researcher effort and policy-maker evidence needs.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Influence of the WHO framework convention on tobacco control on tobacco legislation and policies in sub-Saharan Africa","field_subtitle":"Wisdom J; Juma P; Mwagomba B: BMC Public Health 18(Suppl 1) 954, doi: https://doi.org/10.1186/s12889-018-5827-5, 2018","URL":"https://tinyurl.com/ybqw968f","body":"The World Health Organization\u2019s Framework Convention on Tobacco Control, enforced in 2005, was a watershed international treaty that stipulated requirements for signatories to govern the production, sale, distribution, advertisement, and taxation of tobacco to reduce its impact on health. This paper describes the timelines, context, key actors, and strategies in the development and implementation of the treaty and describes how six sub-Saharan countries responded to its call for action on tobacco control. A multi-country policy review using case study design was conducted in Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo. It involved document review and key informant interviews. Multiple stakeholders, including academics and activists, led a concerted effort for more than 10 years to push the WHO treaty forward despite counter-marketing from the tobacco industry. Once the treaty was enacted, Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo responded in unique ways to implement tobacco policies, with differences associated with the country\u2019s socio-economic context, priorities of country leaders, industry presence, and choice of strategies. All the study countries except Malawi have acceded to and ratified the WHO tobacco treaty and implemented tobacco control policy. Reviewing how six sub-Saharan countries responded to the treaty to mobilize resources and implement tobacco control policies provided insight for how to utilise international regulations and commitments to accelerate policy impact on the prevention of non-communicable diseases.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Is healthcare really equal for all? Assessing the horizontal and vertical equity in healthcare utilisation among older Ghanaians","field_subtitle":"Dei V; Sebastian M: International Journal for Equity in Health 17(86)1-12, 2018","URL":"https://tinyurl.com/y99l9ncx","body":"This paper aimed to assess whether horizontal and vertical equity were being met in the healthcare utilisation among adults aged 50 years and above. The paper was based on a secondary cross-sectional data from the World Health Organization\u2019s Study on global AGEing and adult health wave 1 conducted from 2007 to 2008 in Ghana. Data on 4304 older adults aged 50 years-plus were analysed. Horizontal and vertical inequities were found in the use of outpatient services. Inpatient healthcare utilisation was both horizontally and vertically equitable. Women were found to be more likely to use outpatient services than men but had reduced odds of using inpatient services. Possessing a health insurance was also significantly associated with the use of both inpatient and outpatient services. Whilst equity exists in inpatient care utilisation, more needs to be done to achieve equity in the access to outpatient services. The paper reaffirms the need to evaluate both the horizontal and vertical dimensions in the assessment of equity in healthcare access. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Managing Editor: Health-e News Service","field_subtitle":"Health-e News Service","URL":"http://www.bizcommunity.com/Job/196/1/353653.html","body":"Health-e News Service is looking for a dynamic Managing Editor to lead Africa's first independent health news agency. The successful candidate must have vision about how to develop a multimedia organization; experience in managing a non-profit organization; ability to fundraising; commitment to social justice and a well-functioning public health system. Key performance areas include: managing a diverse multimedia organisation, including editorial oversight over an award-winning team of journalists; overseeing the development and implementation of an annual strategic plan; fundraising and donors relations; managing client relations and expanding the client base. The candidate needs to have at least eight years management experience, extending fundraising experience, editorial management skills and at least a bachelor\u2019s degree. The position is located in Johannesburg although consideration will be given to Cape Town-based candidates. Salary is in line with experience. Preference will be given to candidates from previously disadvantaged groups. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Mental Health Atlas 2017","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"https://tinyurl.com/y8k7rhgc","body":"WHO's Mental Health Atlas 2017 reveals that although some countries have made progress in mental health policy-making and planning, there is a global shortage of health workers trained in mental health and a lack of investment in community-based mental health -based mental health facilities. The inclusion of mental health in the Sustainable Development Agenda, which was adopted at the United Nations General Assembly in September 2015, is likely to have a positive impact on communities and countries where millions of people will receive much needed help. Data included in Mental Health Atlas 2017 demonstrates that progressive development is being made in relation to mental health policies, laws, programmes and services across WHO Member States. However extensive efforts, commitment and resources at global and country level are needed to meet the global targets. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Press release on prosecution of SGBC in Uganda","field_subtitle":"Kwagala P: Centre for Health, Human Rights & Development, 2018","URL":"https://tinyurl.com/yd7okmps","body":"In August 2018, the Center for Health, Human Rights and Development (CEHURD), Nnamala Mary and Simon Kakeeto took the Government of Uganda to the Constitutional Court for failing to put in place shelters for women who have been raped or defiled. CEHURD challenged the unequal punishments that the law provides for sexual offenders as being unjust. Men charged with rape are liable to suffer a maximum penalty of death whereas the law provides for the offense of \u2018defilement\u2019 for persons between the ages of 14-17 and sexual offenders against girls of that category are only given a few years of a jail term. This difference in penalties towards perpetrators who commit the same offense was argued to be unjust and to offend the principle of equality and non-discrimination before the law. It was also observed to have an effect of increasing sexual violence against girls in that particular age group. Women who survive sexual violence need safe spaces, shelters and refuge. The Ugandan Constitution mandates the State to put in place facilities to enhance the welfare of women to enable them to realise their full potential and advancement. It was thus CEHURD's contention that failure by government to construct and finance these shelters is a clear violation of women\u2019s rights guaranteed under article 33(2) of the 1995 Constitution of Uganda. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Public Health approach to hearing across the life course: A call for papers","field_subtitle":"Deadline for submissions: 30 November 2018","URL":"http://www.who.int/bulletin/volumes/96/9/18-221697/en/","body":"Hearing loss, especially disabling hearing loss, is associated with delayed cognitive development in children and early cognitive decline in older adults. Hearing loss was highlighted at the World Health Assembly in 2017, when Member States unanimously adopted a resolution to develop public health strategies to integrate ear and hearing care within countries\u2019 primary health-care systems. Against this background, the Bulletin of the World Health Organization will publish a theme issue on the public health approach of hearing loss. Papers are welcomed which focus on identifying and filling the gaps in evidence across comprehensive hearing-care services, from promotion of ear and hearing care, to screening, hearing devices and rehabilitation. In particular, the papers should report on unmet needs, outcomes of services, and effective and sustainable initiatives to reach underserved groups. Submission of papers reporting on both the magnitude of diseases and conditions, such as ear infections, meningitis and rubella, that can affect hearing, are encouraged, as well as papers addressing health system issues and promoting an intersectoral approach to ear and hearing care, such as looking beyond health. As much as possible, papers should seek to integrate examples from low- and middle-income countries across life course.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Realities and experiences of community health volunteers as agents for behaviour change: evidence from an informal urban settlement in Kisumu, Kenya","field_subtitle":"Aseyo R; Mumma J; Scott K; et al: Human Resources for Health 16(53) 1-12, 2018 ","URL":"https://tinyurl.com/ycw48nsg","body":"This study examines the behaviour change-related activities of community health volunteers (CHVs) community health workers affiliated with the Kenyan Ministry of Health in a peri-urban settlement in Kenya, in order to assess their capabilities, opportunities to work effectively, and sources of motivation. This mixed-methods study included a census of 16 CHVs who work in the study area. All CHVs participated in structured observations of their daily duties, structured questionnaires, in-depth interviews, and two focus group discussions. In addition to their responsibilities with the Ministry of Health, CHVs partnered with a range of non-governmental organizations engaged in health and development programming, often receiving small stipends from these organizations. CHVs reported employing a limited number of behaviour change techniques when interacting with community members at the household level. While supervision and support from the MOH was robust, CHV training was inconsistent and inadequate with regard to behaviour change and CHVs often lacked material resources necessary for their work. CHVs spent very little time with the households in their allocated catchment area. The number of households contacted per day was insufficient to reach all assigned households within a given month as required and the brief time spent with households limited the quality of engagement. Lack of compensation was noted as a demotivating factor for CHVs. This was compounded by the challenging social environment and CHVs\u2019 low motivation to encourage behaviour change in local communities. In a complex urban environment, CHVs faced challenges that limited their capacity to be involved in behaviour change interventions. The authors argue that more resources, better coordination, and additional training in modern behaviour change approaches are needed to ensure their optimal performance in implementing health programmes.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda","field_subtitle":"Musoke D; Ssemugabo C; Ndejjo R; Ekirapa-Kiracho E; et al: Human Resources for Health 16(41) 1-9,  2018","URL":"https://tinyurl.com/yao88rdh","body":"This paper explores the different roles of male and female community health workers in rural Wakiso district, Uganda, using photovoice, as a community-based participatory research approach. The authors trained ten community health workers on key concepts about gender and photovoice. The community health workers took photographs for 5 months on their gender-related roles which were discussed in monthly meetings. The discussions from the meetings were recorded, transcribed, and translated to English, and emerging data were analysed using content analysis. Although responsibilities were the same for both male and female community health workers, they reported that in practice, community health workers were predominantly involved in different types of work depending on their gender. Social norms led to men being more comfortable seeking care from male community health workers and females turning to female community health workers. Due to their privileged ownership and access to motorcycles, male community health workers were noted to be able to assist patients faster with referrals to facilities during health emergencies, cover larger geographic distances during community mobilization activities, and take up supervisory responsibilities. Due to the gendered division of labour in communities, male community health workers were also observed to be more involved in manual work such as cleaning wells. The gendered division of labour also reinforced female caregiving roles related to child care, and also made female community health workers more available to address local problems. Community health workers reflected both strategic and conformist gendered implications of their community work. The authors argue that the differing roles and perspectives about the nature of male and female community health workers while performing their roles should be considered while designing and implementing community health workers programmes, without further retrenching gender inequalities or norms.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The 7th East African Health and Scientific Conference ","field_subtitle":"27-29 March 2019, Dar es Salaam, Tanzania","URL":"https://tinyurl.com/y8dkxedf","body":"The main theme for this conference will be \u2018Technology for health systems transformation and attainment of the UN-Sustainable Development Goals\u2019. The key note speech will be on 'Invest in Digital Health to catalyse East Africa to attain the UN-Sustainable Development Goals\u2019. Various sub-themes will be presented and discussed during the first two days of the conference. Each sub-theme will start with a state-of-the-art presentation, after which evidence-based scientific material will be presented. The presentations will lead to recommendations on technologies for health system decision making, diseases and the improvement of healthcare service delivery and health outcomes. Further sub-themes relate to the health financing and health knowledge management through digital technologies and solutions. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The causes of the growth of 'populism'","field_subtitle":"Navarro V: Other News, October 2018","URL":"https://tinyurl.com/yd5evqzg","body":"In this article (original in Spanish) the author analyses current movements termed 'populist'. He notes that they have some points in common. One of them is their clear opposition to globalization and economic integration and to the cultural and political homogenization that they entail and that is perceived as a threat to their national identity. A desire to recover identity and national control conditions is a nationalist sentiment based primarily (though not exclusively) on globalization being identified with a decline in the quality of life and well-being of the social classes behind this populism, even while this was due to the enormous increase in the wealth and welfare of wealthy minorities at the expense of the great decline in welfare and standard of living of the majority of the population The author asserts that socialist movements that have an opposition and alternative to a neoliberal conservative establishment  differs from most populisms, which have an anti-establishment dimension but lack a proactive dimension . At the same time he argues that the failure of socialist or social democratic parties to develop an effective response to neoliberalism has been one of the main causes of the growth of right wing populist movements. The author argues for responses that recognise that the different sectors of the population have elements and conditions in common, that also provides more radical proposals for how to address these conditions.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The future of health in Zimbabwe","field_subtitle":"Kidia K: Global Health Action 11(1496888) 1-5, 2018","URL":"https://tinyurl.com/y9xy6zre","body":"The author presents the argument that Zimbabwe is at a critical juncture for health reform and argues that this reform should focus on repairing relationships with the international community by focusing on human rights and eliminating corruption; strengthening the health workforce through retention strategies, training, and non-specialist providers and strengthening community engagement to grow local leadership and ensure that interventions are socially and culturally sensitive. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"This is 18: through girls\u2019 eyes. ","field_subtitle":"Bennett J; Strzemien A: New York Times, October, 2018","URL":"https://tinyurl.com/y7masbol","body":"When Malala Yousafzai turned 18, she opened a school for Syrian refugee girls, calling on leaders from around the world to provide \u201cbooks not bullets.\u201d It was at 18 that Cleopatra became ruler of Egypt, in 51 B.C.E., and Victoria the queen of Great Britain, in 1837. By the time she was 18, Britney Spears had had two No. 1 albums on the Billboard chart, and Serena Williams had won the U.S. Open. Emma Gonzalez, 18 now, has become a global leader in the movement to end gun violence. No pressure, right? Eighteen is an age. But it\u2019s also something more. It\u2019s a moment, a rite of passage, a gateway to adulthood.In the United States, 18 means you can finally vote, sign a lease on an apartment, obtain a credit card and buy a Juul. In China and parts of Canada, 18 grants you entrance to a pub, while for most Israelis, it means a mandatory draft into the military. By 18, one in five women across the globe will be married. Millions will enter college or university. \u201cThis is 18\u201d aims to capture what life is like for girls turning 18 in 2018 across oceans and cultures. The editors asked young women photographers to document girls in their communities \u2014 taking the photos and conducting the interviews themselves. Each photographer was paired with a professional mentor to guide them through the process. The result is a celebration of girlhood around the world \u2014 across 12 time zones and 15 languages, featuring 21 subjects and 22 photographers. #ThisIs18 \u2014 a look at girls\u2019 lives, through girls\u2019 eyes.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Towards a global monitoring system for implementing the Rio Political Declaration on Social Determinants of Health: developing a core set of indicators for government action on the social determinants of health to improve health equity","field_subtitle":"Working Group for Monitoring Action on the Social Determinants of Health: International Journal for Equity in Health 17(136) 1-27, 2018","URL":"https://tinyurl.com/yce593dj","body":"In the 2011 Rio Political Declaration on Social Determinants of Health, World Health Organization Member States pledged action in five areas crucial for addressing health inequities. Their pledges referred to better governance for health and development, greater participation in policymaking and implementation, further reorientation of the health sector towards reducing health inequities, strengthening of global governance and collaboration, and monitoring progress and increasing accountability. The authors describe the selection of indicators proposed to be part of the initial World Health Organization global system for monitoring action on the social determinants of health. The authors describe the processes and criteria used for selecting social determinants of health action indicators that were of high quality and the described the challenges encountered in creating a set of metrics for capturing government action on addressing the Rio Political Declaration\u2019s five Action Areas. The authors developed 19 measurement concepts, identified and screened 20 indicator databases and systems, including the 223 Sustainable Development Goals indicators, and applied strong criteria for selecting indicators for the core indicator set. They identified 36 suitable existing indicators, which were often Sustainable Development Goals indicators. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Towards an interdisciplinary approach to wellbeing: Life histories and Self-Determination Theory in rural Zambia","field_subtitle":"White S; Jha S: Social Science & Medicine (212)153-160, 2018","URL":"https://tinyurl.com/y9p9no7a","body":"This paper implemented a qualitative analysis of wellbeing in life history interviews in Chiawa, rural Zambia. The enquiry goes beyond simply reading across methods, disciplines and contexts, to consider fundamental differences in constructions of the human subject, and how these relate to understandings of wellbeing. Field research took place in two periods, August\u2013November, 2010 and 2012. Analysis drew on 46 individual case studies, conducted through open-ended interviews. These were identified through a survey with an average of 390 male and female household heads in each round, including 25% female headed households. As social determinants theory predicts, the interviews confirm elements of autonomy, competence and relatedness as vital to wellbeing. However, these are expressed in ways that highlight material and relational, rather than psychological, factors.  The authors endorsed social determinants theory\u2019s utility in interdisciplinary approaches to wellbeing, but only if it admits its own cultural grounding in the construction of socially and culturally distinctive questions on basic psychological needs. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Towards universal health coverage: a mixed-method study mapping the development of the faith-based non-profit sector in the Ghanaian health system","field_subtitle":"Grieve A; Olivier J: International Journal for Equity in Health 17(97)1-20, 2018 ","URL":"https://tinyurl.com/y73ny96a","body":"This paper presents a mapping of faith-based health assets in Ghana using both qualitative and quantitative evidence to provide a visual representation of changes in the spatial footprint of the faith-based non-profit (FBNP) health sector. The geospatial maps show that FBNPs were originally located in rural remote areas of the country but that this service footprint has evolved over time, in line with changing social, political and economic contexts. The sector has had a long-standing role in the provision of health services and remains a valuable asset within national health systems in Ghana and sub-Saharan Africa more broadly. The authors observe that collaboration between the public sector and such non-state providers, drawing on the comparative strengths and resources of FBNPs and focusing on whole system strengthening, is essential for the achievement of universal health coverage.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Two decades of antenatal and delivery care in Uganda: a cross-sectional study using Demographic and Health Surveys","field_subtitle":"Benova L; Dennis M; Lange I; et al: BMC Health Services Research 18(758) 1-14, 2018","URL":"https://tinyurl.com/yb9en7yq","body":"The authors present a repeated cross-sectional study using four Uganda Demographic and Health Surveys of evidence on births with ANC, facility delivery, caesarean sections and complete maternal care. The authors assessed socio-economic differentials in these indicators by wealth, education, urban/rural residence, and geographic zone in the 1995 and 2011 surveys. ANC coverage with remained high over the study period but ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"United States aid policy and induced abortion in sub-Saharan Africa","field_subtitle":"Brendavid E; Avila P; Miller G: Bulletin of the World Health Organisation 89(12) 853-928, 2011","URL":"http://www.who.int/bulletin/volumes/89/12/11-091660/en/","body":"This study explored the relationship between the reinstatement in 2001 of a US policy requiring all nongovernmental organizations operating abroad to refrain from performing, advising on or endorsing abortion as a method of family planning if they wish to receive federal funding and the probability that a sub-Saharan African woman will have an induced abortion.  The authors used longitudinal, individual data on terminated pregnancies collected by Demographic and Health Surveys (DHS) to estimate induced abortion rates. The study found robust empirical patterns suggesting that the policy was associated with increases in abortion rates in sub-Saharan African countries. Several observations were identified to strengthen this conclusion. First, the association was strong: and second, there was broad agreement among the aggregate graphical analysis and both unadjusted and adjusted statistical analyses, robust across a variety of sensitivity analyses. Third, the timing of divergence between high and low exposure countries was coincident with the policy\u2019s reinstatement: in high exposure countries, abortion rates began to rise noticeably only after the policy was reinstated in 2001 and the increase became more pronounced from 2002 onward. ","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Universal health coverage and community engagement","field_subtitle":"Odugleh-Kolev A; Parrish-Sprowl J: World Health Organisation 96(9)660-661, 2018","URL":"http://www.who.int/bulletin/volumes/96/9/17-202382/en/","body":"In this article, the authors reflect on how efforts towards UHC could offer an opportunity to address those aspects within health systems that continue to hinder efforts to meaningfully engage with patients, their families and local communities. The backbone of these efforts should be a health workforce that is skilled in engagement, responsive to local context and to the needs and expectations of those using their services. Community engagement was introduced in the 2013\u20132016 Ebola virus disease outbreak in recognition of the important role of response staff and their ability to engage with communities, in contrast to social mobilization or behaviour-change interventions. Engagement and empowerment of health service users and community members also re-emerged as a core strategy in the WHO Framework on Integrated People-Centred Health Services, which was formally adopted by Member States in 2016. To move towards a more meaningful understanding of what community engagement is and how it works, the authors suggest that several changes need to take place. First, to recognize that health systems have a fundamental responsibility and obligation for engaging with patients, their families, local communities, as well as a range of stakeholders, partners and sectors, recognising the physiological, emotional, mental and social interconnection of people. Health systems and communities are observed to be in continuous and interdependent action. If community engagement becomes a focus for UHC efforts, it could promote approaches that recognize that health and well-being are co-produced, and that empowers both health-care providers and communities.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Wellcome Photography Prize 2019","field_subtitle":"Deadline for entries: 17 December 2018","URL":"https://tinyurl.com/ybqyphtu","body":"The Wellcome Trust invite photographers and other image makers from all disciplines to enter the Wellcome Photography Prize, which celebrates compelling imagery that captures stories of health, medicine and science. Wellcome are looking for entries that can captivate people with stories of science and medicine, and start conversations about some of the health challenges people face. The winner of each category will receive \u00a31,250, with the overall winner receiving a prize of \u00a315,000. Prizes will be presented at an awards ceremony in London on 3 July 2019. All the winning and shortlisted entries will go on show in a major public exhibition at Lethaby Gallery, Central Saint Martins, University of the Arts London, from 4-13 July 2019. If you\u2019re a winner, Wellcome will also offer opportunities to take part in events to showcase your work to a range of audiences. The winning images receive extensive international media coverage each year. There are four categories in the competition: Social perspectives \u2013 explore how health and illness affect the way we live; Hidden worlds \u2013 reveal details hidden to the naked eye; Medicine in focus \u2013 show health and healthcare up close and personal; Outbreaks (2019 theme) \u2013 capture the impact of disease as it spreads.","php":"","field_issue_date":"2018-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"2nd International Workshop on HIV Adolescence","field_subtitle":"10-12 October 2018, Cape Town, South Africa","URL":"https://tinyurl.com/y87vsujg","body":"At major meetings, advances in HIV management focuses mainly on either adults or children, leaving out adolescents. To meet this need for international interchange in order to bring the field forward, Virology Education and partners have initiated the International Workshop on HIV & Adolescence: challenges and solutions. This workshop is for multidisciplinary experts working with adolescents affected by HIV.  It aims to share experiences, knowledge and best practices in optimizing care for adolescents living with HIV. The program will cover the spectrum of developmental changes in adolescents including social, behavioral, physiological and biological aspects and the impact of an HIV positive status, and prevention programs, testing, treatment and support services among adolescents. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A longitudinal perspective on boys as victims of childhood sexual abuse in South Africa: Consequences for adult mental health","field_subtitle":"Richter L; Mathews S; Nonterah E; et al: Child Abuse & Neglect 84, 1-10, 2018","URL":"http://www.sciencedirect.com/science/article/pii/S0145213418302850?via%3Dihub","body":"Childhood sexual abuse of boys was examined in a longitudinal cohort in South Africa, with data on abuse collected at six age points between 11 and 18 years. Potential personal and social vulnerability of male sexual abuse victims was explored and mental health outcomes of sexually abused boys were examined at age 22\u201323 years. Reports of all sexual activity \u2013 touching, oral and penetrative sex \u2013 increased with age and sexual coercion decreased with age. Almost all sexual activity at 11 years of age was coerced, with the highest rates of coercion occurring between 13 and 14 years of age; 45% of reports of coerced touching were reported at age 14, 41 percent of coerced oral sex at age 13, and 31% of coerced penetrative sex at age 14. Sexual coercion was perpetrated most frequently by similar aged peers and although gender of the assailant was less often reported, it can be presumed that perpetration is by males. Boys who experienced childhood sexual abuse tended to be smaller (shorter) and from poorer families. No relationships to measured childhood intelligence, pubertal stage, marital status of mother or presence of the father were found and there was no significant association between reports of childhood sexual abuse and mental health in adulthood.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Child Rights and Child Law Short Course for Health and Allied Professionals ","field_subtitle":"Course Dates: 3-7 December 2018","URL":"http://www.ci.uct.ac.za/ci/child-rights-course/overview","body":"The Children\u2019s Institute has developed a cutting-edge short course in child rights and child law for health and allied professionals - including training on consent to medical treatment and the reporting of child abuse and neglect as outlined in the new Children\u2019s Act and amendments to the Sexual Offences Act. This five-day intensive course provides an opportunity for doctors, nurses, social workers and allied professionals to explore how best can better give effect to children\u2019s rights in their practice, and is accredited with both the Health Professions Council of South Africa and the SA Council for Social Service Professions. The course is accredited by both the Health Professions Council of South Africa and the SA Council for Social Service Professions, and is targeted at doctors, nurses, educators, social workers and allied professionals who are responsible for child health at all levels of the health care system. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps?","field_subtitle":"Nkosi V; Wichmann J; Voyi K: Environmental Health 14(33), doi: https://doi.org/10.1186/s12940-015-0018-7, 2015","URL":"https://ehjournal.biomedcentral.com/articles/10.1186/s12940-015-0018-7","body":"This study investigated the association between proximity to mine dumps and prevalence of chronic respiratory disease in people aged 55 years and older. Elderly persons in communities 1-2 km (exposed) and 5 km (unexposed), from five pre-selected mine dumps in Gauteng and North West Province, in South Africa were included in a cross-sectional study. Structured interviews were conducted with 2397 elderly people, using a previously validated questionnaire from the British Medical Research Council. Exposed elderly persons had a significantly higher prevalence of chronic respiratory symptoms and diseases than those who were unexposed., Results from the multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma, chronic bronchitis, chronic cough, emphysema, pneumonia and wheeze. Residing in exposed communities, current smoking, ex-smoking, use of paraffin as main residential cooking/heating fuel and low level of education emerged as independent significant risk factors for chronic respiratory symptoms and diseases. This study suggests that there is a high level of chronic respiratory symptoms and diseases among elderly people in communities located near to mine dumps in South Africa.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Contact tracing performance during the Ebola epidemic in Liberia, 2014-2015","field_subtitle":"Swanson K; Altare C; Wesseh C; et al: PLOS Neglected Tropical Diseases, doi: https://doi.org/10.1371/journal.pntd.0006762, 2018","URL":"https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006762","body":"During the Ebola virus disease (EVD) epidemic in Liberia, contact tracing was implemented to rapidly detect new cases and prevent further transmission. The authors describe the scope and characteristics of this contact tracing and assess its performance during the 2014\u20132015 epidemic in six counties. Positive predictive value (PPV) was defined as the proportion of traced contacts who were identified as potential cases. Contact tracing was initiated for 26.7% of total EVD cases and detected 3.6% of all new cases during the period covered, with a PPV  of 1.4%. Potential cases were more likely to be detected early in the outbreak; to hail from rural areas; report multiple exposures and symptoms; have household contact or direct bodily or fluid contact; and report nausea, fever, or weakness, as compared to contacts who completed monitoring. Contact tracing was identified to be a critical intervention in Liberia and represented one of the largest contact tracing efforts during an epidemic in history. While there were notable improvements in implementation over time, the study data suggest there were limitations to its performance\u2014particularly in urban districts and during peak transmission. Recommendations for improving performance include integrated surveillance, decentralized management of multidisciplinary teams, comprehensive protocols, and community-led strategies.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Council for the Development of Social Science Research in Africa (CODESRIA) Iso Lomso Fellowships: Call for Applications 2018, The STIAS Iso Lomso Fellowship Programme","field_subtitle":"Deadline for applications: 20 October 2018","URL":"https://www.codesria.org/spip.php?article2872&lang=en","body":"This fellowship programme is aimed at African scholars who have obtained a doctoral degree within the preceding seven years and who hold an academic position at a university or research institution anywhere in Africa. Candidates should have established a research programme and have completed a post-doctoral fellowship or equivalent post-PhD programme. All disciplines are considered. Iso Lomso Fellowships provide an early career opportunity for Africa\u2019s brightest minds in academia. Fellows will enjoy: a three-year attachment during which time they may spend a total of ten months in residence to develop and pursue a long-term research programme at a sister institute for advanced study in North America, Europe or elsewhere. The fellowship includes funding to attend up to two international conferences or training workshops; support to convene a workshop with collaborators and lecturer replacement subsidy for the fellow\u2019s home institution during residency periods.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Country progress in the implementation of the global action plan on antimicrobial resistance: WHO, FAO and OIE global tripartite database","field_subtitle":"World Health Organisation: WHO Geneva, 2018","URL":"https://tinyurl.com/y9t3fx9a","body":"The World Health Organisation hosts this global open-access tripartite antimicrobial resistance database that provides access to information on the status of countries\u2019 regarding the implementation of the global action plan and actions to address antimicrobial resistance across all sectors. Country responses are visualized through maps and can be sorted by regions and by income groups. Information captured in this database is a result of a country self-assessment questionnaire reporting on progress in: developing national antimicrobial resistance action plans; working with multiple sectors; and implementing key actions to address antimicrobial resistance. The database currently contains data for the reporting year 2016-17 and 2017-18. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Drinking water, sanitation and hygiene in schools, Global baseline report 2018","field_subtitle":"United Nations Children's Fund; World Health Organization: Geneva, 2018","URL":"https://tinyurl.com/y75qczw7","body":"Millions of children around the world do not have access to clean water or decent sanitation at school, putting their education \u2013 and those of girls in particular \u2013 at risk. The first ever global baseline report on drinking-water, sanitation and hygiene in schools \u2013 carried out by WHO and UNICEF \u2013 shows that 620 million children worldwide do not have access to decent toilets at school, and around 900 million children cannot wash their hands properly. Ensuring that children attend school and complete their education is crucial to a country\u2019s social and economic development, yet a lack of decent hygiene facilities discourages children, particularly girls, from doing so. Nearly 570 million children lacked a basic drinking water service at their school. Nearly half of schools in sub-Saharan Africa had no safe drinking water and a third of schools in sub-Saharan Africa had no sanitation service.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Ebola Attacked Congo Again. But Now Congo Seems to Be Winning","field_subtitle":"McNeil D: New York Times, 2 September 2018","URL":"https://tinyurl.com/y7lmn7l6","body":"The month-old Ebola outbreak in the Democratic Republic of Congo, which rose quickly to over 100 cases appears to be fading. More than 3,500 contacts of known cases are being followed, more than 4,000 doses of vaccine have been given and officials reported feeling hopeful enough to allow schools in the area \u2014 North Kivu Province, on the eastern border with Uganda \u2014 to open as usual. Although five experimental treatments for infected patients recently won approval for emergency use, the author reports that so far too few patients have received them to draw conclusions about how well they may work. One reason experts are reluctant to declare the outbreak contained is that some remote towns have not been visited because of armed groups in the area. Ebola experts also said they would not let down their guard because they remembered a brief, deceptive lull in the early days of the 2014 West African outbreak before it reached three capital cities and exploded, killing more than 11,000 people. Medically, the most exciting prospect on the horizon is that, as of Aug. 22, DRC has approved the emergency use of five potential treatments: two antiviral drugs, remdesivir and favipiravir; and three cocktails of antibodies originally found in recovered patients, including ZMapp, mAb114 and Regn3450-3471-3479. Previously, only about half of Ebola patients were saved if they got supportive treatment, including fluid replacement and fever control, in time. Being consistently able to cure most patients is reported to be an important  advance.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 211: How do we keep our health workers in remote rural areas?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Header"}},{"node":{"title":"Exploring multiple job holding practices of academics in public health training institutions from three sub-Saharan Africa countries: drivers, impact, and regulation ","field_subtitle":"Made W; Sanders D; Chilundo B; et al: Global Health Action 11(1491119) 1-10, 2018","URL":"https://tinyurl.com/ycph8xa3","body":"This paper examines and seeks to contribute to understanding of external multiple job holding practices in public health training institutions based in prominent public universities in three sub-Saharan Africa countries. A qualitative multiple case study approach was used. Data were collected through document reviews and in-depth interviews with 18 key informants. Data were then triangulated and analyzed thematically. External multiple job holding practices among faculty of the three public health training institutions were widely prevalent. Different factors at individual, institutional, and national levels were reported to underlie and mediate the practice. While the authors report that it contributes to increasing income of academics, which many described as enabling their continuing employment in the public sector, many pointed to negative effects. Similarities were found regarding the nature and drivers of the practice across the institutions, but differences exist with respect to mechanisms for and extent of regulation. Regulatory mechanisms were often not clear or enforced, and academics are often left to self-regulate their engagement. Lack of regulation is cited as allowing excessive engagement in multiple job holding practice among academics at the expense of their core institutional responsibility. This could further weaken institutional capacity and performance, and quality of training and support to students. The research describes the complexity of external multiple job holding practices, which is characterized by a cluster of drivers, multiple processes and actors, and lack of consensus about its implication for individual and institutional capacity. They argue that in the absence of a strong accountability mechanism, the practice could perpetuate and aggravate the fledgling capacity of public health training institutions.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Health market inquiry: Provisional findings and recommendations","field_subtitle":"Competition Commission: South Africa July 2018","URL":"http://www.compcom.co.za/wp-content/uploads/2018/07/Health-Market-Inquiry-1.pdf","body":"The South African private healthcare sector comprises a complex set of interrelated stakeholders that interact in markets that are not transparent and so not easily understood. This report highlights key features that describe how the private healthcare sector operates. The author identifies features of the private healthcare sector that, alone or in combination, prevent, restrict or distort competition. The report presents recommendations to remedy these adverse effects on competition. Overall, the market is characterised by high and rising costs of healthcare and medical scheme cover, highly concentrated funders\u2019 and facilities\u2019 markets, disempowered and uninformed consumers, a general absence of value-based purchasing, ineffective constraints on rising volumes of care, practitioners that are subject to little regulation and failures of accountability at many levels. An incomplete regulatory regime is attributed to a failure in implementation on the part of regulators and inadequate stewardship by the Department of Health over the years. Intrinsic and extrinsic incentives in the market have promoted over-servicing by medical practitioners which include increased admissions to hospitals, increased length of stay, higher levels of care, greater intensity of care or use of more expensive modalities of care than can be explained by the disease burden of the population. The report presents We evidence of supply induced demand. Various marketing choices are reported to leave consumers confused and disempowered, compounding their inability to use choice as a pressure on schemes. The market is characterized by a dominance of a few schemes and by an absence of effective direct competition between the three big hospital groups. The report recommends changes to the way scheme options are structured to increase comparability between schemes and increase competition in that market; a system to increase transparency on health outcomes to allow for value purchasing and a set of interventions to improve competition in the market through a supply side regulator. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Health systems readiness for adopting mhealth interventions for addressing non-communicable diseases in low- and middle-income countries: a current debate ","field_subtitle":"Feroz A; Kadir M; Saleem S: Global Health Action 11(1496887) 1-7, 2018","URL":"https://tinyurl.com/ybzvdgb7","body":"In low-and-middle-income countries (LMICs), epidemiologic transition is taking place very rapidly from communicable diseases to non-communicable diseases (NCDs). NCD mortality rates are increasing faster and nearly 80% of NCDs deaths occur in LMICs, with human and economic costs, increasing treatment costs and losses to productivity. At the same time, the increasing penetration of mobile phone technology and the spread of cellular network and infrastructure have led to the introduction of the mHealth. While mHealth offers a promising approach in prevention and control of NCDs, it is unclear how ready health systems are to adopt it for this. The authors raise a number of factors which determine health systems readiness and response for adoption of mHealth technology including preparedness of healthcare institutions, availability of the resources, willingness of healthcare providers and communities. They discuss these factors and suggest that they be dealt up-front through constant effort to improve health systems response for NCDs. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda","field_subtitle":"Matovu J; Kisa R; Buregyeya E; et al: Global Health Action 11(1503784) 1-12, 2018","URL":"https://tinyurl.com/y85jwgl6","body":"This was a qualitative study was conducted in Central Uganda between February and March 2017 through 32 in-depth interviews to document women and men\u2019s perceptions about HIV self-testing (HIVST) strategies used by women in delivering the kits to their male partners, male partners\u2019 reactions to receiving kits from their female partners, and positive and negative social outcomes post-test. Women were initially anxious about their male partners\u2019 reaction if they brought HIVST kits home, but the majority eventually managed to deliver the kits to them successfully. Women who had some level of apprehension used a variety of strategies to deliver the kits including placing the kits in locations that would arouse male partners\u2019 inquisitiveness or waited for \u2018opportune\u2019 moments when their husbands were likely to be more receptive. A few women lied about the purpose of the test kit while one woman stealthily took a mucosal swab from the husband. Most men initially doubted the ability of oral HIVST kits to test for HIV, but this did not stop them from using them. Both men and women perceived HIVST as an opportunity to learn about each other\u2019s HIV status. No serious adverse events were reported post-test. The author\u2019s findings lend further credence to the feasibility of female-delivered HIVST to improve male partner HIV testing in sub-Saharan Africa. They suggest that women need support in challenging relationships to minimize potential for deception and coercion.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"How do we keep our health workers in remote rural areas?","field_subtitle":"Rambelani Nancy Malema and  Livhuwani Muthelo, University of Limpopo","body":"Although half of the world population lives in rural and remote areas, these areas are serviced by only a quarter of the world\u2019s nurses and less than a quarter of the doctors. In our region the ratios are even worse, where only 16 doctors service every 100 000 people living in remote rural areas. \r\n\r\nThe global shortage of health workers, estimated by World Health Organisation to reach 18 million by 2030, has motivated resolutions in the World Health Assembly and other fora for member states to find ways of retaining their health workers,  through incentives and working environments that encourage people to stay in rural areas.  Most recently in 2016, a High-level Commission on Health Employment and Economic Growth recommended investing in rural education and creating decent jobs in the rural health sector, particularly recognising the contributions of nurses and midwives to improved health.  \r\n\r\nNotwithstanding these calls, rural and remote areas continue to fail to attract and retain health workers.  So beyond statements of good intention, what practical measures should we be implementing to improve the retention of health workers in our rural areas?\r\n\r\nIt begins with how health workers are enrolled and trained. Our training institutions need to review their admission policies to enrol students from rural backgrounds. They need to include information on rural health care in the curriculum and to integrate rural community experiences to expose students to these environments. Our undergraduate and postgraduate curricula and continuing education programmes should be oriented to building competencies for the shift from hospital-based approaches to preventive, affordable, integrated community-based, people-centred primary and ambulatory care in rural areas, as well as in building capacities for public health and preventing and managing epidemics.\r\n\r\nFinancial incentives have commonly been used to attract and retain health workers in rural areas. In addition to allowances, they may be given as bursaries for further education, study loans and occupation-specific dispensations. There is evidence that these measures have motivated health workers to remain in rural areas. But they can also be eroded if they lose value over time. \r\n\r\nThis makes the living conditions, availability of electricity, proper sanitation, access to schools, telecommunication and internet equally important to enhance retention, together with support for career development and advancement, such as by creation of senior positions in rural institutions. There are new opportunities in using information technologies to enhance rural practice and avoid professional isolation. Providing scholarships, bursaries or other education subsidies and improving living and working conditions can have a more positive effect than compulsory service requirements. Health workers, like others, appreciate their jobs when treated with dignity and respect.\r\n\r\nFrom our review of the literature in a new EQUINET discussion paper 115, we found that many such strategies are being used.  There were some cautions on how we apply these strategies. For example, compulsory measures appear to be best accompanied by relevant support and incentives. Mitigatory strategies such as task shifting should not become \u2018task dumping\u2019 and replace more substantive solutions. Ad hoc financial incentives should not be applied so selectively that they motivate some workers, while demotivating others. They should also not be used as a substitute for a more substantive review of working conditions and of disparities in salaries between different health professionals.\r\n\r\nIt is evident that there is no single approach. There are options, and countries need to choose strategies that are relevant for their own context and in consultation with key stakeholders. This needs to be embedded in the strategic processes for national health planning and financing. Addressing this issue calls for robust management and communication processes and skills, backed by credible evidence from monitoring and evaluation systems, to ensure that the chosen strategies are relevant, appreciated and continually updated.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. Please visit the EQUINET website to read the publications on health worker retention.    ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Implementing Creative Methodological Innovations for Inclusive Sustainable Transport Planning","field_subtitle":"i-CMiiST,: Urban dialogue, Nairobi,  2018","URL":"https://cmiist.wordpress.com/urban-dialogue/","body":"In July 2018 i-CMiiST, a Nairobi based organisation held an Urban Dialogue for to discuss the development of two key areas of the city - Yaya junction and Luthuli avenue. The aim of the dialogue was to engage the general public on issues affecting Nairobi streets, transit and mobility to feed into future interventions and approaches in the development of these areas. The theme of the dialogue was \u2018safety on our streets\u2019  looked at from different perspectives: pedestrians, commuters, drivers and cyclist safety. The dialogue involved about 30 people from different professions and backgrounds \u2013 engineers, planners, cyclists, urban designers, state actors, NGOs, business people etc. It was also live streamed on various social media platforms to involve a wider public, viz: KPF, Naipolitans and Placemaking Network Nairobi pages. Views and contributions came from people watching locally and from other countries while the inputs were recorded and an illustrator documented what participants were saying in a visual form.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"International Lead Poisoning Prevention Week of Action","field_subtitle":"21\u201327 October 2018, World Health Organisation","URL":"http://www.who.int/ipcs/lead_campaign/en/","body":"The International Lead Poisoning Prevention Week of Action will take place from 21\u201327 October 2018, with particular focus on eliminating lead paint in all countries by 2020. Lead poisoning is preventable, yet in 2016 lead exposure was estimated to account for 540 000 deaths and 13.9 million years lost to disability and death due to the long-term health effects, with the highest burden being in developing regions. Of particular concern is the role lead exposure plays in the development of intellectual disability in children. Even though this problem is widely recognised, it remains a key concern of healthcare providers and public health officials worldwide. The World Health Organisation has produced campaign materials for organisations to plan a local event with government, industry or civil society. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"It\u2019s a stick-up. Your money or your health!","field_subtitle":"Heywood M; Daily Maverick, September 2018","URL":"https://tinyurl.com/y9pt9yfj","body":"The Health Market Inquiry (HMI) report published in South Africa is a result of widespread complaints about rising prices and declining benefits in 2014, and was set up by the Competition Commission as an inquiry into the private health care market. A panel of independent experts was appointed, chaired by former Chief Justice Sandile Ngcobo. According to the Competition Commission nearly nine million people in South Africa (16.9% of the population) are members of medical schemes. Many are reported to feel resentful of paying a lot to medical schemes and still having to pay more out of pocket when they need care. The HMI report confirms that premiums are rising and benefits are falling. Expenditure on private health, where R235-billion is spent on nine million people, overshadows the R201-billion the government spends on the other 44-million. Yet the two systems are tied at the hip: they have overlapping staff, overlapping regulatory institutions, and of course an overlapping population for whom healthcare is a right. The National Health Insurance (NHI) reform is raising a need for scrutiny of all providers. The HMI recommends regulations, systems for effective and fair price control and institutions to oversee the market. Scheme members are urged by the author to obtain the report and to challenge the Minister of Health to implement the recommendations.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Literature review: Strategies for recruitment and retention of skilled healthcare workers in remote rural areas","field_subtitle":"Malema NR, Muthelo L: EQUINET discussion paper 115, EQUINET (Harare) and University of Limpopo (South Africa), 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20115%20HR%20ret%20litrev%20Sep%202018lfs.pdf","body":"This literature review, implemented within an EQUINET programme of theme work on health workers at the University of Limpopo, presents published evidence on the recruitment and retention of skilled healthcare workers in rural areas of east and southern Africa. It reviewed published documents in English with a focus on east and southern Africa from 2000-2017.  From the literature reviewed the following strategies emerged as key for health worker retention:  Education and training of healthcare workers; review of regulations and policies regarding provision of healthcare services in rural areas;  provision of financial incentives; and personnel and professional support of healthcare workers. The report identified strategies relating to: Reviewing admission policies and criteria for health worker education; including rural practice issues and skills in health worker training and exposing students to rural areas during training; improving access to continuing professional development (CPD) in rural areas; ensuring that compulsory measures are accompanied by relevant support and incentives; ensuring that mitigatory strategies such as task shifting are not \u2018task dumping\u2019, do not replace more substantive solutions and that they are accompanied by suitable regulatory systems, training and management support; using financial and non-financial incentives to address issues prioritised by health workers, in a way that does not motivate some while demotivating others, and not as a substitute for a more substantive review of working conditions of healthcare workers and strategies to reduce the disparities in salaries between different health professionals; and improving health worker management and support, and the skills of HRH managers.\r\n\r\n","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Missing knowledge of gendered power relations among non-governmental organisations doing right to health work: a case study from South Africa","field_subtitle":"Marx M; London L; Muller A; BMC Internatoinal Health and Human Rights 18(33), doi: https://doi.org/10.1186/s12914-018-0172-4, 2018","URL":"https://bmcinthealthhumrights.biomedcentral.com/articles/10.1186/s12914-018-0172-4","body":"Despite 20 years of democracy, South Africa still suffers from profound health inequalities and gender roles and norms associated with vulnerability to ill-health. Gender inequality influences women\u2019s access to health care and agency to make health-related decisions. This paper explores gender-awareness and inclusivity in organisations that advocate for the right to health in South Africa, and analyses how this knowledge impacts their work. Ten in-depth interviews were conducted with members of The Learning Network for Health and Human Rights (LN), a network of universities and Civil Society Organisations (CSOs) committed to advancing the right to health, but not explicitly gendered in its orientation. The results show that there is a discrepancy in knowledge around gender and gendered power relations between LN members. This suggests that gender is \u2018rendered invisible\u2019 within the LN, which impacts the way the LN advocates for the right to health. The authors thus suggest that even organizations that work on health rights of women might be unaware of the possibility of gender invisibility within their organisational structures.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Patient-led active tuberculosis case-finding in the Democratic Republic of the Congo","field_subtitle":"Andr\u00e9 E; Rusumba O; Evans C; et al:  Bulletin of the World Health Organization 96(8) 522\u2013530, 2018","URL":"http://www.who.int/bulletin/volumes/96/8/17-203968.pdf?ua=1","body":"The paper seeks to investigate the effect of using volunteer screeners in active tuberculosis case-finding in South Kivu, the Democratic Republic of the Congo, especially among groups at high risk of tuberculosis infection. In order to identify and screen high-risk groups in remote communities, the authors trained volunteer screeners, mainly those who had themselves received treatment for tuberculosis or had a family history of the disease. A non-profit organization was created and screeners received training on the disease and its transmission at 3-day workshops. Screeners recorded the number of people screened, reporting a prolonged cough and who attended a clinic for testing, as well as test results. Data were evaluated every quarter during the 3-year period of the intervention (2014\u20132016). Acceptability of the intervention was high. Volunteers screened 650 434 individuals in their communities, 73 418 of whom reported a prolonged cough; 50 368 subsequently attended a clinic for tuberculosis testing. Tuberculosis was diagnosed in 1 in 151 people screened, costing 0.29 United States dollars per person screened and US$ 44 per person diagnosed. Although members of high-risk groups with poorer access to health care represented only 5.1% of those screened, they contributed 19.7% of tuberculosis diagnoses. The intervention resulted in an additional 4300 sputum-smear-positive pulmonary tuberculosis diagnoses, 42% of the provincial total for that period. Patient-led active tuberculosis case-finding represents a valuable complement to traditional case-finding, and should be used to assist health systems in the elimination of tuberculosis.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Perceptions and experiences related to health and health inequality among rural communities in Jimma Zone, Ethiopia: a rapid qualitative assessment","field_subtitle":"Bergen N; Mamo A; Asfaw S; et al: International Journal for Equity in Health 17(84) 1-7, 2018","URL":"https://tinyurl.com/y9ehhkgm","body":"This paper explores community perceptions and experiences related to health and health inequality. The authors conducted 12 focus group discussions and 24 in-depth interviews with community stakeholder groups across six rural sites in Jimma Zone, Ethiopia. Participants described being healthy as being disease free, being able to perform daily activities and being able to pursue broad aspirations. Health inequalities were viewed as community issues, primarily emanating from a lack of knowledge or social exclusion. Poverty was raised as a contributor to poor health that could be overcome through community-level responses. Participants described formal and informal mechanisms for supporting disadvantaged people in form of safety net that provide information and emotional, financial and social support. Understanding community perceptions of health and health inequality can serve as an evidence base for community-level initiatives, including for maternal, new-born and child health. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Public health approach to hearing across the life course: a call-for-papers ","field_subtitle":"Deadline for submissions: 30 November 2018","URL":"http://www.who.int/bulletin/volumes/96/9/18-221697/en/","body":"Hearing loss, especially disabling hearing loss, is associated with delayed cognitive development in children and early cognitive decline in older adults. Hearing loss was highlighted at the World Health Assembly in 2017, when Member States unanimously adopted a resolution to develop public health strategies to integrate ear and hearing care within countries\u2019 primary health-care systems. Against this background, the Bulletin of the World Health Organization will publish a theme issue on the public health approach of hearing loss. Papers are welcomed which focus on identifying and filling the gaps in evidence across comprehensive hearing-care services, from promotion of ear and hearing care, to screening, hearing devices and rehabilitation. In particular, the papers should report on unmet needs, outcomes of services, and effective and sustainable initiatives to reach underserved groups. Submission of papers reporting on both the magnitude of diseases and conditions, such as ear infections, meningitis and rubella, that can affect hearing, are encouraged, as well as papers addressing health system issues and promoting an intersectoral approach to ear and hearing care, such as looking beyond health. As much as possible, papers should seek to integrate examples from low- and middle-income countries across life course.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Q&A: \u2018Research in the global South is of higher quality\u2019","field_subtitle":"Chongwang J: Sci Dev Net, August 2018","URL":"https://tinyurl.com/y8xkk3z6","body":"An article published in the journal Nature on  July 5 puts forward a new technique for the evaluation of research on development. It marks a departure from conventional approaches that, according to the author, have significant weaknesses. This new method for the evaluation of development research \u2014 known as RQ+ or Research Quality Plus \u2014 emphasises the crucial importance of context, local knowledge and the views of the populations whose lives the research aims to improve. Conventional approaches to evaluating scientific endeavours are argued by the author to have a number of inbuilt constraints. For example, they focus primarily on peer assessment or bibliometrics but don\u2019t explicitly pass judgement on the originality or usefulness of the research, nor do they look at the degree of respect for local knowledge. The RQ+ approach goes beyond an evaluation focused solely on the scientific merit of research outputs and includes other dimensions that are essential to measuring the value and quality of research. RQ+ takes account of what evaluators have to say, but their views should be evidence-based, rather than a simple opinion. Those carrying out the evaluation should take into consideration external points of view \u2014 for example those of users targeted by the research or of the communities it is supposed to benefit \u2014 as well as the perspectives of other researchers working in the same field. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Secretariat Director: International malaria programme","field_subtitle":"No closing date: Applications by email of CV","URL":"https://tinyurl.com/ybol5m6z","body":"CA Global Headhunters are recruiting for a a position of Director of a Secretariat for an international organisation implementing malaria control in sub-Saharan Africa. The organisation Ministerial Committee and Secretariat Board are now seeking a Director to continue the momentum that has been started, and to allow the organization to consolidate on the lessons and experiences of its start-up period to steer the next phase of the strategy towards malaria-free Regions. The Director will manage a successful transition from the previous head of the Secretariat, while supporting and guiding the regional partnership through a period of focused growth. He/she will work closely with member states, the Board and the Ministerial Committee to steer the organization to a more impactful and sustainable model for regional malaria elimination, including Ministers of Health, Permanent Secretaries, and Malaria Program Directors/Managers. The Director will facilitate negotiation and alignment between member states to allocate resources effectively for regional priorities, while also strengthening mechanisms for joint monitoring and accountability for the mutual elimination goal. The website provides information for submission of applications.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"South African civil society organisations submit a parallel shadow report to the United Nations Treaty Body on the implementation of socio-economic rights ","field_subtitle":"Socio-Economic Rights Institute of South Africa (SERI); Black Sash; the Dullah Omar Institute (DOI); et al: South Africa, 2018 ","URL":"https://tbinternet.ohchr.org/Treaties/CESCR/Shared%20Documents/ZAF/INT_CESCR_CSS_ZAF_32156_E.pdf","body":"In January 2015, South Africa ratified the International Covenant on Economic, Social and Cultural Rights (ICESCR).  The South African government submitted its initial report to the United Nations Committee on Economic, Social and Cultural Rights (CESCR) in April 2017, raising the steps and measures taken to comply with the provisions of the Covenant, noting its progressive Constitution that includes socio-economic rights. A coalition of civil society organisations called \u201cSouth Africa\u2019s Ratification Campaign of the ICESCR and its Optional Protocol\u201d (the Campaign) submitted a parallel report to the United Nations CESCR. The Campaign\u2019s Steering Group is comprised of the Socio-Economic Rights Institute of South Africa, Black Sash, the Dullah Omar Institute, the People\u2019s Health Movement South Africa and the Studies in Poverty and Inequality Institute. The Campaign\u2019s parallel report provided a civil society perspective on socio-economic rights realisation in South Africa, and raised questions about areas of the state\u2019s record in fulfilling these rights in order to promote greater accountability. The Campaign's report noted that actions to address the binding constraints to realising socio-economic rights are increasingly urgent in the South African context of severe poverty and inequality. For this reason, the authors identified the need for the state to address forced evictions and displacement; to assess the causes of under-expenditure on informal settlement upgrading; to address a lack of investment in infrastructure maintenance and services provision, and to address intergovernmental cooperation issues that impacted severely in the management of the drought in the Western Cape. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Standing up for our lives: A history of the access to medicines movement in South Africa","field_subtitle":"Section 27: South Africa,  2018","URL":"https://standingupforourlives.section27.org.za","body":"Twenty years ago, a group of activists came together to demand access to treatment for all people living with HIV. The introduction of highly effective combination antiretroviral (ARV) therapy offered hope. Yet their high price meant that they were entirely unavailable in the public health system and out of reach for millions of people. In 1998, ARVs cost US$10 000 per year. Demanding access to treatments, activists from the Treatment Action Campaign (TAC), M\u00e9decins Sans Fronti\u00e8res (MSF) and the AIDS Law Project, later incorporated as SECTION27 helped to spur a global movement that radically reduced the prices of HIV medicines. Using skilled legal advocacy, high-quality research, social mobilisation, and public education, these activists transformed the global conversation on drug pricing, making it possible for millions of people to access treatment. Yet despite the remarkable success in increasing access to HIV medicines, this paper notes that systemic problems remain entrenched. New medicines to treat drug-resistant TB, cancers, and many other conditions remain far too expensive. As South Africa develops its intellectual property framework, they argue that it is worth revisiting the strategies, successes, and shortcomings of the access to medicines movement for the insights they may offer. The authors observe that a battle that began nearly twenty years ago engaging pharmaceutical giants and recalcitrant governments continues today. This interactive website showcases their story.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The BRICS, climate catastrophe, resource plunder \u2013 and resistance","field_subtitle":"Maguwu F: Pambazuka News, August 2018","URL":"https://tinyurl.com/yd8f4gb8","body":"The heads of state from Brazil, Russia, India, China and South Africa (BRICS) met in August for a two-day annual BRICS summit, with one of the issues  that of energy related investments and their impact. The author notes that China and India are investing billions of dollars in coal-fired thermal-power generation in Africa while winning global applause for increasing their solar and wind power at home and suggests that this points to a contradiction and policy inconsistency. China is funding coal projects in Ghana, Kenya, Tanzania, Malawi, Zambia and Zimbabwe, yet is a global powerhouse in renewable energy. He suggests that Chinese state energy companies losing business due to government slowing of carbon emissions in China are turning to Africa, even while they have first-hand knowledge on the effects of coal on the environment and human health. The Indian Government is also being praised globally for taking steps to halt carbon emissions, but it too has made investments in Africa in coal-based energy. He describes protest against harmful approaches with pickets by activists raising issues and demands to address  exploitation, climate change, pollution and the  looting of Africa resources with inequality and social harm.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review","field_subtitle":"Gile P; Buljac-Samardzic M; Van De Klundert J: Human Resources for Health 16(34) 1-21, 2018","URL":"https://tinyurl.com/y8jreokr","body":"In this paper the authors present a systematic review of empirical studies investigating the relationship between human resource management and performance in Sub-Saharan Africa hospitals, based on a total of 111 included studies that represent 19 out of 48 Sub-Saharan Africa countries. From a human resource management perspective, most studies researched human practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single human resource management practices. Training and education were the most researched single practices, followed by task shifting. Most studies report human resource management interventions to have positively impacted performance in one way or another. The authors found that specific outcome improvements can be accomplished by different human resource management interventions and conversely that similar human resource management interventions are reported to affect different outcome measures. The review also identified little evidence on the relationship between human resource management and patient outcomes and the evidence often fails to provide contextual characteristics which can affect the impact of human resource management interventions. The authors call for more coordinated research efforts.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Uganda embarks on a journey to universal health cover","field_subtitle":"Asiimwe D: The East African, June 2018","URL":"https://tinyurl.com/y7tgx2lx","body":"Uganda has increased its allocation to the health sector from Ush1.8 trillion ( US $470.6 million) in the 2017/18 financial year to Ush2.3 trillion ($595.6 million), in what the author indicates that some see as an a response to a backlash in 2017 from external funders when the government reduced the nominal value of Ministry of Health\u2019s funding by Ush6 billion ($1.5 million). Officials at the ministry note the increased allocation aims to support the country on a journey to universal health coverage and reduce dependence on external funding. In the 2018/19 financial year, Dr Sarah Byakika, the acting planning commissioner in the Ministry of Health, said the increased allocation will among other things target universal health coverage, recruit community health workers, cover recurrent expenditures at specific hospitals and for the national blood bank. Money is also being provided to avert the perennial strikes of interns and for the drafting of regulations for a new national health insurance law, with national health insurance seen as key for improved domestic financing.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers ","field_subtitle":"Scott K; Beckham S; Gross M; et al: Human Resources for Health 16(39) 1-17, 2018","URL":"https://tinyurl.com/y87fbzrl","body":"The paper synthesizes the current understanding of how community-based health worker programs can best be designed and operated in health systems. The authors searched 11 databases for review articles published between January 2005 and June 2017. The authors identified 122 reviews, 83 from low- and middle-income countries, 29 from high income countries and 10 global. Community-based health worker programs included in these reviews are diverse in interventions provided, selection and training of community-based health workers, supervision, remuneration, and integration into the health system. Features that enable positive community-based health worker program outcomes include community embeddedness, supportive supervision, continuous education, and adequate logistical support and supplies. Effective integration of community-based health worker programs into health systems can bolster program sustainability and credibility, clarify community-based health worker roles, and foster collaboration between community-based health workers and higher-level health system actors. The authors found gaps in the review evidence, including on the rights and needs of community-based health workers, on effective approaches to training and supervision, on community-based health workers as community change agents, and on the influence of health system decentralization, social accountability, and governance. ","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"WHO guidelines for drinking-water quality","field_subtitle":"World Health Organization:  WHO, Geneva, 2017 ","URL":"https://tinyurl.com/y9pe8xh2","body":"The WHO guidelines for drinking-water quality provide recommendations to support countries in developing drinking-water quality regulations and standards, as well as the associated risk management strategies. The guidelines provide an authoritative basis for the effective consideration of public health in\r\nsetting national or regional drinking-water policies and actions; provide a comprehensive preventive risk management framework for health protection, from catchment to consumer, that covers policy formulation and standard setting, risk-based management approaches and surveillance;  emphasize achievable practices and the formulation of sound regulations that are applicable to low-income, middle-income and industrialized countries alike; summarize the health implications associated with contaminants in drinking water, and the role of risk assessment and risk management in disease prevention and control;  summarize effective options for drinking-water management; and  provide guidance on hazard identification and risk assessment.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Why India\u2019s IP policy needs a South African tweak","field_subtitle":"Syed S: The Hindu BusinessLine, July 2018","URL":"https://tinyurl.com/ybxajg6d","body":"South Africa recently adopted a new Intellectual Property Policy, which seeks to align IP with the country\u2019s national development plan. What works for the new SA policy is that it addresses the interface between IP and public health. In facilitating local production and export of pharmaceuticals in line with its industrial policy, the new policy recommends the following changes: introduction of substantive patent search and examination, introduction of patent opposition, strengthening of patentability criteria, incorporation of disclosure requirements, parallel importation, exceptions, provisions to regulate voluntary licensing, compulsory licences, use of IP and competition law. All these provisions use flexibilities provided in the TRIPS (Trade related aspects of IP Rights) Agreement to safeguard development objectives. The South African policy mentions that it must engender the ethos of the South African Constitution and also reflect the country\u2019s broader social economic development objectives. In contrast, India\u2019s IP policy fails to take notice of obligations under Fundamental Rights and Directive Principles of the right to health in its Constitution while promoting IP rights. Instead it focuses on enhancing the protection and enforcement of IP rights, which goes beyond its international obligations (referred as \u2018TRIPS-plus\u2019) without taking into consideration their negative implications. Despite being at the forefront of international fora in defending the TRIPS flexibilities, the author observes that India ignores their use for itself at the domestic level, and recommends following the South African approach.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Zimbabwe launches a Health Financing Policy and Strategy","field_subtitle":"World Health Organisation: WHO Zimbabwe, June 2018","URL":"https://tinyurl.com/yadv82ud","body":"Zimbabwe's Health Financing Policy and strategy launched in June 2018 was informed by WHO guidelines on health financing embedded in a health systems framework. The policy and strategy acknowledge that the way funds are raised and allocated and the way services are paid for influences how services are accessed by the population. It focuses on better use of available resources, and increased Government allocation to health leading to reduced direct out of pocket payments by households, which will in turn reduce financial barriers to access for the poor. It also brings in innovation in exploring more options to raise funding for health, and the creation of a pool of funds to ensure better management of health funds.  Emphasis on achieving sustainable health financing is explicit in the Health Financing Strategy so that gains can be sustained. The financing seeks to ensure that the current National Health Strategy (2016-2020) is well financed and implemented to take steps towards financial risk protection and ultimately universal health coverage.","php":"","field_issue_date":"2018-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"2018 Africa Scorecard on Domestic Financing for Health ","field_subtitle":"African Union Commission: AU 2018","URL":"https://tinyurl.com/ybz8upwn","body":"The Africa Scorecard on Domestic Financing for Health is a health financing management tool for governments on the African continent. AidSpan, the independent observer of the Global Fund, describes the scorecard as a tool intended to help with financial planning for the health sector and with monitoring government domestic health spending performance against key global and regional health financing benchmarks. It is also intended to help governments compare their performance with each other. The 2018 Africa Scorecard on Domestic Financing for Health was adopted by the African Union Heads of State and Government Assembly on 2 July 2018 during the Summit in Nouakchott, Islamic Republic of Mauritania. The Scorecard can be accessed in English, French and Portuguese. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"3rd National Antimicrobial Resistance (AMR) Conference 2018, Makerere University College of Health Sciences 21-22 November 2018","field_subtitle":"Deadline for Submission of Abstracts: 30 September 2018","URL":"http://chs.mak.ac.ug/amr2018","body":"The World Health Organization (WHO) World Antibiotic Awareness Week takes place every year in November, and this year will be 12-18 November, with national events for awareness about antimicrobial resistance. Towards this, the 3rd National Antimicrobial Resistance (AMR) Conference 2018 for Uganda is being hosted by Makerere University College of Health Science (CHS) in partnership with One Health Central and Eastern Africa (OHCEA, http://ohcea.org), an international network of universities in eight African countries and 16 Universities including Makerere University. This year\u2019s conference will be held at Hotel Africana in Kampala on November 21 \u2013 22 and the theme will be Understanding Drivers and Collective Action against Antimicrobial Resistance. At the conference, the National One Health Platform will launch the National Action Plan (NAP) against Antimicrobial Resistance and it will also one health initiatives in the country.   \r\n","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"4th People\u2019s Health Assembly","field_subtitle":"Dhaka, Bangladesh, 15-19 November 2018","URL":"https://phmovement.org/peoples-health-assembly-dhaka/","body":"The Fourth People\u2019s Health Assembly (PHA 4), will draw on civil society organizations and networks, social movements, academia and other  actors from around the globe. PHA4 will provide a space for strengthening solidarity, sharing experiences, mutual learning and joint strategizing for future actions. The Assembly and associated activities aim to: evaluate and critically analyze current processes and policies that impact on health and healthcare at global, regional and local levels; undertake a collective assessment of PHM\u2019s organizational and programmatic activities and to provide a renewed mandate for the years to come. They also seek to enhance the capacity of health civil society activists to engage with and intervene in the policy making process, to monitor and drive policy implementation and to ensure accountability in the functioning of health systems; to foster and support constructive dialogue, planning and mobilization around health and the broader social determinants of health, involving the widest possible range of practitioners; and to  launch renewed sustainable structures and dynamics, both within and outside the health sector, that will continue to drive coordinated action to secure universal and equitable access to health and health care.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"5th Global Symposium on Health Systems Research","field_subtitle":"Programme now online: Liverpool, UK, 8-12 October 2018","URL":"http://healthsystemsresearch.org/hsr2018/","body":"The Global Symposium on Health Systems Research is organized every two years by Health Systems Global to bring together the full range of players involved in health systems and policy research and practice. Beginning with the First Global Symposium in Montreux in 2010, the Symposia have played a crucial, catalytic role in convening a global community dedicated to strengthening health systems and building the field of health systems research. The Fifth Global Symposium on Health Systems Research (HSR2018) will take place at the ACC in Liverpool, UK from 8 to 12 October, 2018, bringing together approximately 2,000 health systems researchers, policymakers and practitioners from around the world. The full programme for the symposium is now online at the website. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"6th Anniversary of the Marikana Massacre","field_subtitle":"Marikana Solidarity Collective; Review of African Political Economy, August 2018","URL":"http://roape.net/2018/08/14/6thanniversarymarikanamassacre/","body":"This paper presents a case that six years after the Marikana Massacre, the London-based mining corporation involved (Lonmin) has decided to leave its platinum mining operation in South Africa by preparing to sell to Sibanye-Stillwater. The authors support the demands of women\u2019s organisation Sikhala Sonke and victims\u2019 representatives that Lonmin must fulfil a social covenant with the community,  rather than to the banks. The paper reports the demands of social movements that Lonmin apologise to the South African nation and to the victims of the massacre and pay reparations to the affected parties. The authors also report the call that Lonmin join calls to release the miners in prison as a result of the massacre and to prosecute the police officers and authors of the massacre, take responsibility for the environmental destruction at Marikana and comply with the obligations of its social and labour plan and add its voice to those calling to review the Farlam Commission and finance the legal process. They reject the excuse that the company is now insolvent. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A Rebel in the Marxist Citadel: Tributes to Samir Amin","field_subtitle":"Shivji I; Lawrence P; Saul J; et al: Review of African Political Economy, August 2018","URL":"https://tinyurl.com/ydx84cnf","body":"In this journal feature, Issa Shivji, Peter Lawrence, John Saul, Natasha Shivji, Ray Bush and Ndongo Samba Sylla pay tribute to the late Samir Amin. Issa Shivji writes of Amin\u2019s support for younger generations, \u2018His intellectual works, scholarly contributions and political interventions have been sufficiently covered in dozens of tributes that are pouring in every day. I will not go over them. I wanted specifically to capture Samir\u2019s attitude and treatment of younger generations, done as a matter of course and without pretense.\u2019 Peter Lawrence highlights one of Amin\u2019s key ideas, \u2018Amin rejected the prevailing view in both the capitalist \u2018West\u2019 and the socialist \u2018East\u2019 that development entailed catching up with the developed capitalist countries. \u2026 The history of the world was not about followers catching up with leaders but about dominant civilizations being \u2018transcended\u2019 by peripheral ones as the former decline and the peripheral overtake them with different social organizations.\u2019 John Saul illuminates Amin\u2019s concept of \u2018an actual and active \u2018delinking\u2019 of the economies of the Global South from the Empire of Capital that otherwise holds the South in its sway. For Amin, delinking was best defined as \u2018the submission of external relations [to internal requirements], the opposite of the internal adjustment of the peripheries to the demands of the polarizing worldwide expansion of capital\u2019. Amin saw it as being \u2018the only realistic alternative [since] reform of the [present] world system is utopian.\u2019 Ndongo Samba Sylla concludes by writing on Amin\u2019s notion of \u2018daring\u2019 in coordinated struggles, \u2018by the emergence of an anti-monopolies front [in the Global North] and in the Global South by that of an anti-comprador front' challenging subservience to neoliberal globalisation. The authors collectively highlight how through his writings, his interventions and engagement Amin profiled the perspective of the Global South 'and the wretched of the earth.\u2019","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"A tribute to those who provoke us to think again","field_subtitle":"Editor, EQUINET News","body":"While working on this month's issue we got news of the passing of an inspiring African thinker, Samir Amin, and then later in the month of the previous UN Secretary General Kofi Annan and pay our respects to both. In different ways and forums they challenged thinking and agendas from an African and southern lens. From Dakar, Senegal, where Samir Amin led the Third World Forum, Vijay Prashad notes that Amin explored and wrote about both the dangers and possibilities of our current world. In the face of a \"world system with finance in dominance and people whipping from one precarious job to another\"  he pointed to both the need and possibility of Africa making different choices and creating and advancing an alternative. \"As long as we are resisting, he would say, we are free.\"  We include one of the many articles published on his work and ideas in this issue. \r\n\r\nBack to our editorial this month on waiting mother shelters. Papers included in this issue point to a continuing research debate on their effectiveness, with one review  finding no evidence of this from randomised control trials. Yet the  evidence from experience of their use in Zimbabwe in the editorial suggests a need to think beyond measured service and morbidity outcomes to understand their value for improving wellbeing, and to understand how, beyond individual interventions, different elements of comprehensive primary health care come together to improve health and wellbeing. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Adolescent Girls and Young Women (AGYW) Grant to Influence Policy In Your Country","field_subtitle":"Application deadline: 30 November 2018","URL":"https://tinyurl.com/yaknfpxm","body":"HER Voice Fund is giving out grants amounting to USD 2000 for activities meant to influence policy processes. The funds are to address the financial access barriers limiting community based organisations (CBOs) working on AGYW issues to fully participate in various stages of Global Fund processes in the 13 target countries. Relevant processes include Global Fund country dialogues across the various stages of the cycle (concept note development, grant-making, grant implementation and grant monitoring); and meaningful participation in related processes including but not limited to: HIV national strategic plans, frameworks, policies, guidelines- development and reviews and their accompanying or related monitoring and evaluation and operational plans; as well as  strategies, policies and guidelines related to adolescent health and their well-being. These funds can be used to support short-term key activities including but not limited to: Transport to attend meetings related to Global Fund processes; meeting arrangements to facilitate dialogue processes by community based organisations and communication processes related to participation in key discussions and forums, among others. Applications can be submitted online or by email ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Advancing Access to SRHRs - Commemoration of The International day for maternal health and Rights","field_subtitle":"Nkoobe F: Centre for Health, Human Rights & Development, 2018","URL":"https://tinyurl.com/ybqmkqr7","body":"On 11th April 2018, Uganda joined the rest of the world to commemorate the International Day for Maternal Health and Rights under the Theme: \u201cRights Based Approach to Maternal Health in Uganda: No Woman Should Die Giving Birth.\u201d Civil Society, led by Center for Health, Human, Rights and Development (CEHURD), and other stakeholders including policy makers marched from the Independence Monument to Parliament where a dialogue with Members of Parliament was held to collectively find sustainable solutions to the alarming maternal mortality rate. Civil Society used dialogue to petition Parliament in demand for the implementation of the resolution that was passed by the house on December 15, 2011 urging Government to institute measures to address Maternal Mortality in Uganda.  Among these included tasking government through the Ministry of Health to strictly enforce maternal health audits and take actions to the established causes, together with developing a policy of compensation to the families of all women who die as a result of maternal related cases through government facilities.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Advancing the right to health in east and southern Africa","field_subtitle":"CEHURD: EQUINET Regional workshop report, Garuga Country Lake Resort, Entebbe, 30 August 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20CEHURD%20Reg%20Mtg%20Right%20to%20Health%20Aug2017.pdf","body":"In 2015-2018, CEHURD, under the Regional Network for Equity in Health in East and Southern Africa (EQUINET) conducted a desk review of the implementation of constitutional provisions on the right to health in east and southern Africa. The objective of the workshop was to introduce the OPERA framework in the region, using evidence from Uganda. It aimed to 1. identify the main bottlenecks in implementing the right to health; 2. devise a common advocacy strategy that aims at removing the bottlenecks;. and 3 explore opportunities for applying this within the region. The workshop built on the previous validation of the Ugandan draft report on constitutional implementation of the right to health.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Brain Drain in Africa: The Case of Tackling Capacity Issues in Malawi's Medical Migration","field_subtitle":"The African Capacity Building Foundation: ACBF Occasional Paper No. 31, Zimbabwe, 2018","URL":"https://tinyurl.com/ya384n7s","body":"Malawi faces severe staffing shortages in the health sector and high migration of health workers. This paper suggests that, like most countries in Sub-Saharan Africa, local training of medical personnel has neither plugged these capacities deficits nor increased retention rates. Given the economic realities in Sub-Saharan Africa and the allure of countries in the Organization for Economic Cooperation and Development, many locally trained physicians migrate. The paper concludes that, like much of Sub-Saharan Africa, Malawi is victim of regional developments. Owing to growth in migration of physicians from South Africa to Organization for Economic Cooperation and Development countries, the paper raises that Malawi has turned to recruiting doctors from other African countries, exacerbating capacity constraints elsewhere in the region.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"BRICS-Johannesburg simultaneously disappoints and threatens","field_subtitle":"Bond P: Pambazuka News, August 2018","URL":"https://tinyurl.com/ychbc4jw","body":"The author asks whether the Brazil-Russia-India-China-South Africa (BRICS) bloc can rise to the talk in Johannesburg about counter-hegemonic prospects during the BRICS summit held in the last week of July. However he also notes that their ideological diversity means that an excellent opportunity for this was lost and that the unity came rather from a support for mercantilist-neoliberalism. This he notes points to progressive international reform being practically impossible at present. He noted that the BRICS further distorted the International Monetary Fund (IMF) during its 2015 vote restructuring. Four of the five countries took much greater shares for themselves (aside from South Africa which lost 21 percent of its vote) at the expense mainly of poorer countries. He argues that the main site to consider antidote analysis and news is \u201cbrics from below,\u201d a tradition of counter-summit critique begun in Durban five years ago, and also witnessed in Fortaleza in 2014, Goa in 2016 and Hong Kong in 2017. and as found in a protest led by four Goldman Environmental Prize winners and their organisations and allies: Makoma Lekalakala of Earthlife Africa, Bobby Peek of groundWork, Thuli Makama of OilChange International and Des D\u2019Sa of the South Durban Community Environmental Alliance. As one outcome the largest proposed mega-project made at prior BRICS summits in 2014 and 2015 on US $100 billion worth of nuclear energy reactors as a deal between former South African president Jacob Zuma and Putin, is now on indefinite hold.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Call for Abstracts: Federation of African Medical Students\u2019 Associations (FAMSA) Conference, Ibadan, Nigeria, November 18th \u2013 24th , 2018","field_subtitle":"Deadline 30 September 2018","URL":"https://famsaga2018.com/submit-abstract/","body":"The FAMSA General Assembly and Scientific Conference will bring together young vibrant minds as well as professionals and relevant stakeholders in both the public and private sectors from across Africa and beyond to discuss ideas and initiate steps to position Africa on the path to sustainable development in health and by extension in every other sphere of human development. The Conference invites medical students, healthcare professionals and researchers to submit abstracts for oral or poster presentations. Abstracts are to be submitted under any of the two categories; Research or Project. Abstract topics should fall under the subthemes or any other topic of relevance to the theme of the conference.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"CODESRIA Humanities Institute: The essence(s), diversity and economies of the (Pan)-African arts - (Re)making and confronting memories and futures, Ouagadougou, Burkina Faso","field_subtitle":"Deadline for Applications: 30 September, 2018 ","URL":"https://www.codesria.org/spip.php?article2865&lang=en","body":"To mark the 50th anniversary of the bi-annual Pan-Africa Film and Television Festival CODESRIA is organising the Humanities Institute in Ouagadougou on February 25- March 1, 2019. The theme will be \u2018The essence(s), diversity and economies of the (Pan)-African arts: (Re)making and confronting memories and futures.\u2019 The theme intends to promote contemplation of the structural conditions that hinder and facilitate involvement in shaping the future of the African arts and the event seeks to bring together a mixed group of scholars and artists.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community-based indicators for HIV Programmes","field_subtitle":"MEASURE Evaluation: Online, USA 2018","URL":"https://www.measureevaluation.org/community-based-indicators","body":"Community-based information systems (CBIS) are key to understanding how HIV programs are working to control the epidemic at the local level in countries with high burden. MEASURE Evaluation developed this collection of indicators to guide community-based HIV programs in monitoring their performance and thereby enhance informed decision making by governments, major donors, and implementing partners. The indicators cover the following themes: vulnerable children, prevention of mother-to-child transmission, key populations, HIV prevention, home-based care and data use cases. The site also provides useful resources and a summary list of indicators. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Countries Pressured to Drop Language on Protecting Access to Affordable Meds from TB Summit Declaration Negotiations","field_subtitle":"Medicins Sans Frontieres; Doctors Without Borders: July 2018","URL":"https://tinyurl.com/ybxwmv65","body":"Countries negotiating the final declaration text for the first-ever UN High-level Meeting on Tuberculosis in September were put under significant pressure to drop references to protecting countries\u2019 rights to take fully-legal actions to access affordable medicines for their people, M\u00e9decins Sans Fronti\u00e8res reports. One of the final sticking points in the negotiations in New York was language on public health safeguards enshrined in the World Trade Organization\u2019s (WTO) Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS). This allows governments, among other things, to issue \u2018compulsory licenses\u2019 to override patents in the interest of public health, so that they can allow generic versions to be produced or imported and more people can receive needed treatment. The \u2018Group of 77\u2019 bloc of developing countries has been under pressure to drop all references to the WTO\u2019s 2001 Doha Declaration that enshrined public health flexibilities and safeguards in the TRIPS agreement. This led to a call by Leena Menghaney, South Asia Head for MSF\u2019s Access Campaign for all countries, including those in the Group of 77, and Brazil, Russia, India, China and South Africa, that have a high burden of TB, to urgently stand up right now against what they refer to as 'bullying', that aims to keep medicines out of the hands of people who need treatment. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Emerging Public Health Practitioner Award: manuscript submissions open","field_subtitle":"November 18th \u2013 24th, 2018, Ibadan, Nigeria ","URL":"https://famsaga2018.com","body":"The FAMSA General Assembly and Scientific Conference will bring together young vibrant minds as well as professionals and relevant stakeholders in both the public and private sectors from across Africa and beyond to discuss ideas and initiate steps to position Africa on the path to sustainable development in health and by extension in every other sphere of human development. The conference will feature keynote addresses, plenary sessions, workshops, trainings, hackathon sessions, and scientific presentations on carefully selected subthemes all related and contributory to the goal of repositioning healthcare in Africa for Sustainable Development. Sub themes for the conference include \u2018The African Medical Student and the SDGs\u2019, \u2018Medical Education in Africa\u2019, \u2018Maternal and Child Health in Africa\u2019, \u2018The Burden of NCDs\u2019, \u2018Infectious Diseases in Africa\u2019, \u2018Sustainable Vaccination Schemes\u2019, \u2018Outbreak and Disaster Management\u2019, \u2018Mental Health\u2019, \u2018Health Policy and Financing\u2019 and \u2018Social Determinants of Health\u2019.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET Call for applicants: Desk review on \u201cA critical assessment of different health financing options in east and southern African countries\u201d","field_subtitle":"Call closes 5pm September 8 2018","URL":"http://www.equinetafrica.org/content/grants","body":"This critical assessment of different health financing options in east and southern African countries is being commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET) through and in collaboration with key regional partners. It aims to inform policy makers on the positive and negative implications and issues to consider in applying the different domestic public health financing options current being explored, advocated and implemented in east and southern Africa -  including mandatory national health insurance; social health insurance, community based health insurance, voluntary insurance, earmarked taxes, wealth taxes, other direct/ indirect taxes and other sources. Read more at the link shown.","php":"Further details: /newsletter/id/63573","field_issue_date":"2018-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 210: Waiting mothers homes save lives: what we have learned from Zimbabwe","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Governance and Equity-oriented Policies for Urban Health ","field_subtitle":"Shakim C: ECSA HC Best Practices Forum, Arusha, Tanzania, 2018 ","URL":"https://tinyurl.com/ybdhe89b","body":"This presentation given at the ECSA HC Best Practices Forum 2018 provides an overview of urban poverty and global commitments to equity oriented policies for urban health; urban health challenges in Sub-Saharan Africa; examples of how youth and community engagement could inform change and how to support the development of governance and equity oriented policies. The author notes that unmanaged urban growth is linked with rising social and economic inequities that benefit the well off and negatively impact health and well-being of the poor and disadvantaged; and that densely packed areas with low levels of sanitation services offer a petri dish for infectious diseases. This contributes to higher cost of living, high risk of school dropout and teenage pregnancy and high rates of crime and violence. Shakim provides evidence of youth as agents of change in urban Tanzania through the Tandale Health Centre.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health Market Inquiry: \u2018Nothing we don\u2019t already know\u2019, says Health Minister","field_subtitle":"Unnamed author: Medical Brief, South Africa, July 2018","URL":"https://tinyurl.com/yarzkznv","body":"This article raises that the four-year long Competition Commission Health Market Inquiry\u2019s findings reveal what Health Minister Dr Aaron Motsoaledi says he already knew \u2013 that South Africa\u2019s private healthcare has become so expensive that even those on medical aid can\u2019t afford it. The article reports that the inquiry singled out the dominance of Discovery Health among medical schemes, and Netcare, Mediclinic and Life Healthcare among hospital groups, as illustrations of competitive market failure. The commission found that the market was characterised by high and rising costs of healthcare and medical scheme cover, by disempowered and uninformed consumers, and by a general absence of value-based purchasing. According to the inquiry\u2019s chair, former Chief Justice, Sandile Ngcobo \u2013 who presented the executive summary of the report \u2013 the private healthcare sector market displayed consistently rising medical scheme premiums accompanied by increasing out-of-pocket payments for the insured, almost stagnant growth in covered lives and a progressively decreasingly range and depth of services covered by scheme options. Although there were 22 open schemes, two medical schemes constitute 70% of the total open scheme market and Discovery Health Medical Scheme comprised 55% of the open scheme market. The Government Employees Medical Scheme (GEMS) was the second largest restricted scheme. There were 16 medical scheme administrators and Discovery Health and Medscheme accounted for 76% of the market based on gross contribution income. The inquiry also found that there was a failure by practitioners to explore multi-disciplinary models of care and that the fee-for-service model of remuneration stimulated oversupply, and incentivised practitioners to provide more services than needed. The inquiry was also reported to raise the issue of an incomplete regulatory regime in the private healthcare sector: Medical facilities were not regulated beyond the requirement to have a licence to operate and practitioners licensed to practice by the Health Professions Council of SA but little more. The report is open for comments until 7 September 2018 and the final report is expected to be released on 30 November.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Home is best: Why women in rural Zimbabwe deliver in the community","field_subtitle":"Dodzo M; Mhloyi M: PLOS One 12(8) e0181771, doi: 10.1371/journal.pone.0181771, 2017","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549963/","body":"Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study the authors investigate why. Twelve focus group discussions with child-bearing women and eight key informant interviews (KIIs) were conducted. Four were traditional birth attendants and four were spiritual birth attendants. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. The authors conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. The authors recommend increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, they argue that there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"How do gender relations a\ufb00ect the working lives of close to community health service providers? Empirical research, a review and conceptual framework","field_subtitle":"Steege R; Taegtmeyer M; McCollum R; et al.: Social Science & Medicine, (209) 1-13, 2018","URL":"http://www.sciencedirect.com/science/article/pii/S0277953618302375?via%3Dihub","body":"This paper synthesises current evidence on gender and close-to-community providers and the services they deliver. The authors used a two-stage exploratory approach drawing upon qualitative research from six countries in the REACHOUT consortium in 2013 to 2014. This was followed by systematic review that took place in 2017, using critical interpretive synthesis methodology. This review included 58 papers. From this, the authors present the holistic conceptual framework to show how gender roles and relations shape close to community provider experience at the individual, community, and health system levels. The evidence presented highlights the importance of safety and mobility at the community level. At the individual level, in\ufb02uence of family and intra- household dynamics are of importance. Important at the health systems level, are career progression and remuneration. The authors present suggestions for how the role of a close to community provider can, with the right support, be an empowering experience. They argue for policymakers to promote gender equity in this cadre through safety and well-being, remuneration, and career progression opportunities. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys","field_subtitle":"Umuhoza S; Ataguba J: International Journal for Equity in Health 17(1):52, 1-15, 2018 ","URL":"https://tinyurl.com/y83sa9g9","body":"This study investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six Southern African Development Community (SADC) countries. Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only statistically significant for South Africa, and marginally significant for Zambia and Zimbabwe. Smoking and inadequate fruit and vegetable consumption were significantly concentrated among poor people. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among poor. people However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. The authors argue for concerted efforts to tackle the significant socioeconomic inequalities in ill-health and health risk factors in the region. Because some of the determinants of ill-health lie outside the health sector, they also indicate that inter-sectoral action is required","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Maternity waiting facilities for improving maternal and neonatal outcome in low- resource countries ","field_subtitle":"van Lonkhuijzen L; Stekelenburg J; van Roosmalen J: University of Groningen, 2011","URL":"https://www.rug.nl/research/portal/files/2535123/03_c3.pdf","body":"A Maternity Waiting Home (MWH) is a facility, within easy reach of a hospital or health centre which provides Emergency Obstetric Care (EmOC). The aim of the MWH is to improve accessibility and thus reduce morbidity and mortality for mother and neonate should complications arise. This study assessed the effects of a maternity waiting facility on maternal and perinatal health. The authors searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2009), CENTRAL (The Cochrane Library 2009, Issue 1), MEDLINE (1966 to April 2009), EMBASE (1980 to April 2009), CINAHL (1982 to April 2009), African Journals Online (AJOL) (April 2009), POPLINE (April 2009), Dissertation Abstracts (April 2009) and the National Research Register archive (March 2008) for conducted randomised controlled trials that compared perinatal and maternal outcome in women using a MWH and women who did not. There were no randomised controlled trials or cluster-randomised trials identified from the search. They found from this evidence that there is insufficient evidence to determine the effectiveness of Maternity Waiting Facilities for improving maternal and neonatal outcomes.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Outbreaks: Behind the headlines","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"http://www.who.int/emergencies/outbreaks-behind-the-headlines","body":"At any one time, dozens of infectious disease outbreaks are happening around the world. Those on the frontlines are often more visible, but behind the scenes, many activities are taking place to control the spread of these diseases. In this special feature, the World Health Organisation highlights a series of recent health emergencies, telling the stories behind the headlines and exploring the many different dimensions of an outbreak response. Humanitarian crises, forced migration, environmental degradation, climate change, reduced access to health services and prolonged conflict often provide exactly the right conditions for an outbreak to occur. Diphtheria - a bacterial disease that is preventable through a simple inexpensive vaccine \u2013 is one such example. Dr. Khadimul Anam Mazhar working in the Rohingya refugee camps in Cox\u2019s Bazar, Bangladesh, found diptheria to be the main focus of his work. The outbreaks of Ebola in DRC and diphtheria among the Rohingya refugees have starkly different profiles. One was a naturally occurring zoonosis in a remote area, the other the result of a major migration of a highly stressed population. For all the differences, however, they also share similar traits: prolonged conflict, inadequate water and sanitation systems, and struggling health systems. The cases highlight two critical and often overlooked issues: 1) multiple countries around the world are facing severe health crises, and 2) many of these countries have several health crises occurring at the same time. While it is critical to treat patients affected by epidemic diseases, the response is much more than purely medical. The range of necessary expertise includes epidemiologists, logisticians, clinicians, data managers, anthropologists and planners.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Participatory meeting in Lusaka on health and wellbeing of urban youth","field_subtitle":" Lusaka District Health Office(LDHO); Training and Research Support Centre (TARSC); Civic Forum on Human Development (CFHD): Meeting report 26-27 June 2018, EQUINET, Lusaka, Zambia","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/UH%20Lusaka%20Mtg%20Rep%20June2018%20fw.pdf","body":"TARSC as cluster lead of the \u201cEquity Watch\u201d 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.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Patients experiences of self-management and strategies for dealing with chronic conditions in rural Malawi","field_subtitle":"Angwenyi V; Aantjes C; Kajumi M; et al: Public Library of Science ONE 13(7) 1-17: 2018 ","URL":"https://tinyurl.com/ycj95pve","body":"This study explored self-management practices of patients with different chronic conditions, and their strategies to overcome care challenges in a resource constrained setting in Malawi. A qualitative study was conducted which involved patients with different chronic conditions from one rural district in Malawi. Data are drawn from semi-structured questions of a survey with 129 patients, 14 in-depth interviews, and four focus-group discussions with patients. Patients demonstrated ability to self-manage their conditions, though this varied between conditions, and was influenced by individual and external factors. Factors included ability to acquire appropriate disease knowledge, poverty level, the presence of support from family caregivers and community-based support initiatives, the nature of one\u2019s social relations; and the ability to deal with stressors and stigma. Non-communicable diseases and HIV co-infected people were more disadvantaged in their access to care, as they experienced frequent drug stockouts and incurred additional costs when referred. These barriers contributed to delayed care, poorer treatment adherence, and likelihood of poorer treatment outcomes. Patients proved resourceful and made adjustments in the face of care challenges. The authors\u2019 findings complement other research on self-management experiences in chronically ill patients with its analysis on factors and barriers that influence patient self-management capacity in a resource-constrained setting. They recommended expanding current peer-patient and support group initiatives to patients with non-communicable diseases, and further investments in the decentralization of integrated health services to primary care level in Malawi.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Register for the Shaping health session: Grounding health action in community cultures and systems ","field_subtitle":"9 October 1330-1700 Global Symposium on Health Systems Research Liverpool Conference Room 11C","URL":"https://tinyurl.com/yaq52b6n","body":"Join us in this participatory satellite session at the Global Symposium on Health System Research where we will be sharing experiences from diverse countries globally on how social participation and power can make health systems more holistic, responsive and inclusive, and how to facilitate such practice. In this session we will share evidence and learning from a multi-country Shaping health consortium on social participation in local health systems, and use participatory approaches to draw also on the experiences of those participating. These experiences show how social participation and power can make health systems more holistic in approach, more responsive and more inclusive. We will discuss and draw recommendations on practices that ground health action and services within community cultures and systems, what challenges they face, and how to facilitate and encourage such practice. For more information see the website below and sign up at admin@tarsc.org.  ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Social support under siege: An analysis of forced migration among women from the Democratic Republic of Congo","field_subtitle":"Wachter K; Gulbas L: Social Science & Medicine (208) 107-116, 2018 ","URL":"https://tinyurl.com/ybvkvc9y","body":"The authors aimed to develop theory to explain how women who migrated from the Democratic Republic of the Congo recreate social support post-resettlement in the United States. An interpretive approach informed by postcolonial feminist perspectives guided the grounded theory methodology. Upon arrival to the United States, women experienced partitioned lives through changing relationships in space and time, which contributed to women being alone and impacted on their well-being. Converging processes propelled women towards learning to stand alone, through which they developed a sense self-reliance, but not without consequences for themselves and their relationships. The analysis contributes to the knowledge of how resettlement is a life altering event that sets into motion psychosocial processes with implications for well-being and health. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Southern Africa HIV and AIDS Regional Exchange (SHARE) Research Digest, April\u2014May 2018 ","field_subtitle":"Southern Africa HIV and AIDS Regional Exchange (SHARE), 2018 ","URL":"https://tinyurl.com/y6w8ljvu","body":"This digest offers article abstracts from peer-reviewed literature related to HIV and AIDS in Southern Africa and is designed to keep readers in touch with the rapidly expanding evidence base pertaining to HIV in the region.  For example in this issue there are 72 abstracts published April through May 2018 that feature articles from Botswana (4), Lesotho (2), Malawi (7), Mozambique (5), South Africa (43), Swaziland (2), Tanzania (4), Zambia (2) and Zimbabwe (9).  Articles include a mixed methods study on access to HIV care and treatment for migrants between Lesotho and South Africa; findings from a cross-sectional study on HIV status disclosure among postpartum women with varied intimate partner violence experiences in Zambia; and lessons learned from the ZENITH trial in Zimbabwe on the role of community health workers in improving HIV treatment outcomes in children. The articles are catered to advocates, health care providers, implementers, lay health workers, policy makers and researchers. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The impact of intimate partner violence on women's contraceptive use: Evidence from the Rakai Community Cohort Study in Rakai, Uganda","field_subtitle":"Maxwell L; Brahmbhatt H: Ndyanabo A; et al: Social Science & Medicine, (209) 25-32, 2018","URL":"https://tinyurl.com/yaxkf83r","body":"A systematic review of longitudinal studies suggests that intimate partner violence is associated with reduced contraceptive use. The authors used seven waves of data from the Rakai Community Cohort Study in Rakai, Uganda to estimate the effect of prior year intimate partner violence at one visit on women's current contraceptive use at the following visit. The analysis included 7923 women interviewed between 2001 and 2013. Women who experienced any form of prior year intimate partner violence were 20% less likely to use condoms at last sex than women who had not. The authors did not find evidence that intimate partner violence affects current use of modern contraception, however, current use of a partner-dependent method was 27% lower among women who reported any form of prior-year intimate partner violence compared to women who had not. Women who experienced prior-year intimate partner violence were less likely to use condoms and other forms of contraception that required negotiation with their male partners and more likely to use contraception that they could hide from their male partners. Longitudinal studies in Rakai and elsewhere have found that women who experience intimate partner violence have a higher rate of HIV than women who do not. The finding in this paper that women who experience IPV are less likely to use condoms may help explain the relation between intimate partner violence and HIV.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The role of maternity waiting homes as part of a comprehensive maternal mortality reduction strategy in Lesotho","field_subtitle":"Satti H; McLaughlin M; Seung K: Partners In Health Reports 1(1) 1-24, 2013 ","URL":"https://tinyurl.com/y97gqd7t","body":"Lesotho has one of the highest maternal mortality rates in the world, Partners In Health (PIH) has  included maternity waiting homes since 2009 as part of a comprehensive effort to increase facility-based deliveries and reduce maternal mortality. The maternity waiting homes are located at seven PIH-supported health centres in some of the most remote, underserved areas of rural Lesotho. The homes provide food and shelter for women who live far away from the health centre or have risk factors for potential obstetric complications, and are well-regarded by both health centre staff  and pregnant women. Since the implementation of the Maternal Mortality Reduction Project, PIH has seen waiting home admissions and the number of monthly deliveries at health centres increase dramatically. The authors suggest that failure of previous studies to demonstrate a positive impact of maternity waiting homes may reflect the failure to successfully implement other supporting components of a larger, comprehensive strategy to increase access to maternal health services.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The Zimbabwe National Maternal and Neonatal Health Road Map 2007-2015","field_subtitle":"Ministry of Health and Child Welfare: Government of Zimbabwe, Harare, 2007","URL":"http://www.who.int/pmnch/countries/zimbabwe_roadmap_web.pdf","body":"Zimbabwe's 2007 National Maternal and Neonatal Health Road Map provided an over- arching strategy for scaling up the national response to reduce the current levels of maternal and neonatal mortality and morbidity in line with the MDG health related targets, bringing together all national stakeholders to support one national MNH programme, one national MNH coordination mechanism, and one national MNH Planning, Monitoring and Evaluation Framework. The concept of the Four Pillars of Safe Motherhood describes comprehensively all prerequisites to be met in order for a woman to safely live through her life cycle, from informed teen age through supervised, healthy pregnancy, through safe delivery and childbirth, the safe-guarding of her newborn\u2019s health start of life, and through a continued, problem free reproductive life. The MNH Road Map sets two clearly defined phases, a first phase of prioritisation on the supply issues of the interventions to make services available first, before fully focusing on a further creation of demand in the second phase. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Waiting mothers homes save lives: what we have learned from Zimbabwe","field_subtitle":"Nonjabulo Mahlangu, Mandy Mathias, Mongi Khumalo, Thabiso Sibanda, Zimbabwe","body":"Silothemba looks lovingly at the little bundle nestled in her arms and beams with pride.  \u201cIt wasn`t easy,\u201d she says. \u201cI nearly lost this baby. I bled a lot and had I not been here the nurses say I may not have made it too.  I wasn`t eager to come to the waiting mothers home because my friends said the nurses keep you there for long and I have two small children at home.  Actually I didn\u2019t go to the home on the day the nurses said as I decided to go to the clinic when I felt labour pains.  My local village health worker encouraged me to take their advice, however, and I am so happy that I did.  My delivery was very difficult. It started at night and had I not been at the clinic my baby and I might not have survived\u201d.  \r\n\r\nSilothemba is one of the many mothers in Zimbabwe who have benefited from waiting mothers homes. These facilities help to reduce home deliveries as they enable mothers to be at health facilities when labour begins. Nutrition gardens at clinics managed by health centre committees provide vegetables for pregnant women, and boost food security for those from poor households.. Kumbudzi clinic in Umzingwane district also has a kitchen project to support and promote nutrition amongst pregnant women.   \r\n\r\nIn Zimbabwe currently 525 mothers die in every 100 000 live births, one of the highest maternal mortality rates in the world. Mother and newborn survival in  Zimbabwe is affected by the \u20183 delays\u2019, that is a delay in making a decision to seek health services, a delay in reaching a health facility and a delay in receiving quality services and care upon reaching a health facility.  These delays and the deaths from them are greater in rural areas.\r\n\r\nBefore the waiting mothers homes were introduced, rural women often gave birth at home with the aid of traditional birth attendants.  While convenient, these home births may expose women to risks from unhygienic conditions or limited ability to manage complications. Waiting mothers` homes increase mothers\u2019 access to skilled birth attendants and emergency specialized care.\r\n\r\nWomen who deliver at home often lack adequate information on the risks associated with pregnancy and childbirth. Health monitors at community level indicate that the delay in deciding to seek health care is a major contributor to maternal deaths, as women decide to seek appropriate health care when it is too late. This delay is exacerbated by the fact that many women do not make these decisions themselves but defer to spouses or relatives, who may also lack knowledge on maternal and child health.   Pregnant women also face barriers from long distances to health facilities, poor road networks, slow transport methods. They may thus deliver before they even reach the clinic. Women in many remote rural and resettlement areas live more than 25 kilometers away from health facilities, above the 10km maximum recommended by government. Going by ox drawn cart is not an option when there are pregnancy related complications have developed and many transport operators fear the risk associated with ferrying such passengers.  \r\n\r\nA waiting mother home reduces the stress of these barriers, giving time to travel to facilities, and reducing costs from different transport options. It brings mothers closer to the skilled health workers they need to manage normal deliveries or obstetric complications. \r\n\r\nThis puts the focus on the third delay, the delay in receiving adequate health care. With postpartum hemorrhage; obstructed labor and hypertensive disorders common causes of maternal death in Zimbabwe, health services need, but often lack,  the staff, training, medicines and equipment to effectively respond to a mother\u2019s needs.  Most rural clinics have at least 2 trained nurses/midwives, but these health workers often face burnout due to overwork and lack electricity, running water and adequate medicines. Higher level referral services may themselves lack skilled personnel.  Antenatal care services and waiting mothers homes allow health workers to monitor the mother before their labour and make early referrals to the next level of care for caesarians, vacuum extraction and induction if this is needed. Referral to these services may also face challenges in some areas from poor road networks, flooding rivers, a shortage of ambulances and poor communication channels. While waiting mother homes cannot solve these referral problems, they can give health workers more time to arrange options to address them.\r\n\r\nTo overcome the three delays, waiting mothers homes need to be backed by other service improvements. Primary health care services need to be available in remote and hard to reach areas, skilled obstetric care needs to be brought closer to rural women through regular visits to health facilities by doctors and stock-outs of relevant medicines avoided. Village Health Workers should be supported by strengthening their knowledge on maternal and child health and support for community led health promotion. Communities especially men should be involved and educated on the risks associated with maternity and the benefits of delivering at health services to encourage their partners to use and benefit from waiting mothers homes, to promote institutional deliveries and to argue for effective primary care and referral services. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Washing with hope: evidence of improved handwashing among children in South Africa from a pilot study of a novel soap technology","field_subtitle":"Burns J; Maughan-Brown B; Mouzinho \u00c2: BMC Public Health 18(709), doi: https://doi.org/10.1186/s12889-018-5573-8, 2018","URL":"http://www.who.int/bulletin/volumes/96/6/17-207175-ab/en/","body":"While regular handwashing effectively reduces communicable disease incidence and related child mortality, instilling a habit of regular handwashing in young children continues to be a challenging task, especially in low income countries. A randomised controlled pilot study assessed the effect of a novel handwashing intervention \u2013 a bi-monthly delivery of a colourful, translucent bar of soap with a toy embedded in its centre (HOPE SOAP\u00a9) \u2013 on children\u2019s handwashing behaviour and health outcomes. Between September and December 2014, 203 households in an impoverished community in Cape Town, South Africa, were randomised (1:1) to the control group or to receive HOPE SOAP\u00a9. Of all children aged 3\u20139 years and not enrolled in early childhood development programmes,  Two \u2018snack tests\u2019 (children were offered crackers and jam) were used to provide objective observational measures of handwashing. Through baseline and endline surveys, data were collected from caregivers on the frequency (scale of 1\u201310) of handwashing by children after using the toilet and before meals, and on soap-use during handwashing. Data on 14 illnesses/symptoms of illness experienced by children in the two weeks preceding the surveys were collected. At the end, HOPE SOAP\u00a9 children were directly observed as being more likely to wash their hands unprompted at both snack tests (49% vs 39%) and were more likely to use soap when washing their hands. HOPE SOAP\u00a9 children, in general, had better health outcomes, used the soap as intended and were less likely to have been ill. Results point towards HOPE SOAP\u00a9 being an effective intervention to improve handwashing among children. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"What is Zimbabwe\u2019s real maternal mortality rate?","field_subtitle":"Mkudu M; van Wyk A: Africa Check, 2015","URL":"https://tinyurl.com/yaofqmtd","body":"The authors report on conflicting figures for pregnancy and childbirth related deaths in Zimbabwe from 525 to 960 maternal deaths for every 100,000 live births. It would seem to be a relatively straightforward task to measure maternal mortality, but they note that in reality, that is not the case. Ideally, you would analyse death certificates, but even in countries with well-functioning birth and death registration systems, they report that the number of maternal deaths is routinely undercounted. This is because death certificates are not always complete and in some cases, the person signing a death certificate may not be aware that the woman was pregnant or that her pregnancy contributed in some way to her death. In some instances, health facilities have been known to try and conceal maternal mortalities because of political pressure to reduce the numbers. Zimbabwe is classified as a country with incomplete birth and death records by the UN. Researchers therefore rely on censuses and surveys to estimate maternal deaths. Household surveys reported 614 deaths / 100,000 live births for the period between 2007 and 2014, and 581 / 100 000 for 2009 to 2014, within the range of global organisations\u2019 estimates. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"WHOs First Global Conference on Air Pollution and Health","field_subtitle":"30 October \u2013 1 November 2018, World Health Organisation, Geneva","URL":"http://www.who.int/airpollution/events/conference/en/","body":"The Global Conference on Air Pollution and Health is the first-ever global event to focus on both air pollution and health. As a contribution towards achieving the Sustainable Development Goals, the Conference will feature a \u201cCall for Urgent Action\u201d where delegates will reach agreement on a target for 2030 to reduce the 7 million deaths caused by air pollution each year, Countries, urban mayors and civil society will be invited to make commitments to the global advocacy campaign www.BreatheLife2030.org to meet WHO Air Quality Guidelines and reduce climate emissions. The Conference will underline the links between air pollution and the global epidemic of noncommunicable diseases (NCDs), and position the health sector to catalyse actions for health-wise policies on clean household energy, transport and waste.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Why indigenous medicine could play a role in rebuilding health systems","field_subtitle":"Falisse J; Masino S; Ngenzebuhoro R: The Conversation, June 2018","URL":"https://tinyurl.com/y9xpqjr9","body":"This study contributes to the health policy debate on medical systems integration by describing and analysing the interactions between health-care users, indigenous healers, and the biomedical public health system, in the so far rarely documented case of post-conflict Burundi. The authors adopted a mixed-methods approach combining (1) data from an existing survey on access to health-care, with 6,690 individuals, and (2) original interviews and focus groups conducted in 2014 with 121 respondents, including indigenous healers, biomedical staff, and health-care users. The findings reveal pluralistic patterns of health-care seeking behaviour, which are not primarily based on economic convenience or level of education. Indigenous healers\u2019 diagnosis is shown to revolve around the concept of \u2018enemy\u2019 and the need for protection against it. The authors suggest ways in which this category may intersect with the widespread experience of trauma following the civil conflict. They find that, while biomedical staff display ambivalent attitudes towards healers, cross-referrals occasionally take place between healers and health centres. The authors emphasise healers\u2019 psychological support role in helping communities deal with trauma.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"World Intellectual Property Day: Are women in Uganda being priced out of life-saving medicine due to Intellectual Property Rights?","field_subtitle":"Lumbasi A: Centre for Health, Human Rights & Development, 2018","URL":"https://tinyurl.com/yao6vu33","body":"Although intellectual property (IP) Rights are intended to promote innovation and creativity, the author argues that they act as barriers for access to essential medicines as they create monopolies for pharmaceutical manufacturers who charge exorbitant prices, making these medicines out of reach for many especially in least developed countries. According to 2016 health data compiled by the Institute for Health Metrics and Evaluation , HIV was ranked number one cause for premature death in Uganda. Moreover women, in particular, were disproportionately affected in comparison to men. Many of the medicines they need are noted to be under patent protection and expensive for those who need them, as inventors seek to make a return on the high costs of research and development. The author proposes that the solution to this lies in the effective utilization of provisions incorporated in the WTO- Trade Related Aspects of Intellectual Property Agreement, commonly referred to as the TRIPS flexibilities. One flexibility is compulsory licensing which allows third parties to use an invention without the holders\u2019 consent. Another is parallel importation which allows procurement of drugs at a lower price from another country without consent of a patent holder of a patented product that is on the market of the exporting country. A further flexibility is the exemption of least developed countries from enforcing pharmaceutical patents until 2033 which can be exploited to promote transfer of technology. The author regards it as imperative to think of those women who are unable to access essential medicines due to their high cost caused by the strict enforcement of IP Rights.","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Zimbabwe: Realising the right to health for mothers and children, a mutli-donor Health Transition Fund helps to revitalise Zimbabwe\u2019s health system","field_subtitle":"UNICEF: UNICEF and MoHCC Zimbabwe 2018","URL":"https://www.unicef.org/zimbabwe/ZIM_newsline_healthtfundfull.pdf","body":"The Health Transition Fund (HTF) is a $435 million, five-year programme (2011-2015) that aimed to revitalize Zimbabwe\u2019s health sector by improving the lives of children and women. It was funded by multiple external funders from the European Union, Canada, Ireland, Norway, the United Kingdom and SIDA Sweden, and managed by UNICEF in cooperation with the Zimbabwean Ministry of Health. It has four pillars: 1) Improvement of maternal, newborn and child health as well as nutrition, 2) Provision of essential medicines, vaccines and technologies, 3) Human resources including assistance with health worker management, training and retention, 4) Health policy, planning and finance. It aimed to reduce maternal mortality by three quarters and under-5 mortality by two thirds (as stated in the Millennium Development Goals) and eliminate user fees for children under the age of five and pregnant and lactating women by 2015. It sought to support the halving of the number of underweight children under five and combating, halting and reversing trends in HIV/AIDS, malaria and other diseases. A steering committee, chaired by the permanent secretary of the Ministry of Health, oversees and directs the rollout of the fund and defines priority interventions within each of the four thematic areas, while funders provide support to monitoring, evaluation and technical expertise. ","php":"","field_issue_date":"2018-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"\"Poverty is the big thing\u201d: exploring financial, transportation, and opportunity costs associated with fistula management and repair in Nigeria and Uganda","field_subtitle":"Keya K; Sripad P; Nwala E; et al: International Journal for Equity in Health 17(70) 1-10, 2018 ","URL":"https://tinyurl.com/ycdhesvx","body":"This paper explored, through women\u2019s, communities\u2019, and providers\u2019 perspectives, the financial, transport, and opportunity cost barriers and enabling factors for seeking services for fistula. A qualitative approach was applied in Kano and Ebonyi in Nigeria and Hoima and Masaka in Uganda. Between June and December 2015, the study team conducted in-depth interviews with women affected by fistula including those awaiting repair, living with fistula, and after repair, their spouses and other family members, and health service providers involved in fistula repair and counseling. Focus group discussions with male and female community stakeholders and post-repair clients were also conducted. Women\u2019s experiences indicate the obstetric fistula results in a combined set of costs associated with delivery, repair, transportation, lost income, and companion expenses that are often limiting. Medical and non-medical ancillary costs such as food, medications, and water are not borne evenly among all fistula care centers or camps due to funding shortages. Women in Uganda spend Ugandan Shilling 10,000 to 90,000 for two people for a single trip to a camp. Factors that influence women\u2019s and families\u2019 ability to cover costs of fistula care access include education and vocational skills, community savings mechanisms, available resources in repair centers, client counseling, and subsidized care and transportation. The concentration of women in poverty and the perceived and actual out of pocket costs associated with fistula repair speak to an inability to prioritize accessing fistula treatment over household expenditures. Innovative approaches to financial assistance, transport, information of the available repair centers, rehabilitation, and reintegration in overcoming cost barriers were recommended. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"African Network for Internationalization of Education (ANIE) 9th Annual Conference 2018: Africa in the global higher education landscape: the role of internationalization","field_subtitle":"3 \u2013 5 October 2018, Nairobi, Kenya","URL":"https://anienetwork.org/-conference/","body":"ANIEs 10th Anniversary and 9th Annual Conference will debate contemporary trends in internationalization of higher education in Africa, the achievements that have been made over the last one decade, main challenges, and the implications of global internationalization of higher education in Africa. It is a timely opportunity to reflect on the crucial role of Africa in the global higher education and research landscape, especially towards the realization of the Sustainable Development Goals (SDGs).The conference ties in with the goals of Agenda2063; a blueprint for the growth of all the nations of the African continent for coming five decades. It aims to critically consider where African universities find themselves at present in the global higher education landscape. In which ways are the colonial and post-colonial legacies of African higher education playing themselves out in internationalization processes? How has internationalization in Africa helped African universities to claim spaces in the African knowledge domain from their former subservient positions? Who are the narrators of African knowledge and how can internationalization reshape the landscape?","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Applications for the 2nd Cohort of Tekano Fellows now open","field_subtitle":"Deadline for  Stage 1 of applications: 31 August 2018","URL":"https://www.tekano.org.za/apply","body":"Tekano's mission to foster dynamic, visionary, value-based leaders working both individually and in catalytic communities of learning and action who articulate, convey and act to promote health equity by addressing the social and structural determinants of health. Tekano's programme is built around annual fellowships for mid-career people from diverse backgrounds and disciplines who have already shown leadership in addressing the determinants of health equity.  The programme is composed of 6 face-to-face modules, held every two months from January to December 2019. Applicants must be a South African citizen or valid permit holders between 25- 45 of age with evidence of showing leadership and commitment to social justice in South Africa, linked to health equity. Applicants must commit to all program activities of the Fellows Programme in 6 modules in 2019 and either be employed or volunteer with a sending organisation/s. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for expressions of interest on Heightening Institutional Capacity for Government Use of Health Research Award","field_subtitle":"Deadline: 15 August 2018","URL":"https://tinyurl.com/y8uhryck","body":"Applications are open for Heightening Institutional Capacity for Government Use of Health Research (HIGH-Res) Award. This is a joint call for proposals from the Alliance for Health Policy and Systems Research and Wellcome to enhance the capacity of ministries of health in lower-middle and low-income countries to use health research evidence in policy-making. This call will fund one consortium up to US$ 1,000,000 for a maximum duration of 36 months. The collaborating research or academic teams must be based at recognized institutions with the capacity to undertake high-quality research. This means an institution that possesses an existing in-house capacity to host a grant and can demonstrate an independent capability to undertake and lead on research programmes. Ministries of health must engage as implementing partners and are required to co-lead the consortium. Applications that include capacity building and comparison across several different institutions and/or countries are encouraged. The primary applicants must be based in at least developed, lower-income or lower-middle income country.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Child Rights and Child Law Short Course for Health and Allied Professionals","field_subtitle":"3 - 7 December 2018 Cape Town","URL":"http://www.ci.uct.ac.za/ci/child-rights-course/overview","body":"Every year the Children\u2019s Institute runs a short course on child rights and child law for health and allied professionals.  This five-day intensive course provides an opportunity for doctors, nurses, social workers and allied professionals to explore how to better support children\u2019s rights in practice. The course aims to build a network of health and allied professionals interested in promoting children\u2019s rights and sharing best practice, and will: deepen understandings of child rights and child law in South Africa; enable participants to apply this understanding in daily practice; enable participants to advocate for children\u2019s health both within and outside the health care system. The course is accredited by both the Health Professions Council of South Africa and the SA Council for Social Service Professions, and is targeted at doctors, nurses, educators, social workers and allied professionals who are responsible for child health at all levels of the health care system. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Digital Democracy, Analogue Politics","field_subtitle":"Nanjala N: Zed Books, 2018","URL":"https://tinyurl.com/yajvqfew","body":"From the upheavals of recent national elections to the success of the #MyDressMyChoice feminist movement, digital platforms have already had a dramatic impact on political life in Kenya \u2013 one of the most electronically advanced countries in sub-Saharan Africa. While the impact of the Digital Age on Western politics has been extensively debated, there is still little appreciation of how it has been felt in developing countries such as Kenya, where Twitter, Facebook, WhatsApp and other online platforms are increasingly a part of everyday life. Written by a respected Kenyan activist and researcher at the forefront of political online struggles, this book presents a unique contribution to the debate on digital democracy. For traditionally marginalised groups, particularly women and the disabled, digital spaces have allowed Kenyans to build new communities which transcend old ethnic and gender divisions. But the picture is far from wholly positive. Digital Democracy, Analogue Politics explores the drastic efforts being made by elites to contain online activism, as well as how \u2018fake news\u2019, a failed digital vote-counting system and the incumbent president's recruitment of Cambridge Analytica contributed to tensions around the 2017 elections. Reframing digital democracy from the African perspective, Nyabola\u2019s work opens up new ways of understanding our current global online era.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"DRAFT Astana Declaration on Primary Health Care","field_subtitle":"WHO: Draft for review for the Global Conference on Primary Health Care, World Health Organisation, Geneva, 2018 ","URL":"https://tinyurl.com/y9c9ufrd","body":"On 25-26 October 2018, the world will come together to renew a commitment to strengthening primary health care to achieve universal health coverage and the Sustainable Development Goals. The World Health Organisation (WHO) have received over 500 comments on the Draft Declaration on Primary Health Care and incorporated them in this updated draft. This draft describes the need for Primary Health Care to address today\u2019s health challenges. WHO are reopening the public consultation to ensure that voices of a broad range of stakeholders are included and has circulated a draft declaration for comment.  It goes to in-person member state consultation in early August.  The proposed text is provided at the website. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EAC Executive decries high number of East Africans seeking health services in India ","field_subtitle":"East African Community Secretariat: Arusha, Tanzania, June, 2018","URL":"https://tinyurl.com/yab2lhe8","body":"The Executive Secretary of the East African Health Research Commission (EAHRC), Professor Gibson Kibiki, has decried the high number of East Africans going to India to seek medical services which can be accessed in hospitals in the region. Prof. Kibiki attributed the huge exodus of patients to India to the lack of information on health services that were available at referral hospitals in the region. He revealed that East Africans may soon be able to access treatment across national borders in addition to enjoying portable health insurance across the region, adding that the Commission would soon undertake research to gauge the feasibility of a regional health insurance scheme before piloting the scheme. He described as counterproductive the tendency by health researchers and medics in the Partner States to work in silos since the region was one and that diseases did not know national borders. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Emerging Public Health Practitioner Award: manuscript submissions open","field_subtitle":"Deadline: 30 August 2018","URL":"https://tinyurl.com/y7dpxmnp","body":"The South African Health Review's Emerging Public Health Practitioner Award (EPHPA) is open to young public health practitioners or student researchers in the fields of health sciences, medicine or public health who are currently studying for their Masters or Honours degree, or are in the final year of their Bachelor's degree. Individuals seeking to publish a paper dealing with any of the following issues are encouraged to apply: Health workers (e.g. community health workers, production and distribution of healthcare workers, planning and forecasting, task-shifting, etc.); Responses to the prevention and management of non-communicable diseases.; Progress and challenges towards implementing universal health coverage. The South African Health Review's Emerging Public Health Practitioner Award is offered to South African citizens or permanent residents who are under the age of 35 on 3 August 2018. See website for further details.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 209: Safeguarding the principles of the Alma Ata Declaration on PHC","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Header"}},{"node":{"title":"Examining equity in health insurance coverage: an analysis of Ghana\u2019s National Health Insurance Scheme","field_subtitle":"Dake F: International Journal for Equity in Health 17(85) 1-10; 2018","URL":"https://tinyurl.com/yakfloxp","body":"This paper examines equity in coverage under Ghana\u2019s National Health Insurance Scheme. Secondary data from the 2008 Ghana Demographic and Health Survey based on an analytical sample of 4821 females and 4568 males were analysed using descriptive, bivariate and multivariate methods. As at 2008, more than 60% of Ghanaians aged 15\u201359 years were not covered under the National Health Insurance Scheme with slightly more females than males covered. Coverage was highest among the highly educated, professionals, those from households in the richest wealth quintile and urban residents. Lack of coverage was most concentrated among poor people. The author calls for  deliberate action to enrol the poor under the National Health Insurance Scheme.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"From health for all to universal health coverage: Alma Ata is still relevant","field_subtitle":"Raj Pandey K: Globalization and Health 14(62), doi: https://doi.org/10.1186/s12992-018-0381-6, 2018","URL":"https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-018-0381-6","body":"With increasing adoption of universal health coverage (UHC), the health for all agenda is resurgent globally.  This commentary discusses the origin of the health for all agenda in the 1970s and the influence of global politico-economic forces in shaping that agenda and its demise. The author proposes that it has resurged in the form of UHC in the twenty-first century, but also discusses UHC\u2019s focus on finances and the increasing role of market economy in health care, and the need to regulate the market based provision of healthcare, and incorporate more of the people and community centred ethos of the PHC of 40 years ago.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Gendered health systems: evidence from low- and middle-income countries","field_subtitle":"Morgan R; Ayiasi R; Barman D; et al: Health Research Policy and Systems 16(58) 2-12, 2018","URL":"https://tinyurl.com/ybw3xpcx","body":"This paper synthesizes findings from nine studies focusing on four health systems domains, namely human resources, service delivery, governance and financing. It provides examples of how a  gender approach can be applied by researchers in a range of low- and middle-income settings to these domains and demonstrates that this can uncover new ways of viewing seemingly intractable problems. The studies used a combination of mixed, quantitative, qualitative and participatory methods, including photovoice and life histories, to prompt deeper and more personal reflections on gender norms. Five core themes that cut across the different studies were the intersection of gender with other social stratifiers, the importance of male involvement, the influence of gendered social norms on health system structures and processes, the reliance on unpaid carers within the health system and the role of gender within policy and practice. These themes indicate the relevance of and need for gender analysis by researchers, policy-makers and health practitioners.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"HIV infection in patients with sexually transmitted infections in Zimbabwe \u2013 Results from the Zimbabwe STI etiology study","field_subtitle":"Kilmarx P; Gonese E; Lewis D; et al.: PLoS One, doi: https://doi.org/10.1371/journal.pone.0198683, 2018","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198683","body":"HIV and other sexually transmitted infections (STI) frequently co-occur. The authors conducted HIV diagnostic testing in an assessment of the etiologies of major STI syndromes in Zimbabwe. A total of 600 patients were enrolled at six geographically diverse, high-volume STI clinics in Zimbabwe in 2014\u201315: 200 men with urethral discharge, 200 women with vaginal discharge, and 100 men and 100 women each with genital ulcer disease (GUD). Patients completed a questionnaire, underwent a genital examination, and had specimens taken for etiologic testing. Patients were offered, but not required to accept, HIV testing using a standard HIV algorithm in which two rapid tests defined a positive result. A total of 489 participants accepted HIV testing; 201 tested HIV-1-positive, including 16 of 134 participants who reported an HIV-negative status at study enrollment, and 58 of 206 participants who reported their HIV status as unknown. Of 147 who self-reported being HIV-positive at study enrollment, 21 tested HIV negative. HIV infection prevalence was higher in women than in men, and was 28.5% in men with urethral discharge, 40.5% in women with vaginal discharge, 45.2% in men with GUD, and 59.8% in women with GUD. The high prevalence of HIV infection in STI clinic patients in Zimbabwe is argued by the authors to underscore the importance of providing HIV testing and referral for indicated prevention and treatment services for this population. The discrepancy between positive self-reported and negative study HIV test results highlights the need for operator training, strict attention to laboratory quality assurance, and clear communication with patients about their HIV infection status.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"How do gender relations affect the working lives of close to community health service providers? Empirical research, a review and conceptual framework","field_subtitle":"Steege R; Taegtmeyer M; McCollum R; et al: Social Science & Medicine 209 (2018) 1\u201313, 2018 ","URL":"http://www.sciencedirect.com/science/article/pii/S0277953618302375?via%3Dihub","body":"This paper synthesises current evidence on gender and close-to-community (CTC) providers and the services they deliver.  The review included 58 papers from literature to inform the development of a conceptual framework. The authors present a holistic conceptual framework to show how gender roles and relations shape CTC provider experience at the individual, community, and health system levels. The evidence presented highlights the importance of safety and mobility at the community level. At the individual level, family and intra-household dynamics are of importance. Important at the health systems level, are career progression and remuneration. The authors present suggestions for how the role of a CTC provider can, with the right support, be an empowering experience. Key priorities for policymakers to promote gender equity in this cadre include: safety and well-being, remuneration, and career progression opportunities. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Key Considerations for Accountability and Gender in Health Systems in Low- and Middle-Income Countries","field_subtitle":"Waldman L; Theobald S; Morgan R: Institute of Development Studies (IDS) Bulletin 49(2), doi: http://dx.doi.org/10.19088/1968-2018.137, 2018","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2967/Online%20article","body":"This article poses questions, challenges, and dilemmas for health system researchers striving to better understand how gender shapes accountability mechanisms, by critically examining the relationship between accountability and gender in health systems. It raises three key considerations, namely that: (1) power and inequities are centre stage: power relations are critical to both gender and accountability, and accountability mechanisms can transform health systems to be more gender-equitable; (2) intersectionality analyses are necessary: gender is only one dimension of marginalisation and intersects with other social stratifiers to create different experiences of vulnerability and there is a need to take account of how these stratifiers collectively shape accountability; and (3) empowerment processes that address gender inequities are a prerequisite for bringing about accountability. The authors suggest that holistic approaches to understanding health systems inequities and accountability mechanisms are needed to transform gendered power inequities, impact on the gendered dimensions of ill health, and enhance health system functioning. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Leveraging the power of partnerships: spreading the vision for a population health care delivery model in western Kenya","field_subtitle":"Mercer T; Gardner A; Andama B; et al.: Globalization and Health 14(44), doi: https://doi.org/10.1186/s12992-018-0366-5, 2018","URL":"https://tinyurl.com/y9s2tbr9","body":"This paper describes an academic partnership to support the public-sector health care system, with a major focus on scaling up HIV care in western Kenya to build a system able to take responsibility for the health of an entire population. The population health care delivery model involved comprehensive, integrated, community-centred, and financially sustainable services, with a path to universal health coverage. The authors share information on the partnership with strategic planning and change management experts from the private sector to use a \u2018Learning Map\u00ae\u2019 to collaboratively develop and share a vision of population health, and achieve strategic alignment with key stakeholders at all levels of the public-sector health system in western Kenya. The authors describe how the model has leveraged the power of partnerships to move beyond the traditional disease-specific silos in global health to a model focused on health systems strengthening and population health. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Managing epidemics: Key facts about major deadly diseases","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"http://www.who.int/emergencies/diseases/managing-epidemics/en/","body":"This manual provides concise and up-to-date knowledge on 15 infectious diseases that have the potential to become international threats, and tips on how to respond to each of them. The 21st century has already been marked by major epidemics. Old diseases - cholera, plague and yellow fever - have returned, and new ones have emerged - SARS, pandemic influenza, MERS, Ebola and Zika. These epidemics and their impact on global public health have convinced the world's governments of the need for a collective and coordinated defence against emerging public health threats and accelerated the revision of the International Health Regulations (2005), that entered into force in 2007. The diseases covered are: Ebola virus disease, lassa fever, Crimean-Congo haemorrhagic fever, yellow fever, Zika, chikungunya, avian and other zoonotic influenza, seasonal influenza, pandemic influenza, Middle-East respiratory syndrome (MERS), cholera, monkeypox, plague, leptospirosis and meningococcal meningitis. Although originally developed as guidance for WHO officials, this publication is available to a wide readership including all frontline responders - communities, government officials, non-state actors and public health professionals - who need to respond rapidly and effectively when an outbreak is detected.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Multimorbidity: a priority for global health research","field_subtitle":"The Academy of Medical Sciences: AMS, London, 2018.","URL":"https://acmedsci.ac.uk/file-download/82222577","body":"This report summarises available evidence on multimorbidity and highlights key evidence gaps which must be addressed to better understand the issue, and improve care and outcomes globally. The report calls for a standardised definition and reporting system for multimorbidity. It recommends a need to better understand the trends and patterns of multimorbidity across  countries; the determinants of and burden caused by common clusters of conditions and how best to prevent and manage multimorbidity. The report draws on insights from a number of workshops, one of which was held in Johannesburg, South Africa. It raises that many populations in high, middle and low income countries are experiencing multimorbidity on a massive scale but that the available evidence about the burden, determinants, prevention and treatment of patients with multimorbidity is inadequate. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials","field_subtitle":"Jacobs A: The New York Times, July 2018","URL":"https://tinyurl.com/yc32f6gt","body":"A resolution to encourage breast-feeding was expected to be approved quickly and easily by the hundreds of government delegates who gathered in Geneva for the World Health Assembly. Based on decades of research, the resolution says that mother\u2019s milk is healthiest for children and countries should strive to limit the inaccurate or misleading marketing of breast milk substitutes. The United States delegation was however reported to have embraced the interests of infant formula manufacturers and to have upended the deliberations. Health advocates scrambled to find another sponsor for the resolution, but at least a dozen countries, most of them poor nations in Africa and Latin America, backed off, citing fears of retaliation, according to officials from Uruguay, Mexico and the United States. In the end, the Russian delegation stepped in to introduce the measure \u2014 and the Americans did not oppose. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Postgraduate training for trauma prevention, injury surveillance and research, Uganda ","field_subtitle":"Bachani A; Paichadze N; Bentley J; et al: Bulletin of the World Health Organisation; 96(6):423\u2013427, 2018","URL":"http://www.who.int/bulletin/volumes/96/6/17-200949.pdf?ua=1","body":"This paper addressed the gaps in shortage of trained people and lack of national data on non-communicable diseases and their risk factors in Uganda. The authors developed and implemented a new track within an existing master of public health programme, aimed at developing graduate-level capacity and promoting research on key national priorities for trauma and injuries. They also offered training opportunities to a wider audience and set up a high-level national injury forum to foster national dialogue on addressing the burden of trauma, injuries and disability. Over the years 2012 to 2017 there were four cohorts of master\u2019s students, with a total of 14 students. Over 1300 individuals participated in workshops and seminars of the short-term training component of the programme. The forum hosted three research symposia and two national injury forums. The authors note that institutional support and collaborative engagement is important for developing and implementing successful capacity development programmes, and that integration of training components within existing academic structures is key to sustainability and appropriate mentorship for motivated and talented students.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Public Health Association of South Africa Annual Conference: Health for All- Thinking Globally, Acting Locally","field_subtitle":"10-12 September 2018, Khaya iBhubesi, Parys, South Africa","URL":"https://tinyurl.com/ybqn8a6v","body":"The Public Health Association of South Africa extends a warm invitation to their 14th annual conference in Parys, North West Province. The conference program features expert plenaries and panel discussions, oral and poster research presentations, skills development workshops, and the opportunity to engage with special interest groups. In commemoration of the World Health Organization\u2019s 70th anniversary celebration, the theme for this year\u2019s conference is \u201cHealth for All- Thinking Globally, Acting Locally.\u201d Since its establishment in 1948, \u201cHealth for All\u201d has been an underlying objective of the World Health Organization\u2019s and its member states; traversing strategic milestones from the Alma Ata Declaration in 1978 and the Millennium Development Goals in 2000, to the Sustainable Developmental Goals in 2015. This theme aims to stimulate robust discussions on progress made, critical reflections on the challenges encountered, and vibrant dialogue on how to move closer to a world where all people are able to attain a state of health that enables them to lead socially and economically productive lives. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Responding to inequalities in health in urban areas in east and southern Africa: Brief 3: What do Harare urban youth say?","field_subtitle":"TARSC; CFHD; Harare youth:  TARSC, CFHD EQUINET, Harare, 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Urban%20health%20Brief3%20May2018%20lfs.pdf","body":"By 2050, urban populations will increase to 62% in Africa. 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 \u201cEquity Watch\u201d work in EQUINET explored these questions in 2016-7, for east and southern African (ESA) countries. We thus integrated many forms of evidence, including a review of literature, analysis of quantitative indicators, internet searches of evidence on practices, thematic content analysis and participatory validation by those more directly involved and affected. This brief covers the participatory validation by youth from six different suburbs in Harare facilitated by TARSC and the Civic Forum on Human Development (CFHD). The six groups of young people involved in the participatory validation came from youth living in northern higher income suburbs; youth in formal jobs (although noting that they may also be in insecure jobs); young people in tertiary education; young people in Epworth, as a suburb with informal settlements.; unemployed youth and youth in informal jobs. In this brief we summarise the findings of the participatory validation in the two meetings in 2016. We present how the views of the Harare youth related to the areas of health and wellbeing identified in the literature, and how far their experiences varied in the different groups. The findings indicate that there is diversity between young people in different parts of the city and different social contexts that affect which dimensions of wellbeing they perceive to be most important. It was evident, however, that the question preoccupying young people was not \u2018how big is the gap between us?\u2019 but \u2018how, collectively do we close the gap\u2019? The brief points to the policies for youth wellbeing in Harare that would be important to closing the gap.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Responding to inequalities in health in urban areas in east and southern Africa: Brief 4: What did we learn from experiences and innovations in other countries to improve youth health and wellbeing?","field_subtitle":"Loewenson R; Masotya M; CFHD and Harare youth:  TARSC, EQUINET, 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Urban%20health%20Brief%204%20May2018%20lfs.pdf","body":"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 \u201cEquity Watch\u201d 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.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Robert Carr Fund Request For Proposals (RFP) for 2019-2021","field_subtitle":"Deadline for applications: 13 August 2018 at 12:00 (noon) CET.","URL":"http://www.robertcarrfund.org/funding/request-for-proposals/","body":"The Robert Carr Fund is inviting proposals from global and regional civil society networks addressing critical factors protecting the rights of inadequately served populations (ISPs); scaling up access to HIV prevention, treatment, care and support; and assuring that resources are mobilized and utilized appropriately to respond to the global HIV epidemic. The goal of the Fund is to contribute to improved health, inclusion and social wellbeing for inadequately served populations (ISPs). To reach this goal, the Robert Carr Fund provides core funding to strengthen the institutional and advocacy capacity of regional and global ISP and civil society networks and/or their consortia. Global and regional networks and consortia of networks which meet the definitions and criteria set by this RFP are invited to apply for a grant to support core funding and/or activity needs of the networks and/or consortia for up to three years (2019-2021). ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Safeguarding the principles of the Alma Ata Declaration on PHC","field_subtitle":"Editor, EQUINET Newsletter","body":"\r\nFor forty years the 1978 Declaration of Alma Ata on Primary Health Care has inspired and galvanised understanding, analysis and action on health. In our region, the aspirations and content that were included in the 1978 declaration were embedded in liberation movement goals and post- independence policies and informed the organisation and transformation of health services. Indeed a context of growing movements for social justice and emergent national health systems in the South was one source of the political momentum, values and practice that fuelled the Declaration.  In various declarations over the past 40 years, African governments and communities have recognised the contribution of PHC to improved health equity in the region and voiced a need to accelerate efforts to implement it, even while resources bled out of public sector services. \r\n\r\nIn preparation for a Global conference in Astana in 2018 to commemorate 40 years of PHC a new declaration is being drafted: \u201cthe Astana Declaration on Primary Health Care: From Alma-Ata towards Universal Health Coverage and the Sustainable Development Goals\u201d. The text can be found at http://www.who.int/primary-health/conference-phc/DRAFT_Declaration_on_Primary_Health_Care_28_June_2018.pdf.  It notes a \u201crenewed commitment to health and well-being for all based on universal health coverage (UHC)\u201d and locates PHC as \u201ca necessary foundation to achieve UHC\u201d.  Its focus is thus on UHC as the end and PHC as the means.  It makes reference to the work of other sectors to address other health determinants in line with the Sustainable Development Goals, \u201c avoiding political and financial conflicts of interest\u201d.\r\n\r\nBut the Alma Ata declaration was so much more ambitious and comprehensive in its vision and scope! It called for an economic order that would serve the attainment of health and reduce inequalities in health globally, while also recognising that the promotion and protection of people\u2019s health is essential for socio-economic development.  Its language on state duties and public rights is unambiguous. Its principles are no less relevant today than in 1978, even if changing contexts, health profiles and knowledge demand creativity in how it is applied. \r\n\r\nAs new statements and declarations circulate, let\u2019s remind ourselves of key features of what the Alma Ata Declaration says:\r\n\r\n\u201c I The Conference strongly reaffirms that health, which is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector. \r\n\r\nII The existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable and is, therefore, of common concern to all countries. \r\n\r\nIII Economic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all and to the reduction of the gap between the health status of the developing and developed countries. The promotion and protection of the health of the people is essential to sustained economic and social development and contributes to a better quality of life and to world peace. \r\n\r\nIV The people have the right and duty to participate individually and collectively in the planning and implementation of their health care. \r\n\r\nV Governments have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social measures. A main social target of governments, international organizations and the whole world community in the coming decades should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. Primary health care is the key to attaining this target as part of development in the spirit of social justice. \r\n\r\nVI Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the country's health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process\u201d. \r\n\r\nThere is more, and the full declaration can be found at http://www.who.int/publications/almaata_declaration_en.pdf\r\n\r\nThose engaging on statements and processes on PHC should carefully compare with the Alma Ata Declaration and ensure that we do not lose or blur its clarity of principles and content. \r\n\r\nPlease send feedback or queries on the issues raised to the EQUINET secretariat: admin@equinetafrica.org. For more information on the Global conference on PHC see http://www.who.int/primary-health/conference-phc/en/ ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Saving lives, spending less: a strategic response to NCDs","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"https://tinyurl.com/y7ohahcs","body":"This report reveals the financing needs and returns on investment of WHO\u2019s cost-effective and feasible \u201cbest buy\u201d policies to protect people from noncommunicable diseases (NCDs), the world\u2019s leading causes of ill health and death. It shows that for every US$1 invested in scaling up actions to address NCDs in low- and lower-middle-income countries (LLMICs), there will be a return to society of at least US$7 in increased employment, productivity and longer life. If all countries use these interventions, the world would move significantly closer to achieving Sustainable Development Goal 3.4 to reduce premature death from NCDs by one-third by 2030. Among the most cost-effective \u201cbest buy\u201d interventions are increasing taxes on tobacco and alcohol, reducing salt intake through the reformulation of food products, administering drug therapy and counselling for people who have had a heart attack or stroke, vaccinating girls aged 9\u250013 years against human papillomavirus and screening women aged 30\u250049 years for cervical cancer. LLMICs currently bear the brunt of premature deaths from NCDs: almost half (7.2 million) of the 15 million people who die globally every year between the age of 30 and 70 are from the world\u2019s poorest countries. Yet global financing for NCDs is severely limited, receiving less than 2% of all health funding. The report indicates that taking effective measures to prevent and control NCDs costs just an additional US$ 1.27 per person per year in LLMICs. The health gains from this investment will, in turn, generate US$350 billion through averted health costs and increased productivity by 2030, and save 8.2 million lives during the same period. Saving lives, spending less: a strategic response to NCDs issues a clear call for funding for scaling up the \u201cbest buy\u201d policies which would save millions of lives.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Shaping health participatory satellite session, Global Symposium for Health Systems Research, 9 October 2018, Liverpool UK ","field_subtitle":"Session open for registration","URL":"https://tinyurl.com/yaq52b6n","body":"In this session at the Global Symposium for Health Systems Research participants will share evidence and learning from a multi-country Shaping health consortium on social participation in local health systems. The session will also use participatory approaches to draw on the experiences of those participating. Experiences in Shaping Health show how social participation and power can make health systems more holistic in approach, more responsive and more inclusive. Participants will discuss and draw recommendations on practices that ground health action and services within community cultures and systems, what challenges they face, and how to facilitate and encourage such practice. The session is open for registration, but there are a limited number of places. See the website for further details on how to register .","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Socioeconomic inequality in self-reported unmet need for oral health services in adults aged 50 years and over in China, Ghana, and India ","field_subtitle":"Kailembo A; Preet R; Williams J; et al.: International Journal for Equity in Health 17(99) 1-14, 2018","URL":"https://tinyurl.com/y7g3s3ce","body":"This study measures and describes socioeconomic inequality in self-reported unmet need for oral health services in adults aged 50 years and over, in China, Ghana and India. The prevalence of unmet need was 60, 80, and 62% in China, Ghana and India respectively. The adjusted relative index of inequality for education was statistically significant for China, Ghana, and India, whereas the adjusted relative index of inequality for wealth was significant only in Ghana. Male sex was significantly associated with self-reported unmet need for oral health services in India. Given rapid population ageing, the author argues that further evidence of socioeconomic inequalities in unmet need for oral health services by older adults in low to medium income countries are needed to inform policies to mitigate inequalities in the availability of oral health services. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"South Africa: Health workers say they are undervalued and poorly equipped","field_subtitle":"Mutandiro K: GroundUp, July 2018","URL":"https://tinyurl.com/yc6atreh","body":"Representatives from the Democratic Nursing Organization of South Africa (Denosa), a trade union that represents nurses and professional midwives, say that nursing staff work under bad conditions. A Denosa spokesman said South African nurses and nursing staff were seeking work out of the country where they were appreciated and would get better salaries. \u201cPeople who rely on the services of public healthcare workers are disadvantaged when public health workers are understaffed or strike due to unresolved grievances,\u201d said Ashwell Jenneker of Statistics South Africa. In a dialogue, the South Africa Minister of Health, Aaron Motsoaledi said, \u201cWe will do our best to ensure that all health workers are given better working conditions. We will also work on making sure that the minimum service level of health workers is implemented.\u201d Those attending the dialogue agreed that a formal investigation was needed into the working conditions of all health workers.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Teenager at centre of Kenyan court case over botched abortion has died","field_subtitle":"Ratcliffe R: The Guardian, July 2018  ","URL":"https://tinyurl.com/y8p7s834","body":"A teenager whose botched abortion was at the centre of a high court case in Kenya has died.  The girl, who was raped aged 14 and then left with horrific injuries after a backstreet termination, had been the subject of a controversy over the liability of the Kenyan government in her case. The girl\u2019s mother and a group of campaigners had filed a case against the government, claiming it had failed to offer the girl \u2013 known as JMM \u2013 adequate post-abortion care. They called for the government to reinstate guidelines on safe abortions. JMM\u2019s mother, as well as the Federation of Women Lawyers-Kenya and two human rights advocates, filed the case in the Kenyan high court in 2015. Campaigners say that if successful it could save the lives of thousands of women a year. The hearings are expected to conclude in July 2018. Access to abortion was widened under Kenya\u2019s 2010 Constitution, which allowed for the procedure in cases where the health or life of a pregnant woman is at risk, and in cases of emergency. But the government has since withdrawn standards and guidelines designed to make legal abortions safer and banned health workers from undergoing training on abortion. In 2012, nearly 120,000 women were admitted to public health facilities for abortion-related complications. The author reports that women seeking post-abortion services face stigma and discrimination in health facilities, particularly poor or young women. The court decision is expected before the end of the year.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The increasing prevalence of non-communicable diseases in low-middle income countries: the view from Malawi","field_subtitle":"Gowshall M; Taylor-Robinson: International Journal of General Medicine, 2018(11), 255-264, 2018","URL":"https://tinyurl.com/yaz3a6u6","body":"As a low-income African country that consistently ranks amongst the world\u2019s poorest nations, Malawi as a case study demonstrates how transition due to societal change and increasing urbanization is often accompanied by a rise in the rate of non-communicable diseases (NCDs). Other factors apart from changing lifestyle factors can explain at least some of this increase, such as the complex relationship between communicable and NCDs and growing environmental, occupational, and cultural pressures. Malawi and other LMIs are struggling to manage the increasing challenge of NCDs, in addition to an already high communicable disease burden. However, the author proposes that health care policy implementation, specific health promotion campaigns, and further epidemiological research may be key to attenuating this impending health crisis, both in Malawi and elsewhere. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Tracking SDG7: The Energy Progress Report ","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"https://tinyurl.com/yaarncr6","body":"Energy is crucial for achieving almost all of the sustainable development goals (SDGs), from eradication of poverty through advancements in health, education, water supply and industriali\u00adzation to combating air pollution and climate change. This new report includes updated data from WHO on household air pollution showing that 3 billion people \u2013 or more than 40% of the world\u2019s popula\u00adtion \u2013 still do not have access to clean cooking fuels and technologies. Household air pollution from burning solid fuels and using kerosene for cooking alone are responsible for some 4 mil\u00adlion deaths a year, with women and children being at greatest risk. The report provides a com\u00adprehensive summary of the world\u2019s progress towards the global energy targets on access to electricity, clean cooking fuels, renewable energy and energy efficiency. It was launched at the Sustainable Energy for All forum held on 2 May 2018 in Lisbon, Portugal.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Trade challenges at the World Trade Organization to national noncommunicable disease prevention policies: A thematic document analysis of trade and health policy space","field_subtitle":"Barlow P; Labonte R; McKee M; et al.: PLOS Medicine, doi: https://doi.org/10.1371/journal.pmed.1002590, 2018","URL":"http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002590","body":"It has long been contested that trade rules and agreements are used to dispute regulations aimed at preventing noncommunicable diseases (NCDs). Yet most analyses of trade rules and agreements focus on trade disputes, potentially overlooking how a challenge to a regulation\u2019s consistency with trade rules may lead to \u2018policy or regulatory chill\u2019 effects, whereby countries delay, alter, or repeal regulations in order to avoid the costs of a dispute. Systematic empirical analysis of this pathway to impact was previously prevented by a dearth of systematically coded data. In this paper, the authors report analysis of a newly created dataset of trade challenges about food, beverage, and tobacco regulations among 122 World Trade Organization (WTO) members from January 1, 1995 to December 31, 2016. The scope and frequency of trade challenges are thematically described, and economic asymmetries between countries are analysed, raising and defending them, and summarised through four cases of their possible influence. Between 1995 and 2016, 93 food, beverage, and tobacco regulations were challenged at the WTO. \u2018Unnecessary\u2019 trade costs were the focus of 16.4% of the challenges. Only one (1.1%) challenge remained unresolved and escalated to a trade dispute. Thirty-nine (41.9%) challenges focussed on labelling regulations, and 18 (19.4%) focussed on quality standards and restrictions on certain products like processed meats and cigarette flavourings. High-income countries raised 77.4% of all challenges raised against low- and lower-middle\u2013income countries. The authors further identified four cases in Indonesia, Chile, Colombia, and Saudi Arabia in which challenges were associated with changes to food and beverage regulations. Data limitations precluded a comprehensive evaluation of policy impact and challenge validity. The authors observe that policy makers appear to face significant pressure to design food, beverage, and tobacco regulations that other countries will deem consistent with trade rules. They note that trade-related influence on public health policy is likely to be understated by analyses limited to formal trade disputes.","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Ugandan citizens unite against social media tax","field_subtitle":"Agence France Press: News24, July 2018","URL":"https://tinyurl.com/yah685x5","body":"Politicians, clerics, feminists and others have formed a broad coalition of Ugandans calling for an end to a social media tax. In July, Uganda's communications regulator blocked access to social media including WhatsApp, Facebook and Twitter, as well as dating sites Tinder and Grindr, unless users pay a Shs200 ($0.05) daily tax. Mobile internet users now have to input a telephone code to pay the tax before they are able to access most social media sites, although implementation has proved patchy with some blocked services still available. Some have turned to virtual private networks (VPNs) to disguise their location and avoid the levy, a trick learned during elections two years ago when the government tried to shut down social media. President Yoweri Museveni - a Twitter user with 855 000 followers - is reported to have urged the imposition of the tax earlier this year, to put an end to \"gossip\". The protesters are resisting the measure and calling for it to be lifted. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"WHO Global Ambient Air Quality Database ","field_subtitle":"World Health Organisation: WHO Geneva 2018","URL":"http://www.who.int/airpollution/data/cities/en/","body":"More than 80% of people living in urban areas that monitor air pollution are exposed to air quality levels that exceed the World Health Organization (WHO) limits. While all regions of the world are affected, populations in low-income cities are the most impacted.  According to the latest air quality database, 97% of cities in low- and middle income countries with more than 100 000 inhabitants do not meet WHO air quality guidelines. However, in high-income countries, that percentage decreases to 49%. In the past two years, the database \u2013 now covering more than 4000 cities in 108 countries \u2013 has nearly doubled, with more cities measuring air pollution levels and recognizing the associated health impacts. As urban air quality declines, the risk of stroke, heart disease, lung cancer, and chronic and acute respiratory diseases, including asthma, increases for the people who live in them. ","php":"","field_issue_date":"2018-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"13th International Conference on ICT for Development, Education and Skills","field_subtitle":"26-28 September 2018, Kigali, Rwanda","URL":"http://www.elearning-africa.com","body":"eLearning Africa 2018 is the 13th International Conference on ICT for Development, Education and Skills, in September in Kigali, Rwanda. The programme includes core dialogues, debates, discovery demos, knowledge exchange sessions, knowledge factories, networking meet-ups, panel talks, plenary sessions and poster presentations on specific topics and informal networking opportunities in which practitioners share their experiences, ideas, new information and perspectives. In the exhibition area, leading international eLearning manufacturers, suppliers and service providers present their latest products and services. eLearning Africa will hold a ministerial round table, an annual meeting of African ICT and Education ministers, who take part in a day-long discussion of key issues affecting education, training, skills and technology before the official opening of the main conference. The sub-themes for the conference include: Creating opportunities through education; transforming the continent; boosting competitiveness and ICT-centric growth; matching skills demand and supply in the African and global context; overcoming barriers; integrating Africa; ensuring inclusiveness diversity matters and digital transformation. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"22nd International AIDS Conference (AIDS 2018)","field_subtitle":"23-27 July 2018, Amsterdam, the Netherlands","URL":"https://tinyurl.com/y8vpr7lx","body":"The International AIDS Conference, first convened during the peak of the AIDS epidemic in 1985, continues to provide a unique forum for the intersection of science, advocacy, and human rights, as an opportunity to strengthen policies and programmes that ensure an evidence-based response to the epidemic. The theme of AIDS 2018 is \u201cBreaking Barriers, Building Bridges\u201d, drawing attention to the need of rights-based approaches to more effectively reach key populations, including in Eastern Europe and Central Asia and the North-African/Middle Eastern regions where epidemics are growing. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage","field_subtitle":"Nelson E; Bloom G; Shankland A: Institute of Development Studies (IDS) Bulletin 49(2), doi: http://dx.doi.org/10.19088/1968-2018.127, 2018","URL":"https://tinyurl.com/ydymed4g","body":"In July 2017, IDS hosted a workshop on \u2018Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity\u2019, with the aim of generating dialogue and mutual learning among activists, researchers, policymakers, and funders working towards more equitable health systems and a commitment to Universal Health Coverage (UHC). This issue of the IDS Bulletin is based around three principal themes that emerged from the workshop as needing particular attention. First, the nature of accountability politics \u2018in time\u2019 and the cyclical aspects of efforts towards accountability for health equity. Second, the contested politics of \u2018naming\u2019 and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology. For the first time in IDS Bulletin history, themes are explored not only in text but also through a selection of online multimedia content, including a workshop video, a photo story and a documentary. This expansion into other forms of communication is explicitly aimed at galvanising larger numbers of people in a movement towards UHC and the linked agenda of accountability for health equity. The articles and multimedia in this IDS Bulletin reflect the fact that while the desired outcome might be the same \u2013 better health for all \u2013 accountability strategies are as diverse as the contexts in which they have developed.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Assessing the community-level impact of a decade of user fee policy shifts on health facility deliveries in Kenya, 2003-2014","field_subtitle":"Obare F; Abuya T; Matanda D; et al.:  International Journal for Equity in Health 17(65), doi: https://doi.org/10.1186/s12939-018-0774-4, May 2018","URL":"https://tinyurl.com/ybdjbab8","body":"This paper examined the community-level impact of a decade of user fee policy shifts on health facility delivery among poorest and rural women and compared the changes with those among the richest and urban women in Kenya using data from three rounds of nationally representative surveys. In 2004, the Ministry of Health implemented the \u201c10/20 policy\u201d for maternal health services in public facilities, that removed user fees at the lowest levels of care.  In 2007, the 10/20 policy was removed and a policy of no user fees for deliveries in public facilities was declared. However, no alternative source of funding was offered and the reality of informal fees remained in place for many service users. Government announced\r\nfree maternity services in all public health facilities in June 2013. Data was gathered from births occurring in the 5 years preceding the survey to women aged 15-49 years who were interviewed in the 2003, 2008-2009 and 2014 Kenya Demographic and Health Surveys. There were no statistically significant immediate changes in the proportion of births occurring in public facilities following the 2004, 2007 and 2013 user fee policy shifts among poor or rural women. There was, however, a statistically significant increase in home deliveries among all women and among those from the poorest households immediately following the 2004 policy and a statistically significant increase in public facility deliveries among women from the two top quintiles, and a statistically decline in home deliveries immediately after the 2007 policy shift. Differences in trends in public facility deliveries between pre- and post-policy periods were not statistically significant for all sub-groups of women, indicating that even among the sub-group that experienced significant immediate increase after the 2007 policy shift, this pattern was not sustained over time. The findings provided empirical evidence that poorly implemented user fee removal policies benefit more well-off than poor women and in cases where there are significant immediate effects on uptake of facility delivery, this trend is not sustained over time.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps?","field_subtitle":"Nkosi V: The Conversation, May 2018","URL":"https://tinyurl.com/ydzcnwkt","body":"There is increasing evidence that environmental factors such as air pollution from mine dumps increase the risk of chronic respiratory symptoms and diseases. This study investigated the association between proximity to mine dumps and prevalence of chronic respiratory disease in people aged 55 years and older. Elderly persons in communities 1-2 km (exposed) and 5 km (unexposed), from five pre-selected mine dumps in Gauteng and North West Province, in South Africa were included in a cross-sectional study. Structured interviews were conducted with 2397 elderly people, using a previously validated ATS-DLD-78 questionnaire from the British Medical Research Council. Exposed elderly persons had a significantly higher prevalence of chronic respiratory symptoms and diseases than those who were unexposed., Results from the multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma, chronic bronchitis, chronic cough, emphysema, pneumonia and wheeze. Residing in exposed communities, current smoking, ex-smoking, use of paraffin as main residential cooking/heating fuel and low level of education emerged as independent significant risk factors for chronic respiratory symptoms and diseases. The study suggests that there is a high level of chronic respiratory symptoms and diseases among elderly people in communities located near to mine dumps in South Africa and that new long term effective dust control measures should be researched and implemented. One possible intervention could be to put buffer zones in place between mining dumps and where people come to settle as a start to what needs to be concerted government efforts to address the problem.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Cochrane South Africa invites applications for the Aubrey Sheiham Evidence-based Health Care in Africa Leadership Award 2018","field_subtitle":"Applications close: 31 July 2018","URL":"https://tinyurl.com/y7dr4eqs","body":"Since 2001 through the generosity of the late Professor Aubrey Sheiham 16 Cochrane researchers from low- and middle-income countries have been funded and supported to complete Cochrane Reviews on topics relevant to their region, and to cascade knowledge about Cochrane and evidence-based health care (EBHC) to their local networks. In 2014, the scholarship evolved into a new award focusing on leadership in EBHC - the Aubrey Sheiham EBHC in Africa Leadership Award, administered by Cochrane South Africa. With an updated and more concentrated focus, the fellowship is awarded annually to an individual based in Africa, and supports the conduct and dissemination of a high-impact Cochrane Review on a topic relevant to resource-constrained settings. The Cochrane Review should be registered with a Cochrane Review Group at the time of application. An update of an existing review is allowed if it will have high impact. The applicant should provide proof that relevant evidence is available for inclusion in the review. In addition to completing their chosen Cochrane Review and disseminating its findings, the award recipient will support capacity development by mentoring a novice author based in Africa through the review process. This continues the scholarship\u2019s tradition of building knowledge and research networks, which will be actively supported by Cochrane South Africa. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community health workers and accountability: reflections from an international \u201cthink-in\u201d","field_subtitle":"Schaaf M; Fox J; Topp S; et al: International Journal for Equity in Health 17(66) 1-5, 2018","URL":"https://tinyurl.com/y6wuf5rx","body":"Community health workers (CHWs) are frequently put forward as a remedy for lack of health system capacity, including challenges associated with health service coverage and with low community engagement in the health system, and as a means for improvement in health system accountability. During a \u2018think in\u2019, held in June of 2017, a diverse group of practitioners and researchers discussed the topic of CHWs and their possible roles in a larger \u201caccountability ecosystem.\u201d This jointly authored commentary resulted from the authors\u2019 deliberations. While CHWs are often conceptualized as cogs in a mechanistic health delivery system, at the end of the day, CHWs are people embedded in families, communities, and the health system. CHWs\u2019 social position and professional role influence how they are treated and trusted by the health sector and by community members, as well as when, where, and how they can exercise agency and promote accountability. Several propositions were made for further conceptual development and research related to the question of CHWs and accountability.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Community-based training of medical students is associated with malaria prevention and treatment seeking behaviour for children under 5 years in Uganda: a study of MESAU-MEPI COBERS in Uganda","field_subtitle":"Obol J; Akera P; Ochola P; et al: BMC Medical Education 18(131), doi: https://doi.org/10.1186/s12909-018-1250-y, 2018","URL":"https://tinyurl.com/y8sngmpp","body":"This paper seeks to assess if targeted community-based medical education programme is associated with better prevention and treatment seeking behaviours in the management of malaria, a leading cause of morbidity and mortality of children under five in Uganda. A cross-sectional survey was done to compare communities around health facilities where medical students were placed at community-based education and Research Service (COBERS) sites with communities around similar health facilities where medical students were not placed (non-COBERS sites). The authors randomly selected two villages near each health facility and consecutively selected 10 households per village for interviews using nearest-neighbour method. The authors used a structured questionnaire to interview household heads on malaria prevention and treatment seeking behaviour for children under 5 years. The authors performed univariate analysis to determine site and demographic characteristics and performed a multivariate logistic regression to assess association between dependent and independent variables. Five hundred twenty-three of the children under 5 years in COBERS communities slept under insecticide treated nets the night before survey compared with 1451 in non-COBERS communities. 100 of children under 5 years in COBERS communities sought care for fever within 24 h of onset compared with 268 in non-COBERS communities. The presence of COBERS in communities is associated with improved malaria prevention and treatment-seeking behaviour for parents of children under 5 years. Further study needs to be done to determine the long-term impact of COBERS training program on malaria control and prevention in Uganda, along with its other effects.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Emerging Public Health Practitioner Award: manuscript submissions open","field_subtitle":"Deadline for Applications: 3 August 2018 ","URL":"https://tinyurl.com/y7dpxmnp","body":"The South African Health Review's Emerging Public Health Practitioner Award (EPHPA) is open to young public health practitioners or student researchers in the fields of health sciences, medicine or public health who are currently studying for their Masters or Honours degree, or are in the final year of their Bachelor's degree. It is offered to South African citizens or permanent residents who are under the age of 35 on 3 August 2018. To apply, please submit your complete chapter along with a copy of your South African ID and EPHPA Entry form. Individuals seeking to publish a paper dealing with any of the following issues are encouraged to apply: human resources for health (e.g. community health workers, production and distribution of healthcare workers, planning and forecasting, task-shifting, etc.); responses to the prevention and management of non-communicable diseases; and progress and challenges towards implementing universal health coverage.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Ensuring health and access to health care for migrants: A right and good public health practice","field_subtitle":"Ncumisa Willie: Research Advisor, South African Human Rights Commission, South Africa ","body":"According to the United Nation\u2019s 2017 International Migration Report, South Africa is host to an estimated four million migrants. This figure is set against a backdrop of a history of migration into South Africa that was marked by exploitative labour arrangements between South Africa and its neighbouring countries. This history is often treated with a \u2018historical amnesia\u2019 of the contribution of migrants to the South African economy and society. Migrants and particularly African migrants are met with a distrust and hostility that appears as xenophobia. \r\n\r\nThis hostility is also reflected in South Africa\u2019s public health system, which does not adequately incorporate the reality of migration and health, nor address the needs of migrants. The South African Immigration Act is silent on the health rights and needs of migrants, placing them in a vulnerable situation and often leading to their exclusion from the public health system. This situation is worse for undocumented migrants, given their insecure legal status. \r\n\r\nIn contrast, recent media reports have often focused on \u2018how an influx of health migrants\u2019 has placed a strain on the country\u2019s ability to deliver health care to its nationals. Some provincial health departments have lamented the strain on their limited resources due to the demand for services from migrants. These media reports and official pronouncements create conditions for refugees, asylum seekers and undocumented migrants to be denied access to health care services in public hospitals and clinics on the basis of their nationality or legal status. This was described by Crush and Tawonzera in 2011 as a form of \u2018medical xenophobia\u2019. \r\n\r\nDenying migrants access to health care constitutes a violation of the internationally recognized right to access health care services, a right that is also enshrined in South Africa\u2019s national law. The Bill of Rights in the South African Constitution enshrines equal rights for all persons in the country and affirms values of human dignity, equality and freedom. Migrants are covered by these constitutional rights, including the right to life, to dignity, freedom and security, to access information and to just administrative action.  Section 27 of the Constitution guarantees everyone the right to basic health care, affirming that \u201ceveryone has the right to have access to health care services, including reproductive health care\u201d and that \u201cno one may be refused emergency medical treatment\u201d. \r\n\r\nThe violation of migrants\u2019 rights to access health care has grave consequences. For example, in 2015, a migrant woman lost her premature baby, allegedly due to denial of access to health care. In another incident, a migrant woman was forced to give birth at a bus station after allegedly being denied access to two hospitals in Gauteng province. Such denials of care violate rights. They have a gendered, racial and class impact, with poor, black women bearing the brunt of this discrimination. \r\n\r\nBeyond the state\u2019s legal obligation to provide access to health care services, there are public health reasons for providing health care services to migrants. The difficult journeys undocumented migrants, asylum seekers and refugees have had to make from their countries to South Africa may have exposed them to health problems, including communicable diseases. Treating these conditions makes public health sense as we live in a shared social space. The health of the local population is linked to that of the migrant population, given their integration into the wider community. \r\n\r\nI would therefore argue that the South Africa state should develop a comprehensive multi-sectoral approach to migration and health, beyond infectious diseases and border control. Both the National Health Act and the Immigration Act should explicitly provide for migrant health care. The Immigration Act needs to be amended to adequately reflect the health rights of documented and undocumented migrants. The law should be supported by a comprehensive national policy, that also details how undocumented migrants should be treated, and that is applied universally across all provinces. \r\n\r\nWe need to advocate for and train health workers to implement migrants\u2019 health rights. Such training, as a collaboration of the South African Department of Health and the Health Professions Council of South Africa, should create and foster an understanding among healthcare professionals of migrants\u2019 health rights and needs. It should also include health administrators, as they are a point of entry for migrants attempting to access health care services. \r\n\r\nThese measures are necessary as a public health care system that excludes migrants creates conditions for poor public health for all.   It increases the vulnerability of migrants, generates and magnifies discrimination and inequalities in health and violates migrants\u2019 constitutional rights to access health care. \r\n\r\nThis is not just a health and human rights issue. It is also a matter of social justice. Migrant labour, often low wage, has been integral to South Africa\u2019s society and economy, raising the profitability and savings of local business and consumers. It is also a matter of good public health practice. Delivering equitable access to care for migrants can reduce the health and social costs of disease, improve social cohesion, protect public health and human rights and contribute to healthier migrants in healthier local communities. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter  208: Ensuring health and access to health care for migrants: A right and good public health practice","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. \r\n","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Policy brief 43: The role of an essential health benefit in health systems in east and southern Africa","field_subtitle":"EQUINET, TARSC, IHI, et al.: EQUINET, Harare, May 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20policy%20brief%2043%20EHB%202018.pdf","body":"This brief presents evidence, learning and recommendations from a regional programme of work in 2015-2017 on the role of essential health benefits (EHBs) in resourcing, organising and in accountability on integrated, equitable universal health systems. It outlines from the regional literature reviews and the case studies implemented in Swaziland, Tanzania, Uganda and Zambia the context and policy motivations for developing EHBs; and how they are being defined, costed, disseminated and used in health systems. EHBs can act as a key entry point and operational strategy for realizing universal health systems, for making clear the deficits to be met and to make the case for improved funding of health systems. The brief points to areas where regional co-operation could support national processes and engage globally on the role of EHBs in building universal, equitable and integrated health systems.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Evaluating efforts that build social power and participation in health systems: Introduction to the briefs","field_subtitle":"Loewenson R; Mastoya M; Beznec P; Frenz P; Mbwili Mueya C; Obando F: TARSC Shaping health, 2018","URL":"http://www.tarsc.org/publications/documents/Shapinghealth%20eval%20brief%20Intro%20May2018.pdf","body":"These four briefs (separately shown on this site) provide information on evaluation of social participation and power in health to support capacity and practice. They are intended primarily for those working directly with social participation and power in health systems, but also for managers, funders and others who engage with them. They intend to inform thinking and approaches and provide links to deeper resources and do not intend to prescribe or be a \u2019how to\u2019 toolkit. The four briefs address:\r\nBRIEF 1: The concepts and approaches applied in \u2018monitoring and evaluation processes at www.tarsc.org/publications/documents/Shapinghealth%20eval%20brief%201%20May2018.pdf \r\nBRIEF 2: Approaches to assessing change in social participation and power in health at www.tarsc.org/publications/documents/Shaping%20health%20eval%20brief%202%202018.pdf \r\nBRIEF 3: The methods used for participatory evaluation at www.tarsc.org/publications/documents/Shaping%20health%20eval%20brief%203%202018.pdf\r\nBRIEF 4: Engaging funders and formal systems on evaluations of social power in health at www.tarsc.org/publications/documents/Shaping%20health%20eval%20brief%204%202018.pdf","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Experimental vaccine to be used against Ebola outbreak in the DRC","field_subtitle":"Branswell H: Stat, 2018","URL":"https://tinyurl.com/yaghzk4u","body":"A campaign to vaccinate people at risk of developing Ebola in the latest outbreak in the Democratic Republic of the Congo began in May 2018. The government of the DRC has formally asked to use an experimental vaccine being developed by Merck. The WHO has a stockpile of 4,300 doses of the vaccine in Geneva and the company has 300,000 doses of the vaccine stockpiled in the United States. Merck has given its permission for the vaccine to be used in this outbreak. As the vaccine \u2014 provisionally called V920 \u2014 is not yet licensed, the government deployed it under a compassionate use protocol. At this stage, it can only be used in the context of a clinical trial, plans for which are already in the works. The WHO director-general noted that DRC has lots of experiencing combating Ebola, since the first known outbreak in 1976 happened there. The 2018 outbreak marks the ninth known time Ebola has broken out in the DRC. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Grandmothers help to scale up mental health care","field_subtitle":"Fleck F, Chibanda D: Bulletin of the World Health Organisation 96(66), doi: http://dx.doi.org/10.2471/BLT.18.020618, 2018","URL":"http://www.who.int/bulletin/volumes/96/6/18-030618/en/","body":"Dixon Chibanda developed the Friendship Bench approach to mental health care in Zimbabwe. In this interview he tells Fiona Fleck how he is taking the innovative approach to other countries. The idea of the Friendship Bench arose when he lost a patient to suicide in 2005. After identifying a large burden of mental health conditions, Chibanda talked to the authorities, but they had no money, staff or facilities to offer. So in 2007 he worked with 14 grandmothers in Mbare, a suburb of Harare that was badly affected by the clearance operation of informally built suburbs in the city. The grandmothers were from the community and already doing community work and the friendship bench formalized their role. The first four years were focused on developing a culturally appropriate evidence-based intervention that they could deliver. They developed a problem-solving therapy in the local language drawing on familiar concepts in the local culture while incorporating elements of cognitive behavioural therapy. Together with the grandmothers, they came up with key terms \u2013 kuvhura pfungwa, which means opening the mind, kusimudzira, (uplifting), and kusimbisa(strengthening) \u2013 that formed the basis of the Friendship Bench approach.  The benches are outside each health facility, initially they were set apart, but now they are quite public, because the programme is widely accepted in the communities. Harare has more than 53 primary health care facilities, each with one to four of these benches. When people come to these facilities seeking mental health services, they are screened with the Shona Symptoms Questionnaire 14 to determine the level of mental health disorders and referred to the grandmothers \u2013lay health workers who have been trained and who are supervised by health professionals. Chibanda\u2019s own grandmother lived in Mbare and \u2013 although she was not one the therapists \u2013 she was instrumental in coming up with the income generating component of the approach, which is an important part of the group peer support. After finishing sessions on the bench, the grandmothers sit in a circle and share the challenges they face with their colleagues, while crocheting bags with recycled plastic to sell. Now, after completing therapy, the grandmothers give their patients further support and show them how to make the bags, as a forum for problem solving and income generation.  In Zimbabwe, the approach has been scaled up in more than 70 communities in Harare, Chitungwiza and Gweru and further roll out is taking place, with a component for adolescents under development. The approach is being rolled out in Tanzania, the USA, Canada, Australia and New Zealand.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"HIV Adolescence Workshop","field_subtitle":"10-12 October 2018, Cape Town, South Africa","URL":"https://tinyurl.com/y9xsr7ks","body":"At major meetings, advances in HIV management focuses mainly on either adults or children, leaving out this key group of individuals \u2013 the adolescents. To meet this need for international interchange in order to bring the field forward, the International Workshop on HIV & Adolescence: challenges and solutions seeks to redress this gap. This workshop is set up as an inclusive summit for multidisciplinary experts working with adolescents affected by HIV. The objective will be to share experiences, knowledge and best practices with the aim of defining a pathway forward for optimizing care for adolescents living with HIV. The program will cover the entire spectrum of developmental changes in adolescents including social, behavioural, physiological and biological aspects and the impact of an HIV positive status. Prevention programs, testing, treatment and support services among adolescents shall be discussed. The barriers encountered in delivering these services and ways to mitigate these barriers shall be key areas of discussion during the workshop.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"How antiretrovirals have cut the HIV/AIDS burden on SA's economy","field_subtitle":"Mahlakoana T: Business live, May 2018","URL":"https://tinyurl.com/ycpysssp","body":"Lost earnings attributable to HIV and AIDS as a result of either death or inability to work have declined significantly globally as countries scale up antiretroviral therapy. In 2005 HIV and AIDS were believed to have resulted in about $17bn in lost income, but the figure is projected to fall to $7.2bn in 2020. A study released by the International Labour Organisation shows that the number of employees living with the virus and unable to work has fallen \"dramatically\" since 2005. South Africa has the biggest HIV epidemic in the world with more than 7-million people living with the virus in 2016 and a stubbornly high rate of new infections.  The country also has the largest antiretroviral treatment programme, which has increased life expectancy from 61 years in 2010 to 67 in 2015. The Employee Assistance Professionals Association\u2019s Dr Dennis Cronson said there had been a great improvement in the effect of the virus on workers, especially in South Africa. \"Hundreds of thousands of people are on ARVs and corporate managed programmes, and it\u2019s a major success story \u2026. the impact on productivity and other factors have improved,\" Cronson said.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"How to stop strikes from killing patients","field_subtitle":"Cullinan K: Health-e News, May 2018","URL":"http://www.health-e.org.za/2018/05/21/how-to-stop-strikes-from-killing-patients/","body":"How can patients and health workers be protected from becoming victims of a fight that is aimed an employer? Non-governmental organisations (NGOs) have asked the SA Human Rights Commission to investigate the violations of patients\u2019 and health workers\u2019 rights during a recent strike in South Africa and to offer guidance on how patients can be protected during future strike action. The human rights group Section 27 believes that such a solution lies in \u201cdetermining essential services from non-essential services, or reaching agreement on the maintenance of some level of services during a legal dispute\u201d. \u201cAddressing the essential services issue is argued to have a two-fold effect. Firstly, those in the public health care system classified as non-essential services personnel would be able to exercise their right to strike. Secondly, patients\u2019 rights would also be protected as they would be ensured of continued access to health care services as those staff properly designated as essential staff would not be striking,\u201d according to a Section 27 opinion on strikes in the essential services. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Inequalities in health and health risk factors in the Southern African Development Community: evidence from World Health Surveys","field_subtitle":"Umuhoza S; Ataguba J: International Journal for Equity in Health 17(52), doi: https://doi.org/10.1186/s12939-018-0762-8, 2018","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0762-8","body":"This study investigates inequalities both in poor self-assessed health (SAH) and in the distribution of selected risk factors of ill-health among the adult populations in six SADC countries. Data come from the 2002/04 World Health Survey (WHS) using six SADC countries (Malawi, Mauritius, South Africa, Swaziland, Zambia and Zimbabwe) where the WHS was conducted. Poor SAH is reporting bad or very bad health status. Risk factors such as smoking, heavy drinking, low fruit and vegetable consumption and physical inactivity were considered, as were other environmental factors. Socioeconomic status was assessed using household expenditures. Generally, a pro-poor socioeconomic inequality exists in poor SAH in the six countries. However, this is only significant for South Africa, and marginally significant for Zambia and Zimbabwe. Smoking and inadequate fruit and vegetable consumption were significantly concentrated among the poor. Similarly, the use of biomass energy, unimproved water and sanitation were significantly concentrated among the poor. However, inequalities in heavy drinking and physical inactivity are mixed. Overall, a positive relationship exists between inequalities in ill-health and inequalities in risk factors of ill-health. The authors argue that there is a need for concerted efforts to tackle the significant socioeconomic inequalities in ill-health and health risk factors in the region. With some of the determinants of ill-health lying outside the health sector, inter-sectoral action is required.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"International Conference on Community Nursing and Public Health","field_subtitle":"19-21 November 2018, Cape Town, South Africa","URL":"https://community.nursingconference.com","body":"This conference on 'Advancement in Public Health by integration of Community Nursing Practices' aims to bring together individuals and organizations from varied fields of healthcare and provide a global platform for the exchange of innovative ideas. Community Nursing 2018 provides an unmatched opportunity for nursing practitioners, healthcare experts, public health organizations, clinical researchers, academics, physicians and students to meet and network with famous individuals and organizations from their respective fields and to get useful insights in the latest clinical researches. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Inverted State and Citizens\u2019 Roles in the Mozambican Health Sector","field_subtitle":"Dias J; Tom\u00e9 T: Institute of Development Studies (IDS) Bulletin 49(2), doi: http://dx.doi.org/10.19088/1968-2018.134, 2018","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2964/Online%20article","body":"This article explores the inversion of roles between the state and citizens, by exploring its historical roots and current implications for processes of social accountability in Mozambique, particularly in the health sector. This is a practice-based reflection grounded in the evidence collected through the implementation of community scorecards in the health sector in 13 districts of Mozambique. The evidence reveals a transfer of responsibilities from local governance institutions and service providers to the communities; diluting the frontiers between the state and citizens\u2019 duties and rights, resulting in the inversion of roles. This inversion results in the minimisation of the state\u2019s performance of its duties and accountability in the health sector to respond to local communities\u2019 needs, allegedly due to the lack of financial resources. The authors suggest that it leads to the overburdening of local communities, who assume the responsibility of meeting their own demands, risking participation fatigue. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Neglected Tropical Diseases and Equity in the Post-2015 Health Agenda","field_subtitle":"Taylor E; Smith J: Institute of Development Studies (IDS) Bulletin 49(2), doi: http://dx.doi.org/10.19088/1968-2018.141, 2018","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2971/Online%20article","body":"The Millennium Development Goals\u2019 focus on just three infectious diseases (HIV/AIDS, malaria, and belatedly, tuberculosis) configured the global health funding landscape for 15 years. Neglected tropical diseases (NTDs) are a group of 17 or so diseases that disproportionately afflict the world\u2019s \u2018bottom billion\u2019. They are a symbol of global health inequities, in terms of prioritisation, research attention, and treatment. This article traces efforts to include NTDs in the Sustainable Development Goal (SDG) agenda and, having achieved that goal, lobby for an influential position in the post-2015 aid agenda. The SDGs herald a shift to a more expansive approach and there is a risk that NTDs will once again be left behind, lost in a panoply of new goals and targets. There is, however, an opportunity for NTDs to lever their \u2018neglect\u2019 and be recast as a tool of accountability, acting as both a target for and proxy indicator of health equity for the SDGs. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"No end to cholera without basic water, sanitation and hygiene","field_subtitle":"Montgomery M; Jones M; Kabole I; et al: Bulletin of the World Health Organisation 96(66), doi: http://dx.doi.org/10.2471/BLT.18.213678, 2018","URL":"http://www.who.int/bulletin/volumes/96/6/18-213678/en/","body":"Safe water, sanitation and hygiene are crucial in protecting people from cholera. The oral cholera vaccine is perceived as an interim solution that can be deployed in advance of, or together with, investments in water sanitation and hygiene. Oral cholera vaccine comes at a cost. Efforts to improve water sanitation and hygiene, on the other hand, have a relatively high return: US$ 4.30 for every dollar invested in water and sanitation, in addition to prevention of most waterborne diseases and time saved from not having to fetch water. Furthermore, several water sanitation and hygiene interventions can be implemented quickly and cheaply, such as point-of-use water treatment and safe storage, community action to end open defecation, provision of soap and promotion of handwashing. The authors argue that the reasonable alternative would be to pursue both oral cholera vaccine and water sanitation and hygiene efforts in parallel as done in, for example, Zanzibar, the United Republic of Tanzania and in Zambia. They argue that three main actions need to be taken to ensure that such investments are prioritized as part of the renewed efforts to end cholera. First, when countries request oral cholera vaccine, they should engage in water sanitation and hygiene efforts. Second, efforts should be made to ensure that initiatives to strengthen health systems and provide quality care devote sufficient resources for providing and sustaining water and sanitation services, especially in cholera treatment centres. Third, external funders and partners must align behind national multisectoral cholera control plans, not simply invest in stand-alone interventions. A shared vision and unanimous agreement among Member States, partners and funders to prioritize broader social and environmental determinants of health, including water, sanitation and hygiene, is needed to end cholera. A proposed World Health Assembly resolution seeks to promote this consensus, ensure effective multisectoral collaborations and address cholera in tandem with other diarrhoeal diseases.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Oral cholera vaccine in cholera prevention and control, Malawi","field_subtitle":"M\u2019bangombe M; Pezzoli L; Reeder B; et al: Bulletin of the World Health Organisation 96(66), 2018","URL":"http://www.who.int/bulletin/volumes/96/6/17-207175-ab/en/","body":"With limited global supplies of oral cholera vaccine, countries need to identify priority areas for vaccination while longer-term solutions, such as water and sanitation infrastructure, are being developed. In 2017, Malawi integrated oral cholera vaccine into its national cholera control plan. The process started with a desk review and analysis of previous surveillance and risk factor data. At a consultative meeting, researchers, national health and water officials and representatives from nongovernmental and international organizations reviewed the data and local epidemiological knowledge to determine priority districts for oral cholera vaccination. The final stage was preparation of an application to the global oral cholera vaccine stockpile for non-emergency use. Malawi collects annual data on cholera and most districts have reported cases at least once since the 1970s. The government\u2019s application for 3.2 million doses of vaccine to be provided over 20 months in 12 districts was accepted in April 2017. By April 2018, over 1 million doses had been administered in five districts. Continuing surveillance in districts showed that cholera outbreaks were notably absent in vaccinated high-risk areas, despite a national outbreak in 2017\u20132018. Augmenting advanced mapping techniques with local information helped to extend priority areas beyond those identified as high-risk based on cholera incidence reported at the district level. Involvement of the water, sanitation and hygiene sectors is key to ensuring that short-term gains from cholera vaccine are backed by longer-term progress in reducing cholera transmission.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Public Health Association of South Africa (PHASA) 14th annual conference ","field_subtitle":"10-12 September, Parys, South Africa","URL":"https://tinyurl.com/ybqn8a6v","body":"In commemoration of the World Health Organization\u2019s (WHO) 70th anniversary celebration, the theme for this year\u2019s Public Health Association of South Africa (PHASA) conference is \u201cHealth For All- Thinking Globally, Acting Locally.\u201d Since its establishment in 1948, \u201cHealth For All\u201d has been an underlying objective of the WHO and its member states; traversing strategic milestones from the Alma Ata Declaration in 1978 and the Millennium Development Goals in 2000, to the Sustainable Developmental Goals in 2015. The organisers hope that this theme will stimulate robust discussions on progress made, critical reflections on the challenges encountered, and vibrant dialogue on how to move closer to a world where all people are able to attain a state of health that enables them to lead socially and economically productive lives. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Responding to inequalities in health in urban areas in east and southern Africa: Brief 1: What does the literature tell us? ","field_subtitle":"Loewenson R; Masotya M: TARSC, EQUINET, Harare, May 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Urban%20health%20Brief%201%20May2018%20lfs.pdf","body":"By 2050, urban populations will increase to 62% in Africa. The World Health Organisation (WHO) and UN Habitat in their 2010 report \u201cHidden Cities\u201d note that this growth constitutes one of the most important global health issues of the 21st century. 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 \u201cEquity Watch\u201d work in EQUINET explored these questions in 2016-7, for east and southern African (ESA) countries. This brief reports what we found from a review of published literature. It draws on an annotated bibliography of the literature can be found in Loewenson R, Masotya M (2015) Responding to inequalities in health in urban areas: A review and annotated bibliography, EQUINET Discussion paper 106, TARSC, EQUINET, Harare. The literature pointed to broad trends, but included less evidence on social inequalities in health within urban areas in ESA countries. The picture presented in the literature is not a coherent one- it is rather a series of fragments of different and often disconnected facets of risk, health and care within urban areas. There is limited direct voice of those experiencing the changing conditions. There is also very limited report of the features of urbanisation that promote wellbeing.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Responding to inequalities in health in urban areas in east and southern Africa: Brief 2: What does the data tell us?","field_subtitle":"Loewenson R; Masotya M: TARSC, EQUINET, Harare, May 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Urban%20health%20brief%202%202018%20lfs.pdf","body":"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 \u201cEquity Watch\u201d 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, (\u2018living well\u2019 or \u2018wellbeing\u2019) 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.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"The 11th ECSA Best Practices Forum and 27th Directors Joint Consultative Committee Meeting ","field_subtitle":"26th to 28th June 2018, Arusha, Tanzania","URL":"http://ecsahc.org/wp-content/uploads/2018/05/Announcement_BPF-and-DJCC-2018-1.pdf","body":"The East, Central and Southern Africa Health Community (ECSA-HC) will host the 11th Best Practices Forum and 27th Directors Joint Consultative Committee from 26 to 28 June 2018 in Arusha, Tanzania. The meetings bring together senior officials from Ministries of Health, Health Research Institutions and Heads of Health Training Institutions from Member States; diverse collaborating Partners and Experts from the region and beyond. The BPF and DJCC will be convened at a time, when ECSA Member States continue with efforts in pursuit of Universal Health Coverage, which forms part of the 2030 global development agenda. Deliberations of the 2018 conference will  therefore focus on the theme Universal Health Coverage: Addressing Health Needs of the Underserved. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review","field_subtitle":"Owusu-Addo E; Renzaho A; Smith B: Health Policy and Planning 33(5) 675\u2013696, 2018","URL":"https://academic.oup.com/heapol/article/33/5/675/4947872","body":"This paper synthesises the evidence on cash transfers (CTs) impacts on social determinants of health and health inequalities in sub-Saharan Africa, and to identify the barriers and facilitators of effective CTs. Twenty-one electronic databases and the websites of 14 key organizations were searched in addition to grey literature and hand searching of selected journals for quantitative and qualitative studies on CTs\u2019 impacts on social determinants of health and health outcomes. Out of 182 full texts screened for eligibility, 79 reports that reported findings from 53 studies were included in the final review. The review found that CTs can be effective in tackling structural determinants of health such as financial poverty, education, household resilience, child labour, social capital and social cohesion, civic participation, and birth registration. CTs modify intermediate determinants such as nutrition, dietary diversity, child deprivation, sexual risk behaviours, teen pregnancy and early marriage. In conjunction with their influence on social determinants of health, there is moderate evidence from the review that CTs impact on health and quality of life outcomes. Many factors relating to intervention design features, macro-economic stability, household dynamics and community acceptance of programs influence the effectiveness of CTs. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Trials and tribulations: cross-learning from the practices of epidemiologists and economists in the evaluation of public health interventions ","field_subtitle":"Powell-Jackson T; Davey C; Masset E; et al.: Health Policy and Planning 33(5) 702\u2013706, 2018","URL":"https://academic.oup.com/heapol/article/33/5/702/4955260#116668602","body":"The authors propose that there are some underlying differences between the disciplines of epidemiology and economics how trials are used and conducted and how their results are reported and disseminated. They hypothesize that evidence-based public health could be strengthened by understanding these differences, harvesting best-practice across the disciplines and breaking down communication barriers between economists and epidemiologists who conduct trials of public health interventions. Differences between disciplines suggests that more can be done to incorporate behavioural theory into trials and to improve the reporting of trial results and share data. The authors hypothesize that evidence-based public health can be strengthened by understanding differences in how economists and epidemiologists conduct trials of public health interventions and harvesting best-practice across the disciplines.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Use of family planning and child health services in the private sector: an equity analysis of 12 DHS surveys","field_subtitle":"Chakraborty N; Sprockett A: International Journal for Equity in Health 17(50) 1-12, 2018","URL":"https://tinyurl.com/ycql8jzb","body":"This paper seeks to explore improved access to healthcare while minimizing financial hardships or inequitable service delivery. The authors analyzed Demographic and Health Survey data from Bangladesh, Cambodia, DRC, Dominican Republic, Ghana, Haiti, Kenya, Liberia, Mali, Nigeria, Senegal and Zambia. They conducted weighted descriptive analyses on current users of modern family planning and the youngest household child under age 5 to understand and compare country-specific care seeking patterns in use of public or private facilities based on urban/rural residence and wealth quintile. The modern contraceptive prevalence rate ranged from 8.1% to 52.6% across countries, generally rising with increasing wealth within countries. For relatively wealthy women in all countries except Ghana, Liberia, Mali, Senegal and Zambia, the private sector was the dominant source. Source of family planning and type of method sought across facilities types differed widely across countries. Across all countries women were more likely to use the public sector for permanent and long-acting reversible contraceptive methods. Wealthier women demonstrated greater use of the private sector for family planning services than poorer women. Overall prevalence rates for diarrhoea and fever/ARI were similar, and generally not associated with wealth. Over 40% of children with cough or fever did not seek treatment in DRC, Haiti, Mali, and Senegal. Of all children who sought care for diarrhoea, more than half visited the public sector and just over 30% visited the private sector; with differences more pronounced in the lower wealth quintiles. Use of the private sector varies widely by reason for visit, country and wealth status. Given these differences, the authors suggest that country-specific examination of the role of the private sector furthers an understanding of its utility in expanding access to services across wealth quintiles and providing equitable care.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"World Health Statistics 2018: Monitoring health for the SDGs","field_subtitle":"World Health Organisation, Geneva, 2018","URL":"http://apps.who.int/iris/bitstream/handle/10665/272596/9789241565585-eng.pdf?ua=1","body":"The World Health Statistics series is WHO\u2019s annual snapshot of the state of the world\u2019s health. This 2018 edition contains the latest available data for 36 health-related Sustainable Development Goal (SDG) indicators. It also links to the three SDG-aligned strategic priorities of the WHO\u2019s 13th General Programme of Work: achieving universal health coverage, addressing health emergencies and promoting healthier populations. The latest data available shows that less than half the people in the world today get all of the health services they need. In 2010, almost 100 million people were pushed into extreme poverty because they had to pay for health services out of their own pockets. 13 million people die every year before the age of 70 from cardiovascular disease, chronic respiratory disease, diabetes and cancer \u2013 most in low and middle-income countries. ","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Zambia\u2019s drive to eliminate malaria faces challenges ","field_subtitle":"Loewenberg S: Bulletin of the World Health Organisation 96(5) 302\u2013303, 2018 ","URL":"http://www.who.int/bulletin/volumes/96/5/18-020518.pdf?ua=1","body":"Zambia is one of eight southern African countries aiming to eliminate malaria in the next few years. Zambia has switched from the goal of its malaria control from reducing the number of cases to a very low level to elimination, defined as reducing the number of indigenous cases to zero. Supporters of the elimination agenda point to the success of the Maldives and Sri Lanka, which received World Health Organization certification for malaria elimination in 2015 and 2016, respectively. Some parts of Zambia such as the Southern Province have made huge progress in reducing the burden of malaria, but the country has not yet achieved overall control. Challenges include shortages of medicines, supplies and health workers with adequate training and supervision at the community level.  However, community health workers are unpaid volunteers, leading to high turnover. While Zambia remains heavily dependent on external funding for its malaria elimination efforts, critics have questioned whether the disease can be successfully tackled without building stronger health systems first. Officials are worried by the challenge of mosquito resistance to insecticides and recent evidence this may be increasing, especially resistance to pyrethroids, the only insecticide class WHO recommends for use in insecticide-treated nets.","php":"","field_issue_date":"2018-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"\"Scared of going to the clinic\u2019: Contextualising healthcare access for men who have sex with men, female sex workers and people who use drugs in two South African cities","field_subtitle":"Duby Z; Nkosi B; Scheibe A; et al: Southern African Journal of HIV Medicine 19(1), doi:https://doi.org/10.4102/sajhivmed.v19i1.701, 2018","URL":"https://sajhivmed.org.za/index.php/hivmed/article/view/701/1078","body":"This study examined the context of access to healthcare experienced by men who have sex with men, female sex workers and people who use drugs in two South African cities: Bloemfontein in the Free State province and Mafikeng in the North West province. In-depth interviews were conducted to explore healthcare workers\u2019 perceptions, beliefs and attitudes. Focus group discussions were also conducted with members of these groups exploring their experiences of accessing healthcare. Healthcare workers demonstrated a lack of relevant knowledge, skills and training to manage the particular health needs and vulnerabilities facing these social groups. Men who have sex with men, female sex workers and people who use drugs described experiences of stigmatisation, and of being made to feel guilt, shame and a loss of dignity as a result of the discrimination by healthcare providers and other community. members. The findings suggest that the uptake and effectiveness of health services amongst these three groups is limited by internalised stigma, reluctance to seek care, unwillingness to disclose risk behaviours to healthcare workers, combined with a lack of knowledge and understanding on the part of the broader community members, including healthcare workers. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"22nd International AIDS Conference (AIDS 2018)","field_subtitle":"23-27 July 2018, Amsterdam, the Netherlands","URL":"https://tinyurl.com/y8vpr7lx","body":"The International AIDS Conference, first convened during the peak of the AIDS epidemic in 1985, continues to provide a unique forum for the intersection of science, advocacy, and human rights, as an opportunity to strengthen policies and programmes that ensure an evidence-based response to the epidemic. The theme of AIDS 2018 is \u201cBreaking Barriers, Building Bridges\u201d, drawing attention to the need of rights-based approaches to more effectively reach key populations, including in Eastern Europe and Central Asia and the North-African/Middle Eastern regions where epidemics are growing. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A Bitter Harvest Child Labour and Human Rights Abuses on Tobacco Farms in Zimbabwe","field_subtitle":"Wurth M; Buchanan J: Human Rights Watch, 2018","URL":"https://tinyurl.com/y9cn4gu5","body":"Tobacco farming is a pillar of Zimbabwe\u2019s economy. Tobacco is the country\u2019s most valuable export commodity\u2014generating US$933.7 million in 2016\u2014and the crop is particularly significant to Zimbabwean authorities\u2019 efforts to revive the economy. However, Human Rights Watch research in 2016 and 2017 into conditions on tobacco farms in Zimbabwe revealed an industry tainted by child labour and confronted by other serious human rights problems as well. This report\u2014based on extensive field research and interviews with 64 small-scale tobacco farmers, as well as 61 hired workers on tobacco farms in the largest tobacco-growing provinces in Zimbabwe\u2014found several human rights problems in the tobacco sector. Children under 18 were found to work in hazardous conditions on tobacco farms in Zimbabwe, some performing tasks that threaten their health and safety or interfere with their education. Adults involved in tobacco production\u2014both small-scale farmers and hired workers\u2014 were reported to face serious health and safety risks, with insufficient information, training, and equipment to protect themselves. Hired workers on some large-scale tobacco farms said they were pushed to work excessive hours without overtime compensation, denied their wages, and forced to go weeks or months without pay. The authors call on companies and government to prohibit children from any work involving contact with tobacco, as a policy that is both protective and straightforward for companies to communicate, implement, and monitor throughout the supply chain.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A pause for review and one last reminder","field_subtitle":"Editor, EQUINET newsletter","body":"We have a shorter newsletter and no editorial this month as we carry out essential review and maintenance work on our site. We hope the papers and content included still provide you with interesting materials for your work and analysis in and beyond the region. We have appreciated editorial contributions from a range of  experiences and invite you to send us editorials written by you, and any links to videos, blogs, papers or other online resources you want to share on your perspective on the opportunities that we should be tapping in east and southern Africa for making immediate or longer term advances in equity in health. \r\n\r\nIn line with data protection requirements we've asked you in May to confirm that you would like to receive the newsletter from us. Thanks to all those who have responded! We are updating the subscriber lists in June, so if you don't want this issue of the newsletter to be the last emailed to you please take a minute to confirm your subscription by completing the form at http://www.equinetafrica.org/content/subscribe. You are free to unsubscribe at any time and you can read our privacy statement on the EQUINET website.\r\n","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"African Capital Cities Sustainability Forum 2018","field_subtitle":"5-7 June 2018, City of Tshwane, South Africa","URL":"http://www.africancapitalcities.org/index.html","body":"The African Capital Cities Sustainability Forum (ACCSF) functions as a network for the mayors of capital cities across the continent to achieve the sustainable development goals that are common to all and, in the words of Solly Msimanga, executive mayor of Tshwane, \u201cto establish commonalities and challenges faced by major cities in Africa while showcasing and sharing successful initiatives towards the emergence of truly African, original and appropriate answers in addressing the sustainability imperative at the urban scale.\u201d","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study ","field_subtitle":"Ongolo-Zogo P; Lavis J; Tomson G; et al: Health Policy and Planning 33(4), 539\u2013554, 2018","URL":"https://academic.oup.com/heapol/article/33/4/539/4913682","body":"This paper assessed, whether and how, two knowledge translation platforms housed in government-affiliated institutions in Cameroon and Uganda have influenced health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals and the general climate for evidence-informed health system policy-making. The authors conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network Cameroon and Regional East African Community Health Policy Initiative Uganda were involved between 2009 and 2011. The authors combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health millennium development goals thus leading to decisions. New policy issue networks have emerged. Knowledge translation platforms were perceived as change agents with positive impact on the understanding, acceptance and adoption of evidence-informed health system policy-making because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. The authors indicate that this embedded case study illustrates how two knowledge translation platforms influenced policy decisions through pathways involving policy issue networks, interest groups interaction and evidence-supported ideas and how they influenced the general climate for evidence-informed health system policy.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Botswana: A model for harnessing Africa\u2019s demographic dividend?","field_subtitle":"Onabanjo J: Pambazuka News, April 2018","URL":"https://www.pambazuka.org/human-security/botswana-model-harnessing-africa%E2%80%99s-demographic-dividend","body":"On 16 March 2018, Botswana became one of a dozen countries in East and Southern Africa that have launched its national demographic dividend study. A demographic dividend is not only contingent on a rapid decline in fertility and mortality. It also requires strategic investments in promoting equality, health and family planning, education and skills development, and job creation. When countries harness the demographic dividend, their young people are argued to become more empowered, healthier, better educated and have more equal access to opportunities. At the launch of Botswana\u2019s demographic dividend report, President Mokgweetsi EK Masisi acknowledged \u201cthe right investments have to be made in Botswana for us to tap into the potential and skills of young people. Our return on investments isn\u2019t commensurate with the expectations we have for Botswana.\u201d The author argues that this is a golden moment for Botswana and other African countries to reprioritise their investments and tap into the potential of their young people \u2013 and for Botswana to plan for its second demographic dividend.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Cochrane South Africa invites applications for the Aubrey Sheiham Evidence-based Health Care in Africa Leadership Award 2018 ","field_subtitle":"Applications close: 31 July 2018","URL":"https://tinyurl.com/y7dr4eqs","body":"Since 2001 through the generosity of the late Professor Aubrey Sheiham 16 Cochrane researchers from low- and middle-income countries have been funded and supported to complete Cochrane Reviews on topics relevant to their region, and to cascade knowledge about Cochrane and evidence-based health care (EBHC) to their local networks. In 2014, the scholarship evolved into a new award focusing on leadership in EBHC - the Aubrey Sheiham EBHC in Africa Leadership Award, administered by Cochrane South Africa. With an updated and more concentrated focus, the fellowship is awarded annually to an individual based in Africa, and supports the conduct and dissemination of a high-impact Cochrane Review on a topic relevant to resource-constrained settings. The Cochrane Review should be registered with a Cochrane Review Group at the time of application. An update of an existing review is allowed if it will have high impact. The applicant should provide proof that relevant evidence is available for inclusion in the review. In addition to completing their chosen Cochrane Review and disseminating its findings, the award recipient will support capacity development by mentoring a novice author based in Africa through the review process. This continues the scholarship\u2019s tradition of building knowledge and research networks, which will be actively supported by Cochrane South Africa. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"De-drug RSA and save the economy \u2026 why not?","field_subtitle":"Schorr D: Pambazuka News, April 2018","URL":"https://tinyurl.com/ydc5kgu3","body":"South Africa\u2019s GDP is reported to have risen from US $3445 in 1994 to US $5284 in 2016, but far from ushering in overall improvement in health or well-being, the author notes that rising white collar crime, violence, small business failure , un- and underemployment and the flight of skills signpost an unhappy place. He notes that South Africa \u201c\u2026 had the highest number of drunk driving incidents at 58 percent\u201d in the world \u2026\u201d. Alcohol is said to account for 40 percent of violent crime. The author calls more regulations to ensure that alcohol companies pays for the consequences that come with heavy drinking in the country. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Defining the global health system and systematically mapping its network of actors","field_subtitle":"Hoffman S; Cole C: Globalisation and Heath 14(38), doi: https://doi.org/10.1186/s12992-018-0340-2, 2018","URL":"https://tinyurl.com/y9e6qvnm","body":"The global health system has faced significant expansion over the past few decades, including continued increase in both the number and diversity of actors operating within it. However, without a stronger understanding of what the global health system encompasses, coordination of actors and resources to address today\u2019s global health challenges will not be possible. This study presents a conceptually sound and operational definition of the global health system. Importantly, this definition can be applied in practice to facilitate analysis of the system. The study tested the analytical helpfulness of this definition through a network mapping exercise, whereby the interconnected nature of websites representing actors in the global health system was studied. Using a systematic methodology and related search functions, 203 global health actors were identified, representing the largest and most transparent list of its kind to date. Identified global health actors were characterised and the structure of their social network revealed intriguing patterns in relationships among actors. These findings are argued to provide a foundation for future inquiries into the global health system\u2019s structure and dynamics that are critical to better coordinate system activities and ensure successful response to pressing global health challenges.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers. You are free to unsubscribe at any time by sending an email to admin@equinetafrica.org with unsubscribe in the subject line.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 207: A pause for review and one last reminder","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available on the EQUINET website. \r\n","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Health-industry linkages for local health: reframing policies for African health system strengthening ","field_subtitle":"Mackintosh M; Mugwagwa J; Banda G; et al: Health Policy and Planning 33(4) 602\u2013610, 2018","URL":"https://academic.oup.com/heapol/article/33/4/602/4942503","body":"A current wave of pharmaceutical industry investment in sub-Saharan Africa is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. The authors present evidence from interviews in 2013\u201315 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. The authors identify key policies that can ensure that local health systems benefit from the investments. They argue for a \u2018local health\u2019 policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health\u2013industry linkages and strengthening of both sectors. This local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with \u2018global health\u2019 frameworks but poses a challenge to some of its underlying assumptions.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"HIV Adolescence Workshop","field_subtitle":"10-12 October 2018, Cape Town, South Africa","URL":"https://tinyurl.com/y9xsr7ks","body":"At major meetings, advances in HIV management focuses mainly on either adults or children, leaving out this key group of individuals \u2013 the adolescents. To meet this need for international interchange in order to bring the field forward, the International Workshop on HIV & Adolescence: challenges and solutions seeks to redress this gap. This workshop is set up as an inclusive summit for multidisciplinary experts working with adolescents affected by HIV. The objective will be to share experiences, knowledge and best practices with the aim of defining a pathway forward for optimizing care for adolescents living with HIV. The program will cover the entire spectrum of developmental changes in adolescents including social, behavioural, physiological and biological aspects and the impact of an HIV positive status. Prevention programs, testing, treatment and support services among adolescents shall be discussed. The barriers encountered in delivering these services and ways to mitigate these barriers shall be key areas of discussion during the workshop.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Massive Open Online Course (MOOC): \u201cPlanning for Climate Change in African Cities\u201d","field_subtitle":"United Cities and Local Governments of Africa, African Local Government Academy, Erasmus University Rotterdam, Institute for Housing and Urban Development","URL":"https://www.coursera.org/learn/climate-change-africa","body":"IHS, the Institute for Housing and Urban Development Studies of Erasmus University Rotterdam is launching their 1st MOOC (Massive Open Online Course): \u201cPlanning for Climate Change in African Cities\u201d.  Developed in collaboration with the African Local Governments Academy (ALGA), United Cities and Local Governments of Africa (UCLG) and Erasmus University Rotterdam, this free MOOC is 5 weeks and it offers the basics of urban resilience and adaptation, climate change planning, and policy assessment tools. The course is open to students and professionals in the fields of urban planning, environmental science, climate change, and other related fields.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Nutrition in the WHO Africa Region","field_subtitle":"World Health Organisation Regional Office for Africa: Brazzaville, 2017","URL":"https://tinyurl.com/y93w5jvk","body":"This report explores the current nutrition status of countries in the WHO African Region in relation to the six primary outcomes achievable by 2025 and the other global nutrition monitoring framework indicators. The aim is to highlight where action is needed to drive progress on the global targets for 2025 and Sustainable Development Goal No. 2 that calls on countries to end hunger through achieving food security, improving nutrition and promoting sustainable agriculture. A complementary objective of the report was to evaluate existing data sources that countries use to monitor programme performance and track progress on the global targets. A key finding in this report is that undernutrition is still persistent in the WHO African Region, with major implications for health, particularly among poor and vulnerable population groups. It finds that persistent drought, famine, flooding, and civil crises will make it difficult for many countries to achieve the target of reducing and maintaining wasting at less than 5%.  Along with persistent undernutrition, the prevalence of overweight among children under 5 years of age (as well as the overall number of children affected) is rising, whereas the target is to halt its increase. WHO AFRO assert that In the absence of survey data, properly functioning routine surveillance systems could provide invaluable real-time information for decision making in policy and programme design and implementation in this area. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Press Release on the Settlement Agreement of the TB/Silicosis Compensation Class Suit ","field_subtitle":"Botswana Labour Migrants Association: Botswana, May 2018","body":"Botswana Labour Migrants Association and its members from all the four corners of Botswana, present a press release reporting the news of the finalization of the TB/Silicosis class action, by way of a settlement agreement between mineworkers and the mining companies. The settlement ceremony which was held on the 3 May 2018 in South Africa, was reported in the press release to be groundbreaking and a vindication of the dues, sweat and rights of ex-miners in the region, their spouses and children and especially the efforts of the Association and its leadership.. ","php":"Further details: /newsletter/id/63446","field_issue_date":"2018-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Prevention of mother-to-child transmission of HIV: a cross-sectional study in Malawi ","field_subtitle":"van Lettow M; Landes M;  van Oosterhout J; et al: Bulletin World Health Organisation96(4) 256\u2013265, 2018","URL":"http://www.who.int/bulletin/volumes/96/4/17-203265.pdf","body":"This paper provided an estimated use and outcomes of the Malawian programme for the prevention of mother-to-child transmission of human immunodeficiency virus. In a cross-sectional analysis of 33 744 mother\u2013infant pairs, the authors estimated the weighted proportions of mothers who had received antenatal human immunodeficiency virus testing and/or maternal antiretroviral therapy and infants who had received nevirapine prophylaxis and/or human immunodeficiency virus testing. The authors calculated the ratios of mother-to-child transmission at 4\u201326 weeks postpartum for subgroups that had missed none or at least one of these four steps. The estimated uptake of antenatal testing was 97.8%; while maternal antiretroviral therapy was 96.3%; infant prophylaxis was 92.3%; and infant human immunodeficiency virus testing was 53.2%. Estimated ratios of mother-to-child transmission were 4.7% overall and 7.7% for the pairs that had missed maternal antiretroviral therapy, 10.7% for missing both maternal antiretroviral therapy and infant prophylaxis and 11.4% for missing maternal antiretroviral therapy, infant prophylaxis and infant testing. Women younger than 19 years were more likely to have missed human immunodeficiency virus testing and infant prophylaxis than older women. Women who had never started maternal antiretroviral therapy were more likely to have missed infant prophylaxis and infant testing than women who had. Most women used the Malawian programme for the prevention of mother-to-child transmission. The risk of mother-to-child transmission increased if any of the main steps in the programme were missed.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Responding to inequalities in health in urban areas: How well do current data measure urban wellbeing in East and Southern Africa?","field_subtitle":"Loewenson R, Masotya M: EQUINET Discussion paper 114: EQUINET Harare, 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Urban%20Health%20Data%20Diss%20114%20May2018.pdf","body":"By 2050, urban populations in Africa will increase to 62%. The World Health Organisation (WHO) and UN Habitat in their 2010 report \u2018Hidden Cities\u2019 note that this growth constitutes one of the most important global health issues of the 21st century. TARSC as cluster lead of the \u2018Equity Watch\u2019 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.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"The burden of tobacco smoking on public health","field_subtitle":"Specioza A: Centre for Health, Human Rights and Development, 2018","URL":"https://tinyurl.com/y8uwnmvh","body":"The tobacco industry has for a long time affected innocent lives world over through several ways including; advertising and encouraging direct smoking of cigarettes, secondhand smoke exposure, smoking of other combustible tobacco products , smokeless tobacco and electronic nicotine delivery systems (ENDS) among others. The WHO report on Global Tobacco Epidemic 2008, confirms that the global tobacco epidemic is one of the greatest public health threats of modern times as smoking causes so many deleterious health effects. Some of these health effects include; diminished health status, susceptibility to acute illnesses and respiratory symptoms, death, coronary heart disease, cancers of any organ of the body, chronic obstructive pulmonary disease or COPD, pre-mature births, among others. Uganda has taken a great leap in tobacco control interventions through ratification of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and consequently the enactment of the Tobacco Control Act of 2016. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The financing gaps framework: using need, potential spending and expected spending to allocate development assistance for health ","field_subtitle":"Haakenstad A; Templin T; Lim S: Health Policy and Planning 33(suppl_1), doi: https://doi.org/10.1093/heapol/czx165, 2018","URL":"https://academic.oup.com/heapol/article/33/suppl_1/i47/4835244","body":"As growth in development assistance for health levels off, development assistance partners must make allocation decisions within tighter budget constraints. In the \u2018financing gaps framework\u2019, the authors propose a new approach for harnessing information to make decisions about health aid. The framework was designed to be forward-looking, goal-oriented, versatile and customisable to a range of organisational contexts and health aims. The framework brings together expected health spending, potential health spending and spending need, to orient financing decisions around international health targets. As an example of how the framework could be applied, a case study is developed, focused on global goals for child health. The case study harnesses data from the Global Burden of Disease 2013 Study, Financing Global Health 2015, the WHO Global Health Observatory and National Health Accounts. Funding flows are tied to progress toward the Sustainable Development Goal\u2019s target for reductions in under-five mortality. The flexibility and comprehensiveness of the framework makes it adaptable for use by a diverse set of governments, donors, policymakers and other stakeholders. The framework can be adapted to short\u2010 or long\u2010run time frames, cross\u2010country or subnational scales, and to a number of specific health focus areas. Depending on donor preferences, the framework can be deployed to incentivise local investments in health, ensuring the long-term sustainability of health systems in low- and middle-income countries, while also furnishing international support for progress toward global health goals.","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Upholding the rights of urban refugees in Uganda ","field_subtitle":"Monteith W; Lwasa S; Nsangi G; et al:  International Institute for Environment and Development (IIED) Briefing, 2017","URL":"https://tinyurl.com/ycb7bpan","body":"Uganda is at the centre of current debate on urban refugees. The country\u2019s Refugees Act 2006, which establishes refugees\u2019 rights to live, work and own land in urban areas, has been hailed as exemplary and a global model for humanitarian responses. However, new evidence on refugee livelihoods in Kampala suggests that the rights to work and move freely, and without fear, are often unmet in urban areas. In the absence of financial assistance, urban refugees often struggle to find gainful employment and report frequent cases of discrimination by both the Ugandan state and the public. This briefing outlines the barriers faced in upholding the rights of urban refugees in Uganda, and recommends ways in which these may be overcome. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa","field_subtitle":"Olu O, Usman A, Kalambay K, et al.: BMC Medical Education, 18; 60, https://doi.org/10.1186/s12909-018-1163-9, 2018","URL":"https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-018-1163-9","body":"As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states. The authors identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. ","php":"","field_issue_date":"2018-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":" International Fellowship funded by the Urban Studies Foundation","field_subtitle":"Deadline for Applications: 15 May 2018","URL":"http://codesria.org/spip.php?article2846&lang=en","body":"The ACADEMY project is designed to provide resources and opportunities for student and staff mobility from four regions of Africa, offering support for Masters, Doctoral and short research, teaching and administrative visits between the consortium partners. Applications are particularly invited from female candidates and disadvantaged groups. Applicants should be nationals and residents of eligible African countries, have sufficient knowledge of the language of instruction of courses in the host country and fulfil the criteria of one of the target groups. Target Group 1 is for those students who are registered in one of partner universities and staff must be working in one of the five partner universities. Target Group 2, students must be registered in any African Higher Education Institution and those who have graduated from any African Higher Education Institution. Students having previously benefitted from a scholarship under the Intra-ACP or the Intra-Africa Academic Mobility Schemes are not eligible.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"15th International Conference on Urban Health: Managing Urbanisation for Health, 26-30 November 2018, Kampala, Uganda","field_subtitle":"Deadline for abstracts: 14 May 2018","URL":"http://www.isuhconference.org","body":"The 15th International Conference on Urban Health will bring together interdisciplinary researchers, practitioners, policy-makers, health and urban stakeholders and community leaders to exchange ideas and advance research and practice across sectors on how best to manage the rapid urbanisation occurring in all regions of the world. Abstracts are invited for oral and poster presentations, pre-formed panels, workshops and special tracks on the following conference themes: The Governance of Complex Systems, Culture and Inclusivity, Disasters, Epidemics, and the Unexpected, Cities as Economic Engines, Monitoring and Evaluation of Urban Health Indicators, Safety, Security, and Justice, Spiritual Health in the City. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"22nd International AIDS Conference (AIDS 2018) 23-27 July 2018, Amsterdam, the Netherlands","field_subtitle":"Registration deadline: 17 May 2018","URL":"https://tinyurl.com/y8vpr7lx","body":"The International AIDS Conference is the largest conference on any global health issue in the world. First convened during the peak of the AIDS epidemic in 1985, it continues to provide a unique forum for the intersection of science, advocacy, and human rights. Each conference is an opportunity to strengthen policies and programmes that ensure an evidence-based response to the epidemic. The theme of AIDS 2018 is \u201cBreaking Barriers, Building Bridges\u201d, drawing attention to the need of rights-based approaches to more effectively reach key populations, including in Eastern Europe and Central Asia and the North-African/Middle Eastern regions where epidemics are growing. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A fuzzy set qualitative comparative analysis of 131 countries: which configuration of the structural conditions can explain health better?","field_subtitle":"Paykani T; Rafiey H; Sajjadi H: International Journal for Equity in Health 17(10) doi: https://doi.org/10.1186/s12939-018-0724-1, 2018. ","URL":"https://tinyurl.com/ycr9fvqv","body":"In this study, following the World Health Organization Commission On Social Determinants of Health (CSDH) approach the authors aimed to unravel complexity and answer the kinds of questions that are outside the scope of conventional variable-oriented approach. A fuzzy-set qualitative comparative analysis of 131 countries was conducted to examine the configurational effects of five macro-level structural conditions on life expectancy at birth. The potential causal conditions were level of country wealth, income inequality, quality of governance, education, and health system. The data collected from different international data sources were recorded during 2004\u20132015. The analysis indicated a configuration of conditions including high level of governance, education, wealth, and affluent health system to be consistently sufficient for high life expectancy. The configurations linked to high life expectancy were not the opposite of those associated with low life expectancy and the authors identified areas for further research.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"A more progressive tax regime is a viable and better alternative to addressing revenue shortfalls, civil society organisations tell Parliament","field_subtitle":"NGOpulse: SANGONeT, South Africa, March 2018","URL":"https://tinyurl.com/y7xjmcah","body":"In February, a broad cross-section of South African civil society organisations (CSOs) called on Parliament to halt the proposed increase in value-added tax (VAT), demonstrating that such a move for general revenue collection would make the tax regime more regressive, potentially violate the equality clause in the Constitution, and worsen already unacceptably high levels of poverty and inequality. They illustrated that more progressive alternatives exist. The organisations argued that a reconsideration of the tax regime was not to be taken lightly and therefore not something National Treasury could unilaterally decide on, without proper public consultation. The CSOs highlighted that tax can and must play a redistributive role in the economy, while ensuring sufficient revenue collection for pressing social needs. Yet the proposed 2018 budget not only increases the fuel levy and VAT, the least progressive tax instruments, but also opts to cut down on social spending in areas such as basic education, health care, housing, municipal infrastructure, informal settlement upgrading and transport. They argue that the VAT increase for general revenue (and not specifically for health), will have negative consequences for service delivery and affect poor and working class communities the most.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"ACADEMY Project: African Trans-Regional Cooperation through Academic Mobility Intra-Africa","field_subtitle":"Deadline for Applications: 15 May 2018 ","URL":"http://codesria.org/spip.php?article2846&lang=en","body":"The ACADEMY project is designed to provide resources and opportunities for student and staff mobility from four regions of Africa, offering support for Masters, Doctoral and short research, teaching and administrative visits between the consortium partners. Applications are particularly invited from female candidates and disadvantaged groups. Applicants should be nationals and residents of eligible African countries, have sufficient knowledge of the language of instruction of courses in the host country and fulfil the criteria of one of the target groups. Target Group 1 is for those students who are registered in one of partner universities and staff must be working in one of the five partner universities. Target Group 2, students must be registered in any African Higher Education Institution and those who have graduated from any African Higher Education Institution. Students having previously benefitted from a scholarship under the Intra-ACP or the Intra-Africa Academic Mobility Schemes are not eligible.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Africa is not poor, we are stealing its wealth","field_subtitle":"Dearden N: Al Jazeera, May 2017","URL":"https://tinyurl.com/y7sr5lvx","body":"\"Africa is rich, but we steal its wealth\". That's the essence of a report from several campaign groups released in May 2017. Based on a set of new figures, it finds that sub-Saharan Africa is a net creditor to the rest of the world to the tune of more than $41bn. It reports that there is money going in to sub-Saharan Africa the tune of around $161bn a year in the form of loans, remittances from those working outside Africa and sending money back home, and from development aid. There's also $203bn leaving the continent. Some of this is direct, such as $68bn from taxes foregone, such as when multinational corporations legally organise flows to indicate that they are generating their wealth in tax havens. These flows are asserted by the author to amount to around 6% percent of the continent's entire gross domestic product and three times what Africa receives in aid. The report estimates that $29bn a year is being lost from Africa through illegal logging, fishing and trade in wildlife. Given these and other sources of loss the author asserts that if African countries are to benefit from foreign investment, they must be allowed to - even helped to - legally regulate that investment and the corporations that often bring it.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"African Doctoral Dissertation Research Fellowship Program (ADDRF) \u2013 Call for Applications","field_subtitle":"Deadline for Applications: 15 May 2018 ","URL":"https://tinyurl.com/y6uka8xp","body":"The African Population and Health Research Center (APHRC) in partnership with Ipas, Guttmacher Institute, Gynuity Health Projects and Ibis Reproductive Health is pleased to announce a call for applications to support up-to four African doctoral candidates undertaking dissertation research on the topic of abortion. These organisations have been involved in efforts to eliminate deaths and injuries from unsafe abortion, as well as increasing women's ability to exercise their sexual and reproductive health and rights globally. The dissertation grant is designed to bridge strategic gaps in research capacity and knowledge management to help researchers, health professionals and policymakers to increase their contribution in addressing issues related to abortion. The ADDRF Program will award up to four (4) fellowships in 2018 to doctoral students. These fellowships will be awarded to doctoral students who are within two years of completing their thesis.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Attitudes towards help-seeking for sexual and gender-based violence in humanitarian settings: the case of Rwamwanja refugee settlement scheme in Uganda","field_subtitle":"Odwe G; Undie C;  Obare F: BMC International Health and Human Rights 18(1) doi: https://doi.org/10.1186/s12914-018-0154-6, 2018","URL":"https://tinyurl.com/yb3h4w3h","body":"This paper examined the association between attitudes towards seeking care and knowledge and perceptions about sexual and gender-based violence (SGBV) among men and women in a humanitarian setting in Uganda. A cross-sectional survey was conducted from May to June 2015 among 601 heads of refugee households in Rwamwanja Refugees Settlement Scheme, South West Uganda. Results showed increased odds of having a favorable attitude toward seeking help for SGBV among women with progressive attitudes towards SGBV; who felt that SBGV was not tolerated in the community; those who had not experienced violence; and those who were aware of the timing for post-exposure prophylaxis. In contrast, results for the male sample showed lack of variations in attitude toward seeking help for SGBV for all independent variables except timing for post exposure prophylaxis. Among individuals who had experienced SGBV, the odds of seeking help was more likely among those with favorable attitude towards seeking help than among those with unfavorable help-seeking attitudes. The findings of the paper suggest that targeted interventions aimed at promoting awareness and progressive attitudes towards SGBV are likely to encourage positive help-seeking attitudes and behaviours in humanitarian contexts.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Can essential benefit packages be a lever for universal health systems?","field_subtitle":"R Loewenson, M Mamdani, EQUINET","body":"\r\nCurrent policy agendas raise an impetus for countries in east and southern Africa to be clearer with the public on what health care services they can expect to access. Commitments made to universal health coverage (UHC) and equity in health care point to a need to define the entitlements or service benefits that will be provided universally to respond equitably to population health needs. Constitutional provisions on the right to health care raise a demand to clarify what services people should be legally entitled to. Yet the gap between demand and resources suggest a need to clarify what can be funded and provided universally, taking costs into account. The diversity of funders and providers in most health systems in the region call for funders and providers to be aligned around these entitlements while social demand for public accountability calls for transparency on how resources and capacities are being used to deliver these entitlements.  \r\n\r\nAs one response, many countries in east and southern Africa (ESA) have developed essential health benefit packages (EHBs) in order to define service benefits, to direct resources to priority, relevant and effective areas of health service delivery. EQUINET research in 2015-2017 through Ifakara Health Institute and Training and Research Support Centre working with ministries of health in Swaziland, Tanzania, Uganda and Zambia found that of the sixteen countries in the ESA region, thirteen had an EHB in place by 2016, albeit with different names and at different stages of design and implementation. \r\n\r\nThere was much in common in the way these EHBs were being developed and what they covered. The EHBs in the region cover similar services for communicable and non-communicable diseases, maternal and child health and public health.  They generally combined an analysis of health burdens and cost-benefit or value-for-money to identify what services to include, taking on board policy goals and commitments. In some cases they took into account the priorities reported by stakeholders and external partners and, to a more limited extent, communities and parliamentarians. When countries used consultative, consensus-building design processes with wider stakeholders they widened awareness and debate on the choices to be made in what services to include, on the cost of care and on the entitlements included.\r\n\r\nIt would appear that the process for defining, costing and clarifying service benefits could be a key entry point for policy dialogue across stakeholders and an important basis to build an operational strategy for realising UHC in an equitable manner and for making clear the deficits to be met. \r\n\r\nIndeed, ESA countries report a range of ways they are using their EHBs: They are being used as a tool for budgeting and planning at local government level; to guide priority setting and budgets; to purchase services from private, not-for-profit services and to monitor service performance. These areas of practice depend on quality system data, including from the from the private health sector, good population health information and data on the costs of services to both design, purchase and be accountable for delivery of the benefit. \r\n\r\nWhile there are shortfalls in some of these areas of data, the funding gap has presented perhaps the greatest challenge in delivering on the EHB. ESA countries face clear challenges in reconciling the services they should provide to respond to population health need with the resources they have to do so. The estimates ESA countries calculated for what their EHBs would cost varied widely, from $4-$83/capita at primary care level to $22-$519/capita for referral services. In part this reflects differing assumptions and methods used for capital and recurrent costings. At the same time, in most ESA countries these figures point to a gap between the cost of a benefit package that responds to health needs, and the funds available for it, particularly in the public sector. Having these costs of the EHB raises a question for national and global levels of how, in the face of commitments to UHC, these costs will be met to turn the talk into action.\r\n\r\nIn the face of this funding gap, some countries have begun to explore new revenue sources from innovative financing, linking the EHB to policy dialogue on health financing. Resource constraints and vertical financing have, however, also motivated rationing of scarce resources, reducing the benefit to a smaller subset that can be funded from current budgets. This may focus resources on what is possible and avoid the frustration generated by the gap between aspiration and delivery. However, it also raises concerns on how to ensure fairness and public health effectiveness in the decisions on what services are covered and what is excluded. How should services treat people who present with a combination of conditions, one covered and one not? How to ensure the integration across services when some are funded and others not? How to avoid \u2018minimum\u2019 benefit packages becoming the \u2018maximum\u2019 provided? How to ensure that the poorest in the population get all their health needs addressed without costs that impoverish them?  \r\n\r\nIn a regional dialogue within the countries involved the research, the EHB as a universal benefit was seen to be consistent with policy goals to build universal equitable health systems. It was seen to be a potentially useful measure to engage and build support from high-level political actors, funders, providers and communities on the different challenges that need to be addressed in implementing UHC, and to align public and private actors around national goals.\r\nIn facing the financing challenges given the desire to ensure universal provision of the benefit, it was felt that the EHB would be best funded through progressive tax financing and pooling of other social insurance, earmarked tax and private sector contributions to avoid segmentation and to ensure the universality of the benefit. At the same time it was felt that funding constraints not present a pressure to limit to curative services, and that the EHB include health promotion, public health and prevention measures, as both value for money, important for service integration and key for health sector engagement on inter-sectoral action for health. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  More information on the issue can be found in the regional meeting report at \r\nhttp://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Regional%20EHB%20Mtg%20Rep%20Nov2017.pdf , the country case study reports on the EQUINET website and synthesis paper at \r\nhttp://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20113%20EHB%20synthesis%202018.pdf\r\n","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Council for the Development of Social Science Research in Africa (CODESRIA) Meaning-making Research Initiatives: Special call for female researchers","field_subtitle":"Deadline for applications: 31 May 2018","URL":"http://codesria.org/spip.php?article2847&lang=en","body":"In 2017 CODESRIA introduced the Meaning-making Research Initiative (MRI) as its principal tool for supporting research. Projects funded under this initiative should propose research on important aspects of African social realities that fall under CODESRIA\u2019s priority themes as outlined in the CODESRIA Strategic Plan. Projects should be guided by clear questions that explore puzzling aspects of the social realities of Africa and its position in the world while at the same time reflecting an interest in questions of diversity including the gendered one, should engage constructively and rigorously with African futures and be theoretically ambitious with a clear goal of providing new and innovative ways of understanding and making sense of African social realities. Applications should indicate the ways in which the following cross-cutting themes are integrated in their proposals: gender, generations, inequality, rurality and urbanity, memory and history, as well as futures and alternatives. Increasing the participation of female scholars in the work and governance of CODESRIA has been a long-term goal of the Council.  All projects should: 1) be headed by female scholars; and 2) have only women as members.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Engaging Men and Boys in Family Planning: A Strategic Planning Guide","field_subtitle":"Family Planning High Impact Practices, USA, 2018","URL":"https://tinyurl.com/yaucdk8q","body":"This document aims to lead program managers, planners, and decision-makers through a strategic process to identify effective investments for engaging men in efforts to improve sexual and reproductive health. In this guide, male engagement refers to the involvement of men and boys in family planning programs across life stages, including addressing gender norms and gender equality. The guide follows four steps; defining the behavioural aim of the initiative, assessing men\u2019s and boys\u2019 knowledge and attitudes related to reproduction and contraception, assessing how gender norms affect male engagement in family planning, and identifying programming approaches that engage men and boys. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org/content/subscribe \r\nThe information on subscribers is used only to email the newsletter to subscribers. You are free to unsubscribe at any time by sending an email to admin@equinetafrica.org with unsubscribe in the subject line.\r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter  206: Can essential benefit packages be a lever for universal health systems?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evaluation of results-based financing in the Republic of the Congo: a comparison group pre\u2013post study","field_subtitle":"Zeng W; Shepard D; de Dieu Rusatira J; et al: Health Policy and Planning 33(3) 392\u2013400, 2018","URL":"https://tinyurl.com/y7zm4mfv","body":"In this study on a pilot results based financing (RBF) in the Republic of the Congo from 2012 to 2014, the authors conducted pre- and post-household surveys and gathered health facility services data from both intervention and comparison groups. Using a difference-in-differences approach, the study evaluated the impact of RBF on maternal and child health services. The household survey found statistically significant improvements in quality of services regarding the availability of medicines, perceived quality of care, hygiene of health facilities and being respected at the reception desk. The health facility survey showed no adverse effects and significantly favourable impacts on: curative visits, patient referral, children receiving vitamin A, HIV testing of pregnant women and assisted deliveries. These improvements, in relative terms, ranged from 42% to 155%. However, the household survey found no statistically significant impacts on the five indicators measuring the use of maternal health services, including the percentage of pregnant women using prenatal care, 3+ prenatal care, postnatal care, assisted delivery, and family planning. Surprisingly, RBF was found to be associated with a reduction of coverage of the third diphtheria, pertussis, and tetanus immunization among children in the household survey. From the health facility survey, no association was found between RBF and full immunization among children. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Flexibilities provided by the Agreement on Trade-Related Aspects of Intellectual Property Rights","field_subtitle":"Correa C: Bulletin of the World Health Organisation 96(3) 148, 2018","URL":"http://www.who.int/bulletin/volumes/96/3/17-206896/en/","body":"To minimize the problems caused by the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), academics, governments of low-income countries, many nongovernmental organizations, the World Health Organization (WHO) and other United Nations organizations pay special attention to the Agreement\u2019s so-called flexibilities. The extent to which such flexibilities have already been incorporated into national laws and practice shows substantial variation. Several compulsory licenses \u2013 allowing a company to produce a patented product or process without the consent of the patent owner \u2013 have been issued for medicines, mainly to treat infections with human immunodeficiency virus. Most of these licenses have led to substantial reductions in the costs of treatment. The use of such licenses is not limited to low- and middle-income countries. Another important flexibility is provided by the definition of the standards of patentability, and the rigour with which they are applied in determining whether a claimed invention is patentable. Weaknesses or gaps in such standards can allow ever-greening by the pharmaceutical industry. Research has shown that the TRIPS flexibilities are poorly exploited and that much more could be done to align intellectual property protection with public health policies. To support the more extensive exploitation of the flexibilities provided by the Agreement on TRIPS, the author argues that a continuous effort from academics, governments, international and nongovernmental organizations is needed, observing that the health of a large part of the world\u2019s population depends on timely and effective action.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"From Kenya\u2019s postelection violence, an online community forms to give aid ","field_subtitle":"Habib J: The Christian Science Monitor, March 2018","URL":"https://tinyurl.com/yav7ccb4","body":"Kenya\u2019s post election violence has led to the founding of RescueBnB \u2013 a community with the mission to map the locations of those in need of shelter and connect them with volunteer hosts. With a core team of volunteers, a web developer set up the pro bono website, and Kenyans have spread the word on social media. Within 48 hours of this, they had assembled more than 100 volunteers across the country and had arranged multiple home stays with vetted hosts. To date, RescueBnB has supported 800 people across Kenya, and team members say that\u2019s just the start. RescueBnB has since begun crowdfunding to provide care packages as well as to cover medical expenses. Its partnerships with community organizations and religious groups helped it reach more individuals, and companies stepped in to assist. A supermarket chain welcomed shoppers to drop off donations, and a boda boda (motorbike) delivery company volunteered to get the donations into the hands of people who needed them. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Health-industry linkages for local health: reframing policies for African health system strengthening","field_subtitle":"Mackintosh M; Mugwagwa J; Banda G; et al: Health Policy and Planning 33(4), doi: https://doi.org/10.1093/heapol/czy022, 2018 ","URL":"https://academic.oup.com/heapol/article/33/4/602/4942503","body":"Low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialisation strategies. The authors present evidence from interviews in 2013\u201315 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. Key policies are identified that can ensure that local health systems benefit from the investments. The authors argue for a \u2018local health\u2019 policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health\u2013industry linkages and strengthening of both sectors. This local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with \u2018global health\u2019 frameworks but poses a challenge to some of its underlying assumptions.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Heterogeneous Infrastructures in African Cities","field_subtitle":"Deadline for Applications: 30 May 2018","URL":"https://tinyurl.com/yb9nff2o","body":"As part of broader efforts to develop regional learning across the continent, the Situated Urban Political Ecology collective and Urban Action Lab at Makerere University will be hosting a workshop on urban infrastructures in Africa from November 12-15, 2018. Scholars and practitioners are increasingly grappling with alternative modes of infrastructural provision. This is motivated by scholarly interest in everyday infrastructural practices and politics as well as concerns about the economic, environmental, social and political viability of universal, uniform infrastructure networks. In theory and practice, this is resulting in challenges to existing urban theorization, political agendas and infrastructure provision. This workshop will seek to develop new research questions, outputs and networks with the aim of thinking through the heterogeneity of infrastructure provisioning in cities across sub-Saharan Africa, thinking beyond individual artefacts towards understanding dynamic configurations of people and technology.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"How Ugandans are mapping their neighbourhoods to Solve Energy and Health-Related Risks","field_subtitle":"Urban Action Lab, Makerere University Uganda, 2016","URL":"https://tinyurl.com/ybkjgkdw","body":"The Urban Action Lab of Makerere University Uganda, is a lead partner of Co-designing Energy Communities (CO-DEC), a collaborative research project in Kampala and Nairobi, which is fostering cross-sector learning amongst university students and local community members to scale up local energy solutions, such as briquette-making, and create highly accurate maps of risk-prone businesses, infrastructure and residential dwellings, in regards to the use of traditional and modern energy sources. The community co-researchers collaborated with academics from Makerere University to map their own neigbourhood of Kasubi-Kawaala, in order to address in-and outdoor air pollution associated with poor management of wastes, leaky toilet seals and sewer pits, the use of biomass and fossil fuels from the informal urban economy. The maps were boundary objects for community-led learning and action that linked participating organisations and individual co-researchers to local sustainability-oriented experiments around regenerative use of wastes for energy briquettes; planting of indigenous trees with leafy canopies that reduce air pollutants in homesteads and around business premises; while building consensus on the policy options for enabling actors from Kampala Capital City Authority to own and energetically pursue an agenda for scaling up alternative energy solutions that bring about co-benefits in the health and housing sector.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"IDRC Doctoral Research Awards 2018","field_subtitle":"Deadline for Applications: 30 May 2018","URL":"https://www.idrc.ca/en/funding/idrc-doctoral-research-awards-2018","body":"IDRC is now accepting applications for this year\u2019s IDRC Doctoral Research Awards (IDRA). This call is open to Canadians, permanent residents of Canada, and citizens of developing countries pursuing doctoral studies at a Canadian university. These awards are intended for field research in developing countries to improve the lives of people in the developing world.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"IMF conditionality: still undermining healthcare? ","field_subtitle":"Brunswijck G; Griffiths J: Global Health Check, April 2018","URL":"https://tinyurl.com/y7huj4xm","body":"An IMF blog in March 2017 claimed that: \u201cA number of studies have found that IMF support for countries\u2019 reforms, on average, either preserve or increase public health spending.\u201d However, the evidence provided was weak. Of the six studies referenced, one, by Oxford and Cambridge university researchers flatly contradicts this claim.  Two were not related to health expenditure: one looked at revenue, not expenditure, and the second had a broader remit and contained no new evidence on the IMF and health. One was over a decade old and did not directly support the claim; while another was a link to an IMF page on the Ebola crisis. In fact  the only referenced study that supported the claim was written by the staff who authored the blog. The IMF\u2019s concern not to be seen to be impacting negatively on health expenditure in the poorest countries can be viewed as an improvement. However, the authors suggest that it is clear that IMF conditionality can constrain expenditure on health and other related services, at odds with the SDG commitment to achieve universal health coverage. The next scheduled review of IMF funding to low-income countries is planned for 2018. The authors argue that it is time for a much broader reform of IMF conditionality. Citing Eurodad\u2019s detailed study, in 2014, that found that IMF conditions are often highly controversial and intrusive on key economic policy issues, they suggest that these policies should be the crux of democratic debate in country, not mandated from Washington. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Implementation of Urban Health Equity Assessment and Response Tool: a Case of Matsapha, Swaziland.","field_subtitle":"Makadzange K; Radebe Z; Maseko N; et al: Journal of Urban Health, doi: 10.1007/s11524-018-0241-y, 2018","URL":"https://link.springer.com/article/10.1007%2Fs11524-018-0241-y","body":"This paper illustrates a case of applying the Urban Health Equity Assessment and Response Tool in Matsapha, Swaziland. A descriptive single-case study design using qualitative research methods was adopted to collect data from purposively selected respondents. The study revealed that residents of the Matsapha peri-urban informal settlements faced challenges with conditions of daily living which impacted negatively on their health. There were health equity gaps. The application of the tools was facilitated by the formation of an all-inclusive team, intersectoral collaboration and incorporating strategies for improving urban health equity into existing programmes and projects. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Jeopardizing quality at the frontline of healthcare: prevalence and risk factors for disrespect and abuse during facility-based childbirth in Ethiopia ","field_subtitle":"Banks K; Karim A; Ratcliffe H; et al: Health Policy and Planning 33(3) 317\u2013327, 2017","URL":"https://academic.oup.com/heapol/article/33/3/317/4772862","body":"The study explored the frequency and associated factors of disrespect and abuse in four rural health centres in Ethiopia. The experiences of women who delivered in these facilities were captured by direct observation of client-provider interaction and exit interview at time of discharge. Incidence of disrespect and abuse were observed in each facility, with failure to ask woman for preferred birth position most commonly observed. During exit interviews, 21% of respondents reported at least one occurrence of disrespect and abuse. Bivariate models using client characteristics and index birth experience showed that women\u2019s reporting of disrespect and abuse was significantly associated with childbirth complications, weekend delivery and no previous delivery at the facility. Facility-level fixed-effect models found that experience of complications and weekend delivery remained significantly and most strongly associated with self-reported disrespect and abuse. The results suggest that addressing disrespect and abuse in health centres in Ethiopia will require a sustained effort to improve infrastructure, support the health workforce in rural settings, enforce professional standards and target interventions to improve women\u2019s experiences as part of quality of care initiatives.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Knowledge integration in One Health policy formulation, implementation and evaluation ","field_subtitle":"Hitziger M; Esposito R; Canali M; et al: Bulletin  World Health Organisation 96(3) 211\u2013218, 2018","URL":"http://www.who.int/bulletin/volumes/96/3/17-202705.pdf","body":"The One Health concept covers the interrelationship between human, animal and environmental health and requires multi-stakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global framework for health governance. Knowledge integration approaches, at all stages of policy development, could help to address these shortcomings. The identification of key objectives, the resolving of trade-offs and the creation of a common vision and a common direction can be supported by multi-criteria analyses. Evidence-based decision-making and transformation of observations into narratives detailing how situations emerge and might unfold in the future can be achieved by systems thinking. Finally, transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop novel networks for collective action. To strengthen One Health governance, the authors propose that knowledge integration becomes a key feature of all stages in the development of related policies and suggest several ways in which such integration could be promoted.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Lessons learnt from implementation of the International Health Regulations: a systematic review ","field_subtitle":"Amitabh S; Allen L; Cifuentes S: Bulletin of the World Health Organisation 96(2)110-121E, 2017","URL":"http://www.who.int/bulletin/volumes/96/2/16-189100/en/","body":"While bi- and multilateral communication and collaboration are the foundation for global control of infectious disease epidemics, they are strengthened by the International Health Regulations (IHR). Although IHR (2005) describes what must be achieved by countries, there is limited knowledge on how countries should proceed in achieving the core capacities. To fill this gap and accelerate implementation of IHR (2005), the World Health Assembly in 2015 identified a need to evaluate and share the lessons learnt from countries that have implemented IHR (2005). This systematic review was conducted in accordance with Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines, using a predefined protocol. The authors identified five global lessons learnt that related to multiple IHR (2005) core capacities. Some major cross-cutting themes included the need for mobilizing and sustaining political commitment; for adapting global requirements based on the local socio-cultural, epidemiological, health system and economic contexts; and for conducting baseline and follow-up assessments to monitor IHR (2005) status. The authors argue that despite considerable progress, countries that are yet to implement IHR (2005) core capacities may have insufficient human and financial resources to meet their obligations in the near future. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Militarized Humanitarianism in Africa","field_subtitle":"Rock J: Foreign Policy in Focus,  May 2014","URL":"http://fpif.org/militarized-humanitarianism-africa/","body":"The U.S. Africa Command (AFRICOM) has rapidly expanded its presence on the African continent since its establishment. Emphasizing a \u201c3D\u201d approach of \u201cdefense, diplomacy, and development,\u201d AFRICOM\u2019s charge is described as coordinating \u201clow-cost, small-footprint operations\u201d throughout the African continent. Writing in the New York Times, Eric Schmitt marveled at AFRICOM\u2019s Operation Flintlock, a multinational and multiagency training operation in Niger. He wrote glowingly about fighting terrorism with mosquito nets: \u201cInstead of launching American airstrikes or commando raids on militants,\u201d he wrote, \u201cthe latest joint mission between the nations involves something else entirely: American boxes of donated vitamins, prenatal medicines, and mosquito netting to combat malaria.\u201d The author asks however if AFRICOM\u2019s humanitarian undertakings should be approached as gestures of goodwill or conflict-deterrence, or rather as signs of a militarized U.S. approach to foreign policy in Africa.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Mining and Public Health in Zambia Meeting report, 10 April 2018, Lusaka, Zambia","field_subtitle":"Ministry of Health Zambia; EQUINET","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Zambia%20mining%20and%20public%20health%20Mtg%20Rep%20April2018.pdf","body":"The Southern African Development Community (SADC) framework for harmonising mining policies, standards and laws, approved by the SADC Mining Ministers in 2006, specifies that member states develop, adopt and enforce appropriate and uniform health, safety and environmental guidelines for the sector and seeks to harmonized standardization in health as an immediate milestone area. The Ministry of Health in Zambia is in the process of improving public health in the mining sector in the country as part of its Universal Health Coverage policy, as well as to address the social determinants of health. A meeting was thus held to dialogue with key national level representatives of health and related sectors on evidence and actions related to public health in mining. The meeting aimed to 1. Share and dialogue with key national level representatives of health and related sectors on: evidence from Zambia on mining and health with a focus on population/public health issues and the current responses to health promotion, prevention and management, and on evidence from regional level on public health issues and health standards in mining, and their implications for regional responses. 2. To discuss follow up actions in relation to key areas of health and cross sectoral collaboration on mining and public health in Zambia and for regional co-operation and exchange on setting and implementing harmonised standards on mining and health.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Mobilization initiative on gender equity in health research launched","field_subtitle":"TDR: World Health Organisation, Geneva, February 2018","URL":"http://www.who.int/tdr/news/2018/mobilization-initiative-gender-equity/en/","body":"TDR Global has launched a 3-month mobilization initiative on gender equity in health research. The aim is to enhance women\u2019s position in health research and to address the impact of gender on infectious diseases of poverty through research. The initiative will share experience and thoughts on gender equity in health research. Challenge-solving workshops are being planned to identify local challenges, create local teams and offer training. TDR Global talks are opportunities to share best practices and experiences on enhancing gender equity in health research. Working groups on specific issues are options for organizing webinars, training and sharing ideas.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"National policies on the management of latent tuberculosis infection: review of 98 countries ","field_subtitle":"Jagger A; Reiter-karam S; Hamadab Y; et al: Bulletin of the World Health Organisation 96(3) 173\u2013184, 2018","URL":"http://www.who.int/bulletin/volumes/96/3/17-199414.pdf","body":"This paper is a review of policies on management of latent tuberculosis infection in countries with low and high burdens of tuberculosis. The authors divided countries reporting data to the World Health Organization Global Tuberculosis Programme into low and high tuberculosis burden, based on World Health Organization criteria. National policy documents on management of latent tuberculosis were identified through online searches, government websites, World Health Organization country offices and personal communication with programme managers. A descriptive analysis was done with a focus on policy gaps and deviations from World Health Organization policy recommendations. Documents were obtained from 68 of 113 low-burden countries and 30 of 35 countries with the highest burdens of tuberculosis or human immunodeficiency virus (HIV)-associated tuberculosis. Screening for children aged < 5 years with household tuberculosis contact was the policy of 25 (83.3%) high- and 28 (41.2%) low-burden countries. In most high-burden countries the recommendation was symptom screening alone before treatment, whereas in all low-burden countries it was testing before treatment. Some low-burden countries\u2019 policies did not comply with WHO recommendations: nine (13.2%) recommended tuberculosis preventive treatment for travellers to high-burden countries and 10 (14.7%) for patients undergoing abdominal surgery. The authors raise that lack of solid evidence on certain aspects of management of latent tuberculosis infection results in national policies which vary considerably and highlight a need to advance research and develop clear, implementable and evidence-based WHO policies. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Nursing education challenges and solutions in Sub Saharan Africa: an integrative review","field_subtitle":"Bvumbwe T; Mtshali N: BMC Nursing, 17:3,  https://doi.org/10.1186/s12912-018-0272-4, 2018","URL":"https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-018-0272-4","body":"This integrative review examined literature on nursing education challenges and solutions in Sub Saharan Africa to inform development of a model for improving the quality, quantity and relevance of nursing education at local level through a search of online libraries. Twenty articles and five grey sources were included. The findings of the review generally support World Health Organisation framework for transformative and scale up of health professions education. Six themes emerged; curriculum reforms, profession regulation, transformative teaching strategies, collaboration and partnership, capacity building and infrastructure and resources. Challenges and solutions in nursing education are common within countries. The review shows that massive investment by development partners is resulting in positive development of nursing education in Sub Saharan Africa. However, strategic leadership, networking and partnership to share expertise and best practices are argued from the evidence to be critical. The authors propose that Sub Saharan Africa needs more reforms to increase capacity of educators and mentors, responsiveness of curricula, strongly regulatory frameworks, and availability of infrastructure and resources. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Practitioner Expertise to Optimize Community Health Systems: Harnessing Operational Insight","field_subtitle":"Ballard M; Schwarz R; Johnson A; et al: Community Health Worker Impact, USA, 2017","URL":"https://tinyurl.com/ya539lkj","body":"To harness the potential of community health workers (CHWs) to extend health services to poor and marginalized populations the authors argue that there is a need to better understand how CHW programs can be optimized. This paper presents the experience of and insights from application by selected organizations that have developed high-impact CHW programs with governments and communities in different countries globally.  They present a series of design principles that, in their experience, drive programmatic quality and are debated or not commonly found in programs across the globe: CHWs must meet minimum standards before working; point of care fees should be avoided when possible; CHWs should go door to door and provide training on when to seek help; continuing training should be a requirement; CHWs should benefit from a dedicated supervisor and be paid and should be part of a strong local health system and data feedback loops. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Scoping literature review on the basic health benefit package and its determinant criteria","field_subtitle":"Hayati R; Bastani P; Kabir M; et al: Globalization and Health 14(26), https://doi.org/10.1186/s12992-018-0345-x, 2018","URL":"https://tinyurl.com/y7v8w2qd","body":"This study aimed to extract criteria used in health systems for defining the benefit package in different countries around the world using scoping review method. A systematic search was carried out in online libraries and databases between January and April 2016. After studying the articles\u2019 titles, abstracts, and full texts, 9 articles and 14 reports were selected for final analysis. In the final analysis, 19 criteria were extracted. Due to diversity of criteria in terms of number and nature, they were divided into three categories. The categories included intervention-related criteria, disease-related criteria, and community-related criteria. The largest number of criteria belonged to the first category. Indeed, the most widely applied criteria included cost-effectiveness, effectiveness, budget impact, equity, and burden of disease. According to the results, different criteria were identified in terms of number and nature in developing benefit package in world health systems. The authors conclude that it seems that certain criteria, such as cost-effectiveness, effectiveness, budget impact, burden of disease, equity, and necessity, that were most widely utilized in countries under study could be for designing benefit package with regard to social, cultural, and economic considerations.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The African Postdoctoral Training Initiative - a partnership of the African Academy of Sciences, the Bill and Melinda Gates Foundation, and the U.S. National Institutes of Health","field_subtitle":"Deadline for Applications: 11 May 2018","URL":"https://tinyurl.com/y6uka8xp","body":"The African Academy of Sciences (AAS), the U.S. National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation are partnering under the auspices of the Coalition of African Research & Innovation (CARI) to establish a post-doctoral training fellowship program, the African Postdoctoral Training Initiative (APTI) at the intramural laboratories of NIH. APTI fellows will train in a global health research area of priority for their home institutions and countries. While at the NIH, the fellows must be on leave or sabbatical from their home institution under the NIH Intramural Visiting Fellow Program. The research priority areas are in infectious diseases, nutrition, and reproductive, maternal, and child health and developing skills for clinical and translational research. Candidates must be citizens of and currently employed in an academic, research, or government position in an African country. Candidates must have less than 5 years of relevant research experience by their entry on duty date at NIH.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Inverse Equity Hypothesis: Analyses of Institutional Deliveries in 286 National Surveys","field_subtitle":"Victora C; Joseph G; Silva I; et al: American Journal of Public Health 108(4) 464-471, 2018","URL":"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304277","body":"This study tested the inverse equity hypothesis, which postulates that new health interventions are initially adopted by the wealthy and thus increase inequalities\u2014as population coverage increases, only the poorest will lag behind all other groups. The authors analysed the proportion of births occurring in a health facility by wealth quintile in 286 surveys from 89 low- and middle-income countries (1993\u20132015) and developed an inequality pattern index. Positive values indicate that inequality is driven by early adoption by the wealthy (top inequality), whereas negative values signal bottom inequality. Absolute inequalities were widest when national coverage was around 50%. At low national coverage levels, top inequality was evident with coverage in the wealthiest quintile taking off rapidly; at 60% or higher national coverage, bottom inequality became the predominant pattern, with the poorest quintile lagging behind. The authors argue that policies need to be tailored to inequality patterns. When top inequalities are present, barriers that limit uptake by most of the population must be identified and addressed. When bottom inequalities exist, interventions must be targeted at specific subgroups that are left behind.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The role of community health workers in improving HIV treatment outcomes in children: lessons learned from the ZENITH trial in Zimbabwe ","field_subtitle":"Busza J; Dauya E; Bandason T; et al: Health Policy and Planning 33(3) 328\u2013334, 2018","URL":"https://academic.oup.com/heapol/article/33/3/328/4788356","body":"For the Zimbabwe study for Enhancing Testing and Improving Treatment of HIV in Children (ZENITH) randomized controlled trial, the authors based their intervention on an existing evidence-based framework for successful community health worker (CHW) programmes. To assess CHWs\u2019 experiences delivering the intervention, they conducted longitudinal, qualitative semi-structured interviews with all 19 CHWs at three times during implementation. The study explored community health workers\u2019 perceptions of how the intervention\u2019s structure and management affected their performance, and considers implications for the programme\u2019s future scale-up and adoption in other settings. Community health workers expressed strong motivation, commitment and job satisfaction. Intensive supervision and mentoring emerged as critical to ensuring community health workers long-term satisfaction. Provision of job aids, standardized manuals and refresher training were also important, as were formalized links between clinics and community health workers. Concerns raised by community health workers included poor remuneration, their reluctance to stop providing support to individual families following the requisite number of home visits, and disappointment at the lack of programme sustainability following completion of the trial. Furthermore, intensive supervision and integration with clinical services may be difficult to replicate outside a trial setting. This study shows that existing criteria for designing successful community health workers programmes are useful for maximizing effectiveness, but challenges remain for ensuring long-term sustainability of \u2018task shifting\u2019 strategies.","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"UN aims to eliminate yellow fever epidemics in Africa by 2026","field_subtitle":"Times LIVE, Reuters, April 2018","URL":"https://tinyurl.com/y8wmsgqv","body":"Nearly 1 billion people in Africa will be vaccinated against yellow fever by 2026 in an ambitious United Nations campaign to eliminate epidemics of the deadly disease on the continent. The mosquito-borne viral disease is a major killer in Africa, where it can spread fast in highly populated areas with devastating consequences. \"With one injection we can protect a person for life against this dangerous pathogen,\" said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) at the programme's launch in Nigeria, a priority target country. A major vaccination campaign in Angola and Congo in 2016 brought one of the worst outbreaks of the disease in decades under control after more than 400 people died. The vaccination programme is a joint venture by the WHO, UNICEF, the GAVI global vaccine alliance and more than 50 health partners. ","php":"","field_issue_date":"2018-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"15th International Conference on Urban Health: Managing Urbanisation for Health, 26-30 November 2018, Kampala, Uganda","field_subtitle":"Deadline for abstracts: 14 May 2018","URL":"http://www.isuhconference.org","body":"The 15th International Conference on Urban Health will bring together interdisciplinary researchers, practitioners, policy-makers, health and urban stakeholders and community leaders to exchange ideas and advance research and practice across sectors on how best to manage the rapid urbanisation occurring in all regions of the world. Abstracts are invited for oral and poster presentations, pre-formed panels, workshops and special tracks on the following conference themes: The Governance of Complex Systems, Culture and Inclusivity, Disasters, Epidemics, and the Unexpected, Cities as Economic Engines, Monitoring and Evaluation of Urban Health Indicators, Safety, Security, and Justice, Spiritual Health in the City. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Advancing public health rights, claims and standards in mining, Report of a Side Session at the Alternative Mining Indaba, 6 February 2018, Cape Town South Africa","field_subtitle":"EQUINET; TARSC; SATUCC; Benchmarks Foundation; SADC CNGO, EQUINET, Harare, 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/AMI%20side%20session%20on%20mining%20and%20health%20rep%202018.pdf","body":"The Alternative Mining Indaba has been held annually since 2010 at the same time as the Mining Indaba to provide a platform for communities affected by mining to voice their concerns and be capacitated to fight for their rights. The theme for the 2018 AMI was: \u201cMaking Natural Resources Work for the People: Towards Just Legal, Policy and Institutional Reform\u201d. This report presents information on a side session at the Indaba that aimed to raise and discuss the key public health challenges facing workers and communities in the extractive sector / mining in east and southern Africa, the strategies for responding to them, including proposals for harmonised regional health standards, and the proposals made by civil society to advance them.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Africa Innovation Summit 2019","field_subtitle":"6-8 June 2018, Kigali, Rwanda","URL":"http://www.africainnovationsummit.com/about","body":"The 2018 Summit will be a multifaceted event that will bring together stakeholders from various sectors, including decision makers to seek innovative and disruptive solutions for the challenges facing African countries. The focus of AIS 2018 will include energy access, water, health, food security and climate change. AIS II will be a three-day event and the program will include five plenary sessions to introduce major thematic issues followed by a series of facilitated workshops, which will take place in focused workgroups to deepen the dialogue and to seek solutions to address the key challenges facing African countries. Each workshop will focus on a specific theme with three to four panelists and will be led by a facilitator. The aims of the discussions are to seek solutions, develop an agenda and mobilize the people and stakeholders for collective action going forward. The AIS 2018 will include activities before, during and after the Summit.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Capital Cities Sustainability Forum 2018","field_subtitle":"5-7 June 2018, City of Tshwane, South Africa","URL":"http://www.africancapitalcities.org/index.html","body":"The African Capital Cities Sustainability Forum (ACCSF) functions as a network for the mayors of capital cities across the continent to achieve the sustainable development goals that are common to all and, in the words of Solly Msimanga, executive mayor of Tshwane, \u201cto establish commonalities and challenges faced by major cities in Africa while showcasing and sharing successful initiatives towards the emergence of truly African, original and appropriate answers in addressing the sustainability imperative at the urban scale.\u201d","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African leaders sign continental free-trade agreement","field_subtitle":"Al Jazeera News: 21 March 2018","URL":"https://tinyurl.com/y8lmrp5b","body":"African leaders have signed an agreement to set up a massive free-trade area to improve regional integration and boost economic growth across the continent. The deal to create the African Continental Free Trade Area (AfCFTA) was signed at an extraordinary summit in Kigali, Rwanda by representatives of 44 of the 55 African Union (AU) member states. The agreement commits countries to removing tariffs on 90 percent of goods, with 10 percent of \"sensitive items\" to be phased in later. It will also liberalise trade in services and might in the future include free movement of people and a single currency. AfCFTA will now have to be ratified by individual countries. Nigeria pulled out of the signing ceremony. The Nigeria Labour Congress (NLC) had warned government against signing the agreement, calling it a \"renewed, extremely dangerous and radioactive neo-liberal policy initiative\". A further protocol, the Protocol on Free Movement of People has to date been signed by 27 countries.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Cochrane South Africa invites applications for the Aubrey Sheiham Evidence-based Health Care in Africa Leadership Award 2018 ","field_subtitle":"Applications close: 31 July 2018","URL":"https://tinyurl.com/y7dr4eqs","body":"Since 2001 through the generosity of the late Professor Aubrey Sheiham 16 Cochrane researchers from low- and middle-income countries have been funded and supported to complete Cochrane Reviews on topics relevant to their region, and to cascade knowledge about Cochrane and evidence-based health care (EBHC) to their local networks. In 2014, the scholarship evolved into a new award focusing on leadership in EBHC - the Aubrey Sheiham EBHC in Africa Leadership Award, administered by Cochrane South Africa. With an updated and more concentrated focus, the fellowship is awarded annually to an individual based in Africa, and supports the conduct and dissemination of a high-impact Cochrane Review on a topic relevant to resource-constrained settings. The Cochrane Review should be registered with a Cochrane Review Group at the time of application. An update of an existing review is allowed if it will have high impact. The applicant should provide proof that relevant evidence is available for inclusion in the review. In addition to completing their chosen Cochrane Review and disseminating its findings, the award recipient will support capacity development by mentoring a novice author based in Africa through the review process. This continues the scholarship\u2019s tradition of building knowledge and research networks, which will be actively supported by Cochrane South Africa. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Determinants of facility readiness for integration of family planning with HIV testing and counseling services: evidence from the Tanzania service provision assessment survey, 2014\u20132015","field_subtitle":"Bintabara D; Nakamura K; Seino K: BMC Health Services Research 17(844), doi: https://doi.org/10.1186/s12913-017-2809-8, 2017","URL":"https://tinyurl.com/yc692fcf","body":"This study examined determinants of facility readiness for integration of family planning with HIV testing and counseling services in Tanzania using data from the 2014\u20132015 Tanzania Service Provision Assessment Survey. A total of 1188 facilities were assessed and considered ready for integration of family planning with HIV testing and counseling services if they scored \u2265\u200950% on both family planning and HIV testing and counseling service readiness indices as identified by the World Health Organization. Of all the health facilities, 915 reported offering both family planning and HIV testing and counseling services, while only 536 were considered ready to integrate these two services. Significant determinants of facility readiness for integrating these two services were being government owned, having routine management meetings, availability of guidelines, in-service training of staff, and availability of laboratories for HIV testing. The authors judge the proportion of facility readiness for the integration of family planning with HIV testing and counseling in Tanzania to be unsatisfactory and suggest that the Ministry of Health distribute and ensure constant availability of guidelines, availability of rapid diagnostic tests for HIV testing, and refresher training to health providers, as determinants of facility readiness.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"District Health Barometer 2016/2017, South Africa","field_subtitle":"Massyn N; Padarath A; Peer N; et al: Health Systems Trust, South Africa, 2017 ","URL":"https://tinyurl.com/y9c5aqwp","body":"This 12th edition of the District Health Barometer (DHB) covers 52 districts and includes a total of 47 financial and health indicators, 11 of which are new. This annual publication provides an overview of the performance of public health services in South Africa and has become an important planning and management resource for health service providers, managers, researchers and policy makers in the country. The DHB plays an important role in providing information for district mangers to benchmark their districts against the others in the country and in strengthening the use of data for priority setting and decision making. The Barometer is used as the basis for workshops with district managers which provides an opportunity to engage with the data and collaborate with technical experts on how best to use this information for planning. This edition paints a mixed picture, showing significant gains in some areas while highlighting areas that need further attention. Mortality rates in South Africa increased between 1997 and 2006 and declined thereafter until 2015, mainly due to the HIV epidemic and the roll-out of ARTs. Despite this, HIV and AIDS and associated conditions still stand out as being a leading cause of morbidity, together with cerebrovascular diseases, ischaemic heart disease, diabetes mellitus, road injuries, interpersonal violence and hypertensive heart disease. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET discussion paper 113: The role of an essential health benefit in health systems in east and southern Africa: Learning from regional research","field_subtitle":"Loewenson R; Mamdani M; Todd G; Kadowa I; Nswilla A; Kisanga O; Luwabelwa M; Banda P; Palale M; Magagula S:  TARSC and IHI, EQUINET, Harare, 2018","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20113%20EHB%20synthesis%202018.pdf","body":"An Essential Health Benefit (EHB) is a policy intervention defining the service benefits (or benefit package) in order to direct resources to priority areas of health service delivery to reduce disease burdens and ensure health equity. Many east and southern African (ESA) countries have introduced or updated EHBs in the 2000s. Recognising this in 2015-2017, the Regional Network for Equity in Health in East and Southern Africa (EQUINET), through Ifakara Health Institute (IHI) and Training and Research Support Centre (TARSC), with ministries of health in Swaziland, Tanzania, Uganda and Zambia, implemented desk reviews and country case studies, and held a regional meeting to gather and share evidence and learning on the role of EHBs in resourcing, organising and in accountability on integrated, equitable universal health systems. This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for developing EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. This research pointed to the evidence within the region for policy dialogue on universal health systems. It raised the usefulness of designing, costing, implementing and monitoring an EHB as a key entry point and operational strategy for realising universal health coverage and systems and for making clear the deficits to be met.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 205: Making markets work for menstrual health: overcoming the \u2018dignity deficit\u2019","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Header"}},{"node":{"title":"Exploring the care provided to mothers and children by community health workers in South Africa: missed opportunities to provide comprehensive care","field_subtitle":"Wilford A; Phakathi S; Haskins L; et al: BMC Public Health 18(171), doi: https://doi.org/10.1186/s12889-018-5056-y, 2018","URL":"https://tinyurl.com/yd38nuqg","body":"In this study the authors explored the performance of by community health workers (CHWs) providing maternal and child health services at household level and the quality of the CHW-mother interaction using observations and in-depth interviews. Fifteen CHWs and 30 mothers/pregnant women were purposively selected in three rural districts of KwaZulu-Natal, South Africa. CHWs provided appropriate and correct health information but there were important gaps in the content provided. Mothers expressed satisfaction with CHW visits and appreciation that CHWs understood their life experiences and therefore provided advice and support that was relevant and accessible. CHWs expressed concern that they did not have the knowledge required to undertake all activities in the household, and requested training and support from supervisors during household visits. The authors assert that key building blocks for a successful CHW programme are in place to provide services for mothers and children in households but further training and supervision is required if the gaps in CHW knowledge and skills are to be filled.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Extending coverage to informal sector populations in Kenya: design preferences and implications for financing policy","field_subtitle":"Okungu V; Chuma J; Mulupi S; et al: BMC Health Services Research 18(37),  doi: https://doi.org/10.1186/s12913-017-2805-z, 2018","URL":"https://tinyurl.com/ycnswr4p","body":"This study documented the views of informal sector workers regarding different prepayment mechanisms, to inform the design and policy implications of financing Universal health coverage in Kenya. This was part of larger study which involved a mixed-methods approach. Data was collected from informal sector workers: focus group discussions, individual in-depth and a questionnaire survey. The findings showed that informal sector workers in rural and urban areas prefer different prepayment systems for financing Universal health coverage. Preference for a non-contributory system of financing Universal health coverage was particularly strong in the urban study site. Over 70% in the rural area preferred a contributory mechanism in financing Universal health coverage. The main concern for informal sector workers regardless of the overall design of the financing approach to Universal health coverage included a poor governance culture, especially one that does not punish corruption. Other reasons especially with regard to the contributory financing approach included high premium costs and inability to enforce contributions from informal sector. On average 47% of all study participants, the largest single majority, are in favour of a non-contributory financing mechanism. Strong evidence from existing literature indicates difficulties in implementing social contributions as the primary financing mechanism for Universal health coverage in contexts with large informal sector populations. The authors argue that non-contributory financing should be strongly recommended to policymakers to be the primary financing mechanism, supplemented by social contributions.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Extractive Laws in Africa: What is the state of these laws? Why are our laws a problem? Why and on what should we call for reforms? ","field_subtitle":"Graham Y: Alternative Mining Indaba, February 2018","URL":"https://tinyurl.com/ycls8c7v","body":"The overarching legal framework for minerals across Africa is public ownership. Citizens should be the collective beneficial owners of the mineral resources that are managed on their behalf by the state as a trustee. Graham asserts, however, that the reality in  Africa is different. The collective ownership of minerals and the trustee role of the state has been compromised. Mining activists have tended to focus on accountability and transparency in relation to the regimes of mineral exploitation that governments have adopted. Graham asserts that there is a more fundamental accountability question in how the choices being made advance the inter- generational interests of citizens. Graham identifies that the citizen should at the very least not be made worse off by the development of assets of which he/she is part owner. He argues that there should be a stronger accountability framework where a minerals and development policy provides for inter-generational benefit, with linkages to development. There is a need to retreat from a 'first come first served' approach to awarding mining contracts, to collect more geological information to inform award of concessions and reform revenue law to be sensitive to mining price cycles so revenue collection can be optimised. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study","field_subtitle":"Abrahams Z; Lund C; Field S; et al: Social Psychiatry and Psychiatric Epidemiology, doi: https://doi.org/10.1007/s00127-018-1497-y, 2018","URL":"https://link.springer.com/article/10.1007%2Fs00127-018-1497-y#citeas","body":"This study aimed to assess factors associated with food insecurity and depression in a sample of pregnant South African women in a low-income suburb in Cape Town. Pregnant women attending a local clinic for their first antenatal visit were invited to participate. The shortened form of the US Household Food Security Survey Module was used to measure food insecurity. The Expanded Mini-International Neuropsychiatric Interview was used to diagnose depression, anxiety, alcohol and drug dependence, and assess for suicidal ideation and behaviour. Logistic regression modelling was conducted to explore factors associated with food insecurity and depression in separate models. The authors found that 42% of households were food insecure and that 21% of participants were depressed. The odds of being food insecure were increased in women with suicidal behaviour, with depression and in those with three or more children. The odds of depression was greater in women who were food insecure, substance dependent or diagnosed with an anxiety disorder. Food insecurity and depression are strongly associated in pregnant women. The relationship between food insecurity and depression is complex and requires further investigation. Interventions that improve both food security and mental health during the perinatal period are likely to benefit the physical and mental well-being of mothers and children.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Factors influencing the capacity of women to voice their concerns about maternal health services in the Muanda and Bolenge Health Zones, Democratic Republic of the Congo: a multi-method study.","field_subtitle":"Mafuta E;  De Cock Buning T; Lolobi  D; et al: BMC Health Services Research, Biology 18(37), doi: https://doi.org/10.1186/s12913-018-2842-2, 2018","URL":"https://tinyurl.com/y8e99e6r","body":"This paper aims to identify factors that influence the capacity of women to voice their concerns regarding maternal health services at the local level. A secondary analysis was conducted of the data from three studies carried out between 2013 and 2015 in the context of a WOTRO initiative to improve maternal health services through social accountability mechanisms in the Democratic Republic of the Congo. Data from 21 interviews and 12 focus group discussions were analysed using an inductive content analysis. The women living in the rural setting were mostly farmers/fisher-women or worked at odd jobs. They had not completed secondary school. Around one-fifth was younger than 20 years old. The majority of women could describe the health service they received but were not able to describe what they should receive as care. They had insufficient knowledge of the health services before their first visit. They were not able to explain the mandate of the health providers. The information they received concerned the types of healthcare they could receive but not the real content of those services, nor their rights and entitlements.  They believed that they were laypersons and therefore unable to judge health providers, but when provided with some tools such as a checklist, they reported some abusive and disrespectful treatments. Factors influencing the capacity of women to voice their concerns in Democratic Republic of the Congo rural settings were found to be mainly associated with insufficient knowledge and a socio-cultural context. These findings suggest that initiatives to implement social accountability have to address community capacity-building, health providers\u2019 responsiveness and the socio-cultural norms .","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Fiscal policy to improve diets and prevent non-communicable diseases: from recommendations to action ","field_subtitle":"Thow A; Downs S; Mayes C; et al: Bulletin of the World Health Organisatio 96(3) 201\u2013210, 2018","URL":"http://www.who.int/bulletin/volumes/96/3/17-195982.pdf","body":"The World Health Organization has recommended that Member States consider taxing energy-dense beverages and foods and/or subsidizing nutrient-rich foods to improve diets and prevent noncommunicable diseases. Numerous countries have either implemented taxes on energy-dense beverages and foods or are considering the implementation of such taxes. However, several major challenges to the implementation of fiscal policies to improve diets and prevent noncommunicable diseases remain. Some of these challenges relate to the cross-sectoral nature of the relevant interventions. For example, as health and economic policy-makers have different administrative concerns, performance indicators and priorities, they often consider different forms of evidence in their decision-making. In this paper, the evidence base for diet-related interventions based on fiscal policies are described and the key questions that need to be asked by both health and economic policy-makers are considered. From the health sector\u2019s perspective, there is most evidence for the impact of taxes and subsidies on diets, with less evidence on their impacts on body weight or health. The authors highlight the importance of scope, the role of industry, the use of revenue and regressive taxes in informing policy decisions.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"From Kisiizi to Baltimore: cultivating knowledge brokers to support global innovation for community engagement in healthcare","field_subtitle":"Ibe C; Basu L; Gooden R; et al: Globalization and Health 14(19), doi: https://doi.org/10.1186/s12992-018-0339-8, 2018","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2917/Online%20article","body":"Reverse Innovation has been endorsed as a vehicle for promoting bidirectional learning and information flow between low- and middle-income countries and high-income countries, with the aim of tackling common unmet needs. One such need, which traverses international boundaries, is the development of strategies to initiate and sustain community engagement in health care delivery systems. In this commentary, the authors discuss the Baltimore \u201cCommunity-based Organizations Neighborhood Network: Enhancing Capacity Together\u201d Study. This randomized controlled trial evaluated whether or not a community engagement strategy, developed to address patient safety in low- and middle-income countries throughout sub-Saharan Africa, could be successfully applied to create and implement strategies that would link community-based organizations to a local health care system in Baltimore, a city in the United States. Specifically, the authors explore the trial\u2019s activation of community knowledge brokers as the conduit through which community engagement, and innovation production, was achieved. Cultivating community knowledge brokers holds promise as a vehicle for advancing global innovation in the context of health care delivery systems. As such, further efforts to discern the ways in which they may promote the development and dissemination of innovations in health care systems is warranted.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Guidelines for responsible short-term global health activities: developing common principles","field_subtitle":"Lasker J; Aldrink M; Balasubramaniam R; et al: Globalization and Health 14(18) doi: https://doi.org/10.1186/s12992-018-0330-4, 2018","URL":"https://tinyurl.com/y99m385v","body":"Growing concerns about the value and effectiveness of short-term volunteer trips intending to improve health in underserved Global South communities has driven the development of guidelines by multiple organizations and individuals. These are intended to mitigate potential harms and maximize benefits associated with such efforts. This paper analyzes 27 guidelines derived from a scoping review of the literature available in early 2017, describing their authorship, intended audiences, the aspects of short term medical missions (STMMs) they address, and their attention to guideline implementation. It further considers how these guidelines relate to the desires of host communities, as seen in studies of host country staff who work with volunteers. There is broad consensus on key principles for responsible, effective, and ethical programs--need for host partners, proper preparation and supervision of visitors, needs assessment and evaluation, sustainability, and adherence to pertinent legal and ethical standards. Host country staff studies suggest agreement with the main elements of this guideline consensus, but they add the importance of mutual learning and respect for hosts. Guidelines must be informed by research and policy directives from host countries that is now mostly absent. Also, a comprehensive strategy to support adherence to best practice guidelines is argued to be needed, given limited regulation and enforcement capacity in host country contexts and strong incentives for involved stakeholders to undertake or host STMMs that do not respect key principles.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Health system strengthening: a qualitative evaluation of implementation experience and lessons learned across five African countries ","field_subtitle":"Rwabukwisi F; Bawah A; Gimbel S; Phillips J et al: BMC Health Services Research 17(Suppl3)  doi: https://doi.org/10.1186/s12913-017-2662-9, 2017 ","URL":"https://tinyurl.com/y7qu9p7v","body":"In this study, the authors captured common implementation experiences and lessons learned to understand core elements of successful health systems interventions in Ghana, Mozambique, Rwanda, Tanzania, and Zambia. Four major overarching lessons were highlighted. Variety and inclusiveness of concerned key players are necessary to address complex health system issues at all levels. A learning culture that promotes evidence creation and ability to efficiently adapt were key in order to meet changing contextual needs. Inclusion of strong implementation science tools and strategies allowed informed and measured learning processes and efficient dissemination of best practices. Five to seven years was the minimum time frame necessary to effectively implement complex health system strengthening interventions and generate the evidence base needed to advocate for sustainable change for the Population Health Implementation and Training partnership projects. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"How to assess and prepare health systems in low- and middle-income countries for integration of services\u2014a systematic review","field_subtitle":"Topp S; Abimbola S; Joshi R: Health Policy and Planning 33(2) March 2018, doi: https://doi.org/10.1093/heapol/czx169, 2017 ","URL":"https://tinyurl.com/y7qu9p7v","body":"Despite growing support for integration of frontline services, a lack of information about the pre-conditions necessary to integrate such services hampers the ability of policy makers and implementers to assess how feasible or worthwhile integration may be, especially in low- and middle-income countries (LMICs). The authors adopted a modified systematic review with aspects of realist review of quantitative and qualitative studies that incorporated assessment of health system preparedness for and capacity to implement integrated services. From an initial list of 10 550 articles, 206 were selected for full-text review by two reviewers who independently reviewed articles and inductively extracted and synthesized themes related to health system preparedness. Five \u2018context\u2019 related categories and four health system \u2018capability\u2019 themes were searched. The contextual enabling and constraining factors for frontline service integration were: the organizational framework of frontline services, health care worker preparedness, community and client preparedness, upstream logistics and policy and governance issues. The intersecting health system capabilities identified were the need for: sufficiently functional frontline health services, sufficiently trained and motivated health care workers, availability of technical tools and equipment suitable to facilitate integrated frontline services and appropriately devolved authority and decision-making processes to enable frontline managers and staff to adapt integration to local circumstances. This review demonstrates that synthesis is possible. It presents a common set of contextual factors and health system capabilities necessary for successful service integration which may be considered indicators of preparedness and could form the basis for an \u2018integration preparedness tool\u2019.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"How to do (or not to do)\u2026 Measuring health worker motivation in surveys in low- and middle-income countries ","field_subtitle":"Borghi J; Lohmann J; Dale E; et al: Health Policy and Planning 33(2) doi: https://doi.org/10.1093/heapol/czx153, 2018","URL":"https://academic.oup.com/heapol/article/33/2/192/4641879","body":"A health system\u2019s ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among researchers in measuring motivation within health worker surveys. However, there is currently limited guidance on how to conceptualize and approach measurement and how to validate or analyse motivation data collected from health worker surveys, resulting in inconsistent and sometimes poor quality measures. This paper begins by discussing how motivation can be conceptualized, then sets out the steps in developing questions to measure motivation within health worker surveys and in ensuring data quality through validity and reliability tests. The paper also discusses analysis of the resulting motivation measure/s. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Listeriosis: One of many food horrors of South Africa\u2019s profit-driven, corporate-controlled food system","field_subtitle":"COPAC, SAFC: South Africa, March 2018","URL":"http://www.safsc.org.za/wp-content/uploads/2018/03/Press-Release_Listeriosis-outbreak_7-March-2018.pdf","body":"The South African Food Sovereignty Campaign (SAFSC) and Co-operative and Policy Alternative Centre issued as press statement calling the outbreak of listeriosis in South Africa as a food horror of a profit-driven corporate food system, with limited state regulation. They blame the current corporate controlled food system for compromised health standards in South Africa, which has led to food horrors of not only listeriosis, but also obesity, hunger, malnutrition, child stunting and diabetes. The private sector with profit as its main motive, claims that it has solutions to end food crises, but these organisations say that it is perpetuating the very crises that the poor and vulnerable face on a daily basis, and that the listeriosis outbreak, as well as ongoing hunger, hiking obesity and diabetes rates and contamination of soils with pesticides, tell a story of the failure of the corporate food system to ensure adequate nutrition for all citizens, and the destruction of natural environments. The South African Food Sovereignty Campaign (SAFSC) calls for greater state regulation based on the People\u2019s Food Sovereignty Act. This Act calls for the democratic planning of the food system, increased state regulation on destructive practices of the corporate controlled food system, prioritising local food supply over trade, a ban on advertising of all junk food, and greater reliance on small-scale food producers to feed citizens culturally appropriate and nutritious food.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Local Government Community of Practice","field_subtitle":"Gender Links for Equality and Justice: website, 2018","URL":"https://tinyurl.com/ycgj9zlo","body":"The Local government Community of Practice is a \u2018virtual\u2019 community that seeks to enable interaction on various gender and governance issues. Ideal for local government practitioners and academia this platform invokes participants to learn and share best practices, resources and critical thinking on gender and service delivery across the SADC region to bring \u2018the local government we want\u2019. Members are encouraged to make use of the Local Government Gender Score Card tool that measures the Centres of Excellence (COE) progress in gender mainstreaming and sensitive service delivery. Aligned is a newly developed Local Government Citizen\u2019s Score Card that provides an opportunity for community members served by COE councils to assess and measure council\u2019s progress towards achieving gender sensitive and responsive service delivery. The results from these tools aim to assist in strengthened policies and development projects that are implemented to achieve the Sustainable Development Goals and SADC Gender Protocol Agenda 2030.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Making markets work for menstrual health: overcoming the \u2018dignity deficit\u2019","field_subtitle":"Nolwazi Ncube, Save the Girl Child Movement, Zimbabwe","body":"\r\nMenstrual health is often mistakenly classified solely as a \u2018women\u2019s issue\u2019. Yet with their link to reproduction and fertility, menstrual health and hygiene are not simply women\u2019s issues, but matters of family and national concern. This is even more important in our region given the high share of adolescent females and women of child-bearing age in the population. In addition, the education, survival and health of girls and of women have an impact on the whole family. An appreciation of this impact underpins the global Sustainable Development Goal (SDG) 4 that seeks to ensure inclusive education for all, and SDG 5 that promotes gender equality. \r\n\r\nSo having just commemorated International Women\u2019s day on 8 March 2018, and ahead of Menstrual hygiene day next month on 28 May, it seems fitting to discuss the issue of menstrual health. \r\n\r\nIn 2016, ahead of the 11 October global commemorations of the International Day of the Girl Child, UNICEF released a report entitled \u2018Harnessing the Power of Data for Girls: taking stock and looking ahead to 2030\u2019 (https://data.unicef.org/resources/harnessing-the-power-of-data-for-girls/). The report presented a rather sombre picture of the state of gender equality in low-income countries, pointing to an unequal division of labour in homes that continues to burden the girl child and impede her educational outcomes. \r\n\r\nZimbabwe, like other countries in the region, has recognised the importance of educating girl children. The country has, over time, made strides with regard to gender parity in education, but still faces gaps in achieving it. To address some of these gaps, the 2005 five-year National Strategic Plan for the education of girls, orphans and other vulnerable children set out to accelerate progress towards universal primary education and to promote equity and empowerment through education. However, with the health, social and economic challenges in the country, the subsequent five-year plans launched in 2011 and 2016 gave more focus to orphaned and vulnerable children. It could have been easy to forget the day-to-day problems girls face with their changing reproductive health. But in a positive step in 2017, the Zimbabwe government introduced a duty rebate on the importation of raw materials (pulp, glue and virgin tissue) used in the manufacture of sanitary wear. \r\n\r\nIt is not the only country in the region to be taking up these pro-girl child measures. \r\n\r\nKenya has repealed sales tax on sanitary wear. Furthermore, since 2011 the Kenya government has allocated approximately 3 million US dollars to support the distribution of sanitary wear in schools in low-income communities. In 2016, Zambia\u2019s Ministry of Health launched its \u2018National guidelines for menstrual hygiene management\u2019. In 2017, the Department of Women in South Africa drafted a \u2018Sanitary dignity policy framework\u2019. \r\n\r\nIn August 2017, I had the opportunity to engage the Deputy Director General of the Department of Women, Mr Prince Booi on this policy framework document. He highlighted that the policy aims to widen access to sanitary wear for extremely poor girls and women, where the provision of this service helps to restore their dignity. The name of this policy framework resonates with me, as it underscores the link between menstrual management and dignity. Girls and women without access to methods and materials for the hygienic management of their menstrual periods experience a cyclical threat to their dignity. Monthly, it can strip away their confidence and may even inhibit their mobility and capacity to carry out physical activities.  \r\n\r\nIn the 1960s in America President Lyndon B Johnson declared \u2018a national war on poverty\u2019, using the term \u2018dignity deficit\u2019 to highlight the effect on men of unemployment and their inability to provide for their families as breadwinners within the home. \r\n\r\nWomen were far less in focus at the time. But women\u2019s reproductive health is an even more powerful sign of the dignity deficit as described in 2017 by Arthur Brooks in an essay in \u2018Foreign Affairs\u2019 (https://www.foreignaffairs.com/articles/united-states/2017-02-13/dignity-deficit). In it he paints the picture of a polarised America in which the rate of births for unmarried mothers is five times higher in women reaching up to high school education than that of college educated women. This is even more profound in girl children. In my own advocacy work in Zimbabwe I have seen how unintended pregnancies lead to dropping out from school and a social reproduction of vulnerability, unemployment and poverty. \r\n\r\nIndeed, when Scottish Member of Parliament Monica Lennon began lobbying in 2017 for a bill to ensure free access to sanitary products in schools, colleges and universities it was profiled as a bid to end \u2018period poverty\u2019. \r\n\r\nThe measures taken by Zimbabwe, Kenya, Zambia and South Africa are thus important equity measures, particularly in overcoming market barriers to menstrual health and dignity. They are also ahead of those taken in many higher income settings. Whilst the City of New York legislated in 2016 for the roll out of free sanitary wear in public schools, homeless shelters and prisons, sanitary wear is still subject to sales tax in other districts in the state and other US states have not followed its example. At the same time, African countries can also look to other countries for further good practice.  The 2013 documentary \u2018Menstrual man\u2019 and the 2018 movie \u2018PadMan\u2019 illuminate the work of Arunachalam Muruganantham in India for example. He confronted gender barriers in championing menstrual management and inventing a low-cost sanitary pad-manufacturing machine that is now used by rural women in India to locally manufacture sanitary pads.\r\n\r\nThese market measures and initiatives signal a potential shift in the recognition of the importance menstrual health in countries \u2013 taking it from a position of being hidden to one that is profiled and addressed in the public sphere, and more importantly an issue that has implications for equity and dignity. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Next wave of interventions to reduce under-five mortality in Rwanda: a crosssectional analysis of demographic and health survey data ","field_subtitle":"Amoroso C; Nisingizwe M; Rouleau D; et al: BMC Pediatrics 18(27) doi: 10.1186/s12887-018-0997-y, 2018","URL":"https://tinyurl.com/y78ynud5","body":"This paper reports on a cross-sectional study of 9002 births to 6328 women age 15\u201349 in the 2010 Rwanda Demographic and Health Survey to identify correlates of under-five mortality in all children under-five, 0\u201311 months, and 12\u201359 months. The results indicated that of 14 covariates associated with under-five mortality in bivariate analysis, the following remained associated with under-five mortality in multivariate analysis: household being among the poorest of the poor, child being a twin, mother having 3\u20134 births in the past 5 years compared to 1\u20132 births, mother being HIV positive, and mother not using contraceptives compared to using a modern method. Mother experiencing physical or sexual violence in the last 12 months was associated with under-five mortality in children ages 1\u20134 years. Under five survival was associated with a preceding birth interval 25\u201350 months compared to 9\u201324 months, and having a mosquito net. It was concluded that in the past decade, Rwanda rolled out integrated management of childhood illness, near universal coverage of childhood vaccinations, a national community health worker program, and a universal health insurance scheme. The results of the study suggest that Rwanda\u2019s next wave of U5 mortality reduction should target programs in improving neonatal outcomes, poverty reduction, family planning, HIV services, malaria prevention, and prevention of intimate partner violence.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Political Priority for Abortion Law Reform in Malawi: Transnational and National Influences","field_subtitle":"Daire J; Kloster M; Storeng K: Health and Human Rights Journal, March 2018","URL":"https://tinyurl.com/y73axkrk","body":"In July 2015, Malawi\u2019s Special Law Commission on the Review of the Law on Abortion released a draft Termination of Pregnancy bill. If approved by Parliament, it will liberalize Malawi\u2019s strict abortion law, expanding the grounds for safe abortion and representing an important step toward safer abortion in Malawi. Drawing on prospective policy analysis (2013\u20132017), the authors identify factors that helped generate political will to address unsafe abortion. Notably, the authors show that transnational influences and domestic advocacy converged to make unsafe abortion a political issue in Malawi and to make abortion law reform a possibility. Since the 1980s, international actors have promoted global norms and provided financial and technical resources to advance ideas about women\u2019s reproductive health and rights and to support research on unsafe abortion. Meanwhile, domestic coalitions of actors and policy champions have mobilized new national evidence on the magnitude, costs, and public health impacts of unsafe abortion, framing action on unsafe abortion as part of a broader imperative to address Malawi\u2019s high level of maternal mortality. Although these efforts have generated substantial support for abortion law reform, an ongoing backlash from the international anti-choice movement has gained momentum by appealing to religious and nationalist values. Passage of the bill confronts, for example, the current United States\u2019 government position prohibiting the funding of safe abortion. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Research gaps and emerging priorities in sexual and reproductive health in Africa and the eastern Mediterranean regions ","field_subtitle":"Ali M; Farron M; Ouedraogo L; et al: Reproductive Health 15(39) doi: https://doi.org/10.1186/s12978-018-0484-9, 2018","URL":"https://tinyurl.com/y8vpr7lx","body":"This paper presented the results of a priority setting exercise that brought together researchers and program managers from the World Health Organization Africa and Eastern Mediterranean regions to identify key sexual reproductive health issues. In June 2015, researchers and program managers from the World Health Organization Africa and Eastern Mediterranean regions met for a three-day meeting to discuss strategies to strengthen research capacity in the regions. A prioritization exercise was carried out to identify key priority areas for research in sexual reproductive health. The process included five criteria which are answerability, effectiveness, deliverability and acceptability, potential impact of the intervention/program to improve reproductive, maternal and newborn health substantially, and equity. The six main priorities were identified as creation and investment in multipurpose prevention technologies, addressing adolescent violence and early pregnancy, improved maternal and newborn emergency care, increased evaluation and improvement of adolescent health interventions including contraception, further focus on family planning uptake and barriers, and improving care for mothers and children during childbirth. They indicate that setting priorities is the first step in a dynamic process to identify where research funding should be focused to maximize health benefits. A focus on priority setting suggests a need to identify who is thus involved in this process.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Scholarships available for the Applied Conflict Transformation Studies [ACTS] programme for Africa, 2018 - 2020","field_subtitle":"Deadline for applications: 29th  April 2018","body":"The ACTS programme takes place under the joint auspices of the International Centre of Nonviolence at Durban University of Technology (DUT) and Grace to Heal, an NGO based in Bulawayo. It is taught by a highly skilled and experienced team, with both local and international staff. This practical programme is offered part-time over 2-2.5 years. Stage one involves three coursework modules, each of which requires up to 10 days residence in Bulawayo, plus guided study at home. Subject to satisfactory progress, students may proceed to stage two, a thesis based on action research. This involves two further residential sessions after formal registration at Durban University of Technology. The final qualification is a Master\u2019s Degree in Management Sciences (MManSc). The programme is closely associated with the ACTS programme for Asia, based at the Centre for Peace and Conflict Studies in Siem Reap, Cambodia. The procedure is for people to make a formal application for the course by filling in the forms, and attach a request for scholarship support. Information can be obtained at the email address below.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Seventy-first World Health Assembly","field_subtitle":"21-26 May 2018, WHO, Geneva, Switzerland","URL":"http://apps.who.int/gb/e/e_wha71.html","body":"The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget. The provisional agenda includes: Addressing the global shortage of, and access to, medicines; the global strategy and plan of action on public health, innovation and intellectual property; preparation for a high-level meeting of the General Assembly on ending tuberculosis; physical activity for health; maternal, infant and young child nutrition; safeguarding against possible conflicts of interest in nutrition programmes; and poliomyelitis \u2013 containment of polioviruses.\r\n","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Strengthening health systems to respond to women subjected to intimate partner violence or sexual violence: A manual for health managers","field_subtitle":"World Health Organization, WHO, Geneva, 2017","URL":"https://tinyurl.com/y9lwktcs","body":"This manual is intended for health managers at all levels of the health systems. It is based on World Health Organization (WHO) 2013 guidelines for responding to intimate partner violence and sexual violence against women. The manual primarily addresses public sector health services, but is also relevant for health services in the private sector, including services provided by nongovernmental organizations. It is intended for policy-makers, health services managers at hospital or health facility level who have responsibility for facility level planning as well as day-to-day coordination and management of services, and offers easy steps, practical tips and job aids to help plan and manage services. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The Council for the Development of Social Science Research in Africa 15th General Assembly: Africa and the Crisis of Globalisation 17 \u2013 21 December 2018, Dakar, Senegal","field_subtitle":"Deadline for abstracts or panel proposals: 15 April 2018","URL":"http://codesria.org/spip.php?article2843","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) announces its 15th General Assembly in Dakar, Senegal from 17-21 December 2018. The theme chosen for the General Assembly is \u2018Africa and the Crisis of Globalization'. Scholars wishing to be considered for participation in the 15th Assembly as paper presenters or convenors of panels are invited to send abstracts or panel proposals for consideration by the CODESRIA Scientific Committee by 15th April 2018. Successful applicants will be expected to submit full papers for a second round of review by 1st July 2018. The selected participants in the GA will be informed in August 2018. Abstracts for paper presentation should not exceed 600 words while panel proposals should not exceed 1,200 words. Each should clearly indicate the sub-theme in which the paper or panel is located. The Council has created a portal on the website through which all abstracts and panel proposals will be submitted.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Global Fund\u2019s paradigm of oversight, monitoring, and results in Mozambique","field_subtitle":"Warren A; Cordon R; Told M; et al: Globalisation and Health 13(89) doi: https://doi.org/10.1186/s12992-017-0308-7, 2017","URL":"https://tinyurl.com/y8km5vv2","body":"The Global Fund is one of the largest actors in global health, disbursing in 2015 close to 10 % of all development assistance for health. In 2011 it began a reform process in response to internal reviews following allegations of recipients\u2019 misuse of funds. Reforms have focused on grant application processes thus far while the core structures and paradigm have remained intact. The authors conducted 38 semi-structured in-depth interviews in Maputo, Mozambique and members of the Global Fund Board and Secretariat in Switzerland. In-country stakeholders were representatives from Global Fund country structures (eg. Principle Recipient), the Ministry of Health, health or development attach\u00e9s bilateral and multilateral agencies, consultants, and the NGO coordinating body. Thematic coding revealed concerns about the combination of weak country oversight with stringent and cumbersome requirements for monitoring and evaluation linked to performance-based financing. Analysis revealed that despite the changes associated with the New Funding Model, respondents in both Maputo and Geneva firmly believe challenges remain in Global Fund\u2019s structure and paradigm. The lack of a country office has many negative downstream effects including reliance on in-country partners and ineffective coordination. Due to weak managerial and absorptive capacity, more oversight is required than is afforded by country team visits. While decision-makers in Geneva recognize in-country coordination as vital to successful implementation, to date, there are no institutional requirements for formalized coordination, and the Global Fund has no consistent representation in Mozambique\u2019s in-country coordination groups. In-country partners provide much needed support for Global Fund recipients, but the authors argue that roles, responsibilities, and accountability must be clearly defined for a successful long-term partnership. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The institutional context of tobacco production in Zambia","field_subtitle":"Labont\u00e9 R; Lencucha R; Drope J: Globalisation and Health 14(5) doi: https://doi.org/10.1186/s12992-018-0328-y, 2018","URL":"https://tinyurl.com/y7w6nvjy","body":"Tobacco production is said to be an important contributor to Zambia\u2019s economy in terms of labour and revenue generation. In light of Zambia\u2019s obligations under the WHO Framework Convention of Tobacco Control (FCTC) the authors examined the institutional actors in Zambia\u2019s tobacco sector to better understand their roles and determine the institutional context that supports tobacco production in Zambia. Findings from 26 qualitative, semi-structured individual or small-group interviews with key informants from governmental, intergovernmental and non-governmental organisations were analysed, along with data and information from published literature. Although Zambia is obligated under the FCTC to take steps to reduce tobacco production, the country\u2019s weak economy and strong tobacco interests make it difficult to achieve this goal. Respondents uniformly acknowledged that growing the country\u2019s economy and ensuring employment for its citizens are the government\u2019s top priorities. Lacklustre coordination and collaboration between the institutional actors, both within and outside government, contributes to an environment that helps sustain tobacco production in the country. A Tobacco Products Control Bill has been under review for a number of years, but with no supply measures included, and with no indication of when or whether it will be passed. As with other low-income countries involved in tobacco production, there is inconsistency between Zambia\u2019s economic policy to strengthen the country\u2019s economy and its FCTC commitment to regulate and control tobacco production. The absence of a whole-of-government approach towards tobacco control has created an institutional context of duelling objectives, with some government ministries working at cross-purposes and tobacco interests left unchecked. With no ultimate coordinating authority, this industry risks being run according to the desire and demands of multinational tobacco companies, with few, if any, checks against them.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The Political Economy of Renewable Energy Investment in Kenya","field_subtitle":"Osiolo H; Pueyo A; Gachanja J: IDS Bulletin 48(5-6),  doi: http://dx.doi.org/10.19088/1968-2017.166, 2017","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2917/Online%20article","body":"Kenya has been hailed as a successful sub-Saharan African country in attracting private investment for renewable energy. However, this paper observes that energy poverty remains very high, with connectivity rates lower than the average for sub-Saharan Africa and poor quality of supply for those connected. Several constraints persist to achieve universal access to clean and affordable electricity: high system costs, including a deficient transmission and distribution infrastructure; low rural demand and inadequate planning to meet it; and local opposition to large renewable infrastructure. This article considers the political economy of these constraints, explaining how they arose, which policies can address them and which actors back or oppose these policies. The overarching message is that a prominent state role is required to fund the network components of the electricity system and to reach the less profitable segments of society, namely the rural poor. However, the authors find that this clashes with a dominant private sector-led narrative in the international development community.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The unfunded priorities: an evaluation of priority setting for noncommunicable disease control in Uganda","field_subtitle":"Essue B; Kapiriri L: Globalization and Health 14(22), doi:  https://doi.org/10.1186/s12992-018-0324-2, 2018","URL":"https://tinyurl.com/y93a64tq","body":"This paper examined the influence of national, sub-national and global factors on priority setting for noncommunicable disease control in Uganda. A mixed methods design that used the Kapiriri Martin framework for evaluating priority setting in low income countries  and the evaluation period was 2005\u20132015. Priority setting for noncommunicable diseases was not entirely fair nor successful. While there were explicit processes that incorporated relevant criteria, evidence and wide stakeholder involvement, these criteria were not used systematically or consistently in the contemplation of noncommunicable diseases. There were insufficient resources for noncommunicable diseases, despite being a priority area. There were weaknesses in the priority setting institutions, and insufficient mechanisms to ensure accountability for decision-making. Priority setting was influenced by the priorities of major stakeholders, such as development assistance partners, which were not always aligned with national priorities. There were major delays in the implementation of noncommunicable disease-related priorities and in many cases, a failure to implement. This evaluation revealed the challenges that low income countries are grappling with in prioritizing noncommunicable diseases in the context of a double disease burden with limited resources. The authors propose that strengthening local capacity for priority setting would help to support the development of sustainable and implementable noncommunicable disease-related priorities and that global support to low income countries for noncommunicable diseases must catch up to align with NCDs as a global health priority.","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Working with Parliamentary Committees of Health to Tackle Health Issues in Africa","field_subtitle":"African Institute for Development Policy (AFIDEP),  Network of African Parliamentary Committees of Health (NEAPACOH): Kenya, 2017","URL":"https://tinyurl.com/yd7h8wcu","body":"The Network of African Parliamentary Committees of Health (NEAPACOH), previously known as the Southern and Eastern Africa Parliamentary Alliance of Committees on Health (SEAPACOH)) is one of the active networks engaging members of parliament in Africa to strengthen the delivery of their functions of oversight, legislation and representation, in tackling health challenges in the region. This study sought to understand NEAPACOH\u2019s contributions in strengthening parliamentary committees in Africa to tackle health and population challenges, and identify ways in which the network can become more effective in the delivery of its mandate. Given the integral role of information or evidence in the delivery of the parliamentary functions, the study had a special interest in understanding how the network promotes evidence-informed discharge of the health committee, to generate learning needed to strengthen NEAPACOH as well as inform future efforts aimed at strengthening the delivery of parliamentary functions in Africa. ","php":"","field_issue_date":"2018-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"2016 Report of Acute public health events assessed by WHO Regional Offices for Africa, the Americas and Europe under the International Health Regulations (2005)","field_subtitle":"World Health Organization: WHO,  Geneva, 2017 ","URL":"https://tinyurl.com/yd5re4y7","body":" The World Health Organization (WHO) and its Member States have committed, within the framework of the International Health Regulations 2005 (IHR), to detect, verify, assess and report events that may pose a risk to international public health. This report summarizes public health events detected, verified, assessed and reported in three WHO Regions, namely Africa, the Americas and Europe from 2001 to 2016, with a focus on 2016. This report illustrates the relevance and importance of conducting and sustaining epidemic intelligence activities in accordance to alleviate the burden and impact of epidemics and emergencies, and thus avoid interference with travel and trade. Achieving this early detection goal\u2014to rapidly and effectively respond to emergencies\u2014requires dedicated human resources, close collaboration across states, partners and other stakeholders, transparent information-sharing and sustained funding.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"5th SA TB Conference 2018","field_subtitle":"12  15 June 2018 Durban, South Africa","URL":"http://www.tbconference.co.za","body":"Major advances in TB prevention and care have been made, especially in the six high burden countries (India, Indonesia, China, Nigeria, Pakistan and South Africa) yet an accelerated approach is needed to end TB, despite above 80% treatment success rates for drug sensitive TB, to ensure a more dramatic annual decline in TB incidence and prevention of TB deaths. Furthermore multidrug-resistant TB with an estimated 480 000 cases worldwide and a treatment success rate of just over 50% requires focussed interventions and an aggressive roll-out of available new drug regimens. South Africa has become the leader in the introduction of INH preventive therapy for people living with HIV for latent TB infection. Leadership is also required in other fields affecting progress, i.e. TB research, universal access to care and treatment, continued and energetic efforts for TB/HIV integration and TB financing. This conference brings together those looking to step up strategies and activities to end the TB epidemic.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"65th  East, Central and Southern Africa Health Community (ECSA-HC) Health Minister\u2019s Conference","field_subtitle":"19 - 21 March 2018, Dar Es Salaam, Tanzania ","URL":"http://ecsahc.org/news/1843/","body":"This conference will bring together Ministers of Health, senior officials from ministries of health, experts, health researchers, heads of health training institutions from member states of the ECSA Health Community; diverse collaborating partners in the region and beyond, with the aim of identifying policy issues and making recommendations for strengthening the region\u2019s responses to emerging and re-emerging health concerns, to improve health outcomes. The 65th ECSA Health Ministers Conference will be held under the theme: \u201cMulti-Sectoral Collaboration for Health towards Achievement of the SDGs\u201d. The Conference sub-thematic areas will include: Governance and Leadership Practices in the Health sector; Mitigating the Impact of emerging and re-emerging diseases; Multi-Sectoral responses to Non-communicable Diseases; and Accountability for Women\u2019s, Children\u2019s and Adolescent Health post-2015.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Alternative Mining Indaba 2018 ","field_subtitle":"Economic Justice Network et al.,: Alternative Mining Indaba, Cape Town, February 2018","URL":"http://altminingindaba.co.za/documents-of-interest/","body":"The Alternative Mining Indaba (AMI) started in 2010 with a small group of approximately 40 participants lead by Faith Based Organisations. It intended to create space for communities living in and around mines affected by and left out of key discussions of extractive industries in Africa. The theme for the 2018 AMI was: \u201cMaking Natural Resources Work for the People: Towards Just Legal, Policy and Institutional Reform\u201d. The Thematic issues for discussion included: human rights defenders; the curse of natural resource policies; gender and legal reforms; the independent problem solving mechanism;  policies and laws that facilitate the benefit sharing for local people and faith and the extractives sector.  The meeting gathered representatives of over 400 members of faith-based organisations, civil society organisations, community-based organisations, pan-African networks and organisations, labour movements, women movements, human rights activists, media, students from African countries and international partners on February 5 \u2013 7, 2018 in Cape Town. The AMI site provides presentations and proceedings from the indaba.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Antipode Foundation Scholar-Activist Project Awards","field_subtitle":"Deadline for Applications: 31 May 2018","URL":"https://antipodefoundation.org/scholar-activist-project-awards/","body":"The Antipode Foundation exists for the promotion and advancement of social scientific research, education and scholarship in the field of radical geography. Antipode Foundation Scholar-Activist Project Awards are intended to support collaborations between academics, non-academics and activists (from NGOs, think tanks, social movements, or community grassroots organisations, among other places) that further radical analyses of geographical issues and engender the development of a new and better society. They are aimed at promoting programmes of action-research, participation and engagement, cooperation and co-enquiry, and more publicly-focused forms of geographical investigation. The Antipode Foundation strives to fund work that leads to the exchange of ideas across and beyond the borders of the academy, and builds meaningful relationships and productive partnerships. Projects could take many forms including, but not limited to: collaborative research with artistic, community, cultural, grassroots, or social movement groups; the production of educational materials and other innovative pedagogical initiatives; and the promotion of links between universities and institutions/organisations outside the academy. Anyone can apply for an Antipode Foundation Scholar-Activist Project Award (including academics and students, and activists of all kinds), but the grant must be held and administered by a host institution (these could be research, higher education or community-based institutions).","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for policymakers to participate in the 5th Global Symposium on Health Systems Research ","field_subtitle":"Deadline for applications: 19th March 2018","URL":"https://tinyurl.com/y8b3e3wg","body":"Applicants are invited from policy-makers from low- and middle-income countries who are involved and interested in strengthening health systems, to participate in the 5th Global Symposium on Health Systems Research. Policy and decision-makers who are involved in policy and decision making at district, state, regional, provincial, federal or national level, with at least 3 years of senior management and policy-making experience in the health system or related sector are invited to apply. Candidates are also invited if they are confident of retaining such a position for the next three years with a demonstrated interest and commitment to evidence-informed decision-making, including the use of research, is from a low- or middle-income country. Women are especially encouraged to apply and will be given priority. Participants will be expected to share their experiences and contribute to mutual learning and understanding by participating in a daily de-briefing session of approximately 60 minutes to share Symposium experiences and engage with featured guests around the role of health systems research in decision- making. Participants will engage in symposium sessions with researchers and funders to share experiences and discuss the role of policy-making and research for strengthening health systems and addressing the Sustainable Development Goals. All applications will be considered by a selection committee comprised of representatives from the Alliance HPSR and Health Systems Global. The Alliance will cover airfare, accommodation, symposium registration fee, and costs for selected participants.  ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Can cash break the cycle of educational risks for young children in high HIV\u2013affected communities? A cross\u2013sectional study in South Africa and Malawi","field_subtitle":"Sherr L; Tomlinson M; Macedo A; et al.: Journal of Global Health 7(1), doi: 10.7189/jogh.07.010409, 2017","URL":"http://gh.bmj.com/content/2/4/e000570","body":"This study describes the impact of cash grants and parenting quality on 854 children aged 5\u201315  in South African and Malawi on educational outcomes including enrollment, regular attendance, correct class for age and school progress, controlling for cognitive performance. Consecutive attenders at randomly selected Community based organisations were recruited. The effects of cash plus good parenting, HIV status and gender were examined. Overall 73.1% received a grant \u2013 significantly less children with HIV (57.3% vs 75.6%). Controlling for cognitive ability, grant receipt was associated with higher odds of being in the correct grade, higher odds of attending school regularly, and much higher odds of having missed less than a week of school recently. Grant receipt was not associated with how well children performed in school compared to their classmates or with school enrollment. Grant receipt was associated with a significant reduction in educational risk for girls.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Child Gauge 2017: Investing in children for sustainable development - Survive. Thrive. Transform","field_subtitle":"Jamieson L; Berry L; Lake L: The Children's Institute,  South Africa, 2017","URL":"https://tinyurl.com/y9lawe2f","body":"The South African Child Gauge\u00ae is published annually by the Children\u2019s Institute, University of Cape Town, to monitor progress towards realising children\u2019s rights. This issue focuses on children and the Sustainable Development Goals (SDGs). Part one summarises and comments on policy and legislative developments that affect children. These include developments in international and South African law. Part two motivates for greater investment to ensure South Africa\u2019s children not only survive but thrive and reach their full potential, by focusing on the SDGs, ensuring that the 2030 Global Agenda promotes children\u2019s survival and development, identifying local priorities, promoting nurturing care, creating safe environments, improving child nutrition, getting reading right, creating inclusive and enabling environments and reflecting on progress and calling for action. Part three presents child-centred data 2002-2015 to monitor progress and track the realisation of children\u2019s socio-economic rights in South Africa. A set of key indicators tracks progress in demography, income poverty, unemployment and social grants, child health and access to education, housing and basic services.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia ","field_subtitle":"Wagenaar B; Hirschhorn L; Henley C; et al: BMC Health Services Research 17 (Suppl 3), doi:10.1186/s12913-017-2661-x, 2017 ","URL":"https://tinyurl.com/y7sfea9k","body":"This paper describes the similar and divergent approaches to increase data-driven quality of care improvements and implementation challenge and opportunities encountered in these three countries. Eight semi-structured in-depth interviews were administered to program staff working in each country. Project successes ranged from over 450 collaborative action-plans developed, implemented, and evaluated in Mozambique, to an increase from 80% of basic clinical protocols followed in intervention facilities in rural Zambia, and a shift from a lack of awareness of health data among health system staff to collaborative ownership of data and using data to drive change in Rwanda. Based on common successes across the country experiences, the authors recommend future data-driven quality improvement interventions begin with data quality assessments to promote that rapid health system improvement is possible, ensure confidence in available data, serve as the first step in data-driven targeted improvements, and improve staff data analysis and visualization skills. They pose that explicit Ministry of Health collaborative engagement can ensure performance review is collaborative and internally-driven rather than viewed as an external \u201caudit.\u201d","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Determinants of facility readiness for integration of family planning with HIV testing and counselling services: evidence from the Tanzania service provision assessment survey, 2014\u20132015 ","field_subtitle":"Bintabara D; Nakamura K; Seino K: BMC Health Services Research 17 (1) doi: 10.1186/s12913-017-2809-8 , 2017","URL":"https://tinyurl.com/yc692fcf","body":"This paper examines determinants of facility readiness for integration of family planning with HIV testing and counselling services in Tanzania using data from the 2014\u20132015 Tanzania Service Provision Assessment Survey. Facilities were considered ready for integration of family planning with HIV testing and counselling services if they scored \u2265 50% on both family planning and HIV testing and counselling service readiness indices as identified by the World Health Organization.  A total of 1188 health facilities were  included in the study. Of all of the health facilities, 915 reported offering both family planning and HIV testing and counselling services, while only 536 were considered ready to integrate these two services. Significant determinants of facility readiness for integrating these two services were being government owned; having routine management meetings, availability of guidelines, in-service training of staff, and availability of laboratories for HIV testing. The proportion of facility readiness for the integration of family planning with HIV testing and counselling in Tanzania was noted to be unsatisfactory. The authors argue that Ministry of Health should distribute and ensure constant availability of guidelines, availability of rapid diagnostic tests for HIV testing, and the provision of refresher training to health providers, as these were among the determinants of facility readiness.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Engage in World Health Day 7 April 2018","field_subtitle":"World Health Organization: WHO, Geneva, 2018","URL":"http://genderlinks.org.za/gender-links-community/","body":"In this 70th anniversary year, WHO is calling on world leaders to live up to pledges they made when they agreed to the Sustainable Development Goals in 2015, and commit to concrete steps to advance #HealthForAll. This means ensuring that everyone, everywhere can access essential quality health services without facing financial hardship. WHO invites everyone to play a part, stimulating conversations and contributing to structured dialogue towards policies that help your country achieve and maintain UHC. WHO also encourages governments to engage in structured conversations with a broad range of community stakeholders who are both affected by and essential to ensuring universal health coverage. Individuals, civil society and health workers are encouraged to communicate their needs, opinions and expectations to local policy-makers, politicians, ministers and other people representatives. The media is encouraged to highlight initiatives and interventions that help to improve access to quality services and financial protection for people and communities.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.\r\n","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 204: We have a right to demand better! Rights based activism in Africa as a determinant of health","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Factors associated with gender equality among church-going young men in Kinshasa, Democratic Republic of Congo: a cross-sectional study ","field_subtitle":"Lusey H; Sebastian M; Christianson M; et al: International Journal for Equity in Health 16(1), doi: 10.1186/s12939-017-0707-7, 2017","URL":"https://tinyurl.com/ybarg7r5","body":"This study assessed gender-equitable norms and their determinants among church-going young men in Kinshasa, the Democratic Republic of Congo. A cross-sectional study was carried out among 289 church-going young men, aged 18\u201324 years, residing in three disadvantaged communes of Kinshasa. The findings provide evidence of attitudes and beliefs that act as barriers to gender equality. For instance, the majority of church-going young men agreed that a man is the only decision maker in the home and about half of the respondents supported the statement \u201cThere are times a woman deserves to be beaten\u201d. Similarly, around half of the participants agreed with the idea of men\u2019s uncontrollable sex drive and men\u2019s toughness. Close to half of the participants agreed that it is women\u2019s responsibility to prevent pregnancy. These attitudes co-existed with a few gender-equitable norms as 82% agreed on the importance of joint decisions concerning family planning. An association between education, certain places of residence, being single or separated, and supportive attitudes towards gender equality was found. The study findings indicated that a high proportion of church-going young men do not endorse gender equitable norms. The authors argue that churches and schools urgently need comprehensive gender equality and masculinity policies and programmes to influence young men\u2019s attitudes and behaviours. ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Foresight Africa: Top priorities for the continent in 2018","field_subtitle":"Kagame P; Coulibaly B; Sign\u00e9 L; et al: Brookings, January 2018","URL":"https://tinyurl.com/yd69f4wo","body":"The Foresight Africa, African Growth Initiative invited scholars and experts to delve into six overarching themes that highlight areas in which African countries and their citizens are taking the lead to achieve inclusive growth. In a world where China and other emerging economies are ascendant, where cooperation on global governance is under challenge, and where free trade faces headwinds, Africa is argued to need its own institutions to play a more assertive role in advancing the continent\u2019s agenda. The report emphasizes that Africa\u2019s future lies in its own hands and that it already has the power to reach its goals. The authors describe, and argue for, new and innovative instruments to better mobilize and leverage resources for development financing. They authors explore and offer recommendations on policy interventions to broaden the benefits of future economic growth. Further chapters explore technological innovations and their potential to transform the continent. The final chapter explores a shifting global landscape of diplomacy \u2013 what will the impact of reduced engagement from the United States be? How do development, defence, and diplomacy best fit into foreign policies toward the continent?","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening","field_subtitle":"Barasa E; Cloete K; Gilson L: Health Policy and Planning 32(Suppl 3) ii91 \u2013 iii94, 2017","URL":"http://onlinelibrary.wiley.com/doi/10.1002/jia2.25028/abstract","body":"Recent health system shocks such as the Ebola disease outbreak have focused global health attention on the notion of resilient health systems. In this commentary, the authors reflect on the current framing of the concept of resilience in health systems discourse and propose a reframing. Specifically, the authors propose that: (1) in addition to sudden shocks, health systems face the ongoing strain of multiple factors. Health systems need the capacity to continue to deliver services of good quality and respond effectively to wider health challenges. The authors call this capacity everyday resilience; (2) health system resilience entails more than bouncing back from shock. In complex adaptive systems, resilience emerges from a combination of absorptive, adaptive and transformative strategies; (3) nurturing the resilience of health systems requires understanding health systems as comprising not only hardware elements (such as finances and infrastructure), but also software elements (such as leadership capacity, power relations, values and appropriate organizational culture). The authors also reflect on current criticisms of the concept of resilient health systems, such as that it assumes that systems are apolitical, ignoring actor agency, promoting inaction, and requiring that there is a need to accept and embrace vulnerability, rather than strive for stronger and more responsive systems. They observe that these criticisms are warranted to the extent that they refer to notions of resilience that are mismatched with the reality of health systems. ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Gender dynamics affecting maternal health and health care access and use in Uganda ","field_subtitle":"Morgan R; Tetui M; Kananura R; et al: Health Policy and Planning 32, Supp 5, v13-v21,  2017 ","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v13/4718137","body":"In an effort to examine ways to sustain the intervention beyond external financial resources, project implementers conducted a follow-up qualitative study to explore the root causes of women\u2019s lack of maternal health care access and utilization. This paper reports the key gender dynamics identified, detailing how gender power relations affect maternal health care access and utilization in relation to: access to resources; division of labour, including women\u2019s workload during and after pregnancy and lack of male involvement at health facilities; social norms, including perceptions of women\u2019s attitudes and behaviour during pregnancy, men\u2019s attitudes towards fatherhood, attitudes towards domestic violence, and health worker attitudes and behaviour; and decision-making. It concludes by discussing the need to integrate gender into maternal health care interventions if they are to address the root causes of these barriers to maternal health care.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Minding the gaps: health financing, universal health coverage and gender ","field_subtitle":"Witter S; Govender V; Ravindran S; et al: Health Policy and Planning 32(Suppl 5)ppv4\u2013v12, 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v4/4036321","body":"This article provides a reflection on the question of why there is a need to focus on gender, given that a well-functioning system moving towards Universal Health Coverage will automatically be equitable and gender balanced, from a panel of health financing and gender experts. The authors traced the evidence of how health-financing reforms have impacted gender and health access through a general literature review and a more detailed case-study of India. The authors found that unless explicit attention is paid to gender and its inter-sectionality with other social stratifications, through explicit protection and careful linking of benefits to needs of target populations, movement towards Universal Health Coverage can fail to achieve gender balance or improve equity, and may even exacerbate gender inequity. Political trade-offs are made on the road to Universal Health Coverage and the needs of less powerful groups, which can include women and children, are not necessarily given priority. The authors identified the need for closer collaboration between health economists and gender experts, and highlight a number of research gaps in this field which should be addressed. While some aspects of cost sharing and some analysis of expenditure on maternal and child health have been analysed from a gender perspective, there is a much richer set of research questions to be explored to guide policy making. Given the political nature of Universal Health Coverage decisions, political economy as well as technical research should be prioritized. The authors concluded that countries should adopt an equitable approach towards achieving Universal Health Coverage and, therefore, prioritize high-need groups and those requiring additional financial protection, in particular women and children.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Monitoring SO2 emission trends and residents\u2019 perceived health risks from PGM smelting at Selous Metallurgical Complex in Zimbabwe","field_subtitle":"Gwimbi P: International Journal for Equity in Health 16(1) doi:https://doi.org/10.1186/s12939-017-0696-6 , 2017 ","URL":"https://tinyurl.com/ycoaghuq","body":"This paper examined sulphur dioxide (SO2) emission trends, emission regulations and residents\u2019 perceived health risks from exposures to such emissions at Selous Metallurgical Complex platinum group metal smelting facility in Zimbabwe. SO2 data from roof monitoring sites at the smelter furnace were aggregated into annual, quarterly and monthly emission trends from 2008 to 2015. The regulatory regime\u2019s ability to protect human health from SO2 pollution in communities located around the smelter was examined. Questionnaire responses to perceived health risks from SO2 exposure from 40 purposively sampled residents were assessed.  Between 2008 and 2015, annual SO2emissions increased from 7951 to 2500 tonnes. Emissions exceeded the recommended standard limit of 50 mg/Nm3, presenting considerable adverse health risks to local residents. Concerns relating to inefficient environmental impact assessment licensing system, poor monitoring and auditing by the environmental management agency, as well as non-deterring SO2emission exceedance penalties were identified as major drivers of emission increase. Thirty-two of the forty respondents perceived exposure to SO2 emissions as adverse and the cause of their illnesses, with coughing, nasal congestion and shortness of breath the most frequently self-reported symptoms. A set of legally-binding SO2 emission standards supported by stringent environmental impact assessment licensing arrangements for smelting industries are suggested for development and enforcement to reduce the SO2 emission problem. Community participation in SO2 emissions monitoring was also proposed as a core part of sustainable environmental management in communities located around smelters.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"MRI, Senior Research Grants 2018","field_subtitle":"Deadline for applications: 15 April 2018","URL":"http://www.codesria.org/spip.php?article2831","body":"In 2017 CODESRIA introduced the Meaning-making Research Initiative (MRI) as a tool for supporting research that contributes to agendas for imagining, planning and creating African futures.  MRI aggressively pushes scholars to build on the close observation of African social realities. Projects funded under this initiative should propose research on important aspects of African social realities that fall under CODESRIA\u2019s priority themes as outlined in the CODESRIA Strategic Plan and be guided by clear questions that explore puzzling aspects of the social realities of Africa and its position in the world. Projects should be theoretically ambitious with a clear goal of providing new and innovative ways of understanding and making sense of African social realities and explore multiple spatial, temporal and sectoral settings where this contributes to the process of meaning-making. Interested applicants should submit a proposal, budget, annotated plan of deliverables, cover letter, CV of the scholar and an identification sheet. ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"New evidence of Africa\u2019s systematic looting, provided by an increasingly schizophrenic World Bank","field_subtitle":"Bond P: Pambazuka News, February 2018 ","URL":"https://tinyurl.com/y9ah5lk5","body":"A recent World Bank report, The Changing Wealth of Nations 2018, offers evidence of how much poorer Africa is becoming thanks to rampant minerals, oil and gas extraction. Yet  the author notes that World Bank policies and practices remain oriented to enforcing foreign loan repayments and transnational corporate profit repatriation. Central to its \u201cnatural capital accounting,\u201d the Bank uses an \u201cAdjusted Net Savings\u201d (ANS) measure for changes in economic, ecological and educational wealth. The Bank asks, \u201cHow does sub-Saharan Africa compare to other regions? Not favourably.\u201d The ANS decline for sub-Saharan Africa was worst from 2001-09 and 2013-15. The author observes that there are two ways to address transnational corporate (TNC) capture of African wealth: bottom-up through direct action blocking extraction, or top-down through reforms. He critiques the latter, such as in the African Union\u2019s 2009 Alternative Mining Vision (AMV) position that foreign resource investors with capital, skills and expertise are critical to development, which ignores these evident trends on the continent.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"One year on, Global Observatory on Health R&D identifies striking gaps and inequalities","field_subtitle":"World Health Organisation: WHO, Geneva, 2018","URL":"https://tinyurl.com/ycb6zorl","body":"Each year, hundreds of billions of dollars are spent on research and development (R&D) into new or improved health products and processes, ranging from medicines to vaccines to diagnostics. But the way these funds are distributed and spent is often poorly aligned with global public health needs. in 2017, the World Health Organization launched an initiative to gather information and provide an accurate picture of where and how R&D monies are being spent. The Global Observatory on Health R&D has identified striking gaps and inequalities in investment both between countries and between health issues, with frequent disconnects between burden of disease and level of research activity. High income countries have an average of 40 times more health researchers than low income countries. Serious imbalances in funding flows mean countries with comparable levels of poverty and health needs receive strikingly different levels of Official development assistance (ODA) for medical research and basic health sectors (health ODA). As little as 1% of all funding for health R&D is allocated to diseases such as malaria and tuberculosis, despite these diseases accounting for more than 12.5% of the global burden of disease. Investing in R&D to discover and develop medicines and vaccines is argued to be key to improving access to medicines and quality health care for people across the world and to achieving universal health coverage.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"People\u2019s everyday practices, not the elites of Davos, hold the human economy answer to inequality","field_subtitle":"Wegerif M: Pambazuka News, February 2018 ","URL":"https://tinyurl.com/y9ah5lk5","body":"The author comments that Oxfam has been successful in highlighting the gross and rapidly growing inequalities in the world in international fora, but critiques the approach of asking rich elites and their allies in governments to do the right thing as perpetuating the myth that there are no alternatives other than to depend on large corporations. The author argues that it is in people\u2019s everyday practices that it is far more likely to find meaningful solutions to inequality and the seeds of a more human economy. He raises, for example, the issue of redistribution of assets, such as to address land inequality, as a more pertinent  pathway for peoples practices to address societal inequality and challenge the structural power of the drovers of inequality.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Psychosocial support for adolescent girls in post-conflict settings: beyond a health systems approach ","field_subtitle":"Samuels F; Jones N;  Hamad B: Health Policy and Planning 32(Suppl 5) v40\u2013v51 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v40/4718142","body":"This paper focuses on the importance of psychosocial support services for adolescent girls in fragile contexts. Its starting point is that adolescence is a pivotal time in the life course but given the physical, cognitive and emotional changes triggered by the onset of puberty, it can also be a period of heightened sensitivity and vulnerability to trauma, social isolation, bullying by peers, a lack of supportive adults and gender-based and sexual violence. The authors\u2019 findings highlighted why humanitarian and biomedical approaches in their current form are inadequate to address these complexities. Drawing on qualitative fieldwork, the authors argued that going beyond biomedical approaches and considering the social determinants of health, including approaches to tackle discriminatory gendered norms and barriers to service access, are critical for achieving broader health and wellbeing. While all three case study countries are classified as post-conflict, the political economy dynamics vary with associated implications for experiences of psychosocial vulnerabilities and the service environment. The study concludes by reflecting on actions to address psychosocial vulnerabilities facing adolescent girls through tailoring services to ensure gender and age-sensitivity, investing in capacity building of service providers to promote service uptake and enhancing strategies to regulate and coordinate actors providing mental health and psychosocial support services.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Research capacity building integrated into PHIT projects: leveraging research and research funding to build national capacity ","field_subtitle":"Hedt-Gauthier B L; Chilengi R; Jackson E; et al,: BMC Health Services Research 17 (Suppl 3) doi: 10.1186/s12913-017-2657-6, 2017 ","URL":"https://tinyurl.com/ybzn8kym","body":"This paper analyses the implementation of health systems strengthening initiatives inclusive of research capacity building. During Population Health Implementation and Training, specific research capacity building activities varied across countries. However, all five countries used African Health Initiative funding to improve research administrative support and infrastructure, implement research training and support mentorship activities and research dissemination. Funders were recommended to provide adequate and flexible funding for research capacity building activities and for institutions to offer a spectrum of research capacity building activities to enable continued growth, provide adequate mentorship for trainees and systematically monitor research capacity building activities.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Resource curse or fair benefit?","field_subtitle":"Loewenson R, EQUINET: Alternative Mining Indaba, Cape Town, February 2018","URL":"https://tinyurl.com/ybetyhno","body":"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.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"SATUCC Holds Its 10th Delegates Congress in Dar-es-salaam","field_subtitle":"SATUCC: SATUCC Blog, Botswana, December 2017","URL":"https://tinyurl.com/y9gwufpo","body":"SATUCC held a successful 10th Delegates\u2019 Congress in Dar-es-salaam Tanzania under the theme: Defending and promoting democracy, human and trade union rights and decent work for all in SADC Region. The Congress debated and adopted policies on corruption, procurement and ethical guidelines, and on the marginalisation of women and youth in the SADC Region and their exclusion in decision making structures, both within trade unions and in national and regional development processes. ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Social health insurance contributes to universal coverage in South Africa, but generates inequities: survey among members of a government employee insurance scheme","field_subtitle":"Goudge J; Olufunke A; Govender V; et al: International Journal for Equity in Health 17(1), doi: https://doi.org/10.1186/s12939-017-0710-z, 2018","URL":"https://tinyurl.com/y7xdmea5","body":"The South African government introduced a voluntary health insurance scheme (GEMS) for government employees in 2005 with the aim of improving access to care and extending health coverage. In this paper, the authors ask whether the scheme has assisted in efforts to move towards UHC. Using a cross-sectional survey across four of South Africa\u2019s nine provinces, the authors interviewed 1329 government employees, from the education and health sectors. Data were collected on socio-demographics, insurance coverage, health status and utilisation of health care.  A quarter of respondents remained uninsured, even higher among 20\u201329 year olds (46%) and lower-skilled employees (58%). The scheme generated inequities in utilisation among its members due to its differential benefit packages, with, for example, those with the most benefits having one outpatient visits/month compared to 0.6/month with lowest benefits. By introducing the scheme, the government chose to prioritise access to private sector care for government employees, over improving the availability and quality of public sector services available to all. Government has recently regained its focus on achieving UHC through the public system, but is unlikely to discontinue GEMS, which is now firmly established. The authors observe that the inequities generated by the scheme have been institutionalised within the country\u2019s financing system, and warrant attention. Raising scheme uptake and reducing differentials between benefit packages will ameliorate inequities within civil servants, but not across the country as a whole.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Socioeconomic differential in self-assessment of health and happiness in 5 African countries: Finding from World Value Survey","field_subtitle":"Adesanya A; Rojas B; Darboe A; et al.,: PLOS One 12(11) doi: https://doi.org/10.1371/ journal.pone.0188281, 2017","URL":"https://tinyurl.com/ya649yst","body":"This study compared socioeconomic differentials in self-rated health and happiness in five sub-Saharan countries. Using the 2010/2014 World Values Survey, the authors obtained a sample of 9,869 participants of age 16 and above from five sub-Saharan countries. Socioeconomic inequalities were quantified using the concentration index. Poor self-rated health ranges from approximately 9% in Nigeria to 20% in Zimbabwe, whereas unhappiness was lower in Rwanda and higher in South Africa. Poor self-rated health and unhappiness were excessively concentrated among the poorest socioeconomic strata. Although magnitudes differ across countries, however, the major contributor to wealth-related inequality in poor self-rated health is satisfaction with financial situation whereas for unhappiness the major contributors are level of income and satisfaction with financial situation. This study underscores an association between wealth related inequalities and poor self-rated health and unhappiness in the context of sub-Saharan countries. Improving equity in health may be useful in fighting against the unfair distribution of resources. The authors suggest that knowledge about the self-rating of health and happiness can serve as proxy estimates for understanding the distribution of health care access and economic resources for well-being.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The gendered health workforce: mixed methods analysis from four fragile and post-conflict contexts ","field_subtitle":"Witter S;  Namakula J;  Wurie H; et al.: Health Policy and Planning 32(Suppl 5) v52\u2013v62 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v52/4718141","body":"The authors examine the experiences of health workers through a gender lens, especially in fragile and post-conflict states. In these contexts, there may not only be opportunities to (re)shape occupational norms and responsibilities in the light of challenges in the health workforce, but also threats that put pressure on resources and undermine gender balance, diversity and gender responsive human resources for health (HRH). The authors used a mixed method for research in Sierra Leone, Zimbabwe, northern Uganda and Cambodia to understand how gender influences the health workforce. They applied a gender analysis framework to explore access to resources, occupations, values, and decision-making and draw largely on life histories with male and female health workers to explore their lived experiences, complemented by surveys, document reviews, key informant interviews, human resource data and stakeholder mapping. The findings shed light on patterns of employment: in all contexts women predominate in nursing and midwifery cadres, are under-represented in management positions and are clustered in lower paying positions. Gendered power relations shaped by caring responsibilities at the household level affect attitudes to rural deployment and women in all contexts face challenges in accessing both pre- and in-service training. Coping strategies within conflict emerged as a key theme, with experiences shaped by gender, poverty and household structure. Most health worker regulatory frameworks did not sufficiently address gender concerns. The authors argue that unless these are proactively addressed post-crisis, health workforces will remain too few, poorly distributed and unable to meet the health needs of vulnerable populations. Practical steps need to be taken to identify gender barriers proactively and engage staff and communities on best approaches for change.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The role of an essential health benefit in the delivery of integrated health services: Learning from practice in East and Southern Africa, Report of a regional research workshop, November 27-28 2017, Zanzibar, United Republic of Tanzania.","field_subtitle":"EQUINET; Ifakara Health Institute; Training and Research Support Centre","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Regional%20EHB%20Mtg%20Rep%20Nov2017.pdf","body":"An Essential Health Benefit (EHB) is a policy intervention designed to direct resources to priority areas of health service delivery to reduce disease burdens and ensure equity in health. Many east and southern Africa (ESA) countries have introduced or updated EHB in the 2000s. Recognising this, the Regional Network for Equity in Health in East and Southern Africa (EQUINET), through Ifakara Health Institute (IHI) and Training and Research Support Centre (TARSC), with country partners from Ministries of Health (MoH) in Swaziland, Tanzania, Uganda and Zambia, implemented research to understand the facilitators and the barriers in nationwide application of the EHB in resourcing, organising and in accountability on integrated, equitable universal health services. A regional review of literature on EHBs in the four country case study reports from the research programme are available on the EQUINET website. This report presents the proceedings of a regional consultative meeting convened on November 27-28, 2017 to present and discuss evidence from the research programme. The regional document review covering 16 east and southern African (ESA) countries, the findings from the country case studies in Swaziland, Tanzania, Uganda and Zambia, experiences from South Africa and Zanzibar and a regional synthesis of the evidence from across the programme were presented at the meeting, and background documents made available. The meeting aimed to: a. Identify issues arising in the motivations for developing the EHB; the methods used to develop, define and cost them; their dissemination, communication and use within countries, including in budgeting, resourcing and purchasing health services; and, in monitoring health system performance for accountability; b. Identify policy-relevant and operational national and regional level recommendations on the role, design and use of EHB; and c. Propose areas for follow up policy, action and research.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Training materials for Health centre committees \u2013 building community participation in health systems","field_subtitle":"Health Rights learning network; UCT, Cape Town, 2018","URL":"https://tinyurl.com/y8cl8f3k","body":"Health Centre Committees are potentially critical vehicles for community voice in health systems. They play not only a service and mobilisation role, but can be effective tools to improve the responsiveness and accountability of services \u2013 and thus have an important governance role to play. UCT\u2019s Health and Human Rights programme in the School of Public Health and Family Medicine has been working with Zimbabwean and Zambian partners in EQUINET, on a project under the leadership of the Community Working Group on Health (CWGH) to strengthen Health Centre Committees (HCC\u2019s) as vehicles for social participation in health systems in East and Southern Africa (ESA). UCT has led work to review and assemble capacity building materials for Health Committee training. . They found HCC training materials and processes in a number of countries, including Ethiopia, Kenya, South Africa, Tanzania, Uganda, Zimbabwe and Zambia. The training commonly covered introductions to the health system, its governance, planning and budget processes and HCC roles. It included information on HCCs functions such as problem solving, monitoring and accountability and social mobilization. There were gaps in some areas, such as on conflict management, fundraising, inter-sectoral work and deeper analysis of the causes of social inequalities in ill health and how to address them.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Universal health coverage law approved in Egypt","field_subtitle":"Devi S: The Lancet 391(10117), doi: https://doi.org/10.1016/S0140-6736(18)30091-6, 2018","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)30091-6.pdf","body":"A new universal health coverage law received parliamentary approval in mid-December in Europe after years of discussion and planning. Health care will be provided for everyone including the estimated 30% of Egyptians who cannot afford to pay at present. Enrolment in the scheme will be obligatory, with fees set according to income with additional sources of funding to include taxes on tobacco and polluting industries including cement. Egypt's population is forecast by the UN Population Fund to reach 119 million in 2030. UNICEF says about three in every ten children suffer from multidimensional poverty, which includes factors such as poor health and lack of education. Tedros Adhanom, director-general of WHO, praised the law for including people with major catastrophic conditions such as cancer. The scheme will be mandatory, with those on low incomes to be covered by the state; with split roles for health-care providers and those bodies to oversee quality and accreditation; and patients would be allowed to choose their own doctor and hospital. However, he raised worries about the level of co-payments that patients might have to make and the long period of implementation that might lead to worsening health disparities.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"We have a right to demand better! Rights based activism in Africa as a determinant of health","field_subtitle":"Kristi Heather Kenyon, Global College, University of Winnipeg, Canada","body":"\r\nHIV represents an unprecedented pandemic, and one that is forcing civil society to innovate to meet the challenges. Civil society engaging on HIV has carried out one of the most vocal, widespread and innovative advocacy campaigns in health, drawing on language and approaches from other sectors and regions. HIV activists have in the process brought   human rights into health advocacy, even in settings where rights are perceived to be foreign and confrontational. Why do civil society advocacy groups working on HIV choose to express their claims in the language of human rights? How do they understand this choice? What impact do they see it having? What impact does it have?\r\n\r\nI explored these questions in sub-Saharan Africa, a region hard hit by the pandemic.\r\n\r\nThe answers might surprise: the decision to use rights was fueled by individual belief not pressure from external funders.  It was also the individual empowerment effects of \u2018rights-talk\u2019, rather than their legal effect, that activists felt to be most important.\r\n\r\nI explored the experience of nine local civil society organizations selected from four countries (Ghana, Uganda, South Africa, Botswana), located respectively in three sub-regions of sub-Saharan Africa (West , East and Southern Africa). Choosing from the three regions provided insight into civil societies operating in different contexts and at different levels - local, national, regional. To allow for a systematic comparison, I chose organizations that vary in the extent to which they use human rights in advocacy. The case studies drew on 145 semi-structured interviews conducted with these organizations, as well as with others in the HIV sector. I also reviewed relevant events, documents and press accounts.\r\n\r\nOver the past twenty years many funders have embraced the human rights framework. While I am not suggesting that international funders are not important, I found that their preferences were not particularly influential in whether organizations used rights-based advocacy.  Groups using this framework didn\u2019t lose interest when it became less popular with external funders, nor did their interest rise or fall with changes in funding. Many of the civil society groups have at least a dozen funders who usually support particular projects rather than the organization as a whole. Because organizations have so many funders, any single funder rarely influences the framework an organization chooses for its advocacy.\r\n\r\nThe organizations instead chose human rights primarily due to a mix of principles and structural factors. Organizations with a leader with a strong human rights orientation and regular interaction with other employees were more likely to choose a rights-based approach. In settings where human rights are not a common discourse, groups manage to thrive- even in isolation - when they had powerful \u201crights champions\u201d as leaders. Such leaders have been able to incubate a rights-oriented organizational culture, attracting personnel who have, or will acquire a similar orientation.\r\n\r\nPeople who worked for organizations that gave strong attention to human rights in advocacy often held strong personal belief in the framework. Respondents often explained this passionately, describing human rights as core to their dignity and identity. Rather than being a topic or a strategy, human rights were described as a fundamental part of who they were, what they believed in and how they saw the world. \r\n\r\nI expected that groups would choose human rights over other approaches because they are linked to legal enforcement, in ways that development work or public health may not be. I thought perhaps the choice to use human rights in advocacy was rooted in an expectation of a government response and legal accountability. Instead, respondents saw the most important impact of human rights as their empowering effect for individuals, particularly amongst those seeking health care. They saw rights as empowering people living with HIV to demand services owed to them, and to make requests from a position of power and entitlement, rather than one of weakness and desperation.\r\n\r\nOne respondent described the shift in mindset that she saw accompanying rights-based advocacy, as \u201ccreating in people\u2019s minds\u201d the idea that they \u201chave the right to demand better.\u201d Respondents gave accounts of these demands: \u201cWhen you say, \u2018It\u2019s my constitutional right, doctor. I am not going to leave this room without having treatment,\u2019 therefore the doctor will make sure that you get the treatment [\u2026] They don\u2019t make a mistake.\u201d\r\n\r\nWhile the above quotation is from South Africa, where health rights are included in the Constitution, even in settings without such constitutional provisions respondents gave very similar accounts. They saw rights language as transforming people from passive recipients of care to active participants engaged in their own health, and as engaged citizens rightfully demanding services from the state.  \r\n\r\nThe findings indicated that \u201chuman rights\u201d may yield important effects in places that human rights scholars seldom look. Beyond state actions and high-profile venues such as the United Nations and national courts, people are wielding human rights in their day-to-day interactions in ways that have meaningful influence on their lives. It appears that human rights-based advocacy has a unique impact. It changes people\u2019s self- perceptions of power in relation to the state and enables them to claim services to which they are entitled from a position of greater strength. Those exposed to human rights-based advocacy were reportedly more likely to seek health care services, to be more informed about their rights, to ask questions of health care providers, and to query delays or denials of service.\r\n\r\nIt would be interesting to see what these findings imply for other areas of public health. They suggest that human rights-based activism could be an overlooked, but powerful positive determinant of health. \r\n\r\nA version of this oped was originally published in Open Global Rights: www.openglobalrights.org/empowering-language-of-rights-underlies-increasing-use-in-hiv-advocacy/.  Further information can be found in \u2018Resilience and Contagion: Invoking Human Rights in African HIV Advocacy\u2019, McGill-Queens University Press, at  www.mqup.ca/resilience-and-contagion-products-9780773550995.php?page_id=119256& ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Who benefits from increased service utilisation? Examining the distributional effects of payment for performance in Tanzania","field_subtitle":"Binyaruka P; Robberstad B; Torsvik G; et al: International Journal for Equity in Health 17(14), doi: https://doi.org/10.1186/s12939-018-0728-x, 2018","URL":"https://tinyurl.com/y9cakt8v","body":"The authors examined pay for performance (P4P) effects on service utilisation across different population subgroups in Tanzania. About 3000 households were surveyed of women who delivered in the last 12 months prior to the interview from seven intervention and four comparison districts in January 2012 and a similar number of households in 13 months later. The household data were used to generate the population subgroups and to measure the incentivised service utilisation outcomes, with a focus on the institutional delivery rate and the uptake of antimalarials for pregnant women. P4P led to a significant increase in the rate of institutional deliveries among women in poorest and in middle wealth status households, but not among women in least poor households. The differential effect was marginally greater among women in the middle wealth households compared to women in the least poor households. The effect of P4P on institutional deliveries was also significantly higher among women in rural districts compared to women in urban districts, and among uninsured women than insured women. The effect of P4P on the uptake of antimalarials was equally distributed across population subgroups. The authors suggest that P4P can enhance equitable healthcare access and use especially when the demand-side barriers to access care such as user fees associated with drug purchase due to stock-outs have been reduced.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"WHO Independent Global High-level Commission on NCDs","field_subtitle":"World Health Organization: WHO, Geneva, February 2018 ","URL":"http://www.who.int/ncds/governance/high-level-commission/en/","body":"The first-ever WHO Independent Global High-level Commission on Noncommunicable Diseases (NCDs) aims to identify and propose bold and practical ways to curb the world\u2019s leading causes of death and illness. The Commission was announced in 2017 by Dr Tedros Adhanom Ghebreyesus, Director-General WHO. The Commissioners will recommend actions to accelerate progress in tackling NCDs, primarily cardiovascular disease, cancers, diabetes and respiratory disease, and promoting mental health and well-being. NCDs kill 15 million people between the ages of 30 and 69 each year. Low- and lower-middle income countries are particularly affected by NCDs with almost 50% of premature deaths from NCDs occurring in these countries. In addition, NCDs are responsible for the deaths of 7 in 10 people across all ages globally, equivalent to approximately 40 million people. In 2015, world leaders committed to reduce premature deaths from NCDs by one third by 2030 as part of the Sustainable Development Goals. Recent WHO reports indicate that the world will struggle to meet that target.","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Wiki Gap Harare ","field_subtitle":"Wiki Gap Harare Nomination Form, 2018","URL":"https://tinyurl.com/ya4lh6m7","body":"Wikipedia is the world\u2019s largest online and user-generated encyclopaedia, and its content has the potential to colour a global view of the world. But women are under-represented there, like in many other parts of society. Sweden is the first country in the world with a feminist foreign policy. The #Wikigap initiative and event is about realising this policy in both word and deed. #WikiGap gathers people around the world to add more content to Wikipedia about women figures, experts, role models and profiles in various fields. Now it is the turn for Zimbabwe. This initiative invites people to help close the internet gender gap by getting more Zimbabwean women featured on Wikipedia. It invites you to nominate a Zimbabwean woman - past and present- who should have a feature/article on Wikipedia. ","php":"","field_issue_date":"2018-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"A comparable yardstick: adjusting for education bias in South African health system responsiveness ratings","field_subtitle":"Rossouw L; Smith A: Health Policy and Planning 32(Suppl3) iii67\u2013iii74, 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_3/iii67/4621471","body":"Health-system responsiveness (HSR) measures the experience of health-system users in terms of the non-clinical aspects of the health system. The authors explore the association between education levels and reporting behaviour in terms of HSR in South Africa using data from the World Health Organization Study on Global Ageing and Adult Health for South Africa (WHO SAGE) conducted in 2007 and 2008. The authors consider the reporting behaviour of 1499 adults aged 50 and older in terms of the reported HSR for their most recent outpatient provider visit during the preceding 12\u2009months. More specifically, they explore whether there are systematic biases in reporting behaviour by education levels and other socio-economic covariates through the use of data from anchoring vignettes. Large differences were found in HSR ratings between the lowest and highest education groups after adjusting for reporting bias using the anchoring vignettes. This finding holds across all seven HSR domains captured in the WHO SAGE dataset. In the most extreme case, individuals with no education are likely to underreport poor HSR by between 2.6 and 9.4% percentage points compared with individuals with secondary schooling or higher. It is proposed that policy-makers take cognizance of potential reporting biases in HSR ratings and make the necessary adjustments to obtain data that are as true and accurate as possible. The need for this is seen to be especially acute in a country such as South Africa with large socio-economic inequalities and disparities in access to healthcare.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Are we making progress in universal access to health workers? Reflections on the global health worker movement","field_subtitle":"Dr Francis Omaswa, ACHEST, Uganda","body":"\r\nThe 4th Global forum on Human Resources for Health (HRH) that took place in Dublin, Ireland in November 2017 provided a useful opportunity to reflect on how far we have progressed in the global movement on human resources for health.  The achievement of Sustainable Development Goal (SDG) 3, including Universal Health Coverage will not be possible without universal access to skilled health workers. A global health workforce movement is thus critical to  ensure this and that access to essential health services is not left to market forces alone, leaving many unable to access basic health services.\r\n\r\nI coordinated the convening of the first Global HRH Forum in Kampala in 2008 as the Executive Director of the Global Health Workforce Alliance at the time and have attended all the subsequent forums in Thailand and Brazil. I was thrilled to witness in Dublin how the HRH movement remains alive and vibrant ten years after the first forum. It was attended by over 1000 delegates from over 70 countries representing government leaders,  civil society, academia,  employers, foundations, health care professional associations and unions, youth and the private sector. \r\n\r\nBeyond the numbers, it was the outcomes of the Dublin Forum that represent potential advances in the health worker movement, globally, and in Africa.\r\n\r\nI saw a renewal and rejuvenation of the global HRH movement, with many new champions committed to act on the Dublin call to provide a skilled, supported and motivated health worker for every person in every village everywhere, and the 2008 Kampala Forum call for \u201cHealth Workers for All and All for Health Workers.\u201d   A Global Health Workforce Network (GHWN) hosted in World Health Organization, Geneva now brings together a range of stakeholders in the movement to organise activities around these commitments, with hubs around various fields such as education and training, leadership and governance, labour markets and civil society. A new civil society coalition on HRH was launched in Dublin to drive advocacy and accountability.\r\n\r\nThere was strong participation of Africans from all parts of Africa at the Dublin Forum. The African Platform on HRH held a side event, adopted a business plan and elected a new governing board that was empowered to update the Constitution, to support the visibility of the movement in Africa and to convene the 6th Forum of the African HRH Platform.\r\n\r\nWe were informed that implementation had been initiated of the recommendations and five year action plan of the UN Secretary General\u2019s High Level Commission of Health Employment and Economic Growth. This commission demonstrated that employment in health and the health sector itself should not be seen as a cost but as a significant contributor to economic growth and employment, especially of women. The economies of high income countries all enjoy significant contributions from the health sector.\r\n\r\nA new international fund named \u201cWorking for Health Multi-Partner Trust Fund (MPTF)\u201d  was launched during the 2017 Dublin forum  as a collaboration between the International Labour Organization, the Organization for Economic Co-operation and Development and the World Health Organization to support countries expand and transform their health workforce. The Government of Norway has made the first contribution and urged others to invest. The fund should enable development partners to pool contributions for use by \u2018pathfinder\u2019 countries to apply innovative approaches to building a \u2018fit-for-purpose\u2019 health workforce, especially those countries that are struggling to provide access to health care and facing the threat of emerging epidemics. \r\n\r\nThe Dublin Forum also saw the launch of the International Platform on Health Worker Mobility. This platform seeks to maximize mutual benefits and mitigate adverse effects from the increasing rate and complexity of the movement of health workers. It will strengthen evidence, analysis, knowledge exchange and policy action on health worker migration, including to support implementation of the WHO Global Code of Practice on International Recruitment of Health Personnel. The forum also made commitments to improving the safety and security of health workers by upholding international humanitarian law. It strongly condemned violence, attacks and threats directed against health personnel and facilities, given their long term consequences for health workers, for the civilian population and for the healthcare systems of the countries concerned and their neighbours. \r\n\r\nA special feature not seen in previous forums was the Youth Forum in Dublin that set its own \u2018call for action\u2019. Attracting and retaining young health workers is critical if we are to avert the shortfall of 18 million health workers, and transform the health and social workforce. \r\n\r\nIt was significant that the 2017 forum took place during a doctors\u2019 strike in my own country, Uganda, and a similar nurses\u2019 strike in Kenya.  One of the most powerful take-away reflections for me was that while several speakers from high income countries reported how money is chasing and seeking to attract scarce health workers, in most of our African countries, it is health workers who are underfunded and chasing money. Unless we act to address the imbalance in the demand for health workers between high and low income countries, African countries will continue to be drained of health workers going to high income countries, even while African people continue to suffer the shortages of skilled health workers that undermine their access to health care and delivery on SDG3.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  More information on the Dublin Forum can be found at http://hrhforum2017.ie/ ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Assessing the health workforce implications of health policy and programming: how a review of grey literature informed the development of a new impact assessment tool","field_subtitle":"Nove A; Cometto G; Campbell J: Human Resources for Health 15(79), doi: https://doi.org/10.1186/s12960-017-0252-x, 2017","URL":"https://tinyurl.com/y7863ecl","body":"In their adoption of WHA resolution 69.19, World Health Organization Member States requested all bilateral and multilateral initiatives to conduct impact assessments of their human resources for health funding. No standard tools exist for assessing the impact of global health initiatives on the health workforce, but tools exist from other fields. This paper describes how a review of grey literature informed the development of a draft health workforce impact assessment tool and how to introduce the tool. A search of grey literature yielded 72 examples of impact assessment tools and guidance from a wide variety of fields including gender, health and human rights. These examples were reviewed, and information relevant to the development of a health workforce impact assessment was extracted from them using an inductive process. A number of good practice principles were identified from the review. These informed the development of a draft health workforce impact assessment tool, based on an established health labour market framework. The tool consists of a relatively short and focused screening module to be applied to all relevant initiatives, followed by a more in-depth assessment to be applied only to initiatives for which the screening module indicates that significant implications for HRH are anticipated. It thus aims to strike a balance between maximizing rigour and minimising administrative burden. The authors propose that the new tool will help to ensure that health workforce implications are incorporated into global health decision-making processes from the outset and to enhance positive human resources for health impacts and avoid, minimise or offset negative impacts.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Call for Emerging Voices for Global Health 2018 (EV4GH 2018)","field_subtitle":"Deadline for submission: 5 March 2018","URL":"https://tinyurl.com/yahv6kxj","body":"Emerging Voices for Global Health (EV4GH) is an innovative multi-partner training program for young, promising and emerging health policy & systems researchers, decision makers and other health system actors with an interest to become influential global health voices and/or local change makers. EV4GH coaches \u201cEmerging Voices\u201d to participate actively in international conferences where global health issues are addressed and to raise their voice in scientific and policy debates. The EV4GH programme is managed by an internationally representative governance committee consisting of EV alumni elected by previous EV4GH participants and a few invited members from academia. There are two tracks for which participants can apply to be an EV 2018. While one track is reserved for researchers involved in health policy and systems research, the other track seeks to attract health professionals, activists, decision or policy-makers and/or other health systems actors.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Children Count","field_subtitle":"Children\u2019s Institute, University of Cape Town, 2017","URL":"http://www.childrencount.uct.ac.za","body":"The Children Count website hosts information about children in South Africa: their living conditions, care arrangements, health status, and access to schools and other services. These child-centred statistics are based on the best available national data. The website includes downloadable fact sheets on 40 indicators, as well as an interactive tool that enables you to view tables and graphs for different years and provinces. Children Count / Abantwana Bablulekile is an ongoing data and advocacy project of the Children\u2019s Institute. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Citizen Voices, Community Solutions: Designing Better Transparency and Accountability Approaches to Improve Health","field_subtitle":"Transparency for Development: Harvard Kennedy School, USA, 2017","URL":"https://tinyurl.com/y7nu5saw","body":"This study was designed to address the question of whether a community-led transparency and accountability program can improve health outcomes and community empowerment, and, if so, how and in what contexts. To answer this question, researchers and civil society organization partners co-designed a program that would activate community participation in improving maternal and newborn health outcomes. This report presents the design of the work that was implemented in 200 villages in Tanzania and Indonesia and studied using a mixed methods impact evaluation. The team faced challenges including how to best foster community participation, how to structure the information gathering and sharing component, how to facilitate social action in communities, and how to ensure communities review their successes and failures in implementing social actions.  \r\n","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"CODESRIA 2017 Gender Institute: Feminist Scholarship, Universities and Social Transformation in Africa","field_subtitle":"Deadline for Applications: 15 March 2018","URL":"http://www.codesria.org/spip.php?article2823&lang=en","body":"CODESRIA invites applications from academics and researchers from African universities and research centres to participate in the 2017 session of the Gender Institute, in Dakar, Senegal May 14-25, 2018. The 2017 session of the institute seeks to provide an opportunity for participants to reflect on gains made and persisting challenges, especially in respect of the ways in which the engagements have made universities in Africa better institutions to spearhead social transformation. Candidates submitting proposals for consideration should be PhD students or early career academics in the social sciences and humanities and those working in the broad field of gender and women studies. Scholars outside universities but actively engaged in the area of policy process and/or social movements and civil society organizations are also encouraged to apply. Twenty places are available.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Decision space for health workforce management in decentralized settings: a case study in Uganda ","field_subtitle":"Alonso-Garbayo A; Raven J; Theobald S: Health Policy and Planning 32(Suppl 3) iii59\u2013iii66, 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_3/iii59/4621480","body":"This paper aimed to improve understanding about how district health managers perceive and use their decision space for human resource management (HRM) and how this compares with national policies and regulatory frameworks governing HRM. To assess the decision space that managers have in six areas of HRM (e.g. policy, planning, remuneration and incentives, performance management, education and information) the study compares the roles allocated by Uganda\u2019s policy and regulatory frameworks with the actual room for decision-making that district health managers perceive that they have. Results show that in some areas District Health Management Team (DHMT) members make decisions beyond their conferred authority while in others they do not use all the space allocated by policy. DHMT members operate close to the boundaries defined by public policy in planning, remuneration and incentives, policy and performance management. However, they make decisions beyond their conferred authority in the area of information and do not use all the space allocated by policy in the area of education. DHMTs\u2019 decision-making capacity to manage their workforce is influenced by their own perceived authority and sometimes it is constrained by decisions made at higher levels. The authors conclude that decentralization, to improve workforce performance, needs to devolve power further down from district authorities onto district health managers. DHMTs need not only more power and authority to make decisions about their workforce but also more control over resources to be able to implement these decisions.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Director: Comprehensive HIV & AIDS Care Management and Treatment","field_subtitle":"Deadline for Applications: 19 February 2018","URL":"https://tinyurl.com/ybfjvnw4","body":"Applications are open for the above post in South Africa to manage the coordination of programme activities related to the implementation of the Comprehensive Care Management and Treatment plan and National Strategic Plan 2017-2022 for persons living with HIV and AIDS. Oversee the implementation of the Comprehensive HIV, TB, and Branch clinical guidelines and reviews thereof. The candidate will oversee the capacity building of clinicians (basic and advanced), quality improvement implementation for HIV plans. The candidate will liaise with all stakeholders such as NHLS, District Support Partners, MRC, Universities for guideline reviews. The post-holder will be expected to develop effective mechanisms to monitor progress of programme implementation and regular reviews of programme performance, writing reports as per statutory requirements.  ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"\r\nContact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 203: Are we making progress in universal access to health workers? Reflections on the global health worker movement","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Header"}},{"node":{"title":"Free maternity services in Kenya: How can the policy be improved going forward?","field_subtitle":"RESYST, London School of Hygiene & Tropical Medicine, 2017","URL":"http://onlinelibrary.wiley.com/doi/10.1002/jia2.25028/abstract","body":"In order to increase access to and use of maternal health services, in June 2013, the President of Kenya announced a policy offering free care for all women giving birth in a public health facility. This policy brief highlights both the positive and negative effects of the Free Maternity Services Policy based on research conducted in health facilities in three counties in Kenya. It outlines the challenges to implementing the policy and suggests how the Ministry of Health can make improvements going forward. The policy appears to have increased use of maternity services and provided additional funding for some facilities; however, its hurried implementation led to confusion about what services were included, and some clients were still required to pay for services. The policy was not accompanied by any supportive interventions to increase the capacity of health facilities. As a result, increased demand for services put a strain on health workers and compromised quality of care. The implementation of the Free Maternity Services Policy highlights the need for whole system change as opposed to isolated policy interventions. Going forward, the authors argue that the national Ministry of Health must provide clear guidelines as to what the policy covers and communicate these effectively to health facilities and providers. The county governments should strengthen the capacity of health facilities to cope with additional demand. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"From blockchain technology to global health equity: can cryptocurrencies finance universal health coverage?","field_subtitle":"Till B; Peters A; Afshar S; Meara J: BMJ Global Health 2(4), doi: https://doi.org/10.1136/bmjgh-2017-000570,, 2017","URL":"http://gh.bmj.com/content/2/4/e000570","body":"Blockchain technology and cryptocurrencies could remake global health financing and usher in an era global health equity and universal health coverage. The authors outline and provide examples for at least four important ways in which this potential disruption of traditional global health funding mechanisms could occur: universal access to financing through direct transactions without third parties; novel new multilateral financing mechanisms; increased security and reduced fraud and corruption; and the opportunity for open markets for healthcare data that drive discovery and innovation. The authors present these issues as a paramount to the delivery of healthcare worldwide and relevant for payers and providers of healthcare at state, national and global levels; for government and non-governmental organisations; and for global aid and intergovernmental organisations.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Growing number of resources on the Participatory Action Research Portal","field_subtitle":"TARSC: EQUINET pra4equity network, 2017","URL":"http://www.equinetafrica.org/content/portal-resources-participatory-action-research","body":"The Participatory Action Research Portal for resources on Participatory Action Research (PAR) on the EQUINET website has a growing number of resources on PAR related to training courses, training guides and reports of training activities; methods, tools and ethics; PAR work and journal publications on PAR. The portal is a resource for all those working with PAR and includes resources in any language. There is a form for people to send videos, photojournalism, organisations, journal papers, training guides and other resources for the portal. The url link shown here is in English but there is also a Spanish version at http://www.equinetafrica.org/content/portal-de-recursos-para-la-investigaci%C3%B3n-acci%C3%B3n-participativa-iap","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Health system strengthening: a qualitative evaluation of implementation experience and lessons learned across five African countries ","field_subtitle":"Rwabukwisi F; Bawah A; Gimbel S; et al.: BMC Health Services Research 17 (Suppl 3), doi: 10.1186/s12913-017-2662-9, 2017","URL":"https://tinyurl.com/y7qu9p7v","body":"This paper captures common implementation experiences and lessons learned to understand core elements of successful health systems interventions. Qualitative data was used rom key informant interviews and annual progress reports from the five Population Health Implementation and Training (PHIT) partnership projects funded through African Health Initiative in Ghana, Mozambique, Rwanda, Tanzania, and Zambia. Four major overarching lessons were highlighted. First, a variety and inclusiveness of concerned key players are necessary to address complex health system issues at all levels, with a learning culture that promotes evidence creation and ability to efficiently adapt were key in order to meet changing contextual needs. Also identified was inclusion of strong implementation science tools and strategies that allowed informed and measured learning processes and efficient dissemination of best practices. Five to seven years was seen to be the minimum time frame necessary to effectively implement complex health system strengthening interventions and generate the evidence base needed to advocate for sustainable change for the PHIT partnership projects. The authors conclude that the African Health Initiative experience has raised remaining, if not overlooked, challenges and potential solutions to address complex health systems strengthening intervention designs and implementation issues, while aiming to measurably accomplish sustainable positive change in dynamic, learning, and varied contexts.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Health Systems Governance Collaborative new interactive web platform","field_subtitle":"Health Systems Governance Collaborative: Geneva, 2017","URL":"https://hsgovcollab.org","body":"The Health Systems Governance Collaborative is a group of practitioners, policy makers, academics, civil society representatives, agencies, decision-makers and other committed citizens seeking to connect and engage about important health systems governance issues. The Collaborative fosters creative and safe spaces to address health systems governance challenges and promote real impact on the ground. It offers a place to connect with the great variety of stakeholders in health systems governance worldwide, confront ideas, disseminate knowledge and share experiences. The Collaborative encourages people to engage through this online interactive platform, where they can participate in consultations and discussions.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Healthy Lives for Vulnerable Women and Children: Applying Health Systems Research","field_subtitle":"Godt S; Agyepong I; Flores W; et al: in_focus, IDRC, October 2017","URL":"https://tinyurl.com/y88xfg3l","body":"Tremendous challenges remain for the most vulnerable populations, including women, children, and adolescents, to enjoy the healthy lives and well-being. Much of their poor health is caused by poverty, gender, lack of education, and social marginalization as well as inaccessible healthcare services. Strong, equitable, and well-governed health systems can contribute to sustainably improving their lives. But building strong health systems is challenging. This book draws on 15 years of IDRC-funded health systems research undertaken by researchers working closely with communities and decision-makers. They have generated contextually relevant evidence at local, national, regional, and global levels to tackle these entrenched health systems challenges. Six lessons have been distilled to inform and inspire a new generation of health leaders and researchers while some critical reflections on the remaining challenges are shared with others in the global health community, including funding organizations.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Honest Accounts 2017: How the world profits from Africa\u2019s wealth","field_subtitle":"Curtis M; Jones T: Curtis Research, Jubilee Debt Campaign and others, 2017","URL":"https://tinyurl.com/y7brab6v","body":"This report presents the movement of all the main financial resources into and out of Africa, mainly using 2012 figures. It found that $134 billion entered the continent in 2017, mainly in the form of loans, foreign investment and aid. However, some $192 billion was taken out, mainly in profits made by foreign companies, tax dodging and the costs of adapting to climate change. Africa was found to suffer a net deficit of $58 billion a year. This is reported to have has led to reductions in government holdings of international reserves and lower (but still significant) multinational company profits taken out of the continent. They report that there are now more loans to African governments, another in inflow, although this comes at the cost of future debt payments and possibly debt crises.\r\n","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia ","field_subtitle":"Witter S; Wurie H; Chandiwana P; et al.: Health Policy and Planning 32(Suppl 3) iii3\u2013iii13, 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_3/iii3/4621476","body":"This article is grounded in a research programme which set out to understand how to rebuild health systems post-conflict. Four countries were studied\u2014Uganda, Sierra Leone, Zimbabwe and Cambodia\u2014which were at different distances from conflict and crisis, as well as having unique conflict stories. The authors captured insights from 128 life histories and in-depth interviews with a variety of staff that had remained in service. This article aims to draw together lessons from these contexts which can provide lessons for enhancing staff and therefore health system resilience in future, especially in similarly fragile and conflict-affected contexts. The authors examine the reported effects, both personal and professional, of the three different types of shock (conflicts, epidemics and prolonged political-economic crises), and how staff coped. They find that the impact of shocks and coping strategies are similar between conflict/post-conflict and epidemic contexts\u2014particularly in relation to physical threats and psychosocial threats\u2014while all three contexts create challenges and staff responses for working conditions and remuneration. Health staff showed considerable inventiveness and resilience, and also benefited from external assistance of various kinds, but important gaps were found which point to ways in which they should be better protected and supported in the future. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Integrating family planning services into HIV care: use of a point-of-care electronic medical record system in Lilongwe, Malawi","field_subtitle":"Tweya H; Feldacker C; Haddad L; et al: Global Health Action 10(1), doi: http://dx.doi.org/10.1080/16549716.2017.1383724, 2017","URL":"http://www.tandfonline.com/doi/full/10.1080/16549716.2017.1383724","body":"Integrating family planning (FP) services into human immunodeficiency virus (HIV) clinical care helps improve access to contraceptives for women living with HIV. However, high patient volumes may limit providers\u2019 ability to counsel women about pregnancy risks and contraceptive options. This study assessed trends in the use of contraceptive methods after implementing an electronic medical record (EMR) system with FP questions and determine the reasons for non-use of contraceptives among women of reproductive age (15\u201349 years) receiving antiretroviral therapy (ART) at the Martin Preuss Center clinic in Malawi. The authors conducted a retrospective, longitudinal cohort study using the EMR routinely collected data. Between February 2012 and December 2016, in HIV clinics, the proportion of women using contraceptives increased significantly from 18% to 39% between February 2012 and June 2013, and from 39% to 67% between July 2013 and December 2016. Common reasons reported for the non-use of contraceptives among those at risk of unintended pregnancy were: pregnancy ambivalence and never thought about it. Incorporating the FP EMR module into HIV clinical care was found to prompt healthcare workers to encourage the use of contraceptives.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Integration of eye health into primary care services in Tanzania: a qualitative investigation of experiences in two districts ","field_subtitle":"Jolley E; Mafwiri M; Hunter J; et al: BMC Health Services Research 17(1), doi:10.1186/s12913-017-2787-x, 2017","URL":"https://tinyurl.com/y9vy5try","body":"This study seeks to understand how eye health services are delivered by primary health workers who have received training and what constraints remain to effective service provision. A qualitative investigation into the experiences of 20 primary health workers trained in primary eye care and eight key informants working within specialist eye health services or regional and district health management positions in two districts in Tanzania. Despite feeling confident in their own eye care skills, most primary health workers felt constrained in the services they could provide to their communities by insufficient resources needed for diagnosis and treatment, and by lack of systematic supportive supervision to their work. Specialist ophthalmic staff were aware of this issue, although for the most part they felt it was not within their capacity to remedy and that it fell within the remit of general health managers. Many participants discussed the low support to eye health from the national government, evidenced through the lack of dedicated funding to the area and traditional reliance on outside funds including international charities. The authors noted that although training of primary health workers is useful, it is not sufficient to address the burden of eye health disease present in rural communities in Tanzania. It is likely that broader engagement with the general health system, and most likely with the private sector, will be necessary to improve the coverage of eye health care to remote and poor communities such as those in Morogoro. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"International Children\u2019s Peace Prize Nomination ","field_subtitle":"KidsRights: The deadline for entries is March 1st 2018","URL":"http://www.childrenspeaceprize.org","body":"The nomination process for the International Children\u2019s Peace Prize 2018 has started. KidsRights calls upon individuals and organizations across the globe to nominate eligible children, regardless of race, place of birth or social standing, who have demonstrated the skill and determination necessary to personally improve the rights of children.  The child should not be older than 17 years by the time of the nomination deadline, from anywhere in the world, and have a clear history of standing up and fighting for his/her own rights and/or the rights of other children, which has led to a concrete result. The child should agree to being nominated for the prize.  The messages of all the nominees will be posted on the Kidrights website. The nomination form and the full list of criteria can be found on the website.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Malaria control in rural Malawi: implementing peer health education for behaviour change","field_subtitle":"Malenga T; Kabaghe A; Manda-Taylor L; et al: Globalization and Health 13(84), doi: https://doi.org/10.1186/s12992-017-0309-6, 2017","URL":"https://tinyurl.com/y9dshrmj","body":"This descriptive study reports on the feasibility, acceptability and appropriateness of health animator-led community workshops for malaria control. Quantitative data were collected from self-reporting and researcher evaluation forms. Qualitative assessments were done with health animators, using three focus groups in 2015 and seven in-depth interviews (October 2016\u2013February 2017). Seventy seven health animators were trained from 62 villages. A total of 2704 workshops were conducted, with consistent attendance from January 2015 to June 2017, representing 10\u201317% of the population. Attendance was affected by social responsibilities and activities, relationship of the village leaders and their community and involvement of community health workers. Active discussion and participation were reported as main strengths of the workshops. Health animators personally benefited from the mind-set change and were proactive peer influencers in the community. Although the information was comprehended and accepted, availability of adequate health services was a challenge for maintenance of behaviour change. the authors argue that community workshops on malaria are a potential tool for influencing a positive change in behaviour towards malaria, and applicable for other health problems in rural African communities. Social structures of influence and power dynamics affect community response. they suggest that there is need for systematic monitoring of community workshops to ensure implementation and sustain health behaviour change.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Prevention of mother to child transmission of HIV in Tanzania: assessing gender mainstreaming on paper and in practice ","field_subtitle":"Nyamhanga T; Frumence G; Simba D: Health Policy and Planning 32 (Suppl 5)ppv22-v30, 2017 ","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v22/3970854","body":"Despite recognition of gender in Tanzania\u2019s political arena and prioritization of  prevention of mother to child transmission (PMTCT) by the health sector, there is very little information on how well gender has been mainstreamed into National PMTCT guidelines and organizational practices at service delivery level. Using a case study methodology, the authors combined document review with key informant interviews to assess gender mainstreaming in PMTCT on paper and in practice in Tanzania. The authors reviewed PMTCT policy/strategy documents using the World Health Organisation\u2019s Gender Responsive Assessment Scale. The scale differentiates between level 1 to 5. Key informant interviews were conducted with 26 leaders purposively sampled from three government health facilities in Mwanza city to understand their practices. The gender responsiveness of PMTCT policy/strategy documents varies. Those which are gender sensitive indicate gender awareness, but with no remedial action developed; while those which are gender specific go beyond indicating how gender may hinder PMTCT to highlighting remedial measures, such as the promotion of couple counselling and testing for HIV. The interviews suggested that there has been little attention to the holistic integration of gender in the delivery of PMTCT services. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Private Sector Participation and Health System Performance in Sub-Saharan Africa","field_subtitle":"Yoong J; Burger N; Spreng C; et al: PLoS ONE 5(10), doi: https://doi.org/10.1371/journal.pone.0013243, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0013243","body":"The role of the private health sector in developing countries remains a much-debated and contentious issue. Critics argue that the high prices charged in the private sector limits the use of health care among the poorest, consequently reducing access and equity in the use of health care. Supporters argue that increased private sector participation might improve access and equity by bringing in much needed resources for health care and by allowing governments to increase focus on underserved populations. However, little empirical exists for or against either side of this debate. The authors examined the association between private sector participation and self-reported measures of utilization and equity in deliveries and treatment of childhood respiratory disease using regression analysis, across a sample of nationally-representative Demographic and Health Surveys from 34 SSA economies. To measure private sector participation, we computed the percentage of live births that took place in a private (for-profit or non-profit/mission) health facility and the percentage of children with ARI symptoms who were treated at a private health facility.  Private sector participation was positively associated with greater overall access and reduced disparities between rich and poor as well as urban and rural populations, including after controlling for confounders including per capita income and maternal education. However, higher private sector participation may be affected by other variables that also affect access and equity. In addition to an increased level of overall service utilization, countries with a relatively large share of private sector participation tend to also have significantly higher levels of maternal education and also higher levels of GDP per capita, so the relationships may be confounded by differences in socioeconomic development (particularly maternal education, a well-established key determinant of health service utilization and child health outcomes). The authors controlled for maternal education and per capita income but report that other confounders such as better functioning transportation infrastructure may also influence both private sector participation and access.  They further notes that the appropriate role of the private sector might depend on the capacity of governments to provide effective stewardship and regulation, the health care financing environment, and the organization of the public health sector.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"The change-makers of West Africa","field_subtitle":"Godt S; Mhatre S; Schryer-Roy AM: Health Research Policy and Systems 15 (52), doi: https://doi.org/10.1186/s12961-017-0208-6, 2017","URL":"https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-017-0208-6","body":"This journal supplement is a contribution to changing practice by putting the perspectives, experiences and knowledge of West Africans on the table. It presents findings from a series of research and capacity development projects in West Africa funded by the International Development Research Centre's Maternal and Child Health programme. The evidence presented centres around two key themes. First, the theme that context matters. The evidence shows how context can change the shape of externally imposed interventions or policies resulting in unintended outcomes. At the same time, it highlights evidence showing how innovative local actors are developing their own approaches, usually low-cost and embedded in the context, to bring about change. The collection of articles discusses the critical need to overcome the existing fragmentation of expertise, knowledge and actors, and to build strong working relationships amongst all actors so they can effectively work together to identify priority issues that can realistically be addressed given the available windows of opportunity. Vibrant West African-led collaborations amongst researchers, decision-makers and civil society, which are effectively supported by national, regional and global funding, need to foster, strengthen and use locally-generated evidence to ensure that efforts to strengthen health systems and improve regional health outcomes are successful. The authors argue that the solutions are not to be found in the \u2018travelling models\u2019 of standardised interventions.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The importance of gender analysis in research for health systems strengthening","field_subtitle":"Theobald S; Morgan R; Hawkins K; et al.: Health Policy and Planning 32(Suppl 5)v1-v3, 2017 ","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v1/4718143","body":"This editorial discusses a collection of papers examining gender across a range of health policy and systems contexts, from access to services, governance, health financing, and human resources for health. The papers interrogate differing health issues and core health systems functions using a gender lens. Together they produce new knowledge on the multiple impacts of gender on health experiences and demonstrate the importance of gender analyses and gender sensitive interventions for promoting well-being and health systems strengthening. The findings from these papers collectively show how gender intersects with other axes of inequity within specific contexts to shape experiences of health and health seeking within households, communities and health systems; illustrate how gender power relations affect access to important resources; and demonstrate that gender norms, poverty and patriarchy interplay to limit women\u2019s choices and chances both within household interactions and within the health sector. The authors note that health systems researchers have a responsibility to promote the incorporation of gender analyses into their studies in order to inform more strategic, effective and equitable health systems interventions, programmes, and policies. Responding to gender inequitable systems, institutions, and services in this sector requires an \u2018all hands-on deck\u2019 approach. They note that it is not possible to claim to take a \u2018people-centred approach\u2019 to health systems if the status quo continues.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa","field_subtitle":"Agyepong I; Sewankambo N; Binagwaho A; et al. Kassebaum: The Lancet 390(10114)p2803\u20132859, 2017","URL":"http://www.thelancet.com/commissions/future-health-Africa","body":"This Commission was prompted by sub-Saharan Africa's potential to improve health on its own terms, and largely with its own resources. It promotes evidence-based optimism, with caution. Sub-Saharan countries are noted to face difficult development agendas in the decades to come, but also immense opportunities to be acted upon. A key message of this commission is that the opportunities ahead cannot be unlocked with 'more of the same' approaches and by keeping to the current pace. The commission advocates an approach based on people-centred health systems and inspired by progress, which can be adapted in line with each country's specific needs. A comprehensive approach and system-wide changes are required. Broad partnerships beyond the medical and health community are argued to be essential to move the health agenda forward. Without a serious shift in mindsets across all levels of society, all sectors of government, and all institutions it is seen to be difficult to have meaningful and sustainable change. Young people in Africa are observed to be key to bringing about the transformative changes needed to rapidly accelerate efforts to improve health and health equity across sub-Saharan Africa.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The role of NGOs in Africa: are they a force for good?","field_subtitle":"Sangonet Pulse, December 2017","URL":"https://tinyurl.com/ybrg288v","body":"Non-governmental organisations (NGOs) have become key actors in responding to poverty and related suffering. In Africa, NGOs play a leading role in providing health care and education. But NGOs also have their detractors who argue that they are receiving growing amounts of external aid, but aren\u2019t the most suitable actors for really improving people\u2019s lives. Some critics insist that the neoliberal policies advanced by international actors have limited the influence of the state and that NGOs have benefited as a result. NGOs are criticised for their focus on technical solutions to poverty instead of the underlying issues, and for being more dependent and accountable to their funders than those they serve. Instead of empowering local populations to organise themselves, the authors argue that there is a risk that  NGOs empower people to attain licensed, rather than emancipatory, freedoms; these are freedoms achieved \u201cwithin the system\u201d which improve lives, but don\u2019t dramatically change power dynamics. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Toolkit for Integrating Gender in the Monitoring and Evaluation of Health Programs","field_subtitle":"MEASURE Evaluation, December 2017","URL":"https://tinyurl.com/y9lawe2f","body":"This toolkit aims to help international health programs integrate a gender perspective in their monitoring and evaluation (M&E) activities, measures, and reporting. It is designed for use by health program staff working in various health sectors (such as HIV; malaria; reproductive, maternal, newborn, and child health; and tuberculosis), and for various health agencies and initiatives. The toolkit will support health program staff to integrate gender in their programs, projects, and M&E activities. Its objectives are to provide processes and tools for integrating gender in a health program\u2019s M&E activities, guidance on facilitating communication with primary stakeholders on the importance of gender and M&E, and additional resources on gender-integrated programming and M&E. ","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Uptake and correlates of cervical cancer screening among HIV-infected women attending HIV care in Uganda","field_subtitle":"Wanyenze R; Bwanika J; Beyeza-Kashesya J; et al: Global Health Action 10(1), doi: http://dx.doi.org/10.1080/16549716.2017.1380361, 2017","URL":"http://www.tandfonline.com/doi/full/10.1080/16549716.2017.1380361","body":"This study assessed uptake and correlates of cervical screening among HIV-infected women in care in Uganda. A nationally representative cross-sectional survey of HIV-infected women in care was conducted from August to November 2016. Structured interviews were conducted with 5198 women aged 15\u201349 years, from 245 HIV clinics. Knowledge and uptake of cervical screening and human papillomavirus (HPV) vaccination were determined. Overall, 94% had ever heard of cervical screening and 66% knew a screening site. However, 47% did not know the schedule for screening and 50% did not know the symptoms of cervical cancer. One-third rated their risk of cervical cancer as low. Uptake of screening was 30%. Women who had never been screened cited lack of information and no time as the main reasons. Increased likelihood of screening was associated with receipt of HIV care at a level II health center and private facilities, knowledge of cervical screening, where to go for screening, and low perception of risk. HPV vaccination was 2%. Cervical screening and HPV vaccination uptake were very low among HIV-infected women in care in Uganda. Improved knowledge of cervical screening schedules and sites, and addressing fears and risk perception are thus seen to potentially increase uptake of cervical screening in this vulnerable population.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Women on the move: migration, care work and health","field_subtitle":"World Health Organisation: WHO, Geneva, 2017","URL":"http://who.int/gender-equity-rights/knowledge/women-on-the-move/en/","body":"Care workers - who are largely migrant women, often working in informal home settings - make a considerable contribution to public health in many countries but are themselves exposed to health risks, face barriers to accessing care, and enjoy few labour and social protections. This WHO report, and its reflection on potential next steps, aims to foster debate about approaches to ensure that the global community meets its obligations in relation to these care workers. The report focuses on paid home-based care workers who attend to the varied needs of children, older people, people with disabilities and the disabled and ill people.It notes that a significant knowledge gap exists when it comes to how migrant care workers\u2019 health is influenced \u2013 both positively and negatively \u2013 by the labour they perform and the contexts in which they undertake this work. The report highlights three key steps for all countries and regions to consider to improve the health and well-being of migrant care workers and their families:1. To generate evidence on the nature of migrant care work, the contributions to global health care and the terms and conditions of their employment. 2. To improve access to health services through specific measures to address non-discrimination, promote inclusion and participation of migrant care workers. 3. Promote and recognize care as a global public good that contributes to global health and well-being. The authors advocate for holistic, universal and person-centred health and social care systems.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Workshop: Comparing the Copperbelt: Political culture and knowledge production in Central Africa, 23-24 July 2018 (Kitwe, Zambia)","field_subtitle":"Deadline for Applications: 15 February 2018","URL":"https://tinyurl.com/yaqds6jy","body":"'Comparing the Copperbelt' is an ERC-funded research project, running at the University of Oxford from 2016-2020. The project aims to examine the Copperbelt (in both Zambia and the DR Congo) as a single region divided by a (post-)colonial border, across which flowed minerals, people and ideas. This workshop aims to bring together researchers on and in the Copperbelt region to share ideas on social, environmental and cultural history. Research papers from a variety of disciplinary backgrounds (history, anthropology, economics, etc.), approaches and regional focuses (both old and new mining regions) are welcomed. The workshop seeks to bring together academics, trade union leaders and environmental activists to foster discussions about the history and current condition of the Copperbelt region.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"World's poor to suffer most unless developed countries act fast on climate change","field_subtitle":"Khan A: Pambuzuka News, December 2017","URL":"https://tinyurl.com/ycqlymps","body":"Storms and hurricanes are becoming more severe due to warmer sea temperatures.  Low lying island nations, like the Maldives, now experience annual flooding with the seawater contaminating groundwater supplies.  Whether flooding, drought or other climate-related catastrophic events, the author observes that low income countries nations and their populations suffer most,  given their lack of resources, infrastructure, emergency services and preparedness. They also point to a further consequence relating to the quality of food.  Rising CO2 levels speed up plant growth increasing carbohydrates through plant sugars and diluting nutrition due to reduced minerals and protein.  The nutrient quality of our food is expected to fall as CO2 levels rise this century.  The effect will be worst felt by the world's poorer populations relying on a plant diet.  Extreme weather events affect production, distribution, spoilage and contamination.  The author notes that those most affected will be people in Africa, Asia and the Americas.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"\u201cIf it's issues to do with nutrition\u2026I can decide\u2026\u201d: gendered decision-making in joining community-based child nutrition interventions within rural coastal Kenya ","field_subtitle":"Muraya K;  Jones C;  Berkley ; et al.: Health Policy and Planning 32 (Suppl 5) ppv31\u2013v39 2017 ","URL":"https://academic.oup.com/heapol/article/32/suppl_5/v31/4718138","body":"This qualitative study undertaken in rural Coastal Kenya aimed to explore the interaction between household gender relations and a community-based child nutrition programme. It focused on household decision-making dynamics related to joining the intervention. Fifteen households whose children were enrolled in the programme were followed up over a period of 12 months. Over 60 household visits, group and individual in-depth interviews were conducted with a range of respondents, supplemented by non-participant observations. Data were analysed using a framework analysis approach. Engagement with the intervention was highly gendered with women being the primary decision-makers and engagers. Women were responsible for managing child feeding and minor child illnesses in households. As such, involvement in community-based nutrition interventions and particularly one that targeted a condition perceived as non-serious, fell within women\u2019s domain. Despite this, the nutrition programme of interest could be categorized as gender-blind. Gender was not explicitly considered in the design and implementation of the intervention, and the gender roles and norms in the community with regards to child nutrition were not critically examined or challenged. In fact, the authors argue that the intervention might have inadvertently reinforced existing gender divisions and practices in relation to child nutrition, by excluding men from the nutrition discussions and activities and thereby supporting the notion of child feeding and nutrition as \u201cwomen\u2019s business\u201d. To improve outcomes, community based nutrition interventions are argued to need to understand and take into account gendered household dynamics, and incorporate strategies that promote behaviour change and attitude shifts in relation to gendered norms and child nutrition.","php":"","field_issue_date":"2018-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"3rd Annual Aid & International Development Forum Africa Summit","field_subtitle":"27-29 February 2018, Nairobi, Kenya","URL":"http://www.africa.aidforum.org","body":"Now in its 3rd year, the Aid & Development Africa Summit returns to Nairobi, Kenya on 27-28 February 2018, uniting humanitarian and development leaders, decision makers and advisors from NGOs, government and UN agencies and the private sector. The Summit will look into latest policy and project updates, best practice and innovations to improve humanitarian aid operations and infrastructure resilience in sub-Saharan East Africa. Participants will gain first hand insights from development banks, donors and government agencies into their financing priorities and funding guidelines as well as benefit from networking opportunities. The agenda is being developed in consultation with key organisations, such as WFP, IRFC, World Vision, USAID, UNICEF, World Bank, Save the Children, UN Habitat, CRS, FHI360, Oxfam, Habitat for Humanity International, IRD and will include case studies, panel discussions, workshops, and interactive roundtable sessions.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Academy For African Urban Diversity Launched At The African Centre For Migration & Society","field_subtitle":"African Centre for Migration and Society; University of Witwatersrand, 2017","URL":"https://tinyurl.com/yb6y44rz","body":"The Academy for African Urban Diversity (AAUD) was launched at the African Centre for Migration & Society (ACMS) in November 2017. AAUD is a joint initiative of ACMS; the African Centre for Cities; and the Max Planck Institute for the Study of Religious and Ethnic Diversity. It brings together a cohort of post-fieldwork doctoral students exploring diversity in African cities to debate and theorize the political, social and economic processes surrounding Africa\u2019s growing and diversifying cities. The initiative creates interdisciplinary engagement among young and senior scholars working on urban studies on the African continent and the collaboration will play a role in supporting the development of skills and knowledge of a new generation of Urban African scholars. The next workshop will be held in G\u00f6ttingen, Germany in 2018. PhD applications are considered on a rolling basis throughout the year. ","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Almost 100 million people a year forced to choose between food and healthcare","field_subtitle":"Bowman V: The Guardian, UK, December 2017","URL":"https://tinyurl.com/y7z58r24","body":"The author raises that almost 100 million people are pushed into extreme poverty each year because of debts accrued through healthcare expenses. Citing a report, published by the World Health Organization and the World Bank, she highlights that the poorest and most vulnerable people are routinely forced to choose between healthcare and other necessities for their household, including food and education, subsisting on $1.90 (\u00a31.40) a day. Researchers found that more than 122 million people around the world are forced to live on $3.10 a day, the benchmark for \u201cmoderate poverty\u201d, due to healthcare expenditure. Since 2000, this number is reported to have increased by 1.5% a year. She cites Timothy Evans, senior director of health, nutrition and population at the World Bank Group: \u201cUniversal healthcare coverage is not just about better health. The reality is that as long as millions of people are being impoverished by health expenses, we will not reach our collective sustainable development goal of ending extreme poverty by 2030.\u201d\r\n","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Ashley Kriel Scholarship for Leadership in Community Development","field_subtitle":"Deadline for applications: 5 January 2018","URL":"https://tinyurl.com/y7yhzkmz","body":"The Community Chest and Cornerstone Institute invite activist and development practitioners to apply for a scholarship to undertake a Bachelor of Arts Honours in Community Development at Cornerstone Institute.  The scholarship provides for 70% of the tuition fee for the programme. Applicants are encouraged to secure the remainder of the fees from non-governmental organisations working in social development.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Brief: Strengthening health centre committees for people-centred health systems","field_subtitle":"EQUINET; CWGH; TARSC; LDHO; UCT: EQUINET, Harare, 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20HCC%20Brief%20Dec2017.pdf","body":"Stakeholders working with Health Centre Committees (HCCs) in East and Southern Africa (ESA) raised proposals in EQUINET policy brief 37 to improve the functioning and impact of HCCs as potential contributors to equitable, people centred health services. These proposals advocated for legal, institutional and social measures to support and clarify HCC roles, composition, powers and duties, to ensure the capacities and resources for them to function. They also proposed that HCCs strengthen their communication with the communities they represent backed up by wider measures for health literate and informed communities. Since then, institutions in EQUINET have followed up to act on the recommendations, building on existing work. This brief shares information on these developments. It reports some progress in legal recognition and setting of clearer constitutions for HCCs, clearer guidelines for the functioning, use of community based processes like photovoice to connect them with communities and their conditions in their dialogue with health services and efforts to share resources for capacity building of HCCs. It highlights that HCCs continue to play a role in improved frontline health systems. However the potential of HCCs still needs to be realised and the work continues.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Call For Papers: Theorising Africa: Reviewing a History of Ideas","field_subtitle":"Deadline: 10 January 2018 ","URL":"https://tinyurl.com/yc4x83pj","body":"Theorising Africa seeks to explore what it means to be human, to be a member of society, through the exploration of identity, aesthetics, and politics by placing cultural theory and African epistemic frameworks in dialogue. For this seminar series, conveners at The University of Leeds are interested in looking to Africa for its history of ideas: How has African thought transcended boundaries and how can it continue to do so? What can African thought contribute to the many blind spots in the fields of cultural theory? How can these contributions account for the work of knowledge-making? In what ways are these contributions necessary? The conveners seek papers and proposals on topics including, but not limited to: African literary theory; Reframing the history of ideas \u2013 philosophical interrogations; Cultural analysis; Psychoanalysis; African Futures; Law; Politics and bio-violence; Feminisms and policy; Community building; The creaturely; Animism; Theology; Art History; Challenges to the legacy of the writer; Any non-conforming inquiry which doesn\u2019t fall into a field. Proposals (max 300 words + bio) in Word format are to be sent to findingpocoafrica@gmail.com ","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Civil society brief: Resource curse or fair benefit: Protecting health in the extractive sector in east and southern Africa","field_subtitle":"EQUINET; TARSC; SATUCC; SADC CNGO: EQUINET, Harare, 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20EI%20civil%20society%20brief%202017.pdf","body":"The extractive (or mining) sector is a major economic actor in east and southern Africa. The mineral resources extracted are sought after globally, and how the sector operates affects the lives of millions of people. This brief aimed mainly civil society discusses the health impacts of the sector, how far these risks are recognised in policy and controlled in practice, and what civil society can do to ensure that health is protected in EI activity. It presents the proposals made at the 13th Southern Africa Civil society Forum in 2017 to advocate for regional health standards for EIs and a bottom up local to regional campaign for civil society to advocate for these harmonised standards for health in the mining (extractive) sector in SADC.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"CSO statement for the Universal Health Coverage (UHC) Forum in Tokyo - Japan","field_subtitle":"Civil society organisations: Universal Health Coverage (UHC) Forum, Japan, December 2017","URL":"http://www.ghadvocates.eu/wp-content/uploads/2016/07/UHC-forum-CSO-statement-VF1.pdf","body":"In this statement civil society organisations call for a change to the business-as-usual approach to achieving UHC and raise following principles that need greater emphasis in national and global efforts: Health is a human right and the achievement of UHC should ensure that no one is left behind; Out-of-pocket payments should be progressively abolished and public financing for health should be significantly increased; and good governance, robust transparency, and sound accountability must be ensured.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Early antenatal care visit: a systematic analysis of regional and global levels and trends of coverage from 1990 to 2013","field_subtitle":"Moller A; Petzold M; Chou D; et al: The Lancet Global Health 5(10) e977-e983, 2017","URL":"https://tinyurl.com/ya8tdn5f","body":"The timing of the first antenatal care visit is paramount for ensuring optimal health outcomes for women and children, and it is recommended that all pregnant women initiate antenatal care in the first trimester of pregnancy (early antenatal care visit). Systematic global analysis of early antenatal care visits has not been done previously. This study reports on regional and global estimates of the coverage of early antenatal care visits from 1990 to 2013. Data were obtained from nationally representative surveys and national health information systems. Estimates of coverage of early antenatal care visits were generated with linear regression analysis and based on 516 logit-transformed observations from 132 countries. The model accounted for differences by data sources in reporting the cutoff for the early antenatal care visit. The estimated worldwide coverage of early antenatal care visits increased from 40.9% in 1990 to 58.6% in 2013, corresponding to a 43.3% increase. Overall coverage in the developing regions was 48.1% in 2013 compared with 84.8% in the developed regions. In 2013, the estimated coverage of early antenatal care visits was 24% in low-income countries compared with 81.9% in high-income countries. Progress in the coverage of early antenatal care visits has been achieved but coverage is still far from universal. Substantial inequity exists in coverage both within regions and between income groups. The absence of data in many countries is of concern and the authors argue that efforts should be made to collect and report coverage of early antenatal care visits to enable better monitoring and evaluation.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 202: Wishing you roots and wings in 2018!","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Header"}},{"node":{"title":"Factors influencing risky sexual behaviour among Mozambican miners: a socio-epidemiological contribution for HIV prevention framework in Mozambique ","field_subtitle":"Martins-Fonteyn E; Loquiha O; Baltazar C; et al: International Journal of Equity in Health 16(179), doi: https://doi.org/10.1186/s12939-017-0674-z, 2017","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-017-0674-z","body":"This study seeks to understand the various factors influencing HIV-related risk behaviours and the resulting HIV positive status of Mozambican miners employed by South African mines to inform a broader and more effective HIV preventive framework in Mozambique. It used data sourced from the first integrated biological and behavioural survey among Mozambican miners earning their living in South African mines. The odds of reporting one sexual partner were roughly three times higher for miners working as perforators as opposed to other types of occupation. The odds of condom use \u2013 always or sometimes \u2013 for miners in the 31-40 age group were three times higher than the odds of condom use in the 51+ age group. Miners with lower education levels were less likely to use condoms. The odds of being HIV positive when the miner reports use of alcohol or drugs is 0.32 times lower than the odds for those reporting never use of alcohol or drugs. And finally, the odds of HIV positive status for those using condoms were 2.16 times that of miners who never used condoms, controlling for biological and other proximate determinants. In Mozambique, behavioural theory emphasising personal behavioural changes is the main strategy to combat HIV among miners. The findings suggested that there is a need to change thinking processes about how to influence safer sexual behaviour. This only stresses the need for HIV prevention strategies to exclusively transcend individual factors while considering the broader social and contextual phenomena influencing HIV risk among Mozambican miners.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Global infection prevention and control priorities 2018\u201322: a call for action","field_subtitle":"Allegranzi B; Allegranzi B; Kilpatrick C; et al: The Lancet Global Health 5(12) e1178-e1180, 2017","URL":"https://tinyurl.com/y8s75anm","body":"The Ebola virus disease outbreak in west Africa and the rapid spread of other emerging viruses, such as the severe acute respiratory syndrome or the Middle East respiratory syndrome coronaviruses, showed how limited or non-existent infection prevention and control (IPC) programmes, combined with an inadequate water supply, poor sanitation, and a weak hygiene infrastructure in health facilities, can threaten global health security. In such outbreaks, instead of serving as points where disease was controlled, health-care facilities became dangerous places for outbreak amplification among staff and patients and transmission back to communities. The authors argue that it is now urgent to consider IPC capacity building and actual implementation as global health priorities. Among its efforts in this field, WHO coordinates the Global IPC (GIPC) Network. There are strong economic and ethical reasons to enhance IPC within the national and global health security agendas and efforts should capitalise upon evidence-based recommendations, proven and feasible implementation strategies, and awareness raised by AMR and epidemic-prone disease threats. ","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"How the introduction of a human resources information system helped the Democratic Republic of Congo to mobilise domestic resources for an improved health workforce ","field_subtitle":"Esanga J; Viadro C; McManus L; et al: Health Policy and Planning 32(Suppl 3)  iii25\u2013iii31, 2017","URL":"https://academic.oup.com/heapol/article/32/suppl_3/iii25/4621477#100468305","body":"In the Democratic Republic of Congo,  recognising the need for reliable health workforce information, the government has worked to implement iHRIS, an open source human resources information system that facilitates health workforce management. In Kasa\u00ef Central and Kasa\u00ef Provinces, health workers brought relevant documentation to data collection points, where trained teams interviewed them and entered contact information, identification, photo, current job, and employment and education history into iHRIS on laptops. After uploading the data, the Ministry of Public Health used the database of over 11\u2009500 verified health worker records to analyse health worker characteristics, density, compensation, and payroll. Both provinces had less than one physician per 10\u2009000 population and a higher urban versus rural health worker density. Most iHRIS-registered health workers (57% in Kasa\u00ef Central and 73% in Kasa\u00ef) reported receiving no regular government pay of any kind (salaries or risk allowances). Payroll analysis showed that 27% of the health workers listed as salary recipients in the electronic payroll system were ghost workers, as were 42% of risk allowance recipients. As a result, the Ministries of Public Health, Public Service, and Finance reallocated funds away from ghost workers to cover salaries and risk allowances for thousands of health workers who were previously under- or uncompensated due to lack of funds. The reallocation prioritised previously under- or uncompensated mid-level health workers, with 49% of those receiving salaries and 68% of those receiving risk allowances representing cadres such as nurses, laboratory technicians, and midwifery cadres. The authors observe that assembling accurate health worker records can help governments understand health workforce characteristics and use data to direct scarce domestic resources to where they are most needed.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Mapping under-5 and neonatal mortality in Africa, 2000\u201315: a baseline analysis for the Sustainable Development Goals","field_subtitle":"Golding N; Burstein R; Longbottom J; et al: The Lancet 390(10108)2171-2182, 2017","URL":"http://gh.bmj.com/content/2/2/e000224","body":"This study aimed to generate high-resolution estimates of under-5 and neonatal all-cause mortality across 46 countries in Africa. The authors assembled 235 geographically resolved household survey and census data sources on child deaths to produce estimates of under-5 and neonatal mortality at a resolution of 5\u2008\u00d7\u20085 km grid cells across 46 African countries for 2000, 2005, 2010, and 2015. Amid improving child survival in Africa, there was substantial heterogeneity in absolute levels of under-5 and neonatal mortality in 2015, as well as the annualised rates of decline achieved from 2000 to 2015. Subnational areas in countries such as Botswana, Rwanda, and Ethiopia recorded some of the largest decreases in child mortality rates since 2000, positioning them well to achieve SDG targets by 2030 or earlier. Yet these places were the exception for Africa, since many areas, particularly in central and western Africa, must reduce under-5 mortality rates by at least 8.8% per year, between 2015 and 2030, to achieve the SDG 3.2 target for under-5 mortality by 2030. In the absence of unprecedented political commitment, financial support, and medical advances, the viability of SDG 3.2 achievement in Africa is argued to be precarious at best. ","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Mine Tailings Storage: Safety is No Accident","field_subtitle":"United Nations Environment Programme: UNEP, December 2017","URL":"https://tinyurl.com/yce5bl62","body":"This report was prompted by tailings dams disasters and rising global concerns about the safety, management and impacts of storing and managing large volumes of mine tailings. The report laments that although the number of dam failures has declined over many years, the number of serious failures has increased, despite advances in the engineering knowledge that can prevent them. The report makes two recommendations that can help the industry to eliminate tailing dam failures. Firstly, it calls for a \u201csafety-first\u201d approach to tailings storage that should be reflected in both management actions and on-the-ground operations. The report also recommends establishing a UN Environment stakeholder forum to facilitate international strengthening of tailings dam regulation. These approaches could include establishing a database of mine sites, identifying best practice and developing technical solutions to the main causes of failure. The assessment also discusses how mining firms can adopt cleaner processes, new technologies and re-use materials in order to reduce waste.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Mobile instant messaging for rural community health workers: a case from Malawi","field_subtitle":"Pimmer C; Mhango S; Mzumara A; et al: Global Health Action 10(1), doi: http://dx.doi.org/10.1080/16549716.2017.1368236, 2017","URL":"http://www.tandfonline.com/doi/full/10.1080/16549716.2017.1368236","body":"Mobile instant messaging (MIM) tools, such as WhatsApp, have transformed global communication practice. In the field of global health, MIM is an increasingly used, but little understood, phenomenon. It remains unclear how MIM can be used by rural community health workers (CHWs) and their facilitators, and what are the associated benefits and constraints. To address this gap, WhatsApp groups were implemented and researched in a rural setting in Malawi. The multi-site case study research triangulated interviews and focus groups of CHWs and facilitators with the thematic qualitative analysis of the actual conversations on WhatsApp. The use of MIM was differentiated according to instrumental (e.g. mobilising health resources) and participatory purposes (e.g. the enactment of emphatic ties). The identified benefits were centred on the enhanced ease and quality of communication of a geographically distributed health workforce, and the heightened connectedness of a professionally isolated health workforce. Alongside minor technical and connectivity issues, the main challenge for the CHWs was to negotiate divergent expectations regarding the social versus the instrumental use of the space. Despite some challenges and constraints, the implementation of WhatsApp was received positively by the CHWs and it was found to be a useful tool to support distributed rural health work.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Optimising the benefits of community health workers' unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries.","field_subtitle":"Kok M; Ormel H; Broerse J; et al: Global Public Health 12(11) 1404-1432, 2017 ","URL":"http://www.tandfonline.com/doi/pdf/10.1080/17441692.2016.1174722?needAccess=true","body":"This qualitative comparative study aimed at understanding similarities and differences in how relationships between community health workers, communities and the health sector were shaped in different Sub-Saharan African settings. The study demonstrates a complex interplay of influences on trust and community health workers\u2019 relationships with their communities and actors in the health sector. Mechanisms influencing relationships were feelings of (dis)connectedness, (un)familiarity and serving the same goals, and perceptions of received support, respect, competence, honesty, fairness and recognition. Sometimes, constrained relationships between community health workers and the health sector resulted in weaker relationships between community health workers and communities. The broader context and programme context in which these mechanisms took place were identified. Policy-makers and programme managers should take into account the broader context and could adjust community health worker programmes so that they trigger mechanisms that generate trusting relationships between CHWs, communities and other actors in the health system. This can contribute to enabling community health workers to perform well and responding to the opportunities offered by their unique intermediary position.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Senior Researcher - African Scholar Program","field_subtitle":"Deadline for applications: 22 January 2018","URL":"http://nai.uu.se/about/job/senior-researcher-african/","body":"The Nordic Africa Institute\u2019s African Scholar Program is targeted at researchers based in Africa who need time and a conducive environment for finishing and writing up their ongoing research. It offers a Senior Researcher position at the Nordic Africa Institute for 12 months. The Institute is looking for a qualified researcher from African universities and research institutions with demonstrable research interest. The successful candidate might use the period of his/her employment to complete on-going research, develop new research projects, or complete articles, books or monograph manuscripts. The scholar-researcher should take advantage of the intellectual and logistical resources of the institute and is expected to contribute meaningfully towards actualizing its vision and mandate in return.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Service readiness of health facilities in Bangladesh, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Uganda and the United Republic of Tanzania ","field_subtitle":"Leslie H; Spiegelman D; Zhoub X; et al: Bulletin World Health Organisation 95(11)738\u2013748, 2017","URL":"http://www.who.int/bulletin/volumes/95/11/17-191916.pdf?ua=1","body":"This study evaluates the service readiness of health facilities in Bangladesh, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Uganda and the United Republic of Tanzania. Using existing data from service provision assessments of the health systems of the 10 study countries, the authors calculated a service readiness index for each of 8443 health facilities. This index represents the percentage availability of 50 items that the World Health Organization considers essential for providing health care. For the analysis, the authors used 37\u201349 of the items on the list. The mean values for the service readiness index were 77% for the 636 hospitals and 52% for the 7807 health centres/clinics. Deficiencies in medications and diagnostic capacity were particularly common. The readiness index varied more between hospitals and health centres/clinics in the same country than between countries. There was weak correlation between national factors related to health financing and the readiness index. Most health facilities in the study countries were insufficiently equipped to provide basic clinical care. The authors argue that if countries are to bolster health-system capacity towards achieving universal coverage, more attention needs to be given to within-country inequities.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"South African Health Review 2018: Call for Abstracts","field_subtitle":"Deadline for submission: 30 January 2018","URL":"http://www.hst.org.za/publications/Pages/SAHR-2018-Call-for-Abstracts.aspx","body":"The South African Health Review (SAHR) is an accredited peer reviewed publication, widely respected as an authoritative source of research, analysis and reflection on health systems.\r\nThe editorial team of the 2018 SAHR is currently seeking abstracts that give consideration to advances made in the health system over the past 21 years, and reflect on areas of improvement for the future. In particular, abstracts that address the following range of topics are requested: Human resources for health, responses to the prevention and management of non-communicable diseases; and progress and challenges towards implementing universal health coverage.  Preference will be given to manuscripts that offer critical review of the implementation of policies and programmes in the health sector and that give examples of good practices and multisectoral partnerships with demonstrated effectiveness, or of implementation and scale-up of initiatives designed to strengthen the health system. Abstracts should be submitted to: sahr@hst.org.za\r\n","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Strengthening expertise for health technology assessment and priority-setting in Africa","field_subtitle":"Doherty J; Wilkinson T; Edoka I; et al: Global Health Action 10(1), http://dx.doi.org/10.1080/16549716.2017.1370194, 2017","URL":"http://www.tandfonline.com/doi/full/10.1080/16549716.2017.1370194","body":"This study aimed to identify how research organisations and partnerships could contribute to capacity strengthening for health technology assessment and priority-setting in Africa. A rapid scan was conducted of international formal and grey literature and lessons extracted from the deliberations of two international and regional workshops relating to capacity-building for health technology assessment. \u2018Capacity\u2019 was defined in broad terms, including a conducive political environment, strong public institutional capacity to drive priority-setting, effective networking between experts, strong research organisations and skilled researchers. Effective priority-setting requires more than high quality economic research. Researchers have to engage with an array of stakeholders, network closely other research organisations, build partnerships with different levels of government and train the future generation of researchers and policy-makers. In low- and middle-income countries where there are seldom government units or agencies dedicated to health technology assessment, they also have to support the development of an effective priority-setting process that is sensitive to societal and government needs and priorities. Research organisations were found to have an important role to play in contributing to the development of health technology assessment and priority-setting capacity. In Africa, where there are resource and capacity challenges, effective partnerships between local and international researchers, and with key government stakeholders, can leverage existing skills and knowledge to generate a critical mass of individuals and institutions. It is proposed that these would help to meet the priority-setting needs of African countries. ","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Tanzania: Campaigners March Peacefully in Dar for Universal Health Coverage","field_subtitle":"Buguzi S: All Africa, 12 December 2017","URL":"http://allafrica.com/stories/201712130064.html","body":"Campaigners for Universal Health Coverage (UHC) camped at Mwananyamala Regional Hospital in Dar es Salaam in December 2017, raising voices for people who fail to access healthcare services due to financial constraints. Campaigns went out of the hospital as Kinondoni District residents and some health activists carried out peaceful demonstrations as a sign of solidarity for the UHC movement. The Universal Health Coverage Day, marked December 12 every year, is a time when health advocates around the globe join forces to demand action and results in healthcare access in every country.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Taxing the ill - How user fees are blocking universal health coverage","field_subtitle":"M\u00e9decins  Sans  Fronti\u00e8res: Belgium, December 2017","URL":"https://tinyurl.com/yakxmzyw","body":"Direct payments by patients at the point of health care delivery, commonly known as user fees, lead to low utilisation of or exclusion from available health care services and impoverish households. Vulnerable groups are particularly affected. Over the past decade, many countries transitioned away from their user fee policies in favour of health care free at point of care for all or for specific population groups, such as pregnant women, children, and people with certain illnesses.  M\u00e9decins  Sans  Fronti\u00e8res teams  report in this paper witnessing evidence which starkly contrasts the discourse around UHC. Instead of improved access to care, they report a trend towards the reintroduction of user fees and other direct payments  within  national  health  financing strategies. They also report a lack of commitment and support to implement free care policies that secure access and sufficient coverage for the population\u2019s health needs. The authors argue that if the global health community is serious about making UHC a reality and \u2018leave no one behind\u2019, removal of user fees for essential medicines and services must be tackled as a priority. \r\n","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Power of 'Know-Who': Adaptation to Climate Change in a Changing Humanitarian Landscape in Isiolo, Kenya","field_subtitle":"Mosberg M; Nyukuri E; Naess L: IDS Bulletin 48(4), doi: 10.19088/1968-2017.154, 2016","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2888/ONLINE%20ARTICLE","body":"This article examines adaptation to climate change in view of changing humanitarian approaches in Isiolo County, Kenya. While humanitarian actors are increasingly integrating climate change in their international and national-level strategies, less is known about how this plays out at sub-national levels, which is key to tracking whether and how short-term assistance can support long-term adaptation. The article suggests that increasing attention to resilience and adaptation among humanitarian actors may not lead to reduced vulnerability because resources tend to be captured through existing power structures, directed by who you know and your place in the social hierarchy. In turn, this sustains rather than challenges the marginalisation processes that cause vulnerability to climate shocks and stressors. The article highlights the important role of power and politics both in channelling resources and determining outcomes.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Tracking Universal Health Coverage: 2017 Global Monitoring Report","field_subtitle":"World Health Organization, World Bank: WHO, Geneva 2017 ","URL":"https://tinyurl.com/ycf88vtw","body":"Ensuring that all people can access the health services they need \u2013 without facing financial hardship \u2013 is key to improving the well-being of a country\u2019s population. This report argues that universal health coverage (UHC) is more than that: it is an investment in human capital and a foundational driver of inclusive and sustainable economic growth and development. It is a way to support people so they can reach their full potential and fulfil their aspirations. However, the report indicates that despite some progress on UHC, at least half of the world\u2019s population still cannot obtain essential health services. And each year, close to 100 million people are being pushed into extreme poverty because they must pay for health expenses out of their own pockets, pointing to the challenges in reaching the global goal of UHC by 2030.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"United Nations University Japan Foundation for UNU (JFUNU) Scholarship Programme in Japan","field_subtitle":"Deadline for applications: 28 February 2018","URL":"https://tinyurl.com/y997dywx","body":"The United Nations University (UNU) is offering sustainability scholarship for outstanding applicants from developing countries undertaking the MSc programme at UNU. The Japan Foundation for UNU (JFUNU) Scholarship is available for outstanding applicants from developing countries who can demonstrate a need for financial assistance. Candidates should have completed a bachelor\u2019s degree (or equivalent) from a recognized university or institution of higher education in a field related to sustainability.  ","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Using health-facility data to assess subnational coverage of maternal and child health indicators, Kenya ","field_subtitle":"Maina I; Wanjala P; Soti D; et al: Bulletin World Health Organisation 95(10) 683\u2013694, 2017","URL":"http://www.who.int/bulletin/volumes/95/10/17-194399.pdf?ua=1","body":"This study seeks to develop a systematic approach to obtain the best possible national and subnational statistics for maternal and child health coverage indicators from routine health-facility data. The approach aimed to obtain improved numerators and denominators for calculating coverage at the subnational level from health-facility data. This involved assessing data quality and determining adjustment factors for incomplete reporting by facilities, then estimating local target populations based on interventions with near-universal coverage. The authors applied the method to Kenya at the county level, where routine electronic reporting by facilities is in place via the district health information software system. Reporting completeness for facility data were well above 80% in all 47 counties and the consistency of data over time was good. Coverage of the first dose of pentavalent vaccine, adjusted for facility reporting completeness, was used to obtain estimates of the county target populations for maternal and child health indicators. The country and national statistics for the four-year period 2012/13 to 2015/16 showed good consistency with results of the 2014 Kenya demographic and health survey. The results indicated a stagnation of immunization coverage in almost all counties, a rapid increase of facility-based deliveries and caesarean sections and limited progress in antenatal care coverage. While surveys will continue to be necessary to provide population-based data, web-based information systems for health facility reporting provide an opportunity for more frequent, local monitoring of progress, in maternal and child health.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Using pharmacists and drugstore workers as sexual healthcare givers: a qualitative study of men who have sex with men in Dar es Salaam, Tanzania","field_subtitle":"Agardh C; Weiji F; Agardh A; et al: Global Health Action 10(1), doi: http://dx.doi.org/10.1080/16549716.2017.1389181, 2017","URL":"http://www.tandfonline.com/doi/full/10.1080/16549716.2017.1389181","body":"This study explored the perceptions and experiences of seeking treatment and advice from pharmacists and drugstore workers in Dar es Salaam, Tanzania, by men who have sex with men (MSM) with regards to their sexual health and STI-related problems. Fifteen in-depth interviews were conducted with MSM with experience of seeking assistance relating to their sexual health at pharmacies and drugstores in Dar es Salaam in 2016. Four themes related to different aspects of MSM\u2019s perceptions and experiences of pharmacy care emerged from the analysis: Balancing threats against need for treatment reflected informants\u2019 struggles concerning risks and benefits of seeking assistance at pharmacies and drugstores; Identifying strategies to access required services described ways of approaching a pharmacist when experiencing a sexual health problem; Seeing pharmacists as a first choice of care focused on informants\u2019 reasons for preferring contact with pharmacies/drugstores rather than formal healthcare services; and lacking reliable services at pharmacies indicated what challenges existed related to pharmacy care. MSM perceived the barriers for accessing assistance for STI and sexual health problems at pharmacies and drugstores as low, thereby facilitating their access to potential treatment. However, the results further revealed that MSM at times received inadequate drugs and consequently inadequate treatment.","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Wishing you roots and wings in 2018!","field_subtitle":"Editor, EQUINET  newsletter","body":"At this time last year we wished you progress towards health and justice in the year. \r\n\r\nOur editorials in 2017 reflect some of the mountains that have to be moved for this:  At several points of the year - in February and June - contributors highlighted preoccupations with emergencies, bio-security and migration that trigger discrimination and exclusion, rather than solidarity and shared responsibility.  In March and in September we heard about the increasing privatisation of public spaces, public institutions and public health services, and in April about the extraction of minerals and other resources from our countries without fair benefit for local communities.  \r\n\r\nHowever, the 2017 contributions also point to ideas and forces that move these mountains:  such as the news in February of thousands of people gathering at Habitat3 around people\u2019s right to the city and to healthy urban life;  the demand in March by civil society to open up a closed world of global policy making;  the claim in April for regional economic communities to set health standards in mining that should apply across the region; the organisation of collective African voice May\u2019s World health assembly to more strongly advance ideas and interests from the region;  and examples raised in September and October of how recognising and nurturing people\u2019s rights, evidence and power generates a critical resource for health systems. In the beginning of 2017 one editorial painted a scenario of a future world where inclusion and investment in wellbeing is recognised not only as a matter of rights and justice, but as vital for our collective survival. So it was inspiring in the end of the year to hear a group of young contributors share ideas of urban futures that would overcome the significant differences in opportunities for wellbeing that they seek to demand, contribute to and achieve.\r\n\r\nThese ideas and forces are all rooted in the challenging conditions described. But they are also challenging these conditions, envisaging both a direction for change and a power to transform that lies in people\u2019s hands. A Sudanese proverb says that we desire to bequeath two things to the next generation; the first one is roots, the other one is wings. Let\u2019s move forward into 2018 with both!","php":"","field_issue_date":"2018-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":" ICASA 2017: 19th International Conference on AIDS and STDs in Africa","field_subtitle":"4-9 December 2017, Abidjan, C\u00f4te d'Ivoire","URL":"http://icasa2017cotedivoire.org","body":"The 2017 ICASA conference theme \u201cAfrica: Ending AIDS-delivering differently\u201d engages the continent and its stakeholders in the post SDG framework, where sustainability of the response in reaching 90, 90, 90 of UNAIDS will not be possible unless human rights are made a key priority with the application of science based evidence, particularly as commitments are threatened as a result of the global economic downturn. The organisers are anticipating 7 000 -10 000 of the world\u2019s leading scientists, policy makers, activists, PLHIV, government leaders and heads of state and civil society representatives as an opportunity to promote inter-sectoral achievements in the AIDS response and to strengthen the partnership among governments, civil society, and development partners. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Access to medicines and hepatitis C in Africa: can tiered pricing and voluntary licencing assure universal access, health equity and fairness? ","field_subtitle":"Assefa Y; Hill PS; Ulikpan A; et al,: Globalization and Health 13(73)1-11, 2017","URL":"https://tinyurl.com/yd43ly6v","body":"This paper analyses the implications of a tiered pricing and voluntary licensing strategy for access to Direct Acting Antivirals (DAAs) for treating Hepatitis C Virus (HCV). Seven countries in Africa were examined (Egypt, Ethiopia, Nigeria, Democratic Republic of Congo, Cameroon, Rwanda and South Africa) to assess their financial capacity to provide DAAs for treating HCV under present voluntary licensing and tiered-pricing arrangements. The cost of 12-weeks of generic DAA varied from $684 per patient treated in Egypt to $750 per patient treated in other countries. The current prices of DAAs are much higher than the median annual income per capita and the annual health budget of most of these countries. If governments alone were to bear the costs of universal treatment coverage, then the required additional health expenditure from present rates would range from a 4% increase in South Africa to a staggering 403% in Cameroon. The current arrangements for increasing access to DAAs, to eliminate HCV would require increases in expenditure that are too burdensome for governments, individuals and families. The authors argue that countries need to implement the flexibilities in the Doha Declaration on Trade Related Intellectual Property Rights agreement, including compulsory licensing and patent opposition to address this, and this requires political commitment, financial will, global solidarity and civil society activism.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Accountability for Health Equity: Reflections for Southern Africa","field_subtitle":"Cynthia Ngwalo Lungu, Johannesburg, South Africa","body":"\r\nIn July 2017, I attended a conference by the Institute of Development Studies (IDS) themed \u2018Unpicking Power and politics for transformative change: Towards Accountability for health equity\u2019. The conference examined the practices and politics shaping accountability in health systems from local to global levels. As a southern African, these are my reflections on this from the conference discussions. \r\n\r\nAccountability for health equity is essentially about citizens being able to hold governments to account to deliver health for all. It is about inclusivity and ensuring better health for the less privileged, marginalised and vulnerable people. \r\n\r\nIt is commonly known that within Southern Africa public sector financing for health is meagre and below the 15% committed to in the Abuja declaration.  People in need struggle to access health care. In some countries people walk up to 30 km to get to the nearest health centre, only to find that it doesn\u2019t have the basic resources to function. In countries where the health system has largely been privatised it can be virtually impossible for poor people to afford health care.  This situation is worsened when there is abuse of resources, a lack of transparency in health management, a lack of public information on health budgets and expenditures, when budget and policy processes are centralised in a top down approach that allows for little or no citizen participation in decision-making. \r\n\r\nIn response, the region has seen a rapid development of social accountability initiatives that trigger active citizenship, where communities actively participate in health decision making and hold governments to account on how resources are mobilised and used. The Centre for civil society capacity building, a Mozambican organisation, recounted in conference how social accountability initiatives in that country have improved transparency in resources for health and but influenced the development of formal national mechanisms for health accountability using scorecards for citizens to input to decisions and provide feedback on services. \r\n\r\nWhile these efforts have achieved varying positive outcomes, they often tackle \u2018low hanging fruit\u2019, addressing local challenges like health worker attitudes or cleanliness within the vicinity of health facilities, thereby bringing about change in local practice. While these changes are commendable, they are often tied to project timelines, are localised and often do not trigger national level changes. Community level initiatives have struggled to address more systemic challenges, such as access to information, budget setting or expenditure tracking and bottlenecks in procuring and supplying medicines. The IDS meeting argued that this is because social accountability efforts have failed to respond to higher level constraints affecting the ability of local service providers to respond to community feedback. Much more broadly social accountability initiatives have in some cases failed to recognise the complex power dynamics that are typical of health systems. Social accountability efforts ought to engage with power if they are to bring about equity and social justice, otherwise, there is the risk that initiatives will simply replicate   existing social hierarchies.  \r\n\r\nAnother factor affecting these social accountability initiatives is sustainability and ability to outlive short-term project timelines. There is a need to cultivate an active citizenship that raises voice to point out accountability concerns without relying on external drivers. Given the weaknesses in general environments to support this, we need to recognise and explore the role of formal structures for accountability in health, notwithstanding their pitfalls. This implies critically considering the extent to which the community voice can be integrated with  local level formal accountability structures without being compromised  or \u2018swallowed\u2019 by them.  In the Northern part of Malawi, for example, the Catholic Commission for Justice and Peace has cultivated an active citizenship that engages within the formal mechanisms in health, as a form of structured and sustainable citizen engagement with the health system.\r\n\r\nFrom the convening it was very clear that social accountability initiatives should respond to particular contexts. For example, in the case of politically charged states within Southern Africa, communities and civil society pushing for health rights and social justice are often tackling a wide range of issues that may confront power and carry unintended political connotations. Traditional social accountability tools  and approaches which work in accommodative participatory environments may not be useful in politically charged contexts as Social accountability proponents become human rights defenders who need a unique set of skills to pursue issues without risking their own lives and security.  The operating environment calls for unique capacities, language, strategies and mechanisms to achieve results without exacerbating conflict. \r\n\r\nWhile many of these social accountability initiatives appear to focus on public sector services, there are other non-state and private for profit actors involved in the delivery of health care. Across the region health has attracted markets and business operators resulting in a range of providers, in some cases in public -private -partnerships. How do we ensure that in the face of a growing private sector, public interests continue to take centre stage as a means to achieving equity in health? What mechanisms can be used to hold these private actors to account on social goals and health needs, when their preoccupation is with profit margins and \u2018fair returns\u2019?  Lessons from the negative effects of pluralistic health markets in other countries, such as Mongolia, can be used by the region to inform the development and implementation of sound regulation of the \u2018business of health\u2019 and to ensure that PPP\u2019s and health financing schemes including health insurance are developed in an accountable manner and in line with equity goals. \r\n\r\nThese are significant challenges, but there are also opportunities to strengthen accountability through innovation. Despite low internet penetration and high telecommunication charges in some parts of the region, information technology is spreading. Throughout the region, technology is fast becoming a powerful tool in pushing for social economic rights- with the click of a button communities can voice public health concerns or access critical health sector information. With these tools, the means to accountability for transformative change may indeed lie in people\u2019s hands!\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  More information on the IDS meeting can be found at  http://www.ids.ac.uk/opinion/naming-the-moment  ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Africa Region webinar: How to submit a successful organised session abstract","field_subtitle":"Health Systems Global: HSG, November 2017","URL":"https://tinyurl.com/ydfvu2ue","body":"Health Systems Global Africa Region hosted a webinar on \u201chow to submit a successful organised session abstract\u201d, the recording of which is now available to watch online. The webinar offered tips on how participants can increase their chances of having their abstracts successfully accepted for an organised session at the Fifth Global Symposium on Health Systems Research in Liverpool, October 2018 (HSR2018). It gives an overview of the importance of raising the profile of African health policy and systems research at HSR2018, and how organised sessions can be a powerful way of achieving this.  It presents a brief overview, a series of short presentations, and a question and answer session with participants.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Antimicrobial resistance among children in sub-Saharan Africa","field_subtitle":"Williams P; Isaacs D; Berkley J: The Lancet Infectious Diseases, doi: http://dx.doi.org/10.1016/S1473-3099(17)30467-X, 2017","URL":"https://tinyurl.com/y7md6eoh","body":"Antimicrobial resistance is an important threat to international health. Therapeutic guidelines for empirical treatment of common life-threatening infections depend on available information regarding microbial aetiology and antimicrobial susceptibility, but sub-Saharan Africa lacks diagnostic capacity and antimicrobial resistance surveillance. The authors systematically reviewed studies of antimicrobial resistance among children in sub-Saharan Africa since 2005. Among neonates, gram-positive bacteria were responsible for a high proportion of infections among children beyond the neonatal period, with high reported prevalence of non-susceptibility to treatment advocated by the WHO therapeutic guidelines. There are few up-to-date or representative studies given the magnitude of the problem of antimicrobial resistance, especially regarding community-acquired infections. Research should focus on differentiating resistance in community-acquired versus hospital-acquired infections, implementation of standardised reporting systems, and pragmatic clinical trials to assess the efficacy of alternative treatment regimens.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for abstracts: Health Systems Trust 2018 Conference","field_subtitle":"9 \u2013 11 May 2018, Birchwood Conference Centre, Johannesburg, South Africa.","URL":"http://www.hst.org.za/hstconference/hstconference2018/takingpart/Pages/Submit-an-Abstract.aspx","body":"The HST 2018 Conference is organised under the theme \u201cReimagining health systems towards achieving the SDGs\u201d and follows the inaugural 2016 gathering of health systems stakeholders from around South Africa and the rest of the continent. The call for abstracts is now open. In the spirit of leaving no one behind, submissions are invited that discuss challenges faced and solutions adopted at various levels in the health system towards achieving the transformative Sustainable Development Goals agenda. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call For Papers: African Street Literatures","field_subtitle":"Deadline for abstracts: 15 December 2017","URL":"https://tinyurl.com/y7a5ptsv","body":"This is an open call for papers for a special issue of English Studies in Africa that will focus on African street literature. This refers to literature that emerges and is shaped by the specific factors determining everyday life in sub-Saharan Africa\u2019s megacities, where new and emergent forms of literary expression dominate cultural circuits and flows. The intensification of social, political, economic, health and environmental precariousness, alongside uneven spurts of economic growth, rapid urbanisation, unprecedented access to technology and global connectivity, and a correlated surge in cultural and aesthetic expression, make African cities concentrated locations of vulnerable modernity. The call thus seeks to give a space for writing that reflects these features of the African city. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for participation VII World Social Forum on Health and Social Security, Brazil ","field_subtitle":"Salvador de Bahia Brazil, 10-12 March 2018","URL":"http://www.fsms.org.br","body":"The VII World Social Forum on Health and Social Security will be held in Salvador de Bahia Brazil from 10th to 13th of march 2018, immediately before the 11th World Social Forum that will happen from the 13th to the 17h of March. The organisers are inviting suggestions for the definition of contents and methodology of the WSFHSS. Contact armandodenegri@yahoo.com or through the website from the 25th of November 2017. Please look at the invitation video: https://youtu.be/DU_ODDLLaYQ\r\n","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Characteristics of community savings groups in rural Eastern Uganda: opportunities for improving access to maternal health services","field_subtitle":"Mutebi A; Kananura R; Ekirapa-Kiracho; et al.:  Global Health Action 10(S4)82-91, 2017 ","URL":"http://tinyurl.com/ya5a9k5k","body":"Data on the characteristics of community-based savings groups were collected from 247 community-based savings group leaders in the districts of Kamuli, Kibukuand Pallisa using a self-administered open-ended questionnaire, and in-depth interviews with seven community-based savings group leaders. Ninety-three percent of the community-based savings groups said they elected their management committees democratically to select the group leaders and held meetings at least once a week. Eighty-nine percent used metallic boxes to keep their money, while 10% kept their money in mobile money and banks. The community-based savings groups were formed mainly to increase household income, to develop the community and to save for emergencies. The community-based savings groups faced challenges of high illiteracy among the leaders, irregular attendance of meetings, and lack of training on management and leadership. Saving groups in Uganda are reported to have the basic required structures, but with challenges in relation to training and management of the groups and their assets, calling for technical support in these areas.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey","field_subtitle":"Simms V; Dauya E; Dakshina S, et al.: Public Library of Science Medicine (PLOSMed) 14(7)  doi: https://doi.org/10.1371/journal.pmed.1002360, 2017","URL":"http://tinyurl.com/y9fu7lm7","body":"The authors investigated the change in the community burden of undiagnosed HIV infection among older children and adolescents following implementation of provider-initiated testing and counselling  (PITC) in Harare, Zimbabwe. Over the course of 2 years (2013\u20132015), 7 primary health clinics (PHCs) in southwestern Harare implemented optimised, opt-out PITC for all attendees aged 6\u201315 years. In 2015, the authors conducted a representative cross-sectional survey of 8\u201317-year-olds living in the 7 communities served by the study PHCs, who would have had 2 years of exposure to PITC. Knowledge of HIV status was ascertained through a caregiver questionnaire, and anonymised HIV testing was carried out.   Of 7,146 children in 4,251 eligible households, 76.8%  agreed to participate in the survey, and 141 were HIV positive. HIV prevalence was 2.6% and over a third of participants with HIV were undiagnosed. Based on extrapolation from the survey sample to the community, the authors estimated that PITC over 2 years identified between 18% and 42% of previously undiagnosed children in the community. The main limitation is that prevalence of undiagnosed HIV was defined using a combination of 3 measures none of which are perfect. Facility-based approaches are argued to be inadequate in achieving universal coverage of HIV testing among older children and adolescents, and community-based approaches are identified as necessary in this age group.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Development of a Hypertension Health Literacy Assessment Tool for use in primary healthcare clinics in South Africa, Gauteng","field_subtitle":"Mafutha N; Mogotlane S; De Swardt H: African Journal of Primary Health Care and Family Medicine 9(1)1-8, 2017 ","URL":"https://tinyurl.com/y7u4eb58","body":"This study investigated the development of a hypertension heath literacy assessment tool to establish patients\u2019 comprehension of the health education they receive in primary healthcare clinics in Tshwane, Gauteng, South Africa. The design was quantitative, descriptive and contextual. The study population comprised health promoters who were experts in the field of health, documents containing hypertension health education content and individuals with hypertension. The tool was administered to 195 participants concurrently with a learning ability battery. The health literacy assessment tool was found to be a valid tool that can be used in busy primary healthcare clinics as it takes less than two minutes to administer. This tool can inform the healthcare worker on the depth of hypertension health education to be given to the patient, empowering the patient and saving time in primary healthcare facilities.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Disentangling regional trade agreements, trade flows and tobacco affordability in sub-Saharan Africa","field_subtitle":"Appau A; Drope J; Labont\u00e9 R; et al: Globalisation and Health 13(81) doi: https://doi.org/10.1186/s12992-017-0305-x, 2017","URL":"https://tinyurl.com/y8mbojpq","body":"In principle, trade and investment agreements are meant to boost economic growth. However, the removal of trade barriers and the provision of investment incentives to attract foreign direct investments may facilitate increased trade in and/or more efficient production of commodities considered harmful to health such as tobacco. The authors analyze existing evidence on trade and investment liberalization and its relationship to tobacco trade in Sub-Saharan African countries. Comparisons are made between tobacco trading patterns and foreign direct investments made by tobacco companies. The authors estimate and compare changes in the Konjunkturforschungsstelle (KOF) Economic Globalization measure, relative price measure and cigarette prices. Preferential regional trade agreements appear to have encouraged the consolidation of cigarette production, which has shaped trading patterns of tobacco leaf. Since 2002, British American Tobacco has invested in tobacco manufacturing facilities in Nigeria, Kenya and South Africa strategically located to serve different regions in Africa. Following this, British America Tobacco closed factories in Ghana, Rwanda, Uganda, Mauritius and Angola. At the same time, Malawi and Tanzania exported a large percentage of tobacco leaf to European countries. After 2010, there was an increase in tobacco exports from Malawi and Zambia to China, which may be a result of preferential trade agreements the EU and China have with these countries. Economic liberalization has been accompanied by greater cigarette affordability for the countries included in the analysis. Only excise taxes and income are reported by the authors to have an effect on cigarette prices within the region. The results suggest that the changing economic structures of international trade and investment are likely heightening the efficiency and effectiveness of the tobacco industry. As tobacco control advocates consider supply-side tobacco control interventions, the authors suggest that they consider carefully the effects of these economic agreements and whether there are ways to mitigate them.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 201: Accountability for Health Equity: Reflections for Southern Africa","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Equity in international health research collaborations in Africa: Perceptions and expectations of African researchers","field_subtitle":"Munung N; Mayosi B; de Vries J: PLOS One 12(10), doi: https://doi.org/10.1371/journal.pone.0186237, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186237","body":"In this paper, the authors report on a qualitative interviewing study in which they involved 17 genomics researchers in Africa. The authors describe their perceptions and expectations of international genomics research and biobanking initiatives in Africa. All interviewees were of the view that externally funded genomics research and biobanking initiatives have played a critical role in building capacity for genomics research and biobanking in Africa and in providing an opportunity for researchers in Africa to collaborate and network with other researchers. Whilst the opportunity to collaborate was seen as a benefit, some interviewees stressed the need for these collaborations to have mutual benefits for all partners, including their collaborators in high income countries. They voiced two major concerns of being part of these collaborative initiatives: the possibility of exploitation of African researchers and the non-sustainability of research capacity building efforts. They thus recommended genuine efforts to create transparent and equitable international health research partnerships through,: having rules of engagement, enabling African researchers to contribute to the design and conduct of international health projects in Africa, and mutual and respectful exchange of experience and capacity between research collaborators. These were identified as hallmarks to equitable international health research collaborations in Africa. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers\u2019 use of information in decision-making: experience from Cape Town, South Africa","field_subtitle":"Scott V and Gilson L: International Journal for Equity in Health 16(159)1-15, 2017","URL":"http://tinyurl.com/y7bjwery","body":"This paper reports on work to explore how primary healthcare facility managers\u2019 use of information for decision-making is influenced by governance across levels of the health system in Cape Town, South Africa. Central governance shaped what information and knowledge was valued \u2013 and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based health information system which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential knowledge to make locally-appropriate and responsive decisions, and to perform the people management tasks required. Despite central level influences, modes of governance operating at the sub-district level had influence over what information was valued, generated and used locally. Strengthening local level managers\u2019 ability to create enabling environments is an important leverage point in supporting informed local decision-making, and, in turn, translating national policies and priorities, including equity goals, into appropriate service delivery practices.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Financing A National Health Insurance for South Africa","field_subtitle":"The Davis Tax Committee: Ministry of Finance, South Africa, 2017","URL":"https://tinyurl.com/y9sbxzy4","body":"The Davis Tax Committee was established in 2013 by the Minister of Finance to inquire into the role of the tax system in promoting inclusive economic growth, employment creation, development and fiscal sustainability. This report concentrates on identifying long term financing principles \u2013 the specific operationalisation which will be informed by more detailed implementation and costing plans in order to manage the transition from the status quo to the financing regime envisaged in the National Health Insurance (NHI) in South Africa. This report examines the definition, rationale and design of the proposed NHI. It explores international experience in financing universal health coverage, with a focus on middle income developing countries and existing sources of health financing in South Africa are analysed. Cost estimates and potential macroeconomic impacts are discussed and the report concludes with an evaluation of options for NHI financing. The authors identify a number of factors in the design of NHI, as well as its implementation, all of which have an impact on its financing trajectory. These include parameters on risk pooling, on health care purchasing and on provision. Risk pooling decisions include whether there would be a single or multiple purchaser, the level of consolidation of risk pools and their coverage and composition as well as the nature of the resources allocation formula (evidence and needs based, risk equalisation etc.). The structure of purchasing encompasses, inter alia, the scope and pricing of the benefit package (which had not yet been defined in the White Paper), contractual arrangements with health care providers such as GPs and hospitals, quality management systems, payment and information systems. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"How does decentralisation affect health sector planning and financial management? a case study of early effects of devolution in Kilifi County, Kenya.","field_subtitle":"Tsofa B; Goodman C; Gilson L; et al.: International Journal for Equity Health 16(1)151-163, 2017 ","URL":"http://tinyurl.com/ybybopx7","body":"In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous devolved county governments, with a substantial transfer of responsibility for healthcare from the central government to these counties. This study analysed the effects of this decentralization on health sector planning, budgeting and financial management at county level in Kilifi County. The authors found that the implementation of devolution created an opportunity for local level prioritisation and community involvement in health sector planning and budgeting, increasing opportunities for equity in local level resource allocation. However, this opportunity was not harnessed due to accelerated transfer of functions to counties before county level capacity had been established to undertake the decentralised functions. The authors also observed some indication of re-centralisation of financial management from health facility to county level. They conclude that to enhance the benefits of decentralised health systems, resource allocation, priority setting and financial management functions between central and decentralised units need to be guided by considerations around decision space, organisational structure and capacity and accountability. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"If you miss them, then you\u2019re missing out","field_subtitle":"Riria J: Daily Nation, 7 November 2017","URL":"https://tinyurl.com/yc8ps42o","body":"The author reports an estimated 65 per cent of women-led small and medium-sized enterprises (SMEs) in the developing economies that are either unserved or underserved financially. SMEs provide 80 per cent of Kenya\u2019s employment and contribute 20 per cent of our GDP, according to latest reports from African Economic Outlook. Data on registered firms shows that women hold ownership roles in 48 per cent of Kenyan SMEs. The World Bank says that only 51 per cent of Kenyan women have access to a simple bank account, much less a business loan or insurance to protect them financially. The author notes that microfinance can address this deficit through loans designed specifically for women-led SMEs that need access to working capital to expand their businesses, that have flexible monthly repayment amounts, security and collateral requirements, and longer repayment periods.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Improving the performance of community health workers in Swaziland: findings from a qualitative study","field_subtitle":"Geldsetzer P; De Neve JW; Boudreaux C; et al.: Human Resources for Health 15(68)1-9, 2017","URL":"http://tinyurl.com/yb7m7ubn","body":"This qualitative formative research study aimed to inform the design of interventions intended to increase the performance of CHW programs in Swaziland. Specifically, focusing on four CHW programs, the authors aimed to determine what leads to improved performance of CHWs. The CHW cadres studied were the rural health motivators, mothers-to-mothers mentors, HIV expert clients, and a community outreach team for HIV. Across the four cadres, participants perceived the following four changes to likely lead to improved CHW performance: increased monetary compensation of CHWs, a more reliable supply of equipment and consumables, additional training, and an expansion of CHW responsibilities to cover a wider array of the community\u2019s healthcare needs. The supervision of CHWs and opportunities for career progression were rarely viewed as key factors. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania","field_subtitle":"Helga N; Mujinja P; Kilewo C; et al.: Human Resources for Health 15(61)1-12, 2017","URL":"http://tinyurl.com/yawlwndc","body":"From March to April 2014, a questionnaire asking about job satisfaction and turnover intentions was administered to all nurses at 36 public-sector health facilities offering antenatal and prevention of mother-to-child transmission services in Dar es Salaam, Tanzania. Slightly over half of the providers were dissatisfied with their current job, and 35% intended to leave it. Most providers were dissatisfied with low salaries and high workload, but satisfied with workplace harmony and being able to follow their moral values. The following factors were associated with providers\u2019 intention to leave their current job: dissatisfaction at not being recognized by one\u2019s superior, and poor feedback on the overall unit performance. Providing reasonable salaries and working hours, clearer job descriptions, appropriate safety measures, job stability, and improved supervision and feedback are argued to be key to retaining satisfied health workers for prevention of mother-to-child transmission providers.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Mental health leadership and patient access to care: a public\u2013private initiative in South Africa","field_subtitle":"Szabo C; Fine J; Mayers P; et al.: International Journal of Mental Health Systems 11(52)1-8, 2017","URL":"https://tinyurl.com/y962732z","body":"Despite the significant adverse social and economic costs of mental illness, psychiatric and related services receive a low level of priority within the health care system. A public\u2013private mental health leadership initiative, emanating from a patient access to care programme, was developed to build leadership capacity within the South African public mental health sector. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants\u2019 daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included with  personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. Participants acquired both skills and the confidence to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum for specialist training. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Organisational culture and trust as influences over the implementation of equity-oriented policy in two South African case study hospitals","field_subtitle":"Erasmus E; Gilson L; Govender V; et al: International Journal of Equity in Health 16(1)164-177, 2017","URL":"https://tinyurl.com/yd4b9beh","body":"This paper uses the concepts of organizational culture and organizational trust to explore the implementation of equity-oriented policies - the Uniform Patient Fee Schedule and Patients' Rights Charter - in two South African district hospitals. The hospitals' implementation approaches were similar in that both primarily understood it to be about revenue generation, that granting fee exemptions was not a major focus, and considerable activity, facility management support, and provincial support was mobilised behind the Uniform Patient Fee Schedule. The hospitals' Patients' Rights Charter paths diverged quite significantly, as Hospital A was more explicit in communicating and implementing the Patients' Rights Charter, while the policy also enjoyed stronger managerial support in Hospital A than Hospital B. Beneath these experiences lie differences in how people's values, decisions and relationships influence health system functioning and in how the nature of policies, culture, trust and power dynamics can combine to create enabling or disabling micro-level implementation environments. Achieving equity in practice requires managers to take account of \"unseen\" but important factors such as organisational culture and trust, as key aspects of the organisational context that can profoundly influence policies. In addition to putting in place necessary staff and resources, tasks such as relationship management, the negotiation of values and paying careful attention to how policies are practically framed and translated into practice are seen to be necessary to ensure equity aspects are not neglected.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Resource curse or fair benefit: Protecting health in the extractive sector in east and southern Africa","field_subtitle":"EQUINET, TARSC, SATUCC, SADC CNGO: Harare, 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20EI%20civil%20society%20brief%202017.pdf","body":"The extractive (or mining) sector is a major economic actor in east and southern Africa. The mineral resources extracted are sought after globally, and how the sector operates affects the lives of millions of people. This brief aimed mainly civil society discusses the health impacts of the sector, how far these risks are recognised in policy and controlled in practice, and what civil society can do to ensure that health is protected in EI activity. It presents the proposals made at the 13th Southern Africa Civil society Forum in 2017 to advocate for regional health standards for EIs and a bottom up local to regional campaign for civil society to advocate for these harmonised standards for health in the mining (extractive) sector in SADC.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Sharing Histories\u2014a transformative learning/teaching method to empower community health workers to support health behaviour change of mothers","field_subtitle":"Altobelli L: Human Resources for Health 15(54)1-9, 2017","URL":"http://tinyurl.com/yaysue5n","body":"One way of improving health globally is promoting mothers\u2019 adoption of healthy home practices for improved nutrition and illness prevention in the first 1000 days of life from conception. The challenge is how to promote learning and behaviour change of mothers more effectively in low-resource settings where access to health information is poor, educational levels are low, and traditional beliefs are strong. In addressing that challenge, a new learning/teaching method called \u201cSharing Histories\u201d is in development to improve the performance of female community health workers in promoting mothers\u2019 behaviours for maternal, neonatal and child health. This method builds self-confidence and empowerment of community health workers in learning sessions that are built on guided sharing of their own memories of childbearing and child care. Community Health Workers can later share histories with the mother, building her trust and empowerment to change. For professional primary health care staff who are not educators, Sharing Histories is simple to learn and use so that the method can be easily incorporated into government health systems and ongoing community health workers programs. The author presents the Sharing Histories method, describes how it differs from other social and behaviour change methods, and discusses selected literature from psychology, communications, and neuroscience that helps to explain how and why this method works as a transformative tool to engage, teach, transform, and empower Community Health Workers to be more effective change agents with other mothers in their communities.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Social Protection or Humanitarian Assistance: Contested Input Subsidies and Climate Adaptation in Malawi","field_subtitle":"Haug R; Wold B: IDS Bulletin 48(4), doi: http://dx.doi.org/10.19088/1968-2017.155, 2016","URL":"http://bulletin.ids.ac.uk/idsbo/article/view/2889/ONLINE%20ARTICLE","body":"This article assesses factors that contributed to the success of the farm input support programme in Malawi in 2005\u201315, and the lessons from this experience in relation to climate change adaptation. Important factors were the ability to balance external and internal drivers that affected policy formulation, national ownership and prestige that influenced and motivated implementation capability, creation of conducive conditions its demand-driven nature. However, the flooding in 2015 and the drought in 2016 revealed that Malawi needs more effective measures to reduce long-term vulnerability to future adverse impacts of climate change. The authors argue that the lessons learned from this social protection programme can prove useful in relation to efforts to achieve sustainable responses to climate change that could reduce the need for humanitarian assistance. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Teaching videos on human rights","field_subtitle":"Yamin A: Global Health Education and Learning Incubator, Georgetown, 2017","URL":"https://vimeopro.com/gheli/human-rights-series","body":"These short videos provide an overview of the history of human rights; health and human rights; and health, human rights and development. They were developed to make human rights more accessible to non-lawyers and non-academics. The videos are accompanied by tools for further learning, including an annotated bibliography, glossary of terms, timeline of key events, and fact sheet on universal health coverage. The first video provides an explanation on what human rights are and why they are important.  The second video offers a brief history of health and human rights since World War II. The third video gives a description of how health-related human rights developed during the era of the Millennium Development Goals (2000-2015) and the Sustainable Development Goals (2016-2030). The series concludes by considering the vital role that human rights plays in diverse political environments.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The 6th Quadriennial General Meeting and the 13th Scientific Conference of the East, Central and Southern Africa College of Nursing (ECSACON) ","field_subtitle":"ECSACON: Safari Park Hotel, Nairobi, Kenya, 3 \u2013 7 September 2018","URL":"http://ecsahc.org/news/1454/","body":"The 2018 ECSACON conference follows the theme \u2018Nurses and Midwives responding to global agenda on sustainable development goals and universal health coverage\u2019. The conference will focus on quality and affordability of Maternal, Newborn and Child Health Services and increasing access to health care including GBV services and SRHR among the youth, nursing and midwifery workforce development to achieve HRH2030 Agenda. The conference will showcase innovations in preparing competent, skilled and motivated nurses and midwives, Nursing and midwifery workforce preparedness to respond to global calls, challenges and/or disasters. The conference will prioritize communicable and NCDs including mental health and nutrition. The call is open to ECSACON Members, Non ECSACON Members from the ECSA region and Non ECSACON Members from outside the region","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Lancet Countdown: Tracking Progress on Health and Climate Change","field_subtitle":"Watts, Nick et al.: The Lancet , 389  (10074 ), 1151 - 1164, 2017","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32124-9/fulltext","body":"The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration between academic institutions and practitioners across the world that aims to track the health impacts of climate hazards; health resilience and adaptation; health co-benefits of climate change mitigation; economics and finance; and political and broader engagement. The Lancet Countdown aims to report annually on a series of indicators across these five areas in tandem with  existing monitoring processes, such as the UN Sustainable Development Goals and WHO's climate and health country profiles. The indicators will also evolve over time through ongoing collaboration with experts and a range of stakeholders, and be dependent on the emergence of new evidence and knowledge.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The Role of Parliamentarians in Ending Child Marriage ","field_subtitle":"Girls not Brides: The Global Partnership to End Child Marriage, 2016","URL":"https://tinyurl.com/y9ysegt6","body":"Developed by Girls Not Brides to promote collaboration between civil society organisations and parliamentarians, this toolkit provides an overview of what child marriage is, and existing international legal instruments that prohibit the practice. It lists concrete examples and recommendations on how parliamentarians can take action, not only in Parliament but in their constituencies and internationally. Parliamentarians are encouraged to take action through means such as parliamentary meetings, establishing forums and meeting with civil society organisations. The toolkit will be particularly useful to hold governments accountable for their commitment to ending child marriage in target 5.3 of the Sustainable Development Goals (SDGs).","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The United Nations Trust Fund to End Violence against Women ","field_subtitle":"Deadline for applications: 5 December 2017","URL":"http://www.unwomen.org/en/trust-funds/un-trust-fund-to-end-violence-against-women","body":"The UN Trust Fund to End Violence against Women (UN Trust Fund) awards grants to initiatives that demonstrate that violence against women and girls can be systematically addressed, reduced and, with persistence, eliminated. Civil society organizations are invited to submit grant proposals for a minimum of US$50,000 up to a maximum of US$1 million for a period of three years. Proposals are invited under the following three programmatic areas: (1) Improving access for women and girls to essential, safe and adequate multi-sectoral services to end violence against women and girls; (2) Increasing effectiveness of legislation, policies, national action plans and accountability systems to prevent and end violence against women and girls; and (3) Improving prevention of violence against women and girls through changes in knowledge, attitudes and practices. This year, the UN Trust Fund is also seeking applications that specifically focus on addressing violence against women and girls in the context of the current forced displacement and refugee crisis; or addressing violence against women and girls with disabilities. Applications from women\u2019s rights, women-led, and small women\u2019s organizations are prioritized, in recognition of them being the driving force of the ending violence against women agenda, as well as being at the forefront of reaching women and girls survivors at the grassroots level. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"UN Environment Assembly ","field_subtitle":"4-6 December 2017, Nairobi, Kenya","URL":"http://web.unep.org/environmentassembly/assembly","body":"The UN Environment Assembly meeting in 2017 aims to produce a political declaration on pollution, linked to the Sustainable Development Goals, to signal that humanity can work together to eliminate the threat of pollution and the destruction of our planet. There will be resolutions and decisions adopted by Member States to address specific dimensions of pollution and voluntary commitments by Governments, private sector entities and civil society organizations to clean up the planet. The Assembly will also include The #BeatPollution Pledge, a collection of individual commitments to clean up the planet. This year's Assembly will also launch the interactive Leadership Dialogues, which will provide participants with an opportunity for high-level engagement and discussion on how to achieve a pollution-free planet.","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity","field_subtitle":"Accountability for Health Equity Programme: Institute of Development Studies, Sussex, 2017 ","URL":"https://opendocs.ids.ac.uk/opendocs/handle/123456789/13258","body":"While \u201caccountability\u201d has become an increasingly popular buzzword in health systems debates and health service delivery, it has multiple \u2013 and contested \u2013 meanings. In July 2017, IDS brought together 80 activists, researchers, public health practitioners and policy makers to examine the forces that shape accountability in health systems, from local to global levels. This workshop report records the presentations and discussions on accountability for health equity that are emerging in different country contexts, exploring how accountability relationships develop and change over time. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Voluntary Medical Male Circumcision for HIV Prevention in 14 Priority Countries in Eastern and Southern Africa","field_subtitle":"World Health Organisation: WHO, Geneva, 2017","URL":"http://tinyurl.com/ybmfgwwf","body":"This progress brief outlines key highlights of the VMMC (Voluntary Medical Male Circumcision) intervention in Eastern and Southern Africa. Nearly 15 million VMMCs have been performed for HIV prevention in 14 countries of eastern and southern Africa. These circumcisions are reported to potentially avert over half a million new HIV infections through to 2030. In 2016, 2.8 million VMMCs were performed and all countries in the region, except Uganda and Rwanda, increased the number of VMMCs performed in the year. The majority of clients were aged 15 years or older. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Where does research fit in a post-truth world?","field_subtitle":"Guth J: Special Programme for Research and Training in Tropical Diseases (TDR), UNICEF, UNDP, World Bank, WHO, November 2017 ","URL":"http://www.who.int/tdr/news/2017/Where-does-research-fit/en/","body":"A large study in 3 west African countries examined how to increase the numbers of pregnant women receiving malaria preventive treatment, and getting diagnosed and treated. There were many health systems issues that were identified that created barriers, such as lack of transportation or well-trained healthcare providers at the regional health facilities. Video interviews were conducted with people involved in the project and shared with policy-makers, healthcare providers and community members. The use of video helped to provide local context \u2013 of settings and people. It strengthened the understanding and credibility of the associated research results and showed strong collaboration between the research team and community, a proven facilitator in research uptake. The video was reported to have had a profound when it was shared and led to strong statements of commitments to make changes based on this study. The author suggests that it is necessary to use every tool possible to show the utility of science and how it improves people\u2019s lives in ways that they can see and feel. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda","field_subtitle":"Namazzi G; Okuga M; Tetui M; et al.: Global Health Action 10(S4)72-81, 2017","URL":"http://tinyurl.com/ya7klsts","body":"This paper explores knowledge levels of community health workers (CHWs), describes the coverage of home visits, and shares lessons learnt from setting up and implementing the CHW strategy in eastern Uganda. The CHWs were trained to conduct four home visits: two during pregnancy and two after delivery. The visits aimed to promote birth preparedness and utilization of maternal and newborn health (MNH) services. CHWs\u2019 knowledge of MNH improved after training. However, knowledge of new born danger signs declined after a year. The level of coverage of at least one CHW visit to pregnant and newly delivered mothers was 57% and CHW reports complemented the facility-based health information. CHWs formed associations, which improved teamwork, reporting, and general performance, and maintained low dropout rates at 3.6%. Their challenges included dissatisfaction with the quarterly transport refund of 6 USD and lack of a means of transport, such as bicycles. ","php":"","field_issue_date":"2017-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"9th Alternative Mining Indaba","field_subtitle":"5th to 7th February 2018, Double Tree by Hilton Upper East Side Hotel Cape Town.","URL":"http://altminingindaba.co.za/","body":"The 9th Alternative Mining Indaba will be held under the theme Making Natural Resources Work for the People: Towards Just Legal, Policy and Institutional Reforms. Attracting several hundred SADC and wider community representatives, civil society organizations, and multi-lateral organizations and other stakeholders it provides a forum to actively participate in discussing and providing viable recommendations for the future of natural resource extraction in Africa.  Registration will be opening soon.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A Political Economy Analysis of Domestic Resource Mobilization in Uganda","field_subtitle":"Kj\u00e6r A; Ulriksen M; Kangave J; Katusiimeh M: United Nations Research Institute for Social Development  WP 2017-8, Geneva, 2017","URL":"http://tinyurl.com/y9h3gtdo","body":"This synthesis paper brings together the research findings from four papers prepared by the Uganda team in the UNRISD Politics of Domestic Resource Mobilisation for Social Development project. It addresses three broad themes: bargaining and contestation, key relations, and institution building with regard to mobilising resources for social development. The authors analyse how political economy factors affect revenue raising and social spending priorities in Uganda. It applies a political settlement theory, exploring revenue bargaining or political negotiations that shape revenue mobilisation, revenue composition and policy priorities guiding revenue allocation. The authors focus on three instances of revenue bargains: legislative tax reform, institutional performance of the revenue agencies, and policy making. The first two instances relate to the actual mobilisation of resources, whereas the third example focuses on bargains over spending priorities within a given revenue base. The findings indicate that in Uganda, a low-income country with competing political factions, there are specific challenges to mobilising resources for social development. The need to maintain political power is argued by the authors to have led to reduced tax intakes as taxes levied on rural voters are abolished and tax exemptions introduced for powerful supporters. On the spending side, social development concerns are argued to compete with other public policy areas as well as the pressure to allocate resources for political purposes. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"A revolutionary power to heal","field_subtitle":"Pashad V: Pambazuka News, October 2017","URL":"https://www.pambazuka.org/global-south/revolutionary-power-heal","body":"In a letter to his five children written en route to Bolivia, Ernesto Che Guevara said: \u201cAlways be able to feel deep within your being all the injustices committed against anyone, anywhere in the world. This is the most beautiful quality a revolutionary can have.\u201d This article about Che Guevara, 50 years after his execution, explores Che\u2019s story and legacy. His tutelage in revolutionary thought came from his experiences among the leprosy patients of Venezuela and the tin miners of Bolivia, among the revolutionaries of Argentina and the 1954 coup in Guatemala. Reality radicalised him. Mario Ter\u00e1n Salazar, the soldier who shot Che, went into hiding. Many years later, in 2006, the Cuban government operated on Che\u2019s killer to remove a cataract from his eye without charge. The author points to this to highlight that Che\u2019s legacy was not revenge, but doctor\u2019s love for humanity.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Africa Region webinar on\u00a0\u201chow to submit a successful organised session abstract\u201d","field_subtitle":"Thursday 9 November 2017, 10:00 - 11:30 UTC","URL":"https://attendee.gotowebinar.com/register/215412305862675969","body":"The Health Systems Global Africa Region webinar on \u201chow to submit a successful organised session abstract\u201d will be to offer tips on how participants can increase their chances of having their abstracts successfully accepted for an organised session at the Fifth Global Symposium on Health Systems Research in Liverpool, October 2018 (HSR2018). The webinar will give an overview of the importance of raising the profile of African health policy and systems research at HSR2018, and how organised sessions can be a powerful way of achieving this. Perspectives from the Programme Working Group on the symposium theme and what the Scientific Committee will be looking for in strong abstracts will be shared, as will the experiences of those who have successfully had their organised session abstracts accepted at previous global symposia.\r\n \r\n","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Call for abstracts - Fifth Global Symposium on Health Systems Research","field_subtitle":"Deadline for organised session abstracts 15 January 2018","URL":"http://healthsystemsresearch.org/hsr2018/call-for-abstracts/","body":"The call for abstracts for the Fifth Global Symposium on Health Systems Research is now open. The Fifth Global Symposium on Health Systems Research will take place in Liverpool, UK, on 8-12 October 2018. The Fifth Global Symposium will advance conversations and collaborations on new ways of financing health, delivering services and engaging the health workforce, new social and political alliances, and new applications of technologies to promote health for all. Within the overarching Symposium theme, we welcome abstracts linked to the following four sub-themes: 1. The SDGs as a stimulus for renewed multisectoral action; 2. Polemic and pragmatism: engaging the private sector in moving towards universal health coverage; 3. Leaving no one behind: health systems that deliver for all and 4. Community health systems \u2013 where community needs are located, but often the invisible level of health systems. The deadline for organized session proposals is the 15 January, 2018 and the deadline for individual abstracts is 5 March, 2018. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Capacity and Consent: Empowering Adolescents to Exercise their Reproductive Rights  ","field_subtitle":"Centre for Reproductive Rights:  Center for Reproductive Rights NY 2017","URL":"https://www.reproductiverights.org/sites/crr.civicactions.net/files/documents/GA-Adolescents-FINAL.pdf","body":"With adolescents and youth constituting a quarter of the global population \u2013 for a total of 1.8 billion people \u2013 it has never been more critical that their human rights be fully recognised and realised within global arenas and at the regional, national, and community level.  This publication sets forth the barriers adolescents face in realising their sexual and reproductive health and rights, discusses recent critical developments in the human rights framework underpinning these rights, and proposes a way forward for guaranteeing all adolescents the full exercise of their sexual and reproductive health and rights. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Commercial determinants of health - the role of governments remains crucial","field_subtitle":"The Graduate Institute: GI, Geneva, 2017","URL":"http://tinyurl.com/yd4xhkz7","body":"A multi stakeholder panel on \u201cGoverning Non-Communicable Diseases - Addressing the Commercial Determinants of Health\u201d was held as a side-event during the 70th session of the World Health Assembly. It explored the commercial determinants of health, their links to the political determinants of health and how to navigate the narrow space to create both health and wealth, not just the latter at the expense of the first. The panel identified that government has a central role in taking the lead in policy formulation and in creating a political space for this. Rocco Renaldi from the International Food and Beverage Alliance highlighted the need for governments to create a regulated space and to encourage systemic change within the private sector which will allow them to adjust their strategies to meet the challenge. of chronic conditions.  NCD Alliance Executive Director Katie Dain raised in contrast that the private sector has no role in policy development as this remains the responsibility of governments. The event made a case for enhanced engagement between different sectors of government to build systems of accountability, monitoring and implementation to manage the private sector in health. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Commons:Wiki Loves Africa 2017/en","field_subtitle":"Wikimedia Commons: Wikimedia, October 2017","URL":"https://commons.wikimedia.org/wiki/Commons:Wiki_Loves_Africa_2017/en","body":"Wiki Loves Africa is an annual contest where anyone across Africa can contribute media that relates to that year's theme to Wikimedia Commons for use on Wikipedia and other project websites of the Wikimedia Foundation. Wiki Loves Africa encourages participants to contribute media (photographs, video and audio) that illustrate the specific theme for that year. Each year the theme changes and is chosen by the community from universal, visually-rich and culturally-specific topics (for example, markets, rites of passage, festivals, public art, cuisine, natural history, urbanity, daily life, notable persons, etc). This year's photo contest is being held under the theme ... People at Work. It invites photographs that document all manner of occupations that are undertaken across the African continent - formal and informal, contemporary or ancient, business-oriented or creative. There are two special prizes for photo essays that capture Women Working or Rare, Fading or Threatened Traditional Crafts, Styles or Way of Working. The competition starts on 1st October 2017 and closes on 30th November 2017. Winners will be announced around February 2018.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Diabetes in sub-Saharan Africa: from clinical care to health policy","field_subtitle":"Atun R; Davies J; Gale E; et al: The Lancet Diabetes & Endocrinology Commission 5(8), doi: http://dx.doi.org/10.1016/S2213-8587(17)30181-X, 2017","URL":"https://tinyurl.com/y79rew24","body":"This study analysed factors affecting variations in the observed quality of antenatal and sick-child care in primary-care facilities in seven African countries. The authors pooled nationally representative data from service provision assessment surveys of health facilities in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania (survey year range: 2006-2014). Based on World Health Organisation protocols, the authors created indices of process quality for antenatal care (first visits) and for sick-child visits. The authors assessed national, facility, provider and patient factors that might explain variations in quality of care, using separate multilevel regression models of quality for each service. Data were available for 2594 and 11 402 observations of clinical consultations for antenatal care and sick children, respectively. Overall, health-care providers performed a mean of 62.2% of eight recommended antenatal care actions and 54.5% of nine sick-child care actions at observed visits. Quality of antenatal care was higher in better-staffed and -equipped facilities and lower for physicians and clinical officers than nurses. Experienced providers and those in better-managed facilities provided higher quality sick-child care, with no differences between physicians and nurses or between better- and less-equipped clinics. Private facilities outperformed public facilities. Country differences were more influential in explaining variance in quality than all other factors combined. The quality of two essential primary-care services for women and children was weak and varied across and within the countries. Analysis of reasons for variations in quality could identify strategies for improving care.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET discussion paper 111: A case study of the role of an Essential Health Benefit in the delivery of integrated health services in Zambia","field_subtitle":"Luwabelwa M; Banda P; Palale M; Chama-Chiliba C: EQUINET Discussion paper 111, Zambia Ministry of Health, EQUINET: Lusaka","URL":"http://w.equinetafrica.org/sites/default/files/uploads/documents/EHB%20Zambia%20Case%20study%20Report%20August%202017pv.pdf","body":"This case study report compiles evidence on the experience of the Essential Health Benefit (EHB) in Zambia. The paper aims to contribute to national and regional policy dialogue regarding the role the EHB plays in budgeting, resourcing and purchasing of health services as well as monitoring health system performance for accountability. It outlines the motivations for developing the EHBs in Zambia, the barriers encountered in the process, the methods used to develop EHBs, and issues related to dissemination and communication of its content. The paper was done under the auspices of an EQUINET research programme through Ifakara Health Institute (IHI) and Training and Research Support Centre (TARSC), in association with the ECSA Health Community, supported by IDRC (Canada), and with the permission of the Ministry of Health of Zambia.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Discussion paper 112: A case study of the Essential Health Care Package in Swaziland","field_subtitle":"Magagula SV: Ministry of Health Swaziland, with IHI, TARSC, EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Swaziland%20EHB%20case%20study%20rep%20final2017pv.pdf","body":"The Essential Health Benefit (EHB) is known as Essential Health Care Package (EHCP) in Swaziland. This desk review provides evidence on the experience of EHCPs in Swaziland and includes available policy documents and research reports. It was implemented in an EQUINET research programme through Ifakara Health Institute (IHI) and Training and Research Support Centre (TARSC), in association with the ECSA Health Community, supported by IDRC (Canada). The desk review presents the motivations for and methods used to develop, define and cost EHCP. It includes key informant input from a multi-disciplinary national task team through a workshop of key stakeholders with technical support from the World Health Organisation (WHO). It outlines how the EHCP has been disseminated and used in the budgeting and purchasing of health services and in monitoring health system performance for accountability. The paper also reports on the facilitators and barriers to development, uptake and use of the EHCP. In guiding the provision of services for all, the EHCP was envisaged to contribute towards the alleviation of poverty and as a tool for universal health coverage. Its implementation calls for a health service Infrastructure that is in good condition, competent health personnel, readiness to undergo training in new medical technology, supporting laws and capacity in the health financing unit. The EHCP in Swaziland was intended to guide the provision of health services. However, its costs were beyond the national resources to fund it. The adoption of a more restricted health service package currently being assessed in ten clinics in all four regions of the country suggests that a phased approach to delivery of an EHB may be more affordable financially for the country.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 200: What do Harare youth think needs to happen in our cities to improve our wellbeing?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\nhttp://www.equinetafrica.org/\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Header"}},{"node":{"title":"Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries","field_subtitle":"Stenberg K; Hanssen O; Edejer T; et al.: The Lancet Global Health 5(9), e875-e887, 2017","URL":"http://tinyurl.com/y6uh7b62","body":"No estimates of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published. The authors developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. They developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. The authors considered four service delivery platforms, and modeled two scenarios with differing levels of ambition: a progress scenario, in which countries' advancement towards global targets is constrained by their health system's assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. They estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. They projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability. The authors estimate that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario\u2014the equivalent of an additional $41 or $58 per person, respectively, by the final years of scale-up. In the ambitious scenario, total health-care spending would increase to a population-weighted mean of $271 per person across country contexts, and the share of gross domestic product spent on health would increase to a mean of 7.5%. Around 75% of costs are for health systems, with health workforce and infrastructure (including medical equipment) as the main cost drivers. Despite projected increases in health spending, a financing gap of $20\u201354 billion per year is projected. Should funds be made available and used as planned, the ambitious scenario would save 97 million lives and significantly increase life expectancy by 3.1\u20138.4 years, depending on the country profile. All countries will need to strengthen investments in health systems to expand service provision in order to reach SDG 3 health targets, but even the poorest can reach some level of universality. In view of anticipated resource constraints, each country will need to prioritise equitably, plan strategically, and cost realistically its own path towards SDG 3 and universal health coverage.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Health systems in low income countries - four new overviews","field_subtitle":"Cochrane: Cochrane EPOC, October 2017","URL":"http://www.cochrane.org/news/health-systems-low-income-countries-four-new-overviews","body":"Four new Cochrane EPOC overviews of reviews show reliable evidence on the effects of different ways of organising, financing, and governing health systems in low-income countries and identify important evidence gaps. Strengthening health systems in low-income countries is key to achieving universal health coverage and achieving the health-related Sustainable Development Goals. Achieving these goals requires informed decisions about health systems. A team of Cochrane researchers from Argentina, Chile, Norway, and South Africa prepared four overviews of the available evidence from up-to-date systematic reviews about the effects of health system arrangements in low-income countries. They included 124 systematic reviews in the four overviews. For each review, a user-friendly summary of key findings was produced (see http://supportsummaries.org/), enabling users to explore the overview findings in more depth. The summaries include over 480 key messages about the effects of health system arrangements in low-income countries.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Longer travel time to district hospital worsens neonatal outcomes: a retrospective cross-sectional study of the effect of delays in receiving emergency cesarean section in Rwanda.","field_subtitle":"Niyitegeka J; Nshimirimana G; Silverstein A; et al.: Biological Medicine Central Pregnancy Childbirth 17(1), doi: 10.1186/s12884-017-1426-1, 2017","URL":"http://tinyurl.com/y9dz5yfz","body":"In low-resource settings, access to emergency caesarean section is associated with various delays leading to poor neonatal outcomes. In this study, the authors described the delays a mother faces when needing emergency caesarean delivery and assessed the effect of these delays on neonatal outcomes in Rwanda. It included 441 neonates and their mothers who underwent emergency cesarean section in 2015 at three district hospitals in Rwanda. Four delays were measured: duration of labour prior to hospital admission, travel time from health centre to district hospital, time from admission to surgical incision, and time from decision for emergency caesarean section to surgical incision. Neonatal outcomes were categorised as unfavourable and favourable. The authors assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In their study, 9.1% of neonates had an unfavourable outcome, 38.7% of neonates' mothers laboured for 12-24 h before hospital admission, and 44.7% of mothers were transferred from health centres that required 30-60 min of travel time to reach the district hospital. Furthermore, 48.1% of caesarean sections started within 5 h after hospital admission and 85.2% started more than 30 min after the decision for caesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 min of travel time from the health centre to the district hospital compared to mothers referred from health centres located on the same compound as the hospital. Neonates with caesarean deliveries starting more than 30 min after decision for caesarean section had better outcomes than those starting immediately. Longer travel time between health centre and district hospital was associated with poor neonatal outcomes, highlighting a need to decrease barriers to accessing emergency maternal services. However, longer decision to incision interval posed less risk for adverse neonatal outcome. While this could indicate thorough pre-operative interventions including triage and resuscitation, this relationship should be studied prospectively in the future.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Mistra Urban Futures Annual International Conference 2017","field_subtitle":"13 \u2013 15 November, Imperial Hotel Kisumu, Kisumu, Kenya","URL":"https://www.mistraurbanfutures.org/en/rjc-2017","body":"Mistra Urban Futures Annual International Conference is taking place from 13 to 15 November 2017 in Kisumu, Kenya under the banner \"Realising Just Cities - Learning Through Comparison\". The rapidly growing number of people moving into cities all over the world also present a challenge of unprecedented size. It is crucial to find ways to make urbanisation a source for wealth, health and sustainability \u2013 which is shared. Mistra Urban Futures arranges yearly a conference about Realising Just Cities. This year\u2019s conference focuses on learning through comparison covering themes such as transportation, urban food, waste management, migration, participatory cities, neighbourhood transformation and cultural heritage. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Noncommunicable Diseases Progress Monitor 2017","field_subtitle":"World Health Organization: WHO, Geneva, 2017 ","URL":"http://tinyurl.com/y7jloxog","body":"In May 2015 the World Health Organization published a Technical Note on its 2017 reporting to the United Nations General Assembly on the progress achieved in the implementation of national commitments included in the 2011 UN Political Declaration and the 2014 UN Outcome Document on NCDs. The Technical Note was updated in September 2017 to ensure alignment with the updated set of WHO \u2018best-buys\u2019 and other recommended interventions for the prevention and control of non communicable diseases that was endorsed by the World Health Assembly in May 2017. The Progress Monitor provides data on the 19 indicators on progress in NCDs and their control and management for all of WHO\u2019s 194 Member States. The indicators include setting time-bound targets to reduce NCD deaths; developing all-of-government policies to address NCDs; implementing key tobacco demand reduction measures, measures to reduce harmful use of alcohol and unhealthy diets and promote physical activity; and strengthening health systems through primary health care and universal health coverage. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Paradigm Shift: South Africa Regional Partnerships Coordinator","field_subtitle":"Closing date: 11 November, 2017","URL":"https://tinyurl.com/y7sm3l2s","body":"The Paradigm Shift Programme is a holistic, economic development outreach tool that connects business men and women within the church to micro entrepreneurs in poor communities. Paradigm Shift seeks to appoint a Regional Partnerships Coordinator to be based in South Africa. This position is part-time, and can be fulfilled working remotely but with frequent teleconferencing and face-to-face meetings built in. The responsibilities include managing communication between volunteer teams and Paradigm Shift, ensuring the training and coaching of Point Persons, creating and executing strategic plans for national expansion, new partnership development and communications. The post requires a minimum of a Bachelor\u2019s Degree, demonstrated expertise in key areas mentioned in job description, interpersonal, written and verbal communication skills and experience of working with people working their way out of poverty. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Pilot study of quality of care training and knowledge in Sub-Saharan African medical schools","field_subtitle":"Bowser D; Abbas Y; Odunleye T; et al.: International Journal of Medical Education 8, 24 doi: 10.5116/ijme.595b.b38c, 2017 ","URL":"https://www.ijme.net/archive/8/quality-of-care-african-medical-schools.pdf","body":"This study identified the level of knowledge and competencies related to quality of care during medical education in sub-Saharan African medical schools. A cross-sectional study design was utilised to examine the capacity of medical schools in sub-Saharan African countries to teach about the concepts of quality of care and the inclusion of these concepts in their curriculum. A purposeful convenience sampling technique was used to select participants from 25 medical schools in 5 sub-Saharan African countries. Respondents included medical school deans or senior academic personnel. While 45% of the schools surveyed are teaching on at least one of the six domains of the Institute of Medicine\u2019s definition of quality of care, there are some schools who report not teaching about quality at all, or that they \u201cdo not know\u201d. Despite these low numbers, when asked about topics related to quality of care, many schools are teaching applied management related topics and almost all schools teach about equity and patient-centred care. The results have implications for incorporating quality of care in medical education and for practitioners. The tool developed for this study could be used in future qualitative and quantitative studies to further understanding of how to improve the teaching and learning about quality of care in medical schools. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Realizing Universal Health Coverage in East Africa: the relevance of human rights","field_subtitle":"Yamin A; Maleche A: Biological Medicine Central International Health Human Rights 17(1) doi: 10.1186/s12914-017-0128-0, 2017.","URL":"http://tinyurl.com/ybcad58k","body":"The authors argue that applying a robust human rights framework would change thinking and decision-making in efforts to achieve Universal Health Coverage (UHC), and advance efforts to promote women's, children's, and adolescents' health in East Africa, a priority under the Sustainable Development Goals. They point to a gap between global rhetoric of human rights and ongoing health reform efforts,. and seeks to fill part of that gap by setting out principles of human rights-based approaches, and then applying those principles to questions that countries undertaking efforts toward UHC and promoting women's, children's and adolescents' health, will need to face. The paper focuses in particular on ensuring enabling legal and policy frameworks, establishing fair financing; priority-setting processes, and meaningful oversight and accountability mechanisms. In a region where democratic institutions are argued to be weak, the authors argue that the explicit application of a meaningful human rights framework could enhance equity, participation and accountability, and in turn the democratic legitimacy of health reform initiatives being undertaken in the region.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Research priority setting for integrated early child development and violence prevention (ECD+) in low and middle income countries: An expert opinion exercise","field_subtitle":"Tomlinson M; Jordans M; MacMillan H; et al.: Jo Child Abuse Negligence 72,131-139, 2017","URL":"http://tinyurl.com/ydggms6a","body":"Reducing children's exposure to harmful events and violence is essential for early childhood development. The authors used the Child Health and Nutrition Initiative method for the setting of research priorities in integrated early childhood development and violence prevention programs. An expert group was identified and invited to systematically list and score research questions. A total of 186 stakeholders were asked to contribute five research questions each, and contributions were received from 81 respondents. These were subsequently evaluated using a set of five criteria: answerability; effectiveness; feasibility and/or affordability; applicability and impact; and equity. Of the 400 questions generated, a composite group of 50 were scored by 55 respondents. The highest scoring research questions related to the training of community health workers to deliver early childhood development and violence prevention programs interventions effectively and whether these interventions could be integrated within existing delivery platforms such as HIV, nutrition or mental health platforms. The findings from this research priority setting exercise is argued to potentially help guide funders and others towards funding priorities for important future research related to early childhood development and violence prevention.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Socioeconomic differences in mortality in the antiretroviral therapy era in Agincourt, rural South Africa, 2001\u201313: a population surveillance analysis ","field_subtitle":"Kabudula C; Houle B; Collinson M; et al.: The Lancet Global Health 5(9) doi: https://doi.org/10.1016/S2214-109X(17)30297-8, 2017","URL":"http://tinyurl.com/yb25mtzo","body":"The authors assessed socioeconomic disparities in mortality indicators in a rural South African population over the period 2001\u201313 using data from 21 villages of the Agincourt Health and socio-Demographic Surveillance System (HDSS). They calculated the probabilities of death from birth to age 5 years and from age 15 to 60 years, life expectancy at birth, and cause-specific and age-specific mortality by sex (not in children ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Tanzania Country Director and Clinical Training Project Manager","field_subtitle":"SolidarMed: Closing date: Thursday, 30 November, 2017","URL":"https://tinyurl.com/y9dbgdxh","body":"SolidarMed is a leading non-profit organization working to improve the health of people in rural Sub Saharan Africa.  This position comprises both the management of the project \u201cSupport to Edgar Maranta School of Nursing\u201d and the coordination of the country program. It is a fixed term appointment based in Ifakara, Tanzania to start as soon as possible, with a certain flexibility. The key responsibilities include coordination, monitoring, budgeting, reporting and annual planning of the country program and providing strategic and public health guidance and leadership to the program. An advanced degree in health and a Master in Public Health, good understanding and clinical experience of issues related to maternal and child health, and infectious diseases such as HIV, TB and malaria are required. Experience in a public health context in Sub-Saharan Africa, ideally at district level, sound knowledge and experience of management and administration and good writing and reporting skills (in English) and basic Kiswahili are required. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Demographic and Health Surveys Fellows Program","field_subtitle":"Deadline for Submissions: 10 November, 2017","URL":"http://tinyurl.com/y8cnuob3","body":"The Demographic and Health Surveys (DHS) Fellows Program aims to increase capacity of university faculty from DHS countries and to build long-term institutional sustainability for universities to train students and faculty to further analyze DHS data. The Program provides intensive mentorship to teams of three university faculty members that are selected on a competitive basis from four to six universities every year. The fellowship includes two separate workshops and preparation of publication-quality research papers with mentoring from DHS Program researchers. In addition to original research projects, fellows are also required to design and implement a range of internal capacity strengthening activities at their home universities. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The SWPER index for women\u2019s empowerment in Africa: development and validation of an index based on survey data","field_subtitle":"Ewerling F; Lynch J;  Victora C;  van Eerdewijk A;  Tyszler M; Barros A: Lancet Global Health 5(9) e916-e923, 2017","URL":"http://tinyurl.com/y7n9ukbb","body":"The Sustainable Development Goals strongly focus on equity. Goal 5 explicitly aims to empower all women and girls, reinforcing the need to have a reliable indicator to track progress. This study developed a novel women\u2019s empowerment indicator from widely available data sources, broadening opportunities for monitoring and research on women\u2019s empowerment. The authors used Demographic and Health Survey data from 34 African countries, targeting currently partnered women. They identified items related to women\u2019s empowerment present in most surveys, and used principal component analysis to extract the components. The authors carried out a convergent validation process using coverage of three health interventions as outcomes; and an external validation process by analysing correlations with the Gender Development Index. Findings 15 items related to women\u2019s empowerment were selected. They retained three components (50% of total variation) which, after rotation, were identified as three dimensions of empowerment: attitude to violence, social independence, and decision making. All dimensions had moderate to high correlation with the Gender Development Index. Social independence was associated with higher coverage of maternal and child interventions; attitude to violence and decision making were more consistently associated with the use of modern contraception. Interpretation The index, named Survey-based Women\u2019s emPowERment index, is argued to have the potential to widen the research on women\u2019s empowerment and to give a better estimate of its effect on health interventions and outcomes. It allows within-country and between-country comparison, as well as time trend analysis, which no other survey based index provides.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Tuberculosis, human rights and ethics considerations along the route of a highly vulnerable migrant from sub-Saharan Africa to Europe","field_subtitle":"Wild V; Jaff D; Shah NS; et al.: International Union Against Tuberculosis and Lung Disease 21(10)1075-1085, 2017","URL":"http://www.ingentaconnect.com/contentone/iuatld/ijtld/2017/00000021/00000010/art00005","body":"Migrant health is a critical public health issue, and in many countries attention to this topic has focused on the link between migration and communicable diseases, including tuberculosis (TB). This paper traces a commonly used migration route from sub-Saharan Africa to Europe, identifying situations at each stage in which human rights and ethical values might be affected in relation to TB care. The authors highlight three strands of discussion in the ethics and justice literature in an effort to develop more comprehensive ethics of migrant health. These strands include theories of global justice and global health ethics, the creation of \u2018firewalls' to separate enforcement of immigration law from protection of human rights, and the importance of non-stigmatization to health justice. ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Understanding the relationship between couple dynamics and engagement with HIV care services: insights from a qualitative study in Eastern and Southern Africa","field_subtitle":"Wamoyi J; Renju J; Moshabela M, et al.: Sexually Transmitted Infections, 93(Issue Supplement 3), doi: http://dx.doi.org/10.1136/sextrans-2016-052976, 2017","URL":"http://sti.bmj.com/content/93/Suppl_3/e052976","body":"This paper explores the interplay between couple dynamics and the engagement of people living with HIV (PLHIV) with HIV care and treatment services in three health and demographic surveillance sites in Tanzania, Malawi and South Africa. A qualitative study was conducted involving 107 in-depth interviews with PLHIV with a range of HIV care and treatment histories, including current users of HIV clinics, and people not enrolled in HIV care. Interviews explored experiences of living with HIV and how and why they chose to engage or not with HIV services. The authors found an interplay between couple dynamics and HIV care and treatment-seeking behaviour in the three countries. Being in a relationship impacted on the level and type of engagement with HIV services in multiple ways. In some instances, couples living with HIV supported each other which improved their engagement with care and strengthened their relationships. The desire to fulfil societal expectations and attract a new partner, or have a baby with a new partner, or to receive emotional or financial support, strengthened on-going engagement with HIV care and treatment. However, fear of blame, abandonment or abuse resulted in unwillingness to disclose and often led to disputes or discord between couples. There was little evidence of intra-couple understanding of each other\u2019s lived experiences with HIV, and the authors found that couples rarely interacted with the formal health system together. Couple dynamics influenced engagement with HIV testing, care and treatment for both partners through a myriad of pathways. The authors propose that couple-friendly approaches to HIV care and treatment move beyond individualised care and which recognise partner roles in HIV care engagement.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"What 115 years of data tells us about Africa\u2019s battle with malaria past and present","field_subtitle":"Snow B: The conversation, October 2017","URL":"https://theconversation.com/what-115-years-of-data-tells-us-about-africas-battle-with-malaria-past-and-present-85482","body":"The author reports on efforts in the last 21 years tracking down malaria survey reports done across Africa. The greatest challenge was that they were mostly hidden in old government archives or curated by the World Health Organisation. Their final report covers over 50,000 surveys dating back 115 years. This is the largest repository containing information on over 7.8 million blood tests for malaria. They analysed malaria infection prevalence for each of 520 administrative units across countries south of the Sahara and Madagascar for 16 time periods. The study suggests that the prevalence of malaria infection in sub-Saharan Africa today is at the lowest point since 1900. The biggest historical reduction in malaria coincided with the introduction of new tools to fight malaria. After the Second World War, the discovery of DDT for indoor spraying and chloroquine drugs made a difference in treating malaria.  In 2005 the rolling out of insecticide treated bed nets and new antimalarial drugs, led to a further drop of malaria cases. The lowest periods of malaria prevalence were evident when the international community abandoned specific malaria control investment in Africa, during the late 1960s, through the 1970s and early 1980s. The gains made after 2005 are also reported to have stalled since 2010. Declining malaria funding, insecticide and drug resistance  are the obvious threats to the elimination of malaria in Africa. The authors observe from the evidence that the malaria map in Africa might shrink a bit at the margins but that middle belt isn\u2019t going anywhere in our lifetimes with what we have at our disposal now \u2013 bed nets and drugs. When insecticide and drug resistance becomes established, they argue that unless we have new classes of both drugs and insecticides or a natural period of drought, malaria will revert in large parts of Africa to what it was in the 1990s, another perfect storm.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"What do Harare youth think needs to happen in our cities to improve our wellbeing?","field_subtitle":"Busisiwe Shumba, Sithembile Zimbeva, Piason Mareya, Simon Kapombe, Bridget Kajawu, Shingirai Denhere, Arthur Nyandwe and Ishmael Makaya, Harare","body":"\r\nIn September this year the civic centre of Harare was buzzing with the sound of music and discussions, markets, installations, workshops and multiple activities. It was Shoko Festival time, and the museum, library and other civic buildings transformed into a magnet for young people to get away from the stresses of our shrinking economy and nourish our creativity. \r\n\r\nShoko festival is one of Zimbabwe\u2019s fastest-growing international festivals and over seven years has grown into a major cultural event. The festival this year was held at a time when many are struggling with the socio-economic problems brought about by the myriad of problems in the economy. We wondered \u2013 is art a luxury at such a time? What can it contribute to improving our wellbeing in a harsh climate?\r\n\r\nOur experience at the festival indicates that it is anything but a luxury!\r\n\r\nThis year\u2019s festival was held with the theme \u2018YOUtopia\u2019, as a vibrant creative space in which people could explore and imagine the qualities they seek for themselves and their community or society. So we took advantage of the space and theme to take a discussion that we have been having as young people on what kind of city will improve our wellbeing to a wider audience. \r\n\r\nIn the past year as a group of young people in the Civic Forum on Human Development from diverse settings and suburbs in Harare we have been working with the Training and Research Support Centre in EQUINET to understand what is driving the inequalities in health in our urban areas, at least for ourselves as young people. With our health services often focused on treating diseases, we took a wider lens to build a more holistic understanding of what will promote our health today and in the future. In our own discussions we identified issues that go well beyond the scope of health services, including the way our cities provide spaces for us to create jobs, the green spaces and access to internet that we need to meet, connect and exchange ideas, and the access to urban land we need to have to grow food and build decent housing. We looked at how these issues are being addressed in other parts of the world and found a lot to inspire us on how we could do things differently here in Harare. \r\n\r\nSo we decided to participate in the Shoko festival with a stand on \u201cpicturing our urban futures\u201d to hear and see what other young people thought. Over two days we explored what kind of city people, especially young people coming to Shoko festival wanted to live in? How did they imagine things could be different in ways that promote their wellbeing?  We had an art table, where people drew in one half of the page features of areas they live, work or meet in in the city as they are now, and in the other half how they would like them to be. We had postits where people wrote short text on what they thought was affecting their wellbeing or what changes they wanted to see in for our cities to promote our wellbeing. We discussed what people saw as the different aspects of their wellbeing. \r\n\r\nWe had no rules and gave a free space and materials for young people to draw or write or say what they thought. Many youth preferred drawing their views than writing or talking. \r\n\r\nBy the end of the two days there were pink, yellow and green postits all over the glass wall on one side of the stand and artwork of all colours filling the wall on the other side and young people talking in between. We were surrounded by the analysis and the possible, in a space youth culture that radiated positive activism and ideas. Shoko is about celebrating positive youth culture that is trending and relevant in the cities that has been associated with hip-hop, dancehall to spoken word and comedy as well as graffiti and cutting edge ideas on how to use new media and technology. \r\n\r\nThe drawings were clear and the statements were short but full of meaning: \u201clitter free and free wifi!\u201d \u201ca violence free city\u201d, \u201c a safe city\u201d. The tensions were economic, but also environmental and many were social or linked to mental stress.\r\n\r\nThe art work and postits highlighted how young people vision a different urban future to overcome the significant differences in opportunities for wellbeing that currently exist and to ensure that our cities work and promote health for all. Many showed how much mental stress is caused by bad conditions like public transport systems where touts push people into overcrowded combis, and how much people want to live in communities free of violence and of rising piles of waste and litter. \r\n\r\nThe art and postits showed the desire to move from roads with potholes, traffic congestion and chaos, environments with rubbish and poorly maintained parks to one where public spaces, roads and transport are safe and clean. Rather than have cities where the best buildings are for private finance and vendors compete for space with pedestrians, they visioned cities where the best buildings are for community processes and economic activities. They indicated that cities need to enable people to work and create jobs, including by giving access to free wifi, and people should have community spaces to gather and exchange views. \r\n\r\nAre these visions of the future utopic? We don\u2019t think so. They are a feasible, practical vision of what we should be demanding, contributing to and achieving for all in our cities and would do more for our health and wellbeing than all the medicines we consume. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  ","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"World running out of antibiotics, says WHO in new reports","field_subtitle":"Third World Network: TWN Info Service on Health Issues, Oct17/02, 2017","URL":"http://www.twn.my/title2/health.info/2017/hi171002.htm","body":"On 19 September, the World Health Organization released a new report that reaffirms the world is running out of antibiotics to fight key and deadly infections due to the fast pace of resistance by bacteria and the lack of new antibiotics to replace or supplement the existing antibiotics. Most new drugs in the pipeline are only modifications of existing classes of antibiotics and are short term solutions, says the WHO.  And there are very few potential treatment options for antibiotic resistant infections causing the greatest health threats including resistant TB. This article by TWN explore the issue and the level of (under)investment in new treatments. It argues further for improved infection prevention and control and for fostering appropriate use of existing and future antibiotics.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Zimbabwe Parliament To Boycott 2018 Budget Unless It Meets Abuja Target","field_subtitle":": Pembere K: Health Times, 11 October 2017","URL":"https://healthtimes.co.zw/2017/10/11/parliament-to-boycott-2018-budget-unless-it-meets-abuja-target/","body":"The Zimbabwe Parliamentary Portfolio committee on Health says it will not entertain a flimsy allocation of funds to the health sector in the forthcoming 2018 budget presentation unless the 15% Abuja target is met. Zimbabwe is a signatory to the Abuja Declaration of 2001 in which African Union countries pledged to allocate at least 15 percent of their annual budgets to improving the health sector. Since then, the country is yet to meet the target. In the 2017 budget, the health sector only got 7 percent of total government spending. Non state organisations expect the treasury to meet the Abuja declaration which states that 15 percent of the National budget should be dedicated to health to show commitment to ensuring a healthy and productive nation. Presenting the 2017 national budget, the then Finance and Economic Development Minister Patrick Chinamasa announced that $281,9 million will be channeled towards the sector inclusive of remuneration for the public health care personnel ($223 million), operations and maintenance ($29,6 million), as well as capital expenditure that has been pegged at $29,5 million. Binga North MP Prince Dubeko Sibanda sharing his experience in Uganda learnt that if a budget ignores the plight of the marginalized it doesn\u2019t get Parliamentary approval to be passed. \u201cOne thing I took in Uganda, they have got a law which says unless the budget meets certain criteria or takes care of people that are generally marginalized that budget should not be passed. Its part and parcel of their law. Its never passed,\u201d the parliamentarian said.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Zimbabwe's public sector health spending one of the lowest in SADC","field_subtitle":"Langa V: NewsDay October 2017","URL":"http://tinyurl.com/yay6jk4j","body":"Zimbabwe government spending towards health this year averaged US$21 per person, lower than 2016 levels, the Community Working Group on Health (CWGH), in Zimbabwe, said in its contribution to the 2018 National Budget consultations. CWGH said the per capita allocation towards health is one of the lowest in the Southern African Development Community (SADC) region whose average spending on health per person is $146. CWGH raised concerns about the total budget allocation to health, which has remained lower than the 15% of the total budget committed to in the Abuja Declaration. The CWGH said Zimbabwe has made significant gains in the area of HIV prevalence, child and maternal mortality, but noted an over-dependence on external funding, poor infrastructure and ill-equipped hospitals, as well as a worrying ratio of patients to health personnel. The CWGH observed that Zimbabwe relies heavily on imports for drugs, equipment and other hospital consumables, and called for government to broaden the tax base to fund health.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"\u2018I am treated well if I adhere to my HIV medication\u2019: putting patient\u2013provider interactions in context through insights from qualitative research in five sub-Saharan African countries","field_subtitle":"Ondenge K; Renju J; Bonnington O; et al.: Jo Sexually Transmitted Infections 93 (Issue Supplement 3), doi: http://dx.doi.org/10.1136/sextrans-2016-052973, 2017","URL":"http://sti.bmj.com/content/93/Suppl_3/e052973","body":"The nature of patient\u2013provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient\u2013provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, the authors seek to unpack local dynamics that serve to hinder or facilitate productive patient\u2013provider interactions. This qualitative study, conducted in Kisumu (Kenya), Kisesa (Tanzania), Manicaland (Zimbabwe), Karonga (Malawi) and uMkhanyakude (South Africa), draws upon 278 in-depth interviews with purposively sampled people living with HIV with different diagnosis and treatment histories, 29 family members of people who died due to HIV and 38 HIV healthcare workers. Data were collected using topic guides that explored patient testing and antiretroviral therapy treatment journeys. The authors analysis revealed an array of inter-related contextual factors and power dynamics shaping patient\u2013provider interactions. These included participants\u2019 perceptions of roles and identities of \u2018self\u2019 and \u2018other\u2019; conformity or resistance to the \u2018rules of HIV service engagement\u2019 and a \u2018patient-persona\u2019; the influence of significant others\u2019 views on service provision; and resources in health services. They observed that these four factors/dynamics were located in the wider context of conceptualisations of power, autonomy and structure. They argue that patient\u2013provider interaction is complex, multidimensional and deeply embedded in wider social dynamics, and that interventions to improve patient experiences and treatment adherence through enhanced interactions need to go beyond the existing focus on patient\u2013provider communication strategies.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"\u201cIf donors woke up tomorrow and said we can't fund you, what would we do?\u201d A health system dynamics analysis of implementation of PMTCT option B+ in Uganda","field_subtitle":"Doherty T; Besada D; Goga A; Daviaud E; Rohde S; Raphaely N: Globalisation and Health 13(51) 2017","URL":"http://tinyurl.com/ydaap2ns","body":"In October 2012 Uganda extended its prevention of mother to child HIV transmission (PMTCT) policy to Option B+, providing lifelong antiretroviral treatment for HIV positive pregnant and breastfeeding women. The rapid changes in and adoption of new PMTCT policies are argued by the authors to have not been accompanied by research to explore health system preparedness to implement such programmes. The implementation of Option B+ provides many lessons which can inform the shift to \u2018Universal Test and Treat\u2019, a policy which many sub-Saharan African countries are preparing to adopt, despite fragile health systems. This qualitative study of PMTCT Option B+ implementation in Uganda three years following the policy adoption, uses the health system dynamics framework to explore the impacts of this programme on ten elements of the health system. Qualitative data were gathered through rapid appraisal during in-country field work. Key informant interviews and focus group discussions (FGDs) were undertaken with the Ministry of Health, implementing partners, multilateral agencies, district management teams, facility-based health workers and community cadres. The authors conducted a simple manifest analysis, using the ten elements of a health system for grouping data into categories and themes. Of the ten elements in the health system dynamics framework, context and resources (finances, infrastructure and supplies, and human resources) were the most influential in the implementation of Option B+ in Uganda. Support from international actors and implementing partners attempted to strengthen resources at district level, but had unintended consequences of creating dependence and uncertainty regarding sustainability. The health system dynamics framework is argued to offer a novel approach to analysis of the effects of implementation of a new policy on critical elements of the health system. Its emphasis on relationships between system elements, population and context is helpful in unpacking impacts of and reactions to pressures on the system, which adds value beyond some previous frameworks.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"\u201cWe are toothless and hanging, but optimistic\u201d: sub county managers\u2019 experiences of rapid devolution in coastal Kenya","field_subtitle":"Nyikuri M; Tsofa B, Okoth P; et al.: International Journal for Equity in Health 16(113)1-11, 2017","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-017-0607-x","body":"This study presents qualitative research to examine the early experiences of devolution in the health sector in Kenya in March 2013. The authors observed a diverse range of management meetings, support supervision visits and outreach activities involving sub-county managers between May 2013 and June 2015, and conducted interviews with purposively selected sub-county managers from three sub-counties. The authors found that sub county managers as with many other health system actors were anxious about and ill-prepared for the unexpectedly rapid devolution of health functions to the newly created county government. They experienced loss of autonomy and resources and confused lines of accountability within the health system. The study illustrates the importance in accelerated devolution contexts for: mid-level managers to adopt new ways of working and engagement with higher and lower levels in the system; clear lines of communication during reforms to these actors and anticipating and managing the effect of change on intangible software issues such as trust and motivation. More broadly, the authors show the value of examining organisational change from the perspective of key actors within the system, and highlight the importance in times of rapid change of drawing upon and working with those already in the system. These actors have valuable tacit knowledge, but tapping into and building on this knowledge to enable positive response in times of health system shocks requires greater attention to sustained capacity building within the health system.","php":"","field_issue_date":"2017-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A Practical Guide To Implementing Community-Based HIV-Prevention Services: Experiences shared and lessons learned from South Africa","field_subtitle":"Desmond Tutu TB Centre: Stellenbosch University, South Africa, 2017","URL":"https://tinyurl.com/y8uf7t24","body":"This guide includes case studies, tips, photographs, training materials and an accompanying video on implementing community-based HIV-prevention services. Each chapter focuses on a different aspect of implementation, from engaging with stakeholders and communities to how to set up teams and conduct HIV testing services that integrate important other services including screening for TB, sexually transmitted infections and non-communicable diseases.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Adolescent HIV Programming: Ready here we come!","field_subtitle":"International HIV/AIDS Alliance: International HIV/AIDS Alliance. UK 2017","URL":"http://www.aidsalliance.org/assets/000/003/006/alliance_gpg-hiv_and_adolescents_final_original.pdf?1494841059","body":"This guide is one of a series of good practice guides, and contains information, strategies and resources to help HIV programmers implement HIV programming for adolescents.  Adolescents are now included as a separate target group in global and national strategies. Increased access to HIV testing and treatment means that, more than ever, adolescents living with HIV know their status and are living longer on antiretroviral therapy (ART). Much more work is needed, however, to meet adolescents\u2019 needs for prevention, care, treatment and support services. Barriers to access, poor uptake of both prevention and treatment services, stigma and discrimination, as well as challenges with adherence to treatment contribute significantly to HIV-related morbidity and mortality among adolescents. This Good Practice Guide contains information, strategies and resources to help programmers meet the standards for Alliance HIV programming for adolescents. Implementing these standards is one of the ways that the Alliance, our partners and other organisations define and promote a unified and quality-driven approach to HIV programming. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Africa Is Not Poor, We Are Stealing Its Wealth","field_subtitle":"Dearden N: Sangonet, NGO Pulse, August 2017","URL":"http://tinyurl.com/yajkywxt","body":"The report Honest Accounts 2017: how the world profits from Africa\u2019s wealth explores how Africa\u2019s wealth is effectively \u201cstolen\u201d from the continent and \u201ccalculates the movement of financial resources into and out of Africa and some key costs imposed on Africa by the rest of the world\u201d. Nick Dearden, director of Global Justice Now, writes that although there is money coming into the continent in the form of remittances, there is a larger amount leaving the continent in the form of taxes, \u201crepatriate[d]\u201d profits and illegal trade. A 2014 estimate suggests that rich Africans were holding a massive $500-billion in tax havens. Africa\u2019s people are effectively robbed of wealth by an economy that enables a tiny minority of Africans to get rich by allowing wealth to flow out of Africa. With few exceptions, countries with abundant mineral wealth experience poorer democracy, weaker economic growth, and worse development. The author raises that to prevent tax dodging, governments must stop prevaricating on action to address tax havens. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"All roads lead to universal health coverage ","field_subtitle":"Ghebreyesus T: The Lancet, 17 August 2017","URL":"http://tinyurl.com/y98umqck","body":"All roads lead to universal health coverage\u2014and this is the top priority at WHO, Dr Ghebreyesus the WHO director general has asserted. The key question of universal health coverage is an ethical one. Should fellow citizens die because they are poor? Or should millions of families be impoverished by catastrophic health expenditures because they lack financial risk protection? Universal health coverage is a human right. The world has agreed on universal health coverage in Sustainable Development Goal 3.8. He asserts that  universal health coverage is ultimately a political choice and responsibility of every country and national government. Countries have unique needs, and tailored political negotiations will determine domestic resource mobilisation. He indicates that WHO will catalyse proactive engagement and advocacy with global, regional, and national political structures and leaders including heads of state and national parliaments. Beyond benchmarking, countries learn from their peers, especially those they see as having similar political or economic contexts. WHO will thus document best practices in universal health coverage at the country level. Once this learning has occurred, countries may request technical assistance and WHO should be prepared to provide technical assistance to countries based on their specific needs, across the full range of health-related Sustainable Development Goals. He further posits that universal health coverage and health emergencies are cousins\u2014two sides of the same coin. Strengthening health systems is the best way to safeguard against health crises. Outbreaks are inevitable, but epidemics are not and strong health systems are the best defence to prevent disease outbreaks from becoming epidemics. Achieving universal health coverage will require innovation. Given that what is measured is managed, data matters and WHO will track progress on how the world is meeting the health-related Sustainable Development Goal indicators. Finally he observes that universal health coverage is not an end in itself: its goal is to improve all health-related Sustainable Development Goals.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania","field_subtitle":"Kuwawenaruwa A; Borghi J; Remme M; Mtei G: International Journal for Equity in Health 16(124) 2017 ","URL":"https://tinyurl.com/y7wsm9k9","body":"This paper assesses equity in the distribution of health care inputs across public primary health facilities at the district level in Tanzania. It reports a quantitative assessment of equity in the distribution of health care inputs (staff, drugs, medical supplies and equipment) from district to facility level. The study was carried out in three districts (Kinondoni, Singida Rural and Manyoni district) in Tanzania. These districts were selected because they were implementing primary care reforms. The authors administered 729 exit surveys with patients seeking out-patient care; and health facility surveys at 69 facilities in early 2014. The authors found a significant pro-rich distribution of clinical staff and nurses per 1000 population. Facilities with the poorest patients (most remote facilities) have fewer staff per 1000 population than those with the least poor patients (least remote facilities): 0.6 staff per 1000 among the poorest, compared to 0.9 among the least poor; 0.7 staff per 1000 among the most remote facilities compared to 0.9 among the least remote. The negative concentration index for support staff suggests a pro-poor distribution of this cadre but the 45 degree dominated the concentration curve. The distribution of vaccines, antibiotics, anti-diarrhoeal, anti-malarials and medical supplies was approximately proportional (non dominance), whereas the distribution of oxytocics, anti-retroviral therapy (ART) and anti-hypertensive drugs was pro-rich, with the 45 degree line dominating the concentration curve for ART. This study has shown there are inequities in the distribution of health care inputs across public primary care facilities. This highlights the need to ensure a better coordinated and equitable distribution of inputs through regular monitoring of the availability of health care inputs and strengthening of reporting systems.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Community-based initiatives improving critical health literacy: a systematic review and meta-synthesis of qualitative evidence","field_subtitle":"de Wit L; Benenga C; Giammarchi C; di Furia L; Hutter I; de Winter A; Meijering L: BMC Public Health 18(40), 2017, ","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4570-7","body":"This study explored how community-based initiatives address the critical health literacy of older adults and their communities. A systematic literature search was conducted. Two reviewers independently screened titles and abstracts, as well as the quality of the methodological and community-based elements of the studies. In addition, a meta-synthesis was carried out, consisting of a qualitative text analysis of the results sections of the 23 included studies. The authors identified two main themes, which are practices that contribute to the critical health literacy of older adults as well as their communities: collaborative learning, and social support. In these practices they identified reciprocity as a key characteristic of both co-learning and social support. This study provides the first overview of community-based initiatives that implicitly address the critical health literacy of adults and their community. The results demonstrate that in the context of one\u2019s own life collaborative learning and social support could contribute to people\u2019s understanding and ability to judge, sift and use health information. The authors therefore suggest to add these two practices to the definition of critical health literacy.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Defending medical malpractice and professional negligence cases: Litigation and mitigation","field_subtitle":"29 \u2013 30 November 2017 Apollo Hotel, Randburg, Johannesburg","URL":"http://www.secolo.co.za","body":"A 2 day Master class  will be held on Defending Medical Malpractice and professional Negligence Cases scheduled for 29-30 November, 2017 in Randburg, Johannesburg, RSA. Medical malpractice liability is incurred when patients suffer damages, which may be attributed to sub-standard care provided by health practitioners or hospital personnel involved in their treatment. This master class aims to provide a sound knowledge of the legal rules applicable to the practice and administration of healthcare. The master class covers legal relationships of physicians and patients down to legal terms, professional attitudes, and the principles and basic concepts of laws involved in providing medical services. For further information contact SECOLO. For further information contact info@secolo.co.za.\r\n","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Effect of non-monetary incentives on uptake of couples\u2019 counselling and testing among clients attending mobile HIV services in rural Zimbabwe: a cluster-randomised trial ","field_subtitle":"Sibanda E; Tumushime M; Mufuka J; et al.: The Lancet Global Health 5(9), doi: https://doi.org/10.1016/S2214-109X(17)30296-6, 2017","URL":"http://tinyurl.com/yag2p8vj","body":"Couples\u2019 HIV testing and counselling (CHTC) is associated with greater engagement with HIV prevention and care than individual testing and is cost-effective, but uptake remains suboptimal.  The authors aimed in this work to determine the impact of incentives for CHTC on uptake of couples testing and HIV case diagnosis in rural Zimbabwe. 68 rural communities (the clusters) in four districts receiving mobile HIV testing services were randomly assigned to incentives for CHTC or not. Allocation was not masked to participants and researchers. Randomisation was stratified by district and proximity to a health facility. Within each stratum random permutation was done to allocate clusters to the study groups. In intervention communities, residents were informed that couples who tested together could select one of three grocery items worth US$1\u00b750. Standard mobilisation for testing was done in comparison communities. The primary outcome was the proportion of individuals testing with a partner. Analysis was by intention to treat. 3 months after CHTC, couple-testers from four communities per group individually completed a telephone survey to evaluate any social harms resulting from incentives or CHTC.  The study indicated that small non-monetary incentives, which are potentially scalable, were associated with significantly increased CHTC and HIV case diagnosis. Incentives did not increase social harms beyond the few typically encountered with CHTC without incentives. The authors suggest that the intervention could help achieve UNAIDS 90-90-90 targets.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban Kenya: A randomised clinical trial","field_subtitle":"Bryant R; Schafer A; Dawson K;  et al.: Public Library of Science Medicine( PLOS Med) 14(8) https://doi.org/10.1371/journal.pmed.1002371, 2017","URL":"http://tinyurl.com/yac5v4tk","body":"Gender-based violence (GBV) represents a major cause of psychological morbidity worldwide, and particularly in low- and middle-income countries). Although there are effective treatments for common mental disorders associated with GBV, they typically require lengthy treatment programs that may limit scaling up in low- and middle-income countries. This study tested the effectiveness of a new 5-session behavioural treatment called Problem Management Plus (PM+) that lay community workers can be taught to deliver. In this single-blind, parallel, randomised controlled trial, adult women who had experienced GBV were identified through community screening for psychological distress and impaired functioning in Nairobi, Kenya. Participants were randomly allocated in a 1:1 ratio either to PM+ delivered in the community by lay community health workers provided with 8 days of training or to facility-based enhanced usual care (EUC) provided by community nurses. Participants were aware of treatment allocation, but research assessors were blinded. The primary outcome was psychological distress as measured by the total score on the 12-item General Health Questionnaire (GHQ-12) assessed at 3 months after treatment. Between 15 April 2015 and 20 August 2015, 1,393 women were screened for eligibility on the basis of psychological distress and impaired functioning. Of these, 37% screened positive, of whom 81% were women who had experienced GBV. Of these women, 209 were assigned to PM+ and 212 to EUC. Follow-up assessments were implemented. The study found that  among a community sample of women in urban Kenya with a history of GBV, a brief, lay-administered behavioural intervention, compared with EUC, resulted in moderate reductions in psychological distress at 3-month follow-up.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Environmental health policies for women\u2019s, children\u2019s and adolescents\u2019 health","field_subtitle":"Neira M; Fletcher E; Brune-Drisse M; Pfeiffer M; Adair-Rohani H; Dora C: Bulletin of the World Health Organisation 95(7), 2017 ","URL":"http://www.who.int/bulletin/volumes/95/8/16-171736/en/","body":"Environmental health risks especially affect women and children, because they are more vulnerable socially and because exposures to environmental contaminants create greater risks for children\u2019s developing bodies and cognitive functions. According to the 2016 World Health Organisation (WHO) estimates, modifiable environmental risk factors cause about 1.7 million deaths in children younger than five years and 12.6 million total deaths every year. The sustainable development goals (SDGs) offer opportunities for countries to create healthier environments for women, children and adolescents. This paper explores how the SDGs can be used to reduce environmental health risks and enhance the health of women, children and adolescents. In particular, the authors focus on drivers for urbanisation and sustainable development (e.g. transport, housing, urban design and energy provision) that can advance the global strategy, but have not traditionally been a focus of health policy-making. They frame the discussion around the three pillars of the global strategy: survive, thrive and transform, while recognising the inevitable overlap between these objectives.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET discussion paper 109: A case study of the Essential Health Benefit in Tanzania mainland","field_subtitle":"Todd G; Nswilla A; Kisanga O; Mamdani M: Ifakara Health Institute, Tanzania, EQUINET Harare, 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EHB%20Tanzania%20case%20study%20rep%20Aug2017pv.pdf","body":"An Essential Health Benefit (EHB) is a policy intervention designed to direct resources to priority areas of health service delivery to reduce disease burdens and ensure equity in health. Mainland Tanzania\u2019s most recent benefit package \u2013 the National Essential Health Care Interventions Package-Tanzania (NEHCIP-TZ) \u2013 describes the EHB as a minimum or \u201climited list of public health and clinical interventions.\u201d The package identifies where priorities are set for improved public health. This report shows the challenges of turning a policy \u2018wish list\u2019 and package into a reality of services that can be accessed across different facility levels. This report describes the evolution of mainland Tanzania\u2019s EHB; the motivations for developing the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting. The case study on Tanzania was implemented in a research programme of the EQUINET through Ifakara Health Institute  and Training and Research Support Centre. The programme is being implemented in association with the East Central and Southern African Health Community, supported by IDRC (Canada).","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Discussion paper 110: A case study of the Uganda National Minimum Healthcare Package","field_subtitle":"Kadowa I: Ministry of Health, Uganda, EQUINET, Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EHB%20Uganda%20case%20study%20repAug2017pv.pdf","body":"The Essential Health Benefit (EHB) policy interventions aim to optimize efficiency while extending coverage by increasing equity of access to the defined benefits. Uganda\u2019s EHB is referred to as the Uganda National Minimum Healthcare Package (UNMHCP) introduced in the 1999 Health Policy. The UNMHCP is composed of cost efficient interventions against diseases or conditions most prevalent in the country. This report compiles evidence from published, grey literature and key informants on the UNMHCP since its introduction in Uganda\u2019s health system, and findings were further validated during a one day national stakeholder meeting. It includes information on the motivations for developing the EHBs, the methods used to develop, define and cost them, and how it has been disseminated, used in budgeting, resourcing and purchasing health services and in monitoring health system performance for accountability. It was implemented in an EQUINET research programme through Ifakara Health Institute and Training and Research Support Centre, in association with the ECSA Health Community, supported by IDRC (Canada).","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 199: To fight the next Ebola, the G20 need to empower people to respond to everyday challenges","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Header"}},{"node":{"title":"Fifth Global Symposium on Health Systems Research (HSR2018)","field_subtitle":"8 \u2013 12 October 2018, Liverpool, UK","URL":"http://healthsystemsresearch.org/hsr2018/","body":"The Global Symposium on Health Systems Research is organised every two years by Health Systems Global to bring together the full range of players involved in health systems and policy research and practice. The Alma Ata vision of \u2018Health for All\u2019 remains as compelling today as it was in 1978, as reflected in goal 3 of the Sustainable Development Goals (SDGs). But the world has changed in forty years. Despite improved health outcomes, there remain extraordinary challenges for health equity and social inclusion, such as demographic and disease transitions, conflicts and their subsequent migrations, pluralistic health systems and markets, and climate change. Political systems still marginalise those most in need. Yet there are new opportunities for health systems to achieve universal coverage. The Fifth Global Symposium will advance conversations and collaborations on new ways of financing health; delivering services; and engaging the health workforce, new social and political alliances, and new applications of technologies to promote health for all.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Forum on Internet Freedom in Africa (FIFAfrica) 2017","field_subtitle":"Forum on Internet Freedom in Africa: South Africa, September 2017","URL":"https://cipesa.org/2017/09/update-forum-on-internet-freedom-in-africa-2017/","body":"The Forum on Internet Freedom in Africa convened stakeholders in end September 2017 from the internet governance and online rights arenas in Africa and beyond to deliberate on gaps, concerns and opportunities for advancing the right to privacy, access to information, free expression, non-discrimination, and the free flow of information online. The Forum gathered human rights defenders, journalists, government officials, private sector players, global information intermediaries, bloggers, developers, the arts community, law enforcers and regulators \u2013 all of whom have a role to play in advancing internet freedom in Africa. Highlights at FIFAfrica include the launch of the annual State of Internet Freedom in Africa research report, as well the commemoration of the International Day for Universal Access to Information (IDUAI), which falls on September 28. Further information, thoughts and ideas can be found at the #InternetFreedomAfrica hashtag.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Global funding trends for malaria research in sub-Saharan Africa: a systematic analysis","field_subtitle":"Head M: Lancet Global Health 5,  doi: http://dx.doi.org/10.1016/ S2214-109X(17)30245-0, 2017","URL":"https://tinyurl.com/y9fbrv6s","body":"Total domestic and international funding for malaria is inadequate to achieve WHO global targets by 2030. The authors describe the trends of investments in malaria-related research in sub-Saharan Africa and compare investment with the national disease burden to identify areas of funding strength and potentially neglected populations, including that for malaria control. Research funding data related to malaria for 1997\u20132013 were sourced from existing datasets, from 13 major public and philanthropic global health funders, and from funding databases. Investments (reported in US$) were considered by geographical area and compared with data on parasite prevalence and populations at risk in sub Saharan Africa. 45 sub-Saharan African countries were ranked by amount of research funding received. The authors found 333 research awards totalling US$814.4 million. Public health research covered $308.1 million (37.8%) and clinical trials covered $275.2 million (33.8%). Tanzania ($107.8 million [13.2%]), Uganda ($97.9 million [12.0%]), and Kenya ($92.9 million [11.4%]) received the highest sum of research investment and the most research awards. Malawi, Tanzania, and Uganda remained highly ranked after adjusting for national gross domestic product. Countries with a reasonably high malaria burden that received little research investment or funding for malaria control included Central African Republic (ranked 40th) and Sierra Leone (ranked 35th). Congo (Brazzaville) and Guinea had reasonably high malaria mortality, yet received little investment. Some countries receive reasonably large investments in malaria-related research (Tanzania, Kenya, Uganda), whereas others receive little or no investments (Sierra Leone, Central African Republic). Research investments are typically highest in countries where funding for malaria control is also high. The authors suggest that investment strategies should consider more equitable research and operational investments across countries to include currently neglected and susceptible populations.  ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Health for All, All for Health: Lessons from the universalisation of health care in emerging economies","field_subtitle":"United Nations Research Institute for Social Development:  Research and Policy Brief 22, UNRISD, Geneva, 2017","URL":"http://tinyurl.com/y99bwd5w","body":"This brief summarizes key findings from the UNRISD research project Towards Universal Social Security in Emerging Economies. The project analysed the efforts of selected emerging economies to move towards universal provision of health care. The brief provides a comparative analysis of the political, economic and social drivers of, and constraints on, the extension of health care service for all and draws out the implications for poverty reduction, equity, growth and democracy. The brief identifies the following factors enabling universalisation: facilitating an empowered civil society, working together with government; political will, institutional capacity and political support for reform to create fiscal space for universal health care; democratic mechanisms to build consensus between different interest groups and maintain reform momentum; strategies to reduce resistance in and from the private sector; comprehensive and coherent national framework for health care, with mechanisms to ensure vertical coherence of policies between different levels of government; and tax- financed health care systems. An overarching finding emerges from the successful cases of the universalisation of health care observed in this UNRISD research: they all adopted integrated approaches that can promote synergies between health and non- health sectors; equally the contestation and consensus that reforms for universal health care entailed were not limited to the health sector alone. Health is interconnected with other areas of social, economic and environmental well- being, so the expansion of health care systems must happen alongside efforts to address the determinants of health that lie beyond the health sector.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Healthcare is not a commodity but a public good","field_subtitle":"Vermuyten S; Public Services International (PSI): Spotlight on Sustainable Development, 2017","URL":"http://tinyurl.com/y9k72zf8","body":"The author argues that social protection systems that are based on solidarity, sharing of risks, and built on collective bargaining and social dialogue, democratic structures and long-term strategies are needed to combat poverty and address inequalities and inequity. Universal social protection is essential to achieve gender equality, given a strong link between the provision of public services and the ability of women to enter the labour market, to address unpaid care work responsibilities and to ensure that children have access to health and social services. The push for the individualisation of social protection is reported to have had a major impact on the delivery of these services, including on the provision of health and social care, pensions and unemployment benefits, to which austerity programmes have added perverse effects that lead to social exclusion or risk exposure \u2013 instead of inclusion and protection. Genuine support for universal social security and healthcare could thus, he argues, make important contributions to the achievement of decent work and reduced inequality. However, the international financial institutions (IFIs) continue to promote social protection reforms that focus on targeting, which is less efficient and more costly, rather than broad coverage. Reforms promoted by the World Bank, IFC and Regional Development Banks, including marketisation, decentralisation and corporatization of the public sector, provide opportunities for multinational companies to enter the public health care sector. In addition, public health spending is coming under increasing scrutiny across the world, particularly since the 2008-2009 global financial and economic crisis. Cuts to public sector funding often penalise health workers and lead to reduced services at a time when demand for such services is increasing, as the economic crisis impacts on the wider economy. The author thus argues that the main policy tools in the orthodox approach to health sector financing risk being counter-productive. Efforts to reduce costs by increasing competition have created fragmented structures that work against the integration and coordination of healthcare. Bringing in the private sector is likely to accentuate this silo mentality in provision, in the name of commercial confidentiality and profit maximisation. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"In which developing countries are patents on essential medicines being filed?","field_subtitle":"Beall R; Blanchett R; Attaran A: Globalisation and Health 13(38) 2017","URL":"https://tinyurl.com/ya733xy7","body":"This article is based upon data gathered during a study conducted in partnership with the World Intellectual Property Organisation on the patent status of products appearing on the World Health Organisation\u2019s 2013 Model List of Essential Medicines (MLEM). It is a statistical analysis aimed at answering: in which developing countries are patents on essential medicines being filed? Patent data were collected by linking those listed in the United States and Canada\u2019s medicine patent registers to corresponding patents in developing countries using two international patent databases (INPADOC and Derwent) via a commercial-grade patent search platform (Thomson Innovation). The respective supplier companies were then contacted to correct and verify their data. The authors tallied the number of MLEM patents per developing country. A subset of 20 of the 375 (5%) products on the 2013 MLEM fit the inclusion criteria. The number of MLEM patents per country was positively associated with human development index (HDI), gross domestic income (GDI) per capita, total healthcare expenditure per capita, population size, the Rule of Law Index, and average education level of the country. Population was a powerful predictor of the number of patent filings in developing countries along with GDI and healthcare expenditure. Broad surveillance and benchmarking of the global medicine patent landscape is valuable for detecting significant shifts that may occur over time. With improved international medicine patent transparency by companies and data available through third parties, the authors suggest that studies such as this will be increasingly feasible.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Innovations from BRICS countries on people-centred health reforms at 70th World Health Assembly","field_subtitle":"World Health Organisation: WHO, Geneva, 2017","URL":"https://tinyurl.com/ydgv3arr","body":"At the 70th World Health Assembly, the \u201cBRICS countries\u201d \u2013 Brazil, the Russian Federation, India, China and South Africa \u2013 convened a side event sponsored by China. The aim was to share experiences and innovations on people-centred reforms as a means to making progress towards universal health coverage, The Executive Deputy Director, Office of State Council Healthcare Reform Leading Group in China, Dr Liang Wannian highlighted the importance the Chinese government has placed on providing improved primary health services, by transforming the primary service model and enhancing division and cooperation to build an integrated health service system. For Brazil, Mr Ricardo Barros, Minister of Health shared the aspiration that \u201cwhat we want is to have 80% of problems resolved in primary-level care so that people don\u2019t need to go to the hospital\u201d. He noted that \u201c(delivering) primary-level care is the great challenge that we have\u201d and that although \u201cwe have resources available for health, we don\u2019t use them very wisely, so we are trying to improve that.\u201d Dr Veronika Skvortsova, Minister of Health of the Russian Federation also highlighted the important role of designing a patient-focused system for health care based on accessibility and quality. For India, Mr Sanjeev Kumar, Additional Secretary, Ministry of Health and Family Welfare highlighted that the country had adopted a new national policy linked to universal health coverage in March 2017. Dr Aaron Motsoaledi, Minister of Health of South Africa, concluded the series of country presentations by returning the conversation to the importance of reorienting the model of care to focus on primary care. He shared South Africa\u2019s \u201cideal clinic\u201d innovation, which encourages the development of more attractive primary care clinics to draw patients away from tertiary care centres. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Legal Empowerment and Social Accountability: Complementary Strategies Toward Rights-based Development in Health?","field_subtitle":"Joshi A: World Development 99, doi: https://doi.org/10.1016/j.worlddev.2017.07.008, 2017","URL":"http://www.sciencedirect.com/science/article/pii/S0305750X17302425","body":"Citizen-based accountability strategies to improve the lives of the poor and marginalised groups are increasingly being used in efforts to improve basic public services. The latest thinking suggests that broader, multi-pronged, multi-level, strategic approaches that may overcome the limitations of narrow, localised successes, hold more promise. This paper examines the challenges and opportunities, in theory and practice, posed by the integration of two such citizen-based accountability strategies\u2014social accountability and legal empowerment. It traces the foundations of each of these approaches to highlight the potential benefits of integration. Consequently it examines whether these benefits have been realised in practice, by drawing upon five cases of organisations pursuing integration of social accountability and legal empowerment for health accountability in Macedonia, Guatemala, Uganda, and India. The cases highlight that while integration offers some promise in advancing the cause of social change, it also poses challenges for organisations in terms of strategies they pursue.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"National health inequality monitoring: a step-by-step manual","field_subtitle":"World Health Organisation: WHO, Geneva, 2017","URL":"http://tinyurl.com/ycpjm8be","body":"This manual provides an accessible, practical reference to encourage and strengthen the practice of health inequality monitoring. It aims to foster regular reporting of inequalities across diverse health topics, and promote greater integration of health inequality considerations in policies, programmes and practices. It is organised according to a flow chart, showing the steps and sub-steps of the health inequality monitoring cycle, with key questions and itemised checklists of data requirements, analysis/reporting activities and/or decision points. The steps include firstly, determining the scope of monitoring, obtaining data, then analysing and reporting results before implementing changes. Relevant examples and resources, including sample table templates and recommended readings, are provided for further exploration. While the manual focuses on health at the national level, the step-by-step approach may be applied to monitor inequalities within any defined population, ranging from a community context to a multi-country context. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Non-physician clinicians in rural Africa: lessons from the Medical Licentiate programme in Zambia","field_subtitle":"Gajewski J; Mweemba C; Cheelo M; et al.: Human Resources for Health 15(53), doi: https://doi.org/10.1186/s12960-017-0233-0, 2017","URL":"http://tinyurl.com/yagp2tsy","body":"Most sub-Saharan African countries struggle to make safe surgery accessible to rural populations due to a shortage of qualified surgeons and the difficulty in retaining them in district hospitals. In 2002, Zambia introduced a new cadre of non-physician clinicians, medical licentiates, trained initially to the level of a higher diploma and from 2013 up to a Bachelor of Science degree. Medical licentiates have advanced clinical skills, including training in elective and emergency surgery, designed as a sustainable response to the surgical needs of rural populations. This qualitative study aimed to describe the role, contributions and challenges surgically active medical licentiates have experienced. Based on 43 interviewees, it includes the perspective of medical licentiates, their district hospital colleagues\u2014medical officers, nurses and managers; and surgeon-supervisors and national stakeholders. In Zambia, medical licentiates play a crucial role in delivering surgical services at the district level, providing emergency surgery and often increasing the range of elective surgical cases that would otherwise not be available for rural dwellers. They work hand in hand with medical officers, often giving them informal surgical training and reducing the need for hospitals to refer surgical cases. However, medical licentiates often face professional recognition problems and tensions around relationships with medical officers that impact their ability to utilise their surgical skills. The paper provides new evidence concerning the benefits of \u2018task shifting\u2019 and identifies challenges that need to be addressed if medical licentiates are to be a sustainable response to the surgical needs of rural populations in Zambia. Policy lessons for other countries in the region that also use non-physician clinicians to deliver essential surgery include the need for career paths and opportunities, professional recognition, and suitable employment options for this important cadre of healthcare professionals.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Philanthropy in a Recession","field_subtitle":"Gastrow S: Daily Maverick, South Africa, August 2017 ","URL":"http://tinyurl.com/y8dg2erv","body":"The author raises that South Africa has limited data on what grant making takes place and on the size and scope of the civil society sector, despite a a dependency on international funding and support from private philanthropic foundations. According to Nedbank Private Wealth\u2019s Giving Report III, however, only 5% of the high net worth individuals surveyed had actually established a giving trust or foundation. That meant that the balance were giving money on an ad hoc basis. The same report indicated that South African givers \u201cdemonstrated a long-term commitment to the causes they support. Nearly half had supported beneficiaries for longer than five years (and) 22% had been supporting them for their entire lives. The author suggests that in principle, philanthropy should be focusing on organisations that are involved in systemic change and government should be supporting those organisations that deal with basic human requirements. In that case, non-profits are unlikely to be greatly affected by recession. However, that does not apply in South Africa where philanthropy is being stretched to its limits by the high level of needs not being met by the state. The choice of where limited resources can go is a hard one, but it is argued that those donating funds will support those organisations that are aligned with their individual passions for specific causes and their values, combined with effective and efficient outcomes.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Portal page on resources for Participatory Action Research now live!","field_subtitle":"TARSC: EQUINET pra4equity network, 2017","URL":"http://www.equinetafrica.org/content/portal-resources-participatory-action-research","body":"The new \u201cParticipatory Action Research Portal\u201d for resources on Participatory Action Research (PAR) is now live on the EQUINET website. The portal has a homepage and a series of \u2018subpages\u2019 for Training, resources - which will provide links to online training courses, whole training guides and reports of training activities; Methods, tools and ethics - which will provide links to online specific papers on PAR methods, to specific examples of tools, and to discussions/ guidelines on ethical issues; PAR work \u2013 which will provide links to stories, case studies, briefs, videos, text or photojournalism stories of PAR work, including facilitator reflections; Organisations and networks -  which will provide the name, snippet of information, country and link to organisations and networks involved PAR; Publications - which will provide published journal papers and reports on PAR through links to the urls or on the EQUINET database; and Other - which will provide ad hoc information that doesn\u2019t fit anywhere else. The portal is a resource for all those working with PAR and includes resources in any language. There is a form for people to send videos, photojournalism, organisations, journal papers, training guides and other resources for the portal. The url link shown here is in English but there is also a Spanish version at http://www.equinetafrica.org/content/portal-de-recursos-para-la-investigaci%C3%B3n-acci%C3%B3n-participativa-iap ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Practicing governance towards equity in health systems: LMIC perspectives and experience","field_subtitle":"Gilson L; Lehmann U; Schneider H: International Journal for Equity Health, 16(1):171, 2017","URL":"http://tinyurl.com/yc47zmzu","body":"This introductory paper to a series suggests that rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, it should be located in the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts - in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity. Analysis of governance can be viewed through diverse health policy and system issues, considers actors located at multiple levels of the system and draws on multi-disciplinary perspectives. This article introduces papers that present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings, providing an empirical and embedded research perspective on governance and equity in health systems.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Progress and priorities for reproductive, maternal, newborn, and child health in Kenya: a Countdown to 2015 country case study","field_subtitle":"Keats E; Ngugi A;  Macharia W; et al.: The Lancet Global Health 5(8) , 2017","URL":"https://tinyurl.com/y9q3rwdh","body":"Progress in reproductive, maternal, newborn, and child health (RMNCH) in Kenya has been inconsistent over the past two decades, despite the global push to foster accountability, reduce child mortality, and improve maternal health in an equitable manner.   This report provides a comprehensive assessment of RMNCH in Kenya from 1990 to 2015, using data from nationally representative Demographic Health Surveys implemented between 1989 and 2014. The authors estimated time trends for key RMNCH indicators, as defined by Countdown to 2015, at both the national and the sub-national level, explored the determinants of change in intervention coverage during the past decade and modelled the effect of intervention scale up by 2030. After an increase in mortality between 1990 and 2003, there was a reversal in all mortality trends from 2003 onwards, although progress was not substantial enough for Kenya to achieve Millennium Development Goal targets 4 or 5. Between 1990 and 2015, maternal mortality declined at half the rate of under-5 mortality, and changes in neonatal mortality were even slower. National-level trends in intervention coverage have improved, although some geographical inequities remain, especially for counties comprising the northeastern, eastern, and northern Rift Valley regions. Disaggregation of intervention coverage by wealth quintile also revealed wide inequities for several health service interventions, such as skilled birth assistance.  Maternal literacy and family size were found to be important drivers of positive change in key interventions across the continuum of care.  The analysis highlighted the importance of quality of care around birth for maternal and newborn survival, and for targeting poor households and least educated and rural women, through the scale-up of community-level interventions, to improve equity and accelerate progress.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Seven key messages from the World Health Organisation meeting on Global Strategic Purchasing","field_subtitle":"Barasa E: Resilient & Responsive Health Systems (RESYST), London School of Hygiene and Tropical Medicine, June 2017","URL":"https://tinyurl.com/y7veok5q","body":"The purchasing function of health financing is gaining increasing attention and traction in global health systems and universal health coverage (UHC) debates, which have, in the past, focused predominantly on revenue collection and pooling. A recent workshop convened by the World Health Organisation on strategic purchasing. In the blog, the author summarises seven key messages from the workshop that are likely to feature in future discussions on strategic purchasing. Purchasing refers to the process by which funds are allocated to healthcare providers to obtain services on behalf of identified groups. Strategic purchasing is a continuous search for the best ways to maximise health system performance, by deciding which interventions should be purchased, how, and from whom. It is typically considered from the point of view of the purchaser. However, by looking at it from the perspective of healthcare facilities, a complex picture of multiple purchasers and funding flows emerges. A key responsibility of healthcare purchasers is in deciding what to include in the benefit package for health. However, decisions about priority setting are often neglected in this process. The governance boards of many purchasing organisations, such as social health insurers, include representatives from the government, employers (e.g. an umbrella employer association) and employees (labour unions). However, in most low and middle income countries, a significant proportion of the population work in the informal sector. They do not belong to the labour unions, and do not have formal employers to represent them on such boards. A further governance issue is the perennial problem regarding oversight of purchasers that are separate entities from the Ministry of  health, such as social health insurers. Strategic purchasing cannot occur in the absence of good quality data. Often information systems are fragmented, presenting a partial view of the system. While it was appreciated that Results Based Financing (RBF) can contribute to strategic purchasing and act as a catalyst for health system reform,  there is a need to ensure that RBF mechanisms are embedded and integrated within the wider health system. Strategic purchasing is argued to be not just a technical issue, but also a political issue. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"SolidarMed: Child Health Project Manager Ancuabe, Mo\u00e7ambique","field_subtitle":"Closing date:  Thursday, 5 October, 2017","URL":"http://www.ngopulse.org/opportunity/2017/09/11/child-health-project-manager-ancuabe-mo%C3%A7ambique","body":"SolidarMed is a leading non-profit organization working to improve the health of people in rural Sub Saharan Africa. Working together with national partners to strengthen health systems and community capacities, it is committed to scientific evidence and policy dialogue. They are offering an position for an experienced Project Manager as Child Health Project Manager Ancuabe, Mo\u00e7ambique in the Mo\u00e7ambique team. For this key position, they are looking for a well-grounded and experienced professional with strong interpersonal and management skills and an academic background in medical sciences and/or public health.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Supporting and retaining Village Health Teams: an assessment of a community health worker program in two Ugandan districts","field_subtitle":"Mays D; O\u2019Neil E; Mworozi E; Lough B; et al.: International Journal for Equity in Health 16(129), doi:10.1186/s12939-017-0619-6, 2017","URL":"http://tinyurl.com/ydhxl9qp","body":"Uganda\u2019s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, the authors examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. The authors reported on findings from a standardised survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to strengthen and sustain community health care delivery in Uganda. A mixed-methods approach was employed through a survey of 134 individual VHT members and semi-structured interviews with six key stakeholders. Descriptive and bivariate regression analysis of quantitative survey data was performed along with thematic analysis of qualitative data from surveys and interviews. In the regression analysis, the dependent variable is 10-year anticipated longevity among VHTs, which asked respondents if they anticipate continuing to volunteer as VHTs for at least 10 more years if their current situation remains unchanged. VHTs desire additional support primarily in the forms of money (for example transportation allowance) and material supplies (for example rubber boots). VHTs commonly report difficult working conditions and describe a lack of respect from their communities and other health workers. If their current situation remains unchanged, 57% of VHTs anticipate remaining in their posts for at least 10 years. Anticipated 10-year longevity was positively associated with stronger partnerships with local health centre staff and greater ease in home visiting. The authors note that supporting and retaining Uganda\u2019s VHTs would be enhanced by building stronger partnerships between VHTs and other health workers and regularly providing supplies and transportation allowances. Pursuing such measures would likely improve equity in access to healthcare for all Ugandans.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Systems science for universal health coverage","field_subtitle":"Evans T; Kieny M: Bulletin of the World Health Organisation 95(7) 2017 ","URL":"http://www.who.int/bulletin/volumes/95/7/17-192542/en/","body":"It is 20 years since an international consultation in Lejondal, Sweden, highlighted the need for more and better research \u201cto understand and improve how societies organize themselves in achieving collective health goals, and how different actors interact in the policy and implementation processes to contribute to policy outcomes.\u201d One outcome was the creation of the Alliance for Health Policy and Systems Research. There have since been several important milestones on the path towards more and better health systems research. Such encouraging developments need to be carefully balanced against areas where progress has not met expectations. The development of national capacity for financing and institutional leadership of health policy and systems research has been slow. The authors ask: how can health policy and systems research seize this favourable context and contribute more effectively to universal health coverage, greater health security, improved value in health and effective engagement of citizens? First, they propose that there is a need a comprehensive review of the progress that has been made and the progress that might be anticipated in the future. Second, there is a need to accelerate the development of capacity and opportunity for health policy and systems research in low- and middle-income countries. Lastly, they suggest that there is a need for a revitalised approach to stewardship that reflects the pluralistic reality of contemporary health systems and prioritises health policy and systems research across all countries. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The impact of a supportive supervision intervention on health workers in Niassa, Mozambique: a cluster-controlled trial","field_subtitle":"Madede T; Sidat M; McAuliffe E; et al.: Human Resources for Health 15(58), doi: https://doi.org/10.1186/s12960-017-0213-4; 2017","URL":"http://tinyurl.com/ybhesnqo","body":"Studies have shown the  contribution that supportive supervision can make to improving job satisfaction amongst over-stretched health workers in in resource-constrained settings. The Support, Train and Empower Managers study designed and implemented a supportive supervision intervention and measured its\u2019 impact on health workers using a controlled trial design with a three-arm pre- and post-study in Niassa Province in Mozambique. Post-intervention interviews with a small sample of health workers were also conducted. The quantitative measurements of job satisfaction, emotional exhaustion and work engagement showed no statistically significant differences between end-line and baseline. The qualitative data collected from health workers post the intervention showed many positive impacts on health workers not captured by this quantitative survey. Health workers perceived an improvement in their performance and attributed this to the supportive supervision they had received from their supervisors following the intervention. Reports of increased motivation were also common. An unexpected, yet important consequence of the intervention, which participants directly attributed to the supervision intervention, was the increase in participation and voice amongst health workers in intervention facilities.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The Role and Status of National Research and Education Networks in Africa","field_subtitle":"Foley M: World Bank Group, SABER-ICT Technical Paper Series, 2016","URL":"https://openknowledge.worldbank.org/handle/10986/26258","body":"This report aims to provide guidance to governments, institutions, and development partners on how to approach the provision of advanced information and communication technology (ICT) services to the higher education and research community in Africa. It coincides with a transformation in the telecom infrastructure and services on the continent as fibre optic connectivity, both undersea and on land, is expanding at a rapid pace. The report suggests that the organisation of ICT services and connectivity is best provided by a dedicated organisation called the National Research and Education Network (NREN) based on international best practice and the current plans of the stakeholders in the region. The nature of NRENs and the case for their establishment is outlined and the story of their development in Africa to their current status is described. The report also provides guidance on how to establish or strengthen an NREN, with recommendations to the government, the private sector, institutions, development partners.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Threats posed by stockpiles of expired pharmaceuticals in low- and middle-income countries: a Ugandan perspective","field_subtitle":"Kamba P; Ireeta M; Balikuna S; Kaggwa B: Bulletin World Health Organisation; 95(8)594\u2013598, 2017","URL":"http://www.who.int/bulletin/volumes/95/8/16-186650.pdf?ua=1","body":"In some low- and middle-income countries, the national stores and public-sector health facilities contain large stocks of pharmaceuticals that are past their expiry dates. In low-income countries like Uganda, many such stockpiles are the result of donations. If not adequately monitored or regulated, expired pharmaceuticals may be repackaged and sold as counterfeits or be dumped without any thought of the potential environmental damage. The rates of pharmaceutical expiry in the supply chain need to be reduced and the disposal of expired pharmaceuticals needs to be made both timely and safe. Many low- and middle-income countries need to: strengthen public systems for medicines\u2019 management, to improve inventory control and the reliability of procurement forecasts; reduce stress on central medical stores, through liberalisation and reimbursement schemes; strengthen the regulation of drug donations; explore the salvage of officially expired pharmaceuticals, through re-analysis and possible shelf-life extension; strengthen the enforcement of regulations on safe drug disposal; invest in an infrastructure for such disposal, perhaps based on ultra-high-temperature incinerators; and include user accountability for expired pharmaceuticals within the routine accountability regimes followed by the public health sector.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"To fight the next Ebola, the G20 need to empower people to respond to everyday challenges","field_subtitle":"Lucy Gilson, Resilient & Responsive Health Systems (RESYST), London School of Hygiene and Tropical Medicine","body":"\r\nAs global leaders prepared for the G-20 Summit in Hamburg, they prioritised efforts to build functioning health systems \u201cas a prerequisite for safeguarding disease outbreaks.\u201d This is vital as the world prepares for the next Ebola-like emergency, but the organizational stress that comes with these shifts in priorities also requires attention if those efforts are going to succeed. Any attempt to strengthen health systems must take seriously well-recognized stressors such as increasing workloads, changing health needs, resource challenges, and less-often identified but routine challenges. Critical amongst these are the stresses posed by managing people and relationships in the uncertain contexts that are the norm for health systems.\r\n\r\nIntroducing new and revised policies is a major part of this chronic stress, even with the best intentions. The constant, and sometimes unconsidered, imposition of new initiatives and ideas on national health systems places great pressure on those working at the front lines of health care delivery and community engagement. Policy changes may include new treatment guidelines and protocols or quality assurance processes, as well as revised human resource and financial management rules, guidance on management structures such as community committees or new planning processes. New policies are often implemented in a top down manner through the hierarchy of public sector bureaucracy. Often, they are implemented without preparation or adequate information sharing. In addition, new policies frequently come hand in hand with rigid accountability mechanisms \u2014 such as those linked to results and performance-based financing or to targets set for health programs, or to finance-linked audit processes that are part and parcel of \u201cgood governance\u201d strategies.\r\n\r\nThese types of accountability mechanisms contribute to creating a \u201ccompliance culture\" that undermines the managerial flexibility needed to problem-solve and deal with chronic stress or acute challenges. All generally come with yet another new reporting requirement. In fact, the amount of reporting done by frontline health workers in countries such as Kenya and South Africa is simply astounding. As a result, health workers battle to cope with changing demands from managers and communities, whilst remaining poorly supported and resourced.\r\n\r\nSo, what do global leaders need to do to nurture everyday resilience in the face of chronic stress \u2014 and so also strengthen health systems?\r\n\r\nFirst, they need to understand that the \"personal\" is absolutely integral to a functioning and responsive health system. Without emphasis and acknowledgment of this, efforts to strengthen health systems will be futile. Managing human relations is identified by public health system managers in Kenya and South Africa, including primary care clinics, as a constant challenge in their jobs, and one for which they rarely have adequate training, acknowledgment and resources. Constant policy change can undermine relationships, and is part of the wider organizational change commonly experienced by health systems. From the radical devolution of public management in Kenya in 2013, to the continuing processes of change experienced in South Africa since 1994, organizational change creates an unstable environment that makes managing other challenges \u2014 of people and resources \u2014 even more difficult.\r\n\r\nSecond, and most critically, global leaders must pay attention to how they engage with health systems. They should exercise their power much more cautiously than currently and in ways that empower others to lead and take action. They need to support national and local organizational capacity to problem-solve, motivate, and learn. The \u201cThinking and Working Politically\u201d and \u201cDoing Development Differently\u201d networks call wholeheartedly for global leaders to take heed, by refraining from imposing rigid blueprint approaches and paying \u201cfar more attention to issues of power, politics and local context.\u201d Ultimately, strong health systems depend on communities, health workers, managers, researchers and other local stakeholders being empowered to respond to the inevitable, future waves of change we all face. At Health Systems Global, our members represent these multiple groups.\r\n\r\nStrengthening everyday resilience demands that we all \u2014 governments, donors, researchers, communities, health professionals \u2014 work with the resources that health systems already have \u2014 their people and relationships. This must be done as we take wider action to confront inequality at all levels. If we do not do that, then efforts to safeguard disease outbreaks will be meaningless.\r\n\r\nThis oped was originally produced as a blog for the G20 summit in July 2017 and was published on the Devex website and the Resilient & Responsive Health Systems (RESYST) website. For further information on this research programme visit http://resyst.lshtm.ac.uk/. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Uganda\u2019s refugee hospitality is exemplary","field_subtitle":"Woldemariam Y: Pambazuka News, July 2017","URL":"https://tinyurl.com/yc6gcud6","body":"Instead of being locked in crowded camps surrounded by barbed wire, the 1.2 million refugees in Uganda are given large plots of land in sprawling settlements to build homes or, if they like, small farms. If agrarian life isn\u2019t for them, they can move freely around the country, traveling to towns or to the bustling capital of Kampala, which 95,000 refugees call their home. The distinguished scholar and humanitarian activist Noam Chomsky characterizes European attitudes towards refugees \u201c[as] among the signs of the severe moral-cultural crisis of the West that is mislabeled a \u2018refugee crisis.\u2019\u201d The five wealthiest countries [the U.S., China, Japan, the U.K. and Germany]\u2014 which make up half the global economy \u2014 are hosting less than 5 percent of the world\u2019s refugees, while 86 percent of refugees are in poorer developing countries that are often struggling to meet the needs of their own people.  The authors argues that Uganda points the way forward and that the country is a good model for compassionate hospitality towards refugees. It is however noted that the country is reaching a breaking point due to increasing demands for accommodation of the large numbers of refugees. What was promised for Uganda from external funders at the 2016 high level summit in New York has not been forthcoming. Supporting viable resettlement programs and working towards durable solutions is argued to be the only way to resolve the crisis. This involves using leverage to promote human rights and good governance in refugee producing countries. ","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania","field_subtitle":"Kruk ME; Chukwuma A;  Mbaruku G;  Leslie H: Bull World Health Organ 95:408\u2013418, 2017","URL":"https://tinyurl.com/y79rew24","body":"This study analysed factors affecting variations in the observed quality of antenatal and sick-child care in primary-care facilities in seven African countries. The authors pooled nationally representative data from service provision assessment surveys of health facilities in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania (survey year range: 2006-2014). Based on World Health Organisation protocols, the authors created indices of process quality for antenatal care (first visits) and for sick-child visits. They assessed national, facility, provider and patient factors that might explain variations in quality of care, using separate multilevel regression models of quality for each service. Data were available for 2594 and 11 402 observations of clinical consultations for antenatal care and sick children, respectively. Overall, health-care providers performed a mean of 62.2% of eight recommended antenatal care actions and 54.5% of nine sick-child care actions at observed visits. Quality of antenatal care was higher in better-staffed and -equipped facilities and lower for physicians and clinical officers than nurses. Experienced providers and those in better-managed facilities provided higher quality sick-child care, with no differences between physicians and nurses or between better- and less-equipped clinics. Private facilities outperformed public facilities. Country differences were more influential in explaining variance in quality than all other factors combined. The quality of two essential primary-care services for women and children was weak and varied across and within the countries. Analysis of reasons for variations in quality could identify strategies for improving care","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"WHO estimates cost of reaching global health targets by 2030","field_subtitle":"World Health Organisation: WHO, Geneva, 2017","URL":"http://www.who.int/mediacentre/news/releases/2017/cost-health-targets/en/","body":"The SDG Health Price Tag estimates the costs and benefits of progressively expanding health services in order to reach 16 Sustainable Development Goal (SDG) health targets in 67 low- and middle-income countries that account for 75% of the world\u2019s population. The analysis shows that investments to expand services towards universal health coverage and the other SDG health targets could prevent 97 million premature deaths globally between now and 2030, and add as much as 8.4 years of life expectancy in some countries. While most countries can afford the investments needed, the poorest nations will need assistance to reach the targets. The SDG Health Price Tag models two scenarios: an \u201cambitious\u201d scenario in which investments are sufficient for countries to attain the health targets in the SDGs by 2030, and a \u201cprogress\u201d scenario in which countries get two thirds or more of the way to the targets. These investments would boost health spending as a proportion of gross domestic product across all 67 countries from an average of 5.6% to 7.5%. The global average for health spending as a proportion of GDP is 9.9%. Although higher spending does not necessarily translate to improved health, making the right investments at the right time can. The SDG Health Price Tag does not prescribe what countries should spend on health, but is intended as a tool to inform further research. It also highlights that achieving universal health coverage and the other health targets requires not only funding but political will and respect for human rights. WHO plans to update the estimates every five years and will include other health-related targets and diseases as more evidence becomes available.","php":"","field_issue_date":"2017-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"2017 CODESRIA Social Policy in Africa Conference","field_subtitle":"20 - 22 November 2017, Tshwane, South Africa","URL":"http://www.codesria.org/spip.php?article2747","body":"The DST/NRF SARChI Chair in Social Policy and its partners invite abstracts of papers to be presented at the 2017 Social Policy in Africa Conference. The conference will take place from 20-22 November 2017 at the University of South Africa (Pretoria, South Africa). The organisers invite abstracts and papers that offer critical reflections on (a) Africa\u2019s experience with social policy since Africa\u2019s decade of independence in the 1960s, (b) contemporary experiences of social policy, and (c) prospective inquiries into social policy for addressing Africa\u2019s diverse challenges of developmental and human wellbeing. The conference seeks to theorise Africa\u2019s social policy experiences (formal and non-formal) in rethinking social policy to return to a wider vision of social policy and a more holistic development that reinforces the complementarity of economic and social policies. the conference calls for reflections on how the multiple tasks of social policy can be activated to enhance the quality of lives for the rural population. How can land and agrarian reforms be understood from a social policy perspective? ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A global database of abortion laws, policies, health standards and guidelines","field_subtitle":"Johnson B; Mishra V; Lavelanet A; Khosla R; Ganatra B: World Health Organisation, doi: http://dx.doi.org/10.2471/BLT.17.197442, 2017","URL":"http://www.who.int/bulletin/volumes/95/7/17-197442/en/","body":"In June 2017 the United Nations Development Programme in collaboration with other United Nations agencies launched a new, open-access Global Abortion Policies Database. The online database contains comprehensive information on the abortion laws, policies, health standards and guidelines for WHO and United Nations (UN) Member States. It is intended for use by policy-makers, human rights bodies, nongovernmental organisations, public health researchers and civil society. The database is designed to further strengthen global and national efforts to eliminate unsafe abortion by facilitating comparative and country-specific analyses of abortion laws and policies, placing them in the context of information and recommendations from WHO technical and policy guidance on safe abortion. The main objectives of the database are to promote greater transparency of abortion laws and policies and state accountability for the protection of women and girls\u2019 health and human rights.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"A paradigm shift for socioeconomic justice and health: from focusing on inequalities to aiming at sustainable equity","field_subtitle":"Garay J; Chiriboga D: Public Health 149, doi: http://dx.doi.org/10.1016/j.puhe.2017.04.015, 2017","URL":"http://www.publichealthjrnl.com/article/S0033-3506(17)30161-0/fulltext","body":"This study measured the \u2018best possible health for all\u2019, incorporating sustainability, to establish the magnitude of global health inequity. The authors identified countries with three criteria: firstly, a healthy population\u2014life expectancy above world average; secondly, living conditions feasible to replicate worldwide\u2014per-capita gross domestic product (GDP-pc) below the world average; and thirdly, sustainability\u2014per-capita carbon dioxide emissions lower than the planetary pollution boundary. Using these healthy, feasible, and sustainable (HFS) countries as the gold standard, the authors estimated the burden of global health inequity (BGHiE) in terms of excess deaths, analysing time-trends (1950\u20132012) by age, sex, and geographic location. Finally, the authors defined a global income \u2018equity zone\u2019 and quantified the economic gap needed to achieve global sustainable health equity. A total of 14 countries worldwide met the HFS criteria. Since 1970, there has been a BGHiE of about 17 million avoidable deaths per year (about 40% of all deaths), with 36 life-years-lost per excess death. Young children and women bore a higher BGHiE, and, in recent years, the highest proportion of avoidable deaths occurred in Africa, India, and the Russian Federation. By 2012, the most efficient HFS countries had a GDP-per capita/ year of US$2165, which the authors proposed as the lower equity zone threshold. The estimated US$2.58 trillion economic gap represents 3.6% of the world's GDP\u2014twenty times larger than current total global foreign aid. Sustainable health equity metrics provide a benchmark tool to guide efforts toward transforming overall living conditions, as a means to achieve the \u2018best possible health for all.\u2019","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"African peasants highlight their struggles at Via Campesina global conference","field_subtitle":"Monjane B: Pambuzuka News, July 2017","URL":"http://tinyurl.com/y7mvgtfn","body":"Peasants across Africa are intensifying their struggles against land grabs and other harmful policies that promote industrial agriculture. At a recent international conference organised by the world\u2019s largest peasants movement, Via Campesina, African peasants had opportunities to share their experiences of struggle and to learn. This conference happens at a time when Africa is undergoing a harsh moment, as indicated by Ibrahima Coulibaly from the National Coordination of Peasant Organizations (CNOP) in Mali. They note that land, mineral resources, seeds and water are increasingly being privatised due to the myriad of investment agreements and policies driven by new institutional approaches, imposed on the continent by western powers and Bretton Woods institutions. Elizabeth Mpofu, from the Zimbabwe Smallholder Farmers Forum, is a small-scale farmer who had access to land after she took part in the radical land occupation that resulted in the fast-track land reform in the early 2000s. According to her, building alternatives is to take direct action. Domingos Buramo, from the Mozambique Peasants Union (UNAC), brought to the conference the experience of the Mozambican peasants and other civil society organisations against land grabbing and large-scale investment projects in Mozambique. He mentioned that the resistance to ProSavana, a large-scale agricultural project proposed for Mozambique, is an example of how transformative articulated struggles could be. \u201cNow the government is changing its vision as a result of our work. We can change our societies\u201d, he said. Africa - including the Maghreb region - was the last continent to be part of Via Campesina. Since 2004 the number of African peasant movements joining La Via Campesina has been increasing. African movements consider their membership to the peasant movement as a strategic process of amplifying their struggles and reinforcing internationalism.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Charter of the North African Network for Food Sovereignty","field_subtitle":"North African Network for Food Sovereignty: Pambazuka News, July 2017","URL":"https://tinyurl.com/yc7nd7na","body":"Activists from organisations in North Africa met in Tunis in July 2017 to set up the North African Network for Food Sovereignty. The network\u2019s charter states that food sovereignty is the human right of peoples as individuals and communities to define their own food systems. Food sovereignty is tied to the right of people to self-determination at the political, economic, social, cultural and environmental levels. It means, working with nature and protecting resources to produce sufficient, healthy and culturally appropriate food by giving priority to local production and staple food, putting in place popular agrarian reforms, guaranteeing free access to seeds, protecting national produce and by involving people in elaborating agricultural policies. The charter identifies that this is undermined by  extractivist policies implemented in the name of development and by neoliberal adjustment policies. In order to address this the North African Food Sovereignty Network was formed to achieve food sovereignty, climate and environmental justice, through critical studies; campaigns, workshops, direct actions as well as networking, coordination and solidarity with movements that share objectives.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Effect of eliminating CD4-count thresholds on HIV treatment initiation in South Africa: An empirical modelling study","field_subtitle":"Bor J; Ahmed S; Fox M; Rosen S; Meyer-Rath G; Katz I; Tanser F; Pillay D; B\u00e4rnighausen T: PLOS One, doi: https://doi.org/10.1371/journal.pone.0178249, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178249","body":"The World Health Organisation recommends initiating antiretroviral therapy (ART) regardless of CD4 count. The authors assessed the effect of ART eligibility on treatment uptake and simulated the impact of WHO\u2019s recommendations in South Africa, through an empirical analysis of cohort data using a regression discontinuity design, used for policy simulation. They enrolled all patients (n = 19,279) diagnosed with HIV between August 2011 and December 2013 in the Hlabisa HIV Treatment and Care Programme in rural South Africa. Patients were ART-eligible with CD4","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Engaging Parliament to clarify the legal and policy frame work of Abortion in Uganda","field_subtitle":"Juuko D: Center for Health, Human Rights and Development (CEHURD), Uganda, June 2017","URL":"https://tinyurl.com/ydxs5om3","body":"CEHURD within the Coalition to Stop Maternal Mortality Due to Unsafe Abortion (CSMMUA) held a meeting in June 2017 with Uganda Women\u2019s Parliamentary Association (UWOPA) to clarify on the legal and policy framework on sexual and reproductive health and to discuss evidence based approaches to address unsafe abortion even where the law is restrictive. In Uganda, unsafe abortion is one of the leading causes of maternal morbidity and mortality, contributing to approximately 26% of the estimated 6,000 maternal deaths every year and an estimated 40% of admissions for emergency obstetric care. The meeting was motivated by a conviction that as policy makers, Members of Parliament (MPs) have a role to play in law reform on sexual and reproductive health issues and to interact with communities in their various constituencies. The meeting paved a way for an open discussion on unsafe abortions as a public health issue and the different stakeholders\u2019 and policy makers' roles in reducing abortion related deaths in Uganda. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"EQUINET in the 13th annual Southern African Civil Society Forum ","field_subtitle":"Johannesburg, August 14-16 2017","body":"The  13th Southern African Civil Society Forum was held from  14-17 August 2017 at  Birchwood Hotel and Conference Centre Johannesburg, organised by the Southern African Development Community (SADC) Council of Non government organisations (CNGO), Southern African Trade Union  Co-ordinating Council (SATUCC) and   Federation of Churches in Southern Africa (FOCISA). It involved about 300 delegates from different constituencies and civil society organisations across the SADC region.  A commission session was convened by EQUINET and SATUCC within the 13th Southern African Civil Society Forum to share information on the findings and proposals for harmonised regional standards on health in the extractive sector. The session objectives were to discuss the key issues and formulate concrete strategies for responding to the regional context and priority challenges for protection of health in the extractive sector in the region and to make proposals for harmonised regional standards to protect health in the sector.  Delegates recommended that  health be included in the SADC harmonised standards for the mining sector, with a comprehensive focus on public health and environment, with details of what this means and actions proposed at national, regional and local level. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"\r\nContact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 198: Take health systems out of the market place to build their resilience ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries","field_subtitle":"Stenberg L; Hanssen O; Edejer T; et al.: The Lancet Global Health, Doi: http://dx.doi.org/10.1016/ S2214-109X(17)30263-2, 2017","URL":"https://tinyurl.com/yaeld9k8","body":"The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published. The authors developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time and calculated projections for 67 low-income and middle-income countries from 2016 to 2030. The authors estimated that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario\u2014the equivalent of an additional $41 or $58 per person, respectively, by the final years of scale-up. In the ambitious scenario, total health-care spending would increase to a population-weighted mean of $271 per person across country contexts, and the share of gross domestic product spent on health would increase to a mean of 7.5%. Around 75% of costs are for health systems, with health workforce and infrastructure (including medical equipment) as the main cost drivers. Despite projected increases in health spending, a financing gap of $20\u201354 billion per year is projected. Should funds be made available and used as planned, the ambitious scenario would save 97 million lives and significantly increase life expectancy by 3\u00b71\u20138\u00b74 years, depending on the country profile. All countries will need to strengthen investments in health systems to expand service provision in order to reach SDG 3 health targets, but even the poorest can reach some level of universality. In view of anticipated resource constraints, each country will need to prioritise equitably, plan strategically, and cost realistically its own path towards SDG 3 and universal health coverage.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Harmonising community-based health worker programs for HIV: a narrative review and analytic framework","field_subtitle":"De Neve JW; Boudreaux C; Gill R;  Geldsetzer P; Vaikath M; B\u00e4rnighausen T; Bossert T: Human Resources for Health 15 (45), doi:10.1186/s12960-017-0219-y, 2017","URL":"https://tinyurl.com/ych6olrk","body":"Many countries have created community-based health worker (CHW) programs for HIV, often through national and non-governmental initiatives, raising questions of how well these different approaches co-ordinate. The authors conducted a literature review on the harmonisation of CHW programs, defining harmonisation, and identifying and describing the major issues and relationships surrounding the harmonisation of CHW programs, including key characteristics, facilitators, and barriers for each of the priority areas of harmonisation. The authors found a large number and immense diversity of CHW programs for HIV. This includes integration of HIV components into countries\u2019 existing national programs along with the development of multiple, stand-alone CHW programs. While harmonisation is likely a complex political process, with in many cases incremental steps toward improvement, a wide range of facilitators are available to decision-makers. They can be categorised into those involved in the intervention itself, in relation to stakeholders, health systems, and the broad context. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"How access to knowledge can help universal health coverage become a reality","field_subtitle":"Bruijns S: The Conversation, 29 June 2017","URL":"https://tinyurl.com/y8cnbmtm","body":"The WHO Director General Dr Ghebreyesus has set universal health coverage (UHC) as one of the main priorities for his term. His goal is a challenging one, especially for low and middle income countries which make up around 84% of the world\u2019s population. They only have access to half the physicians and a quarter of the nurses that high income countries have access to. Similarly low and middle income countries only spend around US $266 per capita on health care. In contrast, high income countries spend US $5 251 per capita. This means that attaining universal health coverage in poorer settings is challenging. Large cuts to foreign aid investment from a number of high income economies only compound this challenge.  Low and middle income countries also invest around a third of what high income countries invest in research to generate the knowledge needed for UHC. They also have access to around a fifth of the researchers high income countries have access to.  Much of the knowledge required to establish the universal health coverage already exists but poor access presents a major barrier to achieving the goal. To unlock this knowledge for everyone\u2019s benefit, the author proposes that policymakers and publishers consider more innovative ways to provide access to available knowledge.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"ICASA 2017: 19th International Conference on AIDS and STDs in Africa","field_subtitle":"4-9 December 2017, Abidjan, C\u00f4te d'Ivoire","URL":"http://icasa2017cotedivoire.org","body":"The conference theme \u201cAfrica: Ending AIDS-delivering differently\u201d engages the whole continent and all stakeholders in the post SDG framework. The 19th ICASA is an opportunity to renew this global commitment by drawing the world\u2019s attention to the fact that the legacy is now under threat as a result of the global economic downturn. This year\u2019s ICASA is an opportunity for the international community, and all Africans, to join efforts in committing to achieving an AIDS-free Africa. Given the urgency of the issue the organisers are anticipating 7 000 -10 000 of the world\u2019s leading scientists, policy makers, activists, PLHIV, government leaders \u2013 as well as a number of heads of state and civil society representatives \u2013 will be joining the debate on how to achieve this vision. The conference will be chaired by Dr Ihab AbdelRhaman Ahmed, an epidemiologist and President of the Society for AIDS in Africa (SAA). It will be co-chaired by Dr. Raymonde Coffie Goudou, Ministry of Health representing the Government of C\u00f4te d\u2019Ivoire. The conference will be an opportunity to promote inter-sectoral achievements in the AIDS response and to strengthen the partnership among governments, civil society, and development partners. The objectives of ICASA include promoting innovation, partnerships to increase domestic investments to achieve 90/90/90 targets, integrating approaches for sustainable Responses towards ending AIDS, TB, Hepatitis and associated diseases and translating science into action to maximise programme impact. Further objectives include providing a platform to Maintain and Sustain Investment for CSO and FBO\u2019s, providing a platform to promote rights-based models to overcome structural and policy barriers towards universal access.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Implementation research to improve quality of maternal and newborn health care, Malawi","field_subtitle":"Brenner S; Wilhelm D; Lohmann J; Kambala C; Chinkhumba J; Muula A; Allegri M: Bulletin of World Health Organisation 95(7), 491\u2013502, 2017","URL":"https://tinyurl.com/y86o42zy","body":"This study evaluated the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. The authors conducted a non-randomised controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. The authors assessed changes in the facilities\u2019 essential drug stocks, equipment maintenance and clinical obstetric care processes. The authors observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. The authors observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants\u2019 adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Improving primary health care facility performance in Ghana: efficiency analysis and fiscal space implications ","field_subtitle":"Novignon J; Nonvignon J: Biological Medical Central Health Services Research 17(1) 399, doi: 10.1186/s12913-017-2347-4, 2017","URL":"https://tinyurl.com/ybyasxtg","body":"This study estimated efficiency among primary health facilities (health centres), examined the potential fiscal space from improved efficiency and  investigated the efficiency disparities in public and private facilities. Data was from the 2015 Access Bottlenecks, Cost and Equity project conducted by the Institute for Health Metrics and Evaluation. The Stochastic Frontier Analysis was used to estimate efficiency of health facilities. Efficiency scores were then used to compute potential savings from improved efficiency. Outpatient visits was used as output while number of personnel, hospital beds, expenditure on other capital items and administration were used as inputs. Disparities in efficiency between public and private facilities were estimated using the Nopo matching decomposition procedure. The average efficiency score across all health centres included in the sample was estimated to be 0.51, about 0.65 and 0.50 for private and public facilities, respectively. Significant disparities in efficiency were identified across the various administrative regions. With regards to potential fiscal space, the authors found that, on average, facilities could save about US$7634 if efficiency was improved. The authors also found that fiscal space from efficiency gains varies across rural/urban as well as private/public facilities, if best practices are followed. They argue for primary health facility managers to improve productivity via effective and efficient resource use, through training of health workers and improving the facility environment alongside effective monitoring and evaluation exercises. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Lawyers for Human Rights: National Director, South Africa","field_subtitle":"Application closing date: 1 October 2017","URL":"http://tinyurl.com/ya9n8feg","body":"With six offices spread around the country, Lawyers for Human Rights (LHR) has a national footprint and offers specialist public interest legal services in key programme areas such as refugee and migrant rights, land reform, housing, environmental justice, penal reform, gender equality, worker rights and strategic litigation. LHR is seeking to appoint a National Director to lead the organisation with various human rights programmes and law clinics around the country. The candidate will be required to provide strategic thinking, positioning and management of LHR and manage the organisations programmes and law clinics effectively. The candidate will represent the organisation and advocate with government, multilateral organisation, the United Nations and other relevant institutions, and coordinate closely with programs managers on fundraising. The candidate will need to identify and build strategic partnerships and networks and foster meaningful relationships and have a close and interactive relationship with the LHR Board on developmental issues and be accountable to the Board. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Lifestyle and income-related inequality in health in South Africa","field_subtitle":"Mukong A; Van Walbeek C; Ross H: International Journal for Equity in Health 16(103), doi: 10.1186/s12939-017-0598-7, 2017","URL":"https://tinyurl.com/y7yrx69d","body":"Many low - and middle-income countries are experiencing an epidemiological transition from communicable to non-communicable diseases, imposing both economic and health burdens on their societies. While the prevalence of such diseases varies with socioeconomic status, the inequalities can be exacerbated by lifestyles. This paper explored the contribution of smoking and alcohol consumption to health inequalities, incorporating measures of health directly associated with these lifestyle practices from National Income Dynamic Study panel data for South Africa. The authors found significant smoking-related and income-related inequalities in both self-reported and lifestyle-related ill-health. The results suggest that smoking and alcohol use contribute positively to income-related inequality in health. Smoking participation accounts for up to 7.35% of all measured inequality in health and 3.11% of the inequality in self-reported health. The estimates are generally higher for all measured inequality in health (up to 14.67%) when smoking duration is considered. Alcohol consumption accounts for 27.83% of all measured inequality in health and 3.63% of the inequality in self-reported health. This study provides evidence that inequalities in both self-reported and lifestyle-related ill-health are highly prevalent within smokers and poor people. The authors suggest that policies aimed at reducing tobacco consumption and harmful alcohol will improve health and reduce health inequalities.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Magufuli: Barrick ready to pay what it owes Tanzania","field_subtitle":"Mtulya A: The Citizens, 14 June 2017","URL":"http://tinyurl.com/yctn4wcv","body":"President of the United Republic of Tanzania, John Magufuli has met with Prof John Thornton, Chairman of Barrick Gold Canada, parent company of Acacia Mining to discuss the issue of mineral sand exportation in Tanzania. The new development came after Dr Magufuli received two reports on the exportation of mineral concentrates abroad for smelting. The first committee probed at the technical aspects of the concentrate and the second committee examined the economic and legal frameworks around the export. Both reports damned Acacia for foul play and suggested that Tanzania lost over Sh100 trillion since it started exporting concentrates in the late 1990s. Dr Magufuli who was accompanied by the Minister for Legal and Constitutional Affairs Prof Palamagamba Kabuki said the meeting was successful and Barrick have \u201crepented\u201d for what has happened and they are ready to compensate Tanzania for the loss that has been incurred over the years. Dr Magufuli announced on a video clip tweeted on the official government spokesperson account that Barrick have \u201crepented\u201d and are ready to compensate Tanzania for the loss incurred over the years. Garrick Gold Canada is the largest shareholder of the Acacia Mining Company. On March 2017, the export of mineral concentrates by Barrick from Tanzania was stopped by Presidential directive.   ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Measurement and decomposition of socioeconomic inequality in single and multimorbidity in older adults in China and Ghana: results from the WHO study on global AGEing and adult health ","field_subtitle":"Kunna R; Sebastian M; Williams J: International Journal for Equity in Health 16(79), doi: 10.1186/s12939-017-0578-y, 2017","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-017-0578-y","body":"There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana, using data from the World Health Organisation Study on Global AGEing and Adult Health 2007\u20132010.  In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China. In Ghana inequalities were significant and more highly concentrated among the rich. In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth quintiles contributed most to inequality in multi morbidity (39.0%). In Ghana, the wealth quintiles contributed 24.5% to inequality in single morbidity and body mass index contributed 16.2% to the inequality in multi- morbidity. The country comparison reflects different stages of economic development and social change in China and Ghana. More studies of this type are needed to inform policy-makers about the patterning of socioeconomic inequalities in health, particularly in developing countries undergoing rapid epidemiological and demographic transitions.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Measuring three aspects of motivation among health workers at primary level health facilities in rural Tanzania","field_subtitle":"Sato M; Maufi D; Mwingira U; Leshabari M;  Ohnishi M; Honda S: PLoS ONE 12(5): e0176973, doi: https://doi.org/10.1371/journal.pone.0176973 , 2017","URL":"https://tinyurl.com/y74pxu2r","body":"Tanzania faces a critical shortage of skilled health workers. While training, deployment, and retention are important, motivation is also necessary for all health workers, particularly those who serve in rural areas. This study measured the motivation of health workers who were posted at government-run rural primary health facilities. The authors sought to measure three aspects of motivation\u2014management, performance, and individual aspects\u2014among health workers deployed in rural primary level government health facilities. In addition, they also sought to identify the job-related attributes associated with each of these three aspects. Two regions in Tanzania were selected for the research. In each region, the authors further selected two rural districts in each in which they carried out their investigation.  Motivation was associated with marital status, having a job description  and number of years in the current profession  for management aspects; having a job description for performance aspects; and salary scale for individual aspects. The authors conclude that having a clear job description motivates health workers, and that the existing Open Performance Review and Appraisal System, of which job descriptions are the foundation, needs to be institutionalised in order to effectively manage the health workforce in resource-limited settings.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries","field_subtitle":"Monden C; Smits J: The Lancet Global Health 5(7), e673-e679, 2017","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30197-3/fulltext","body":"Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. The authors pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014 to address this question. Under-5 mortality among twins declined from 327 per 1000 live births in 1995\u20132001 to 213 in 2009\u201314. This decline of 35% was less steep than the 51% reduction among singletons. Twins account for an increasing share of under-5 deaths in sub-Saharan Africa: currently 11% of under-5 mortality and 15% of neonatal mortality. Excess twin mortality cannot be explained by common risk factors for under-5 mortality, including birth-weight. The difference with singletons was especially stark for neonatal mortality and 52% of women pregnant with twins reported receiving medical assistance at birth. The authors note that an alarming one-fifth of twins in the region dies before age 5 years, three times the mortality rate among singletons. Twins account for a substantial and growing share of under-5 and neonatal mortality, but they are largely neglected in the literature. They argue that co-ordinated action is required to improve the situation of this extremely vulnerable group.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Open letter to WHO on industrial animal farming","field_subtitle":"Weathers S; Hermanns S; and 270 expert signatories: Open Letter Animal Farming, 2017","URL":"https://openletteranimalfarming.com/welcome/","body":"In this letter over 200 scientists, policy experts and others concerned persons are urging the new World Health Organisation Director-General to recognise and address factory farming as a growing public health challenge. The authors suggest that WHO negotiate country-level standards for antibiotic use in animal husbandry, in coordination with the Food and Agricultural Organisation. Member states should be encouraged to articulate specific, verifiable standards for what constitutes legal antibiotic use in animal farms. Further, meat producers should dispose of antibiotics and waste residue properly to prevent environmental contamination and excess greenhouse gas emissions and work with all relevant ministries, including those outside of health, to reduce the size and number of factory farms to better balance dietary need and ecological capacity. WHO should discourage member states from subsidising factory farming and its inputs, which can cause significant harm to the public and consider the application of relevant fiscal policies in member states that would help to reduce meat demand and consumption, especially where consumption exceeds health recommendations. WHO should encourage member states to adopt nutrition standards and implement health education campaigns which inform citizens of the health risks of meat consumption and work closely with ministers of health and agriculture to formulate policies that advocate for a greater proportion of plant-based foods in the diets of member states. Lastly, they recommend that the WHO should consider funding the scientific development of plant-based and other meat alternatives, which have the potential to eliminate or reduce the harms of factory farming.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Rural Health Conference 2017","field_subtitle":"22-25 September 2017, North West Province, South Africa","URL":"http://ruralhealthconference.org.za","body":"The Rural Health Conference is an vibrant event bringing together doctors, therapists, nurses, clinical associates, health students and NGOs, always in a rural location. Attendees will meet up and share ideas and friendship  with colleagues from around South Africa and Africa. The themes for the conference include Recognising Rural Health Challenges, Working together \u2013 Better and Smarter, Use of innovations in Communication Technology and Healthcare, Using Trans-disciplinary Teamwork to find innovative solutions and Working together to Advocate for better Rural Health.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Smile Train: Programme Manager","field_subtitle":"Application closing date: 8 September 2017","URL":"http://tinyurl.com/yaplmts8","body":"Smile Train is an international children\u2019s charity that provides 100%-free cleft repair surgery and comprehensive cleft care to children in 85+ developing countries. Their sustainable model empowers local doctors to provide cleft care in their own communities. The overall purpose of the role is to devise, plan and implement local strategies to achieve the mission and goals of Smile Train in terms of high-quality and safe cleft lip and palate care through effective management of programmes and partnerships in Southern Africa. Key responsibilities for the position include instituting suitable business processes and necessary control mechanisms for the continual monitoring of financial, programmatic, and medical targets in the region and receiving, reviewing, and analysing all grant requests from local stakeholders. The candidate will need to ensure all operations are legally and financially transparent and in compliance with all local laws and laws of the U.S. that apply to local business practices and lead efforts to share Smile Train\u2019s global messaging locally and help to build the brand and awareness of Smile Train programs in Southern Africa. The candidate will be responsible for capturing and sharing stories, images, and videos that help to tell Smile Train\u2019s story and that could be used across the organisation to further Smile Train\u2019s mission. Lastly the candidate will be required to build and nurture the \u2018Smile Train\u2019 brand, developing an image of a focused, committed, ethical and caring organisation upholding and furthering \u2018best practices\u2019 in cleft care.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Take health systems out of the market place to build their resilience","field_subtitle":"Mulumba, Moses, Center for Health Human Rights and development, Uganda","body":"\r\nThere is increasing global focus on building resilient and responsive health systems to improve population health. It raises questions: What constitutes a resilient health system? Is it one that is able to absorb shocks? Is it one that is able to anticipate shocks and engage with their political and economic determinants? To what extent has this language of resilience enabled an approach towards sustaining health systems in the most economically efficient manner feasible, with minimal public sector investments? And what does this mean for people\u2019s rights to health?\r\n\r\nA retrospective look at lessons from key moments in health policy, research and practice sheds light on some of these concerns. Key documents such the 1974 Lalonde Report, the 1978 Alma Ata Declaration on Primary Health and the 1986 Ottawa Charter from the first International Conference on Health Promotion focused policy attention on health systems built on prevention of health problems and promotion of good health. The Alma Ata Declaration emphasized investments in primary health care and highlighted that people have a right and duty to participate individually and collectively in the planning and implementation of their health care. The policy focus moved away from medicalized health systems to more inclusive ones, with community-engagement based on human rights principles. \r\n\r\nThere was however a shift in health policy from the last 1980\u2019s. Primary health care approaches and health promotion strategies were criticized for being unmanageable, lacking clear measurable targets and being costly to sustain. Alternative, selective approaches were advanced, focused on specific diseases and measurable, cost effective interventions. Disease specific programs grew for key areas such as HIV and AIDS, tuberculosis, malaria and maternal health, with funding mainly targeting these programs. Funding and incentivizing disease specific intervention targets carries the risk of weakening wider primary health care measures, including for community participation in health decision making. A disease focus can ignore determinants of epidemics and other \u2018neglected\u2019 diseases, and set up parallel programming siphoning key health personnel from the wider health system to the better resourced diseases specific projects. These effects lead to health systems that have weak links to communities and wider health problems, that are neither resilient not responsive and that leave people exposed to outbreaks of epidemics, such as Ebola virus disease and cholera. \r\n\r\nThe mindset of efficiency over-riding other considerations in health systems was heavily reinforced in the late 1980s and early 1990\u2019s, when the World Bank and the IMF introduced neoliberal structural adjustment programs as a condition for loans. The major budget cuts to the social sectors, including health, from these programmes are well documented. Economic models that imply that public expenditure on systems and social roles is wasteful or inefficient combined with a pressure of reduced public funding for health services, as reported in EQUINETs regional equity analyses in 2007 and 2012, reducing investment in comprehensive primary health care despite its pro-poor benefit and reinforcing the narrow disease focus. It also enabled the health sector to be judged by the same principles as other areas of the market, within development frameworks that heavily promoted the \u2018free market\u2019, despite the global market being anything but free. At national level, poverty reduction strategy papers that were seen as dealing with \u2018transitional poverty\u2019, segmenting it as an unfortunate by product of an essentially positive approach, metamorphosed into national development plans that conceptualised national health policies and strategies more from an economic than a public health perspective. \r\n\r\nAs raised in various reports, including by EQUINET, Oxfam and the Municipal Services Project, and by S Nishtar in her submission to the 2016 World Economic Forum, this mindset has opened the doorway in the current decade to the commodification of our public health systems in the market place, and in some settings to the sale of public assets or private sector roles that have commercialised the provision of health care and deepened inequities. The effect has been to slowly but surely weaken the role of the state in resilient and responsive health systems. It is therefore not surprising that the private sector role is growing in our health systems in the region, whether in terms of provisioning of services, or in the heavily promoted role of social health insurance and even voluntary and community health insurance (rather than mandatory insurance or taxes) as a vehicle for service funding, with the untested promise in the region of more resources and more efficient funding. As private actors have gained an increasing role in our health systems, they are also giving increasing voice to the private sector in health agenda setting at national and global level, most recently raised in the debates on the Framework for engagement of non-state actors in the World Health Organisation. It is thus not surprising to find that the current proposals on universal health coverage that we hear in the region are dominated by business models centred on health insurance rather than human rights principles.\r\n\r\nThese trends raise a challenge for us: To carry out research that critically interrogates that assumptions and paradigms introduced into our region and to explore how to defend and advance comprehensive primary health care and human rights based approaches in health systems. This implies more questioning from the region at global level of the assumptions that are driving this role of the market and the private sector in our health systems, and what implications it has for rights-holders and duty bearers. This has two evident implications: it implies that we cannot continue to allow a retreat of the state from the health sector, whether in terms of diminished funding, weakened regulatory power, public health services or participatory governance. It also implies that we bring communities, their rights and evidence, more centrally into the setting of policies, priorities and in shaping services, not simply as a means of taking on unfunded service burdens, but as the central resource for the state and public sector in building resilient and responsive health systems.\r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"The Cholera Epidemic in Zimbabwe, 2008\u20132009: A Review and Critique of the Evidence","field_subtitle":"Cuneo N; Sollom R; Beyrer C: Health and Human Rights Journal, Papers in Press Blog, July 2017","URL":"https://tinyurl.com/yaegjkvh","body":"The 2008\u20132009 Zimbabwe cholera epidemic resulted in 98,585 reported cases and caused more than 4,000 deaths. In this study, the authors used a mixed-methods approach that combined primary qualitative data from a 2008 Physicians for Human Rights-led investigation with a systematic review and content analysis of the scientific literature. Their initial investigation included semi-structured interviews of 92 key informants, which the authors supplemented with reviews of the social science and human rights literature, as well as international news reports. The authors investigation revealed that the 2008\u20132009 Zimbabwean cholera epidemic was exacerbated by a series of rights abuses, including the politicisation of water, health care, aid, and information. The authors argue that the failure of the scientific community to directly address the political determinants of the epidemic exposes the challenges to maintaining scientific integrity in the setting of humanitarian responses to complex health and human rights crises. While the period of the cholera epidemic is now a decade in the past, the findings remain relevant for contexts where health and rights interact and in contexts where governance concerns affect improvements in health.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The future of cities according to women : Interview with Thozama Mputa, Michelle Mlati and Counterspace","field_subtitle":"Interview with Thozama Mputa, Michelle Mlati and Counterspace: Future Cape Town, 9 August 2017  ","URL":"http://tinyurl.com/ya9l4mpk","body":"In April and May 2017, the Constructing Future Cities project supported by the British Council engaged with 5 women artists on the topic of future cities. Mputa identified the fact that women do not feel safe and are not safe in cities as something that needs to be addressed. Sputa noted that one would experience a space differently if one had an opportunity to contribute and to be informed during the design process. One would take pride in the space, be able to use the space effectively and educate others on spaces in the city. Her vision of a future city; a city that acknowledges its past, celebrates the present and plans for change, an inclusive city designed by its inhabitants and explored by its visitors. Her artwork makes use of hatching to illustrate and merge faces, landscapes and cityscapes. Creating rhythm and pattern emphasised by the use of colour. Mlati identified a need to expand thinking about energy sources, moving beyond solar panels as infrastructure towards thinking of an intersection of art, architecture and energy. Mlati notes that those whose experiences of the city have flourished despite alienation hold clues from future urban practice. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The importance of sexual and reproductive health and rights to prevent HIV in adolescent girls and young women in eastern and southern Africa","field_subtitle":"World Health Organisation: WHO Evidence Brief, WHO/RHR/17.05, Geneva, 2017","URL":"https://tinyurl.com/y7z6hx5a","body":"Over the last several years, countries in the eastern and southern Africa (ESA) region have made significant and commendable progress in preventing mother-to-child transmission (PMTCT) of HIV and in scaling up HIV treatment efforts. However, despite these gains, there have been no significant reductions in new HIV infections and the region continues to be the hardest hit by the epidemic, highlighting the need to place stronger emphasis on HIV prevention. The risk of HIV infection among adolescent girls and young women (AGYW) in the ESA region is of particular concern. The 2016 UNAIDS World AIDS Day report, Get on the Fast-Track \u2013 The life-cycle approach to HIV, stated that efforts to reduce new HIV infections among young people and adults have stalled, threatening to undermine progress towards ending AIDS as a global public health threat by 2030. This evidence brief reviews the background and makes recommendations for steps to develop a comprehensive approach to HIV prevention for AGYW in the context of sexual and reproductive health and rights. Firstly, it calls for measures to build on current commitments and national priorities and in a comprehensive approach. Further steps include reviewing evidence-based interventions for AGYW, operationalising and evaluating multisectoral approaches through reviewing different country strategies and identifying funding opportunities. Several next steps were proposed, including exploring and developing a few case studies of specific programme experience or coordination processes and mechanisms to illustrate possible best practices and address outstanding questions and monitoring, evaluating and documenting the scale-up of integrated HIV-prevention and SRHR interventions for AGYW in the context of different initiatives, to identify optimal approaches to scaling up the delivery of successful interventions.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The Land of No Men: Inside Kenya\u2019s Women-Only Village","field_subtitle":"Tadic E: Broadly, 2015","URL":"http://tinyurl.com/ycw4rg5f","body":"Titled \u201cThe Land of No Men: Inside Kenya\u2019s Women-Only Village\u201d the 30-minute documentary report takes audiences to northern Kenya, \u201cwhere the foothills of Mount Kenya merge into the desert,\u201d home to the people of Samburu, which is also where Rebecca Lolosoli founded Umoja village as a safe haven for women from a society long-maintained as a strict patriarchy for over 500 years. \u201cUmoja, which means \u201cunity\u201d in Swahili, is quite literally a no man\u2019s land, and the matriarchal refuge is now home to the Samburu women who no longer want to suffer abuses, like genital mutilation and forced marriages, at the hands of men. Throughout the years, it has also empowered other women in the districts surrounding Samburu to start their own men-excluding villages. Broadly visited Umoja and the villages it inspired to meet with the women who were fed up with living in a violent patriarchy.\u201d","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The potential of task-shifting in scaling up services for prevention of mother-to-child transmission of HIV: a time and motion study in Dar es Salaam, Tanzania","field_subtitle":"Naburi H; Ekstr\u00f6m A; Mujinja P; et al.: Human Resources for Health 15(35), doi: 10.1186/s12960-017-0207-2, 2017","URL":"http://tinyurl.com/y75enjqy","body":"This time and motion study in Dar es Salaam, Tanzania estimated the potential of task-shifting in services for prevention of mother to child transmission (PMTCT) to reduce nurses\u2019 workload and health system costs. The time used by nurses to accomplish PMTCT activities during antenatal care (ANC) and postnatal care (PNC) visits was measured. These data were then used to estimate the costs that could be saved by shifting tasks from nurses to community health workers in the Tanzanian public-sector health system. A total of 1121 PMTCT-related tasks carried out by nurses involving 179 patients at ANC and PNC visits were observed at 26 health facilities. The average time of the first ANC visit was the longest, 54 min, followed by the first PNC visit which took 29 minutes on average. ANC and PNC follow-up visits were substantially shorter, 15 and 13 minutes, respectively. During both the first and the follow-up ANC visits, 94% of nurses\u2019 time could be shifted to community health workers, while 84% spent on the first PNC visit and 100% of the time spent on the follow-up PNC visit could be task-shifted. Depending on community health workers salary estimates, the cost savings due to task-shifting in PMTCT ranged from US$ 1.3 to 2.0 (first ANC visit), US$ 0.4 to 0.6 (ANC follow-up visit), US$ 0.7 to 1.0 (first PNC visit), and US$ 0.4 to 0.5 (PNC follow-up visit). Nurses working in PMTCT spend large proportions of their time on tasks that could be shifted to community health workers, giving them more time for specialised PMTCT tasks and reducing the average cost per PMTCT patient.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The role of women's leadership and gender equity in leadership and health system strengthening","field_subtitle":"Dhatt R; Theobald S; Buzuzi S; et al.: Global Health, Epidemiology and Genomics 2(e8), doi: https://doi.org/10.1017/gheg.2016.22, 2017","URL":"http://tinyurl.com/y8o8yjpq","body":"This empirical research examines gender and leadership in the health sector, pooling learning from three complementary data sources: literature review, quantitative analysis of gender and leadership positions in global health organisations and qualitative life histories with health workers in Cambodia, Kenya and Zimbabwe. The findings highlight gender biases in leadership in global health, with women underrepresented. Gender roles, relations, norms and expectations shape progression and leadership at multiple levels. Increasing women's leadership within global health is an opportunity to further health system resilience and system responsiveness. The authors conclude with an agenda and tangible next steps of action for promoting women's leadership in health as a means to promote the global goals of achieving gender equity. This includes leadership that is gender responsive and institutionalised; development of enabling environments for women's leadership; increasing thought leadership events related to women's role in global health; supporting leadership development, including management training and soft skills and building capacity, including formal training in technical skills, research and mentorship. The authors also call for improved policy and practice in terms of the health and safety risks women face in carrying out their health-related roles.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The State of the World\u2019s Children 2016: A fair chance for every child ","field_subtitle":"United Nations Children's Fund: UNICEF, New York, 2016","URL":"https://www.unicef.org/sowc2016/","body":"Based on current trends, 69 million children under five will die from mostly preventable causes, 167 million children will live in poverty, and 750 million women will have been married as children by 2030, the target date for the Sustainable Development Goals \u2013 unless the world focuses more on the plight of its most disadvantaged children, according to a UNICEF report released today. The State of the World\u2019s Children, UNICEF\u2019s annual flagship report, paints a stark picture of what is in store for the world\u2019s poorest children if governments, funders, businesses and international organisations do not accelerate efforts to address their needs. The publication argues that progress for the most disadvantaged children is not only a moral, but also a strategic imperative. Stakeholders must have an obvious choice to make: invest in accelerated progress for the children being left behind, or face the consequences of a far more divided world by 2030. At the start of a new development agenda, the report concludes with a set of recommendations to help chart the course towards a more equitable world. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Tunatazama","field_subtitle":"A Network of Southern African Communities Living Near Mines","URL":"http://communitymonitors.net/about-us/","body":"This website is a space for community activists living near mines in southern Africa to share information, resources and experiences.\r\nThe countries currently participating in this project are: Lesotho, South Africa, Zimbabwe, Zambia, the Democratic Republic of Congo (DRC), Mozambique and Tanzania. Activists in each country document problems they experience and events they participate in and share this on a WhatsApp group. These posts are then shared on this site in the respective country blogs. Each country, in addition, maintains their own country blog. Additionally, Activists can view the posts on a mobile app called \u201cAction Voices\u201d which can be downloaded on an Android phone from the Google Play store. This website and the activities are a joint project of several organisations in southern Africa. These include:The Bench Marks Foundation \u2013 South Africa; Southern Africa Resource Watch (SARW) \u2013 Southern Africa; Zimbabwe Environmental Law Association (ZELA) \u2013 Zimbabwe; Centre for Environment Justice (CEJ) \u2013 Zambia; Associa\u00e7\u00e3o de Apoio e Assist\u00eancia Jur\u00eddica \u00e0s Comunidades (AAAJC) \u2013 Mozambique; Norwegian Church Aid (NCA), Tanzania and Maluti Community Development Forum \u2013 Lesotho.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"UFS: Master in Development Studies","field_subtitle":"Application closing date: 29 September 2017","URL":"http://tinyurl.com/yd8txf77","body":"The Centre for Development Support within the Faculty of Economic and Management Sciences at the University of the Free State is presenting a two-year part-time, interdisciplinary degree - Master of Development Studies. This programme combines distance-based learning with five one-week contact sessions held at the University f the Free State. The programme is a qualification aimed at those in NGOs, government, parastatals or private sector. Candidates with an Honours degree or postgraduate diploma or candidates with a degree and extensive development related work experience are invited to apply. The compulsory first year modules include studies in development, underdevelopment and poverty, governance and development, development and the environment, applied development research and project management. Students select two elective modules with a mini-dissertation in the second year. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania.","field_subtitle":"Kruk M; Chukwuma A; Mbaruku G; Leslie H: Bulletin World Health Organisation 95(6), 408-418, 2017","URL":"https://tinyurl.com/y79rew24","body":"This study analysed factors affecting variations in the observed quality of antenatal and sick-child care in primary-care facilities in seven African countries. The authors pooled nationally representative data from service provision assessment surveys of health facilities in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania (survey year range: 2006-2014). Based on World Health Organisation protocols, the authors created indices of process quality for antenatal care (first visits) and for sick-child visits. The authors assessed national, facility, provider and patient factors that might explain variations in quality of care. Quality of antenatal care was higher in better-staffed and -equipped facilities and lower for physicians and clinical officers than nurses. Experienced providers and those in better-managed facilities provided higher quality sick-child care, with no differences between physicians and nurses or between better- and less-equipped clinics. Private facilities outperformed public facilities. Country differences were more influential in explaining variance in quality than all other factors combined. The quality of two essential primary-care services for women and children was weak and varied across and within the countries. The authors propose that analysis of reasons for these variations in quality could identify strategies for improving care.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"World Health Organisation: What is people-centred care?","field_subtitle":"World Health Organisation: WHO, Geneva, 2017","URL":"http://www.youtube.com/watch?v=pj-AvTOdk2Q","body":"This video from WHO introduces the concept of people-centred care. Globally, one in 20 people still lack access to essential health services that could be delivered at a local clinic instead of a hospital. And where services are accessible, they are often fragmented and of poor quality. WHO is supporting countries to progress towards universal health coverage by designing health systems around the needs of people instead of diseases and health institutions, so that everyone gets the right care, at the right time, in the right place.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"World health statistics 2017: monitoring health for the SDGs, Sustainable Development Goals","field_subtitle":"World Health Organization: WHO, Geneva, 2017","URL":"http://tinyurl.com/y7t7h3fy","body":"The World Health Statistics series is World Health Organisation\u2019s annual compilation of health statistics for its 194 Member States. World Health Statistics 2017 focuses on the health and health-related Sustainable Development Goals (SDGs) and associated targets by bringing together data on a wide range of relevant SDG indicators. World Health Statistics 2017 is organised into three parts. In Part 1, six lines of action are described which WHO is now promoting to help build better systems for health and to achieve the health and health-related SDGs. In Part 2, the status of selected health-related SDG indicators is summarised, at both global and regional level, based on data available as of early 2017. Part 3 then presents a selection of stories that highlight recent successful efforts by countries to improve and protect the health of their populations through one or more of the six lines of action.  Annexes A and B present country level estimates for selected health-related SDG indicators. As in previous years, World Health Statistics 2017 has been compiled primarily using publications and databases produced and maintained by WHO or United Nations groups of which WHO is a member, such as the United Nations Inter-agency Group for Child Mortality Estimation. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"World poverty could be cut in half if all adults completed secondary education","field_subtitle":"United Nations Educational, Scientific and Cultural Organisation: UNESCO Policy Paper 32, Fact sheet 44, New York, 2017","URL":"http://unesdoc.unesco.org/images/0025/002503/250392E.pdf","body":"This UNESCO policy paper reports that the global poverty rate could be more than halved if all adults completed secondary school. Yet, new data from the UNESCO Institute for Statistics (UIS) show persistently high out-of-school rates in many countries, making it likely that completion levels in education will remain well below that target for generations to come. The paper demonstrates the importance of recognising education as a core lever for ending poverty in all its forms, everywhere. The analysis of education\u2019s impact on poverty shows that nearly 60 million people could escape poverty if all adults had just two more years of schooling. Despite education\u2019s potential, new UIS data show that there has been virtually no progress in reducing out-of-school rates in recent years. Globally, 9% of all children of primary school age are still denied their right to education, with rates reaching 16% and 37% for youth of lower and upper secondary ages, respectively. In total, 264 million children, adolescents and youth were out of school in 2015. UNESCO argues that education must reach the poorest households to maximise its benefits and reduce income inequality. ","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"World Trade Organisation Public Forum 2017 \u2014 \u201cTrade: Behind the Headlines\u201d","field_subtitle":"Registration closing date: 12 September 2017","URL":"https://www.wto.org/english/forums_e/public_forum17_e/public_forum17_e.htm","body":"At a time when the debate on trade has rarely been as prominent or controversial, the WTO's 2017 Public Forum, \"Trade: Behind the Headlines\", offers an opportunity to go beyond the rhetoric and examine in detail the realities of trade \u2013 the opportunities it offers and the challenges it can bring. The Forum will provide a platform for discussions among policy makers, civil society representatives, business people and researchers as they consider how to make trade work for more people and ensure that the trading system is as inclusive as it can be. The opportunities that trade generates for greater growth and development and its ability to create jobs, raise incomes and reduce prices is, for some, only part of the story. There is a growing feeling that now is the time to consider the broader picture. While trade has indeed pulled millions out of poverty, the reality is that for some the experience has been different. The Public Forum is the WTO\u2019s largest annual outreach event.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Youth Voices at the 13th Southern African Civil Society Forum","field_subtitle":"Mahlangu S; Dick S; Chizungu R;  Mwanza E: Youth@SAIIA, August 2017","URL":"https://www.saiia.org.za/youth-blog/youth-voices-at-the-13th-southern-african-civil-society-forum","body":"Each year, the Southern African Development Community (SADC) holds a special Southern Africa Civil Society Forum. The 13th annual Forum took place in mid August in Johannesburg. Members of the SAIIA Youth Policy Committee and alumni of the SAIIA Young Leaders Conference were there, to provide an eye-witness account of the proceedings. Civil society is defined as a \u2018community of citizens linked by common interests and collective activity.\u2019 This was evident at the 13th SADC Civil Society Forum from day one.\r\nThe Forum serves as a platform for civil society organisations from all over the region to meet and consolidate their stance, which is then presented as a declaration to the SADC secretariat. The theme for this year\u2019s forum was \u2018Building People\u2019s Organisations, Securing Our Common Future, Consolidating Our Gains and Confronting Our Challenges\u2019. These four blogs present the voice and reflections of young people attending various sessions at the Forum.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"\u201cI cry every day and night, I have my son tied in chains\u201d: physical restraint of people with schizophrenia in community settings in Ethiopia","field_subtitle":"Asher L; Fekadu A; Teferra S; De Silva M; Pathare S; Hanlon C: Globalisation and Health 13(47), doi: 10.1186/s12992-017-0273-1, 2017","URL":"https://tinyurl.com/yb677kqz","body":"A primary rationale for scaling up mental health services in low and middle-income countries is to address human rights violations, including physical restraint in community settings. The voices of those with intimate experiences of restraint, in particular people with mensystetal illness and their families, are rarely heard. This study aimed to understand the experiences of, and reasons for, restraint of people with schizophrenia in community settings in rural Ethiopia in order to develop constructive and scalable interventions. A qualitative study was conducted, involving 15 in-depth interviews and 5 focus group discussions  with a purposive sample of people with schizophrenia, their caregivers, community leaders and primary and community health workers in rural Ethiopia. Most of the participants with schizophrenia and their caregivers had personal experience of the practice of restraint. The main explanations given for restraint were to protect the individual or the community, and to facilitate transportation to health facilities. These reasons were underpinned by a lack of care options, and the consequent heavy family burden and a sense of powerlessness amongst caregivers. Whilst there was pervasive stigma towards people with schizophrenia, lack of awareness about mental illness was not a primary reason for restraint. All types of participants cited increasing access to treatment as the most effective way to reduce the incidence of restraint. Restraint in community settings in rural Ethiopia entails the violation of various human rights, but the underlying human rights issue is one of lack of access to treatment, calling for the scale up of accessible and affordable mental health care.","php":"","field_issue_date":"2017-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa","field_subtitle":"Horwood C; Butler L; Barker P; et al.: Human Resources for Health 15(39), doi: 10.1186/s12960-017-0210-7, 2017","URL":"http://tinyurl.com/ycembflw","body":"Community health workers (CHWs) play key roles in delivering health programmes in many countries worldwide. CHW programmes can improve coverage of maternal and child health services for the most disadvantaged and remote communities, leading to substantial benefits for mothers and children. However, there is limited evidence of effective mentoring and supervision approaches for CHWs. This cluster randomised controlled trial investigated the effectiveness of a continuous quality improvement intervention amongst CHWs providing home-based education and support to pregnant women and mothers. Thirty CHW supervisors were randomly allocated to intervention (n\u2009=\u200915) and control (n\u2009=\u200915) arms. Intervention CHWs received a 2-week training in WHO Community Case Management followed by mentoring for 12 months.  Baseline and follow-up surveys were conducted with mothers of infants ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Adolescent and Youth Health Policy Short Course","field_subtitle":"Deadline for applications: 25 August 2017","URL":"https://tinyurl.com/y83pjdsv","body":"This short-course in Cape Town, South Africa, has been developed to support staff of governmental and non-governmental organisations working at national, provincial and district levels, in the implementation of the new Adolescent & Youth Health Policy 2017 and allied policies. It aims to build the capacity of those with management responsibilities for the implementation of policies through improved knowledge about adolescence, key health problems affecting young people and priority evidence-based interventions to address them and strengthen programming skills. This course is provided by the Desmond Tutu HIV Foundation, housed within the Desmond Tutu HIV Centre (DTHC) at the University of Cape Town. ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"AND THEN SHE SAID - 5 Novels, 5 Women, 5 Stories","field_subtitle":"Jallow M: Positively African, October 2016","URL":"https://www.youtube.com/watch?v=mXqQLIWbsDQ","body":"Experience African literature in a totally new way through an intimate re-imagining of five acclaimed novels, performed for the stage. Reimagined and retold by five women the stories grapple with questions of race, sexuality, patriarchy, friendship, love, loneliness and much more. Drawing from the historical novel \u2018The Orchard of Lost Souls\u2019 by the young award-winning Somali-British writer Nadia Mohamed, Raya Wambui bears witness to the painful experience of three Somali women. Patricia Kihoro\u2019s presents a performance of Zukiswa Wanner\u2019s painfully funny and profoundly perceptive \u2018Maid in SA: 30 ways to leave your madam\u2019. ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Are Health Centre Committees a Vehicle for Social Participation in Health? Report on a Regional HCC Review Meeting, June 2017 ","field_subtitle":"CWGH; TARSC; UCT; LDHO: EQUINET, Harare 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Equinet%20HCC%20RegMtg%20Rep%20June2017.pdf","body":"EQUINET through the Community Working Group on Health (CWGH) as the cluster lead for the work on social empowerment in health, in partnership with Training and Research Support Centre (TARSC), University of Cape Town (UCT) and Lusaka District Health Office (LDHO), with support from Open Society Initiative for Eastern Africa (OSIEA) have embarked on a regional programme, \u2018HCCs as a vehicle for social participation in health systems in East and Southern Africa\u2019 to address some of the outcomes mentioned above. This report documents the proceedings during the Regional HCC exchange visit held at Mwanza clinic, Goromonzi district on the 20th of June 2017 and the review meeting held in Harare on the 21st of June 2017. The meeting aimed to: discuss experiences with laws, policies, guidelines and constitutions on HCCs; share experiences in using Photovoice to enhance the role of HCCs;  discuss current training materials and programmes for HCCs in the region  and discuss strengthening of internal capacities of institutions working with HCCs through information exchange and skills inputs.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Capacity-building for a strong public health nutrition workforce in low-resource countries","field_subtitle":"Delisle H; Shrimpton R; Blaney S; Du Plessis L; Atwood S; Sanders D; Margetts B: Bulletin of the World Health Organisation 95(5) 385-388, 2017","URL":"http://www.who.int/bulletin/volumes/95/5/16-174912/en/","body":"This paper highlights current issues and challenges in public health nutrition in low- and middle-income countries and shares recommendations for the development of this workforce. Several factors are argued to contribute to a scarcity of nutrition professionals in low- and middle-income countries, including: a lack of understanding of the role of public health nutrition in the prevention and management of the various forms of malnutrition; a low-income country priority for doctors and nurses (and sometimes also frontline workers) within meagre health workforce expenditures; a higher priority for undernutrition interventions than for those for nutrition-related chronic diseases, despite their escalation in these countries. Both food system changes, at the level of production, processing and distribution, and behaviour change communication are argued to be needed to reorient the nutrition transition, and nutritionists have a major role to play in this regard. Although it requires sustained efforts, training can be regarded as the easy part of nutrition workforce development in low- and middle-income countries.  More challenging steps are recognition of the nutrition profession and its regulation, opening up government jobs for nutrition graduates and financing local training programmes and nutritionists\u2019 salaries in the public sector. The underlying causes of malnutrition, and hence sustained solutions to the problem, lie to a large extent in the non-health sectors. The authors argue that nutrition has to be addressed not only by other health professionals, but also by agriculture and education professionals and field workers, who need to integrate relevant nutrition tasks into their professional activities (such as orienting food production towards meeting the population\u2019s nutrition requirements or teaching healthy eating to schoolchildren). ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Center for Health, Human Rights and Development (CEHURD) Court case wins the Gender Justice Uncovered Awards 2017","field_subtitle":"Nanfuka G: CEHURD, June 2017","body":"The Center for Health, Human Rights and Development (CEHURD), is an EQUINET cluster lead for the theme work on the right to health. CEHURD, Mubangizi Michael and Musimenta Jennifer Vs the Executive Director of Mulago National Referral Hospital and Attorney General of Uganda (Civil Suit No 212 of 2013), \u201cMulago case\u201d and Justice Lydia Mugambe\u2019s judgement won the Gender Justice Uncovered Awards in May 2017 hosted by Women\u2019s Link Worldwide. In this landmark ruling Justice Lydia Mugambe noted that the disappearance of the couple's baby also resulted to psychological torture for the parents as well as putting the spotlight on the State's failure to fulfil its obligations under the right to health. The Court also pointed to the overburdened hospital staff which led to errors as another example of the failure of the State to comply with its obligations. The judgment won with 3,829 votes beating 17 other rulings that were nominated for the best judicial decision from all around the world in the Gender Justice Uncovered Awards under the People's Choice Gavel 2017 category. This award comes at a time when CEHURD is implementing the judgment through discussions and support to Mulago National Referral Hospital to develop and put in place mechanisms to ensure the safety of babies after delivery.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Council for the Development of Social Science Research in Africa (CODESRIA) Humanities Call: Meaning-making Research Initiatives (MRI)","field_subtitle":"Deadline for applications: 15 September 2017","URL":"http://www.codesria.org/spip.php?article2734&lang=en","body":"Within the framework of its 2017-2021 Strategic Plan, CODESRIA introduces Meaning-Making Research Initiative (MRI) as the principal tool for supporting research. Like previous tools, MRI will focus on supporting research that contributes to agendas for imagining, planning and creating African futures. The Council is issuing this special call for proposals because of the peculiar challenges that teaching and research in the Humanities are encountering in African universities today. It is also motivated by the important contributions that scholarship in the Humanities can make to an understanding of Africa and efforts to construct African futures. CODESRIA seeks projects that broach new and interesting questions and employs innovative methods to address these issues. Projects that address important social challenges on the continent and that are rooted in conversations between the Humanities and other fields of knowledge like the social and natural sciences are strongly encouraged. Work that examines on the status and importance of the Humanities in society and reflects on how to develop humanities teaching and research in universities are also encouraged. Group initiatives: MRIs under this special call should be groups of researchers from one country or multiple countries. Each group should have between 3 and 5 members and should take into account CODESRIA\u2019s core principles of gender, linguistic, intergenerational, interdisciplinary diversity. All applications must engage with CODESRIA\u2019s 2017-2021 thematic priorities and cross-cutting issues: democratic processes, governance, citizenship and security in Africa; ecologies, economies and societies in Africa; higher education dynamics in a changing Africa.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Determining baselines for human-elephant conflict: A matter of time","field_subtitle":"Pozo R; Coulson T; McCulloch G; Stronza A; Songhurst A: PLOS One, doi: https://doi.org/10.1371/journal.pone.0178840, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178840","body":"Northern Botswana holds the largest population of African elephants in the world, and in the eastern Okavango Panhandle, 16,000 people share and compete for resources with more than 11,000 elephants. Hence, it is not surprising this area represents a human-elephant conflict (HEC) \u2018hotspot\u2019 in the region. Crop-raiding impacts lead to negative perceptions of elephants by local communities, which can strongly undermine conservation efforts. The authors investigated the trend in the number of reported raiding incidents as one of the indicators of the level of HEC, and assessed its relationship to trends in human and elephant population size, as well as land-use in the study area from the 1970s to 2015. They found that the level of reported crop raiding by elephants in the eastern Panhandle appears to have decreased since 2008, which seems to be related more to the reduction in agricultural land allocated to people in recent years, more than the human and elephant population size.  Although the study represents a first step in developing a HEC baseline in the eastern Panhandle, it highlights the need for additional multi-scale analyses that consider progress in conservation conflict to better understand and predict drivers of HEC in the region.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Early menarche: A systematic review of its effect on sexual and reproductive health in low- and middle-income countries","field_subtitle":"Ibitoye M; Choi C; Lee G; Sommer M: PLOS One, doi: https://doi.org/10.1371/journal.pone.0178884, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178884","body":"Adolescent girls aged 15\u201319 bear a disproportionate burden of negative sexual and reproductive health outcomes in low- and middle-income countries. The authors conducted this systematic review to better understand whether and how early menarche is associated with various negative sexual and reproductive health outcomes in low- and middle-income countries and the implications of such associations. They systematically searched eight health and social sciences databases for peer-reviewed literature on menarche and sexual and reproductive health in low- and middle-income countries. The authors\u2019 review of the minimal existing literature (with 24 papers included) showed that early menarche is associated with early sexual initiation, early pregnancy and some sexually transmitted infections in low- and middle-income countries, as has been observed in high-income countries. Early menarche is also associated with early marriage\u2013an association that may have particularly important implications for countries with high child marriage rates. Early age at menarche may be an important factor affecting the sexual and reproductive health of adolescent girls and young women in low- and middle-income countries. Given the association of early menarche with early marriage, the authors propose that ongoing efforts to reduce child marriage may benefit from targeting efforts to early maturing girls.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"\r\nContact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 196: The EQUINET newsletter as a health equity resource from the region ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Header"}},{"node":{"title":"Fifth Global Symposium on Health Systems Research (HSR2018)","field_subtitle":"8 \u2013 12 October 2018, Liverpool, UK ","URL":"http://healthsystemsresearch.org/hsr2018/","body":"The Global Symposium on Health Systems Research is organised every two years by Health Systems Global to bring together the full range of players involved in health systems and policy research and practice. The Alma Ata vision of \u2018Health for All\u2019 remains as compelling today as it was in 1978, as reflected in goal 3 of the Sustainable Development Goals (SDGs). But the world has changed in forty years. Despite improved health outcomes, there remain extraordinary challenges for health equity and social inclusion, such as demographic and disease transitions, conflicts and their subsequent migrations, pluralistic health systems and markets, and climate change. Political systems still marginalise those most in need. Yet there are new opportunities for health systems to achieve universal coverage. The Fifth Global Symposium will advance conversations and collaborations on new ways of financing health; delivering services; and engaging the health workforce, new social and political alliances, and new applications of technologies to promote health for all.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure prospective cohort study","field_subtitle":"Dokainish H; Teo K; Zhu J; et al.,INTER-CHF Investigators: The Lancet Global Health 5(7), e665-e672, 2017 ","URL":"http://thelancet.com/journals/langlo/article/PIIS2214-109X(17)30196-1/fulltext","body":"Most data on mortality and prognostic factors in patients with heart failure come from North America and Europe, with little information from other regions. Here, in the International Congestive Heart Failure (INTER-CHF) study, the authors aimed to measure mortality at 1 year in patients with heart failure in Africa, China, India, the Middle East, southeast Asia and South America and to explore demographic, clinical, and socioeconomic variables associated with mortality. The authors enrolled 5823 patients within 1 year with a 98% follow-up. Mortality was highest in Africa (34%) and India (23%), compared to an overall average of 16%. Regional differences persisted after multivariable adjustment. Independent predictors of mortality included cardiac variables and non-cardiac variables (body-mass index, chronic kidney disease, and chronic obstructive pulmonary disease). 46% of mortality risk was explained by multivariable modelling with these variables; however, the remainder was unexplained. Marked regional differences in mortality in patients with heart failure persisted after multivariable adjustment for cardiac and non-cardiac factors. Therefore, variations in mortality between regions could be the result of health-care infrastructure, quality and access, or environmental and genetic factors. Further studies in large, global cohorts are suggested to be needed.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Grand Challenges Canada Funding Opportunities","field_subtitle":"Deadline for applications: 3 August 2017","URL":"http://www.grandchallenges.ca/funding-opportunities/","body":"Through the Stars in Reproductive, Maternal, Newborn and Child Health Request for Proposals, Grand Challenges Canada seeks bold ideas for products, services and implementation models that could transform how persistent challenges in reproductive, maternal, newborn and child health are addressed in low- and middle-income countries. Of particular interest to Grand Challenges Canada are innovations to improve reproductive, maternal, newborn and child health in humanitarian contexts, notably among internally displaced and refugee populations, as well as innovations that improve the sexual and reproductive health and rights of women and girls, so that they are empowered and have greater influence over their lives and futures.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health workforce and governance: the crisis in Nigeria","field_subtitle":"Adeloye D; David R; Olaogun A; Auta A; Adesokan A; Gadanya M; Opele J; Owagbemi O; Iseolorunkanmi A: Human Resources for Health 15(32), doi: 10.1186/s12960-017-0205-4, 2017","URL":"http://tinyurl.com/y8j5636g","body":"In Nigeria, several challenges have been reported within the health sector, especially in training, funding, employment, and deployment of the health workforce. The authors reviewed the recent health workforce crises in the Nigerian health sector to identify key underlying causes and provide recommendations toward preventing and/or managing potential future crises in Nigeria. The authors observe that the Nigerian health system is relatively weak, and there is yet a coordinated response across the country. A number of health workforce crises have been reported in recent times due to several months\u2019 salaries owed, poor welfare, lack of appropriate health facilities and emerging factions among health workers. Poor administration and response across different levels of government were found to have played contributory roles to further internal crises among health workers, with different factions engaged in protracted supremacy challenge. These crises have consequently prevented optimal healthcare delivery to the Nigerian population. The authors argue for various measures, including an inclusive stakeholders\u2019 forum in the health sector; and a  solid administrative policy foundation that allows coordination of priorities and partnerships in the health workforce and among various stakeholders. ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Healthy people and healthy profits? Elaborating a conceptual framework for governing the commercial determinants of non-communicable diseases and identifying options for reducing risk exposure","field_subtitle":"Buse K; Tanaka S; Hawkes S: Globalisation and Health 13(34), doi: 10.1186/s12992-017-0255-3, 2017","URL":"https://tinyurl.com/ybo23n7p","body":"Non-communicable diseases (NCDs) represent a significant threat to human health and well-being, and carry significant implications for economic development and health care and other costs for governments and business, families and individuals. Risks for many of the major NCDs are associated with the production, marketing and consumption of commercially produced food and drink, particularly those containing sugar, salt and transfats (in ultra-processed products), alcohol and tobacco. The problems inherent in primary prevention of NCDs have received relatively little attention from international organisations, national governments and civil society, especially when compared to the attention paid to provision of medical treatment and long-term clinical management. Low political priority may be due in part to the complexity inherent in implementing feasible and acceptable interventions, such as increased taxation or regulation of access, particularly given the need to coordinate action beyond the health sector, and the fact that this brings public health into conflict with the interests of profit-driven food, beverage, alcohol and tobacco industries. The authors use a conceptual framework to review three models of governance of NCD risk: self-regulation by industry; hybrid models of public-private engagement; and public sector regulation. The authors analysed the challenges inherent in each model, and review what was known (or not) about their impact on NCD outcomes. While piecemeal efforts have been established, the authors argued that mechanisms to control the commercial determinants of NCDs are inadequate and efforts at remedial action too limited. The authors set out an agenda to strengthen each of the three governance models, with reforms that will be needed to the global health architecture to consolidate the collective power of diverse stakeholders, its authority to develop and enforce clear measures to address risks, as well as establish monitoring and rights-based accountability systems across all actors to drive measurable, equitable and sustainable progress in reducing the global burden of NCDs.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Listen to Civil Society: Medicines for People, Not Profit","field_subtitle":"Quigley F: Health and Human Rights Journal Blog, May 2017","URL":"http://tinyurl.com/y7jlwu6c","body":"In her final address to the World Health Assembly (WHA) as WHO Director-General, Dr. Margaret Chan identified access to medicines as the most contentious issue of her decade-long tenure. That struggle was engaged, she said, \u201cespecially when intellectual property and the patent system were perceived as barriers to both affordable prices and the development of new products for diseases of the poor.\u201d Dr. Chan also had advice for the delegates gathered before her at the Palais de Nations in Geneva: \u201cListen to civil society. Civil society are society\u2019s conscience.\u201d Just a few hours after Dr. Chan yielded the podium, a spirited demonstration was held outside the grounds of the Palais de Nation. Organised by the student-led advocacy group Universities Allied for Essential Medicines, the demonstrators called for the WHA delegates and the new director-general to listen to the WHA\u2019s member states from Southeast Asia, Africa, and Latin America. Those nations have long called for WHO to prioritise the medicines issue. The term \u201cde-linkage\u201d was repeated by many panellists at an antimicrobial resistance discussion which happened at a side event. It describes a drug development model that is an alternative to the current intellectual property paradigm, where government-granted patent monopolies allow drug prices to be hiked to levels that are sometimes hundreds of times above the price of production. The justification for the high prices is that the price charged for medicines needs to fund research and development. Deliberately \u201cde-linking\u201d the R&D costs from the price of medicines bypasses those calculations, and instead undercuts the very foundation of the monopoly pricing argument. It calls for taking advantage of the already-significant government and philanthropic commitment to research and using it to fund non-profit R&D to a sufficient level that the price of medicines does not need to be connected to research costs. This would allow medicines to be far more affordable","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"MPhil in Public Mental Health: Call for Applications","field_subtitle":"Deadline for Applications 1 September 2017","URL":"http://www.cpmh.org.za/teaching/mphil-public-mental-health/","body":"The Alan J. Flisher Centre for Public Mental Health (CPMH), a joint initiative of the Psychology Department at Stellenbosch University and the Department of Psychiatry and Mental Health at the University of Cape Town, is an independent inter-disciplinary academic research and teaching centre for public mental health promotion and service development in Africa.  The CPMH is proud to invite applications from across the African continent for the MPhil in Public Mental Health in 2018. A key gap in current mental health professional training in South Africa and elsewhere in Africa is an orientation to public mental health. This means an orientation to the mental health needs of populations, and the policies, laws and services that are required to meet those needs. The training offered by the Centre provides clinicians, health service managers, policy makers and NGO workers with crucial skills to enable them to plan and evaluate the services that they deliver and manage; lobby effectively for mental health; take on leadership roles in the strengthening of mental health systems; and conduct research in various aspects of public mental health in Africa. The MPhil in Public Mental Health is a part-time research degree that aims to develop advanced research skills, enabling participants to undertake their own research projects (such as evaluating services, policies and interventions) as well as interpret research findings for mental health policy and practice.  The programme is designed to be accessible to practitioners who work full-time, and who are from a range of backgrounds: social work, psychology, psychiatry, medicine, occupational therapy, nursing, health economics, public mental health, public health, health service management, policy making and non-governmental organisations (NGOs).  The training aims to build the professional capacity and leadership of the participants in their work, while contributing to knowledge generation in Africa. The degree requires the completion of a 3-week residential training module in research methodology for public mental health in Cape Town and the preparation of a dissertation of a minimum of 20 000 words, in either monograph or publication ready format.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"New BMC and HSG webinar series: Understanding the peer review and publication process","field_subtitle":"Logan H: BMC Health Services Research and BioMed Central journals, 2017","URL":"https://tinyurl.com/ybct8ed8","body":"Publishing is an important part of sharing the outcomes of research, but the publication process and requirements may sometimes feel like a closed book. HSG and BioMed Central, publisher of BMC Health Services Research which is affiliated with HSG, have partnered to deliver a series of five webinars to open up the peer review and publication processes. Aimed at researchers at a variety of career stages, the series covered: how to prepare an article and choose the right journal, what happens during peer review, publishing models and open access, research and publication ethics and how to be a peer reviewer. This series is now finished, but information on the full series of webinars is provided, including the recordings and slides of all of the webinars.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Non-communicable diseases and HIV care and treatment: models of integrated service delivery ","field_subtitle":"Duffy M; Ojikutu B; Andrian S; Sohng E; Minior T; Hirschhorn L: Tropical Medicine and International Health 00(00), doi:10.1111/tmi.12901, 2017","URL":"http://onlinelibrary.wiley.com/doi/10.1111/tmi.12901/epdf","body":"Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with human immunode\ufb01ciency virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programmes. The authors described the models of NCD and HIV integration, challenges and lessons learned. A literature review of published articles on integrated NCD and HIV programs in low-income countries and key informant interviews were conducted with leaders of identi\ufb01ed integrated NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service delivery integration. Three models of integration were identified as follows: NCD services integrated into centres originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models. conclusions Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. The authors argue that operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policymakers seeking to address all the chronic care needs of their patients. ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Open letter to WHO on industrial animal farming and public health","field_subtitle":"Weathers S; Hermanns S; and 270 expert signatories: Open Letter Animal Farming, 2017 ","URL":"https://openletteranimalfarming.com/welcome/","body":"Over 200 scientists, policy experts and others concerned persons are urging the new World Health Organisation (WHO) Director-General to recognise and address factory farming as a growing public health challenge. Just as the WHO has bravely confronted companies that harm human health by peddling tobacco and sugar-sweetened beverages, they argue that it must not waver in advocating for the regulation of industrial animal farming. Total consumption of antibiotics in animal food production is projected to grow by almost 70% between 2010 and 2030. According to the WHO, two of the three most commonly used classes of antibiotics in U.S. animal farming\u2014penicillins and tetracyclines\u2014are of critical importance to humans. Practices such as the constant low dosing of antibiotics and environmental pollution through animal waste make industrial animal farms the perfect breeding ground for antibiotic resistance by allowing transmission into the environment and nearby community. The authors raise other risks of industrial animal farming and call on WHO to strengthen WHO\u2019s Global Action Plan on Antimicrobial Resistance to encourage member states of the WHO to ban the use of growth-promoting antibiotics in animal farming, as well as low-dose \u201cdisease prevention\u201d antibiotics. Member states should be encouraged to articulate specific, verifiable standards for what constitutes legal antibiotic use in animal farms. Amongst other recommendations they argue that WHO should encourage member states to adopt nutrition standards and implement health education campaigns to inform citizens of the health risks of meat consumption and work closely with ministers of health and agriculture to formulate policies that advocate for a greater proportion of plant-based foods in the diets of member states. Lastly, they recommend that the WHO should consider funding the scientific development of plant-based and other meat alternatives, which have the potential to eliminate or reduce the harms of factory farming.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"PHASA Conference 2017 (The Public Health Association of South Africa)","field_subtitle":"4-7 September 2017, Johannesburg, South Africa","URL":"http://www.phasaconference.org.za","body":"The Public Health Association of South Africa invites the local, regional and international public health community  to Johannesburg, South Africa for their 13th annual conference. The theme of the 2017 conference is \u201cA Global Charter for the Public\u2019s Health\u201d: Implications for Public Health Practice in South Africa. Last year, the conference considered public health practices in the context of the Sustainable Development Goals.  This year the conference will critically reflect on the WFPHA/WHO collaboration \u201cA Global Charter for the Public\u2019s Health\u201d and its implications for public health in South Africa. The conference will examine the four enabling functions of the Charter, viz. governance, capacity, information and advocacy. There will be conversations on how these four enabling functions can be strengthened in South Africa and discussions on critical current issues like globalisation and decolonisation in relation to public health.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"PhD Bursaries for Researching Obesogenic Food Environments in South Africa","field_subtitle":"Applications considered monthly. Final closing date 31st October 2017.","URL":"https://tinyurl.com/ybsvq8ad","body":"The Postgraduate Diploma in Poverty, Land and Agrarian Studies is a unique programme offered by PLAAS at the University of the Western Cape. It is the only programme in the land and agrarian studies field at a South African university. Two PhD bursaries are available as part of the IDRC-funded project \u201cResearching Obesogenic Food Environments\u201d, which is led by Profs David Sanders and Rina Swart at the UWC School of Public Health in partnership with the Institute for Poverty, Land and Agrarian Studies (PLAAS) and with Kwame Nkrumah University of Science and Technology (KNUST) in Ghana. PLAAS is an excellent platform for academic teaching and learning in land and agrarian reform, poverty and natural resources management. Established PLAAS researchers, involved in socially relevant and innovative research, are also course coordinators. The application of teaching and learning takes place through contact time with coordinators, self-learning through extensive reading and analysis, together with writing assignments. Applicants with extensive work experience (at least ten years) in land and agrarian issues, and with good writing abilities, without an undergraduate degree, may apply to be considered on the basis of recognition of prior learning (RPL).","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Quality of care: measuring a neglected driver of improved health","field_subtitle":"Akachi Y; Kruk M: Bulletin of the World Health Organisation 95(6), 389-480, 2017","URL":"http://www.who.int/bulletin/volumes/95/6/16-180190/en/","body":"The quality of care provided by health systems contributes towards efforts to reach sustainable development goal 3 on health and well-being. There is growing evidence that the impact of health interventions is undermined by poor quality of care in lower-income countries. Quality of care will also be crucial to the success of universal health coverage initiatives; citizens unhappy with the quality and scope of covered services are unlikely to support public financing of health care. Moreover, an ethical impetus exists to ensure that all people, including the poorest, obtain a minimum quality standard of care that is effective for improving health. However, the measurement of quality today in low- and middle-income countries is argued to be inadequate to the task. Health information systems provide incomplete and often unreliable data, and facility surveys collect too many indicators of uncertain utility, focus on a limited number of services and are quickly out of date. Existing measures poorly capture the process of care and the patient experience. Patient outcomes that are sensitive to health-care practices, a mainstay of quality assessment in high-income countries, are rarely collected. The authors propose six policy recommendations to improve quality-of-care measurement and amplify its policy impact: (i) redouble efforts to improve and institutionalise civil registration and vital statistics systems; (ii) reform facility surveys and strengthen routine information systems; (iii) innovate new quality measures for low-resource contexts; (iv) get the patient perspective on quality; (v) invest in national quality data; and (vi) translate quality evidence for policy impact.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Reclaiming policies for the public ","field_subtitle":"Third World Network (TWN): TWN Info, July 2017","URL":"https://www.2030spotlight.org/en","body":"A global coalition of civil society organisations and trade unions presented a report  on 'Spotlight on Sustainable Development 2017'.  The report provides a comprehensive independent assessment of the implementation of the 2030 Agenda and its Sustainable Development Goals (SDGs). In the 2030 Agenda governments committed to a revitalised Global Partnership between States and declared that public finance has to play a vital role in achieving the SDGs. But in recent decades, the combination of neoliberal ideology, corporate lobbying, business-friendly fiscal policies, tax avoidance and tax evasion has led to a massive weakening of the public sector and its ability to provide essential goods and services. The same corporate strategies and fiscal and regulatory policies that led to this weakening have enabled an unprecedented accumulation of individual wealth and increasing market concentration. The proponents of privatisation and public-private partnerships (PPPs) use these trends to present the private sector as the most efficient way to provide the necessary means for implementing the SDGs. But many studies and experiences by affected communities have shown that privatisation and PPPs involve disproportionate risks and costs for the public sector. PPPs can even exacerbate inequalities, decrease equitable access to essential services and jeopardise the fulfilment of human rights. Therefore, it is high time to counter these trends, reclaim public policy space and take bold measures to strengthen public finance, regulate or reject PPPs and weaken the grip of corporate power on people\u2019s lives. These are indispensable prerequisites to achieve the SDGs and to turn the vision of the transformation of the world, as proclaimed in the title of the 2030 Agenda, into reality. The 160-page report is supported by a broad range of civil society organisations and trade unions, and based on experiences and reports by national and regional groups and coalitions from all parts of the world. Its 35 articles cover all sectors of the 2030 Agenda and the SDGs, and reflect the rich geographic and cultural diversity of their authors.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Scholarship for Research on Demilitarisation in Lesotho","field_subtitle":"Deadline for applications: 31 August 2017","URL":"https://tinyurl.com/ydxtokw9","body":"For many countries, there are arguments against military expenditure, including its opportunity costs and the availability of cost effective alternative ways of providing security. A number of countries exist without a military, including Costa Rica, Iceland, Panama and Mauritius. The Peacebuilding Programme at Durban University of Technology is offering a scholarship at master\u2019s or doctoral level to extend this work. In particular, the student might work in the following areas: Examine the findings of the Lesotho foresight and scenarios project, titled \u2018The Lesotho we want: imagining the future, shaping it today\u2019; and ideas towards a demilitarisation initiative which fit with and build on the attitudes and priorities of the population. The student would, in conjunction with others, plan a campaign to build acceptance of the idea of demilitarisation and then implement the plan. Demilitarisation would be a political decision so the idea has to find acceptance in the minds of politicians. In conjunction with others, the student would plan and implement ways to bring this about.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa","field_subtitle":"Toska E; Pantelic M; Meinck F; Keck K; Haghighat R; Cluver L: PLOS One, doi: https://doi.org/10.1371/journal.pone.0178106, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178106","body":"This systematic review synthesises the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10\u201324 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Forty-two records reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"SFH: HIV Self-Testing Programme Manager","field_subtitle":"Deadline for applications: 20 August 2017","URL":"https://tinyurl.com/y845nman","body":"The Society for Family Health (SFH) is a South African affiliate of Population Services International (PSI), an international NGO network operational in over 70 countries. SFH in South Africa concentrates on issues of HIV/ AIDS. As part of their HIV/AIDS control efforts, SFH is using social marketing to motivate behaviour change with respect to consistent condom use, HIV testing and other safer behaviours. The duties and responsibilities include project management, monitoring and evaluation, supervision, coordination and relationship management, managing budgets and reporting. The successful candidate will be a creative, innovative and strategic thinker, and will have: excellent communication, analytical, organisational, interpersonal and cross-cultural skills; a strong interest in private sector approaches to development; and a proven ability to produce results and meet objectives under difficult circumstances. ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"South Africa\u2019s vital statistics are currently not suitable for monitoring progress towards injury and violence Sustainable Development Goals","field_subtitle":"Prinsloo M; Bradshaw D; Joubert J; Matzopoulos R; Groenewald P: South African Medical Journal 107(6), 470-471, 2017","URL":"http://www.samj.org.za/index.php/samj/article/view/11922","body":"Two of the most important targets to achieving the United Nation\u2019s Sustainable Development Goals (SDGs) for reducing violence and other injuries are Target 3.6: to \u2018halve the number of global deaths and injuries from road traffic accidents\u2019 by 2020; and Target 16.1: the significant reduction of \u2018all forms of violence and related death rates everywhere\u2019. Police statistics on homicide, and transport deaths from the Road Traffic Management Corporation, are considered to be under-reported and are not a reliable source for monitoring SDGs. In South Africa (SA), vital statistics data are the only routine source that captures unnatural and natural deaths through death registration. Since the early 1990s, focused initiatives have identified and addressed deficiencies in the completeness of death registration and recent estimates indicate that completeness for persons aged \u22652 years is >90%. However, there are still concerns about the quality of data relating to the cause of death, i.e. under- reporting of HIV/AIDS deaths owing to misclassification to other causes, a large proportion of deaths with ill-defined causes, and the validity of single-cause data. The misclassification of injury deaths is another major limitation. The Inquest Act of 1959 precludes forensic pathologists from reporting the manner of death, i.e. whether it is due to homicide, suicide, transport or other unintentional injuries, on the basis that it may prejudice the findings of the inquest. Homicides are therefore grossly under-represented in official vital statistics. The misclassification of injury deaths was clearly demonstrated in a nationally representative study of injury deaths presenting to state forensic mortuaries in 2009. The absence of information on the manner of injury death in the official statistics needs to be addressed urgently. A review and possible amendment of the Inquest Act would possibly take years. The authors recommend that the death notification form be amended in line with the updated World Health Organisation\u2019s recommendation, to include a stand-alone field for information about the manner of injury death for unnatural causes. Forensic pathologists when uncertain can include a proviso stating that such information is for statistical purposes only. This matter is currently being discussed with relevant stakeholders.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Sub-national assessment of aid effectiveness: A case study of post-conflict districts in Uganda","field_subtitle":"Ssengooba F; Namakula J; Kawooya V; Fustukian S: Globalisation and Health 13(32), doi: 10.1186/s12992-017-0251-7, 2017","URL":"https://tinyurl.com/yb425rth","body":"In post-conflict settings, many state and non-state actors interact at the sub-national levels in rebuilding health systems by providing funds, delivering vital interventions and building capacity of local governments to shoulder their roles. Aid relationships among actors at sub-national level represent a vital lever for health system development. This study was undertaken to assess the aid-effectiveness in post-conflict districts of northern Uganda. This was a three district cross sectional study conducted from January to April 2013. Managers of organisations involved in service delivery were interviewed and asked to list the external organisations that contribute to three key services. For each inter-organisational relationship a custom-made tool designed to reflect the aid-effectiveness in the Paris Declaration was used. Three hundred eighty four relational ties between the organisations were generated from a total of 85 organisations interviewed. Satisfaction with aid relationships was mostly determined firstly by the extent managers were able to negotiate own priorities, by their awareness of expected results, and thirdly on the provision of feedback about their performance. Provider satisfaction was mostly determined by awareness of expected results and feedback on performance. These findings illustrate the focus on \u201cresults\u201d domain and less on \u201cownership\u201d and \u201cresourcing\u201d domains. The capacity and space for sub-national level authorities to negotiate local priorities requires more attention especially for health system development in post-conflict settings.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The EQUINET newsletter as a health equity resource from the region ","field_subtitle":"Editor, EQUINET Newsletter","body":"\r\nThe EQUINET newsletter intends to raise the visibility and accessibility of evidence about and from east and southern Africa on different aspects of equity in health. Now in its 197th issue, it has since its inception shared a total of nearly 12 000 papers, articles, resources and other information on and from the region on areas related to health equity. \r\n\r\nLaunched in May 2001 by EQUINET from within the region and appearing monthly for the sixteen years since then, it has included new knowledge and evidence on a range of areas, from values, policies and rights, financing, health worker issues, clinical and health service practices through to health determinants and governance that have a bearing on improved delivery on policy commitments to equity in health. Thank you to the many people generating evidence and debate on these areas and to those who have helped the newsletter to be a consistent vehicle for sharing this information.\r\n\r\nWhile it appears monthly in members\u2019 email boxes, what may be less well known is that the current database of 11 500 articles compiled over the years on the EQUINET website is a resource that can be searched by themes and by title, author or text key words, to support research and evidence for social and policy dialogue. \r\n\r\nThis database may itself be an interesting source of evidence for those reviewing policy trends in the region. While it provides an accessible source of specific information for people working on equity in health and its determinants, it may also provide an interesting insight into the rise and fall of attention to specific issues in the region, from HIV and the retention of health workers, to emergencies, chronic conditions and universal coverage. Some areas, such as gender equity, poverty and social participation in health, have also had persistent presence since the first newsletter in 2001, albeit with less visible focus and with different lenses and perspectives. For others, such as privatisation and the public-private mix of health services, there appears to have been a deficit in attention, with far less open access publication, despite their importance for health equity in the region. \r\n\r\nThe sixteen years of the newsletter also provide an insight into the changing nature of evidence. In 2001 there was a predominance of formal publications in journals, reports and print media. This continues, with a slow improvement in journal papers being led by authors from within the region. Today, however, there is a more diverse mix in the forms of evidence, adding an increasing presence of blogs, videos, talks, photojournalism and art forms. This has brought new voice to the evidence and analyses on health equity, although many still face barriers in access to digital media.  \r\n\r\nWe\u2019d like to hear your voice.\r\n\r\nAs we head towards the 200th issue, let us know where the newsletter has been useful to you and what improvements you would want to see. \r\n\r\nFor our 200th issue, we invite you to send us in August and September editorials written by you, and any links to videos, blogs, papers or other online resources you want to share on your perspective on the opportunities that we should be tapping in east and southern Africa for making immediate or longer term advances in equity in health (whether generally, or on a specific aspect), and how and by whom they could be taken forward. \r\n\r\nPlease send feedback or queries or editorial or url links to information to the EQUINET secretariat: admin@equinetafrica.org","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"The medical device development landscape in South Africa: Institutions, sectors and collaboration","field_subtitle":"De Jager K; Chimhundu C; Saidi T; Douglas TS: South African Journal of Science 13(5/6), 2017","URL":"http://www.scielo.org.za/pdf/sajs/v113n5-6/18.pdf","body":"A characterisation of the medical device development landscape in South Africa would be beneficial for future policy developments that encourage locally developed devices to address local healthcare needs. The landscape was explored through a bibliometric analysis (2000\u20132013) of relevant scientific papers using co-authorship as an indicator of collaboration. Collaborating institutions found were divided into four sectors: academia (A); healthcare (H); industry (I); and science and support (S). A collaboration network was drawn to show the links between the institutions and analysed using network analysis metrics. The academic sector collaborated the most extensively both within and between sectors; local collaborations were more prevalent than international collaborations. Translational collaborations (AHI, HIS or AHIS) are considered to be pivotal in fostering medical device innovation that is both relevant and likely to be commercialised. Few such collaborations were found, suggesting room for increased collaboration of these types in South Africa. These results could inform the development of strategies and policies to promote certain types of medical device development. Further studies could identify drivers and barriers to successful medical device development in South Africa.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"The WHO\u2019s new African leader could be a shot in the arm for poorer countries","field_subtitle":"Sanders D: The Conversation, May 2017","URL":"https://www.pambazuka.org/economics/new-way-doing-business","body":"Dr Tedros Ghebreyesus is the first African to be elected as the Director-General of the World Health Organisation (WHO) in its 70 year history. The massive margin for Tedros \u2013 133 votes vs 50 for the UK candidate \u2013 suggests that the entire Global South voted for him.  Professor David Sanders in this interview suggests that the vote almost certainly represents a vote against big power domination and machinations in the WHO which often appears to ignore the main challenges and aspirations of low and middle income countries. Professor Sanders notes that Dr Ghebreyesus needs to use his strong mandate \u2013 notably from the Global South \u2013 to truly reform the WHO and its operations in favour of the world\u2019s poor majority. To do this, he needs to push strongly for member states to honour their commitments to the WHO and to rapidly and significantly increase their financial contributions. He also needs to ensure that the influence of the food, beverage, alcohol and tobacco industries to control non communicable diseases is resisted. This will be difficult given that a framework has been passed that allows non-state actors to participate in WHO policy-making processes. Further he argues that Dr Ghebreyesus must ensure that the health systems of low and middle income countries are strengthened so that health emergencies such as infectious disease outbreaks can be contained. This will ensure that agenda for health security isn\u2019t focused on securing the health of rich country populations against contagion from the poor but on protecting all, particularly the most vulnerable. Hi raises that what will be interesting to watch over the next five years is whether the evident solidarity between low and middle income counties in voting in Dr Ghebreyesus as their candidate is maintained during the debates and decisions about world health. ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Uganda\u2019s Achievement in Family Planning and Reproductive Health: Advocacy pays off","field_subtitle":"Partners in Population and Development: PPD, Uganda,  2017","URL":"https://tinyurl.com/lfmmbnd","body":"Uganda has released the result of Demographic Health Survey (UDHS 2016) highlighting the success in family planning and reproductive health. Uganda\u2019s population is the second youngest in the world, with half of the country younger than 15.7 years old (just older than Niger\u2019s median age of 15.5 years). As of January 2017, the population of Uganda was estimated to be 40 million, the age structure defines 49.9% in the below 15 years, 48.1% in 15-64 year of age group and the rest 2.1% are 64+ n the past 10 years, showing increasing growth rate (3.24 in 2016 est.), the country has added more than 10 million, from 24 to 35 million. DHS 2016 showed noteworthy success in maternal health care. Nearly three-quarters (74%) of live births were delivered by a skilled provider and almost the same proportion (73%) were delivered in a health facility which was almost half in 15 years back. Throughout the course of their lifetimes, Ugandan women have a 1-in-35 chance of dying due to pregnancy-related causes; every day, 16 women die in childbirth. However, the overall trend indicates a decline of pregnancy-related mortality over the time. Infant and child mortality rates are basic indicators of a country\u2019s socioeconomic situation and quality of life. The country\u2019s infant mortality rate was one of the highest in the world, but 2016 DHS showed steep declining trend. The Contraceptive Prevalence Rate (CPR) has risen steadily from a low starting point and moved upward sharply in most years in Uganda, on the other hand the unmet need of contraceptive is showing gradual decreasing trend. As the country\u2019s population continues to grow,  the majority of that growth is taking place in rural areas, where access to health services is extremely limited. PPD argues that with the call for universal access to reproductive health and family planning, the country is moving rapidly towards this goal. Such progress will help the country move closer to the targeted demographic that are linked with the larger development goals. Significant effort is argued to still be required to mitigate rural-urban disparity. Political commitment beyond the health sector, partner collaboration, community provision to increase community engagement is reported to lie behind the trends in the DHS key indicators report.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Understanding how domestic health policy is integrated into foreign policy in South Africa: a case for accelerating access to antiretroviral medicines","field_subtitle":"Modisenyane M; Hendricks S; Fineberg H: Global Health Action 10(1), doi: http://dx.doi.org/10.1080/16549716.2017.1339533, 2017  ","URL":"http://www.tandfonline.com/doi/full/10.1080/16549716.2017.1339533","body":"South Africa, as an emerging middle-income country, is becoming increasingly influential in global health diplomacy. However, little empirical research has been conducted to inform arguments for the integration of domestic health into foreign policy by state and non-state actors. This study aimed to address this knowledge gap, as an empirical case study analysing how South Africa integrates domestic health into its foreign policy, using the lens of access to antiretroviral (ARV) medicines. It explored state and non-state actors\u2019 perceptions regarding how domestic health policy is integrated into foreign policy to achieve better insights into health and foreign policy processes at the national level. Employing qualitative approaches, the authors examined changes in the South African and global AIDS policy environment. Purposive sampling was used to select key informants, a sample of state and non-state actors who participated in in-depth interviews. Secondary data were collected through a systematic literature review of documents retrieved from five electronic databases, including review of key policy documents. Qualitative data were analysed for content. The findings showed the interplay among social, political, economic and institutional conditions in determining the success of this integration process. A series of national and external developments, stakeholders, and advocacy efforts and collaboration created these integrative processes. South Africa\u2019s domestic HIV/AIDS constituencies, in partnership with the global advocacy movement, catalysed the mobilisation of support for universal access to ARV treatment nationally and globally, and the promotion of access to healthcare as a human right. The report concludes that transnational networks may influence government\u2019s decision making by providing information and moving issues up the agenda.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania","field_subtitle":"Kruk M; Chukwuma A; Mbaruku G; Leslie H: Bulletin of the World Health Organisation 95(6), 389-480, 2017","URL":"http://www.who.int/bulletin/volumes/95/6/16-175869/en/","body":"This study analysed factors affecting variations in the quality of antenatal and sick-child care in primary-care facilities in seven African countries, using service provision assessment surveys of health facilities in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania in 2006\u20132014. Based on World Health Organization protocols, they created indices of process quality for antenatal care (first visits) and for sick-child visits and assessed national, facility, provider and patient factors that might explain variations in quality of care. Overall, health-care providers performed a mean of 62% of eight recommended antenatal care actions and 55% of nine sick-child care actions at observed visits. The quality of antenatal care was higher in better-staffed and -equipped facilities and lower for physicians and clinical officers than nurses. Experienced providers and those in better-managed facilities provided higher quality sick-child care, with no differences between physicians and nurses or between better- and less-equipped clinics. Private facilities outperformed public facilities. Country differences were more influential in explaining variance in quality than all other factors combined. The authors conclude that the quality of two essential primary-care services for women and children was weak and varied across and within the countries. They observe that analysis of reasons for variations in quality could identify strategies for improving care.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"What is it going to take to move youth-related HIV programme policies into practice in Africa? ","field_subtitle":"Mark D; Taing L; Cluver L; Collins C; Iorpenda K; Andrade A; Hatane L: Journal of the International AIDS Society 20(Suppl 3)21491, 2017","URL":"http://www.jiasociety.org/index.php/jias/article/view/21491/pdf","body":"HIV has been reported to be the leading cause of mortality amongst adolescents in Africa. This has brought attention to the changes in service provision and health management that many adolescents living with HIV experience when transferring from specialised paediatric- or adolescent-focused services to adult care. When transition is enacted poorly, adherence may be affected and the continuum of care disrupted. The authors present the case that considerable gaps remain in moving policy to practice on this at global, national, and local levels and  that standard operating procedures or tools to support this transition are lacking. Guidance often overlooks the specific needs and rights of adolescents, in particular for those living with HIV. In some cases, prohibitive laws can impede adolescent access by applying age of consent restriction to HIV testing, counselling and treatment, as well as SRH services. Where adolescent-focused policies do exist, they have been slow to emerge as tangible operating procedures at health facility level. A key barrier is the nature of existing transition guidance, which tends to recommend an individualised, client-centred approach, driven by clinicians. In low- and middle-income settings, flexible responses are resource intensive and time consuming, and therefore challenging to implement amidst staff shortages and administrative challenges. They propose that national governments adopt transition-specific policies to ensure that adolescents seamlessly receive appropriate and supportive care, as part of a broader adolescent-centred policy landscape and adolescent-friendly orientation and approach at health system level. Youth involvement and community mobilisation are seen to be essential for this. . ","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"World Health Organisation (WHO) Call for Research Findings on Digital Health Interventions","field_subtitle":"Deadline for submissions: 15 September 2017","URL":"https://tinyurl.com/ybd3qbvw","body":"In response to a global need for evidence-based global recommendations on the use of digital health interventions available via mobile device, the WHO Department of Reproductive Health and Research in collaboration with other WHO departments has commenced the process of developing WHO Guidelines. As part of this process, over the coming months, a series of systematic reviews of research evidence have been commissioned on specific digital health topics. WHO is requesting from the global community any and all relevant primary studies that should be considered for inclusion in the systematic reviews. This is an opportunity to contribute to the literature that will be included in the systematic reviews that will be informing WHO Guidelines on Digital Health Interventions. The Guidelines will systematically consolidate evidence of effectiveness related to these digital health interventions, as well as review associated feasibility, costs, and risks, in order to formulate concrete recommendations to inform evidence-based investments and prioritisation. Studies can focus on issues related to effectiveness, equity, resource use acceptability, feasibility, or resource use/cost-effectiveness, and can be from any setting, can be both published or unpublished, can include both randomised and non-randomised studies and qualitative studies. The systematic review team will review all submitted papers and determine if they fulfil the inclusion criteria.","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"\u2018These are not luxuries, it is essential for access to life\u2019: Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa","field_subtitle":"Hanass-Hancock J; Nene S; Deghaye N; Pillay S: African Journal of Disability 6(0), a280, 2017","URL":"http://ajod.org/index.php/ajod/article/view/280/566","body":"Middle-income countries are home to a growing number of persons with disabilities but with limited evidence on the factors increasing economic vulnerability in people with disabilities in these countries. This article presents data related to elements of this vulnerability in one middle-income country, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs. A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices. The development of poverty alleviation and social protection mechanisms in middle-income countries like South Africa should, the authors argue,  better consider diverse disability-related care and support needs not only to improve access to services such as education and health but also to increase the effect of disability-specific benefits and employment equity policies","php":"","field_issue_date":"2017-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana.","field_subtitle":"Koduah A; Agyepong IA; van Dijk H, Social Science & Medicine 167, doi: 10.1016/j.socscimed.2016.08.051, 2016  ","URL":"http://www.ncbi.nlm.nih.gov/pubmed/27614028","body":"This paper seeks to advance the authors\u2019 understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. The authors theorised that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. The authors argue that understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"1st EAC Heads of State Summit on Investment in Health & Joint International Health Sector Investors and Donors Roundtable Meeting","field_subtitle":"27-30 November 2017, Kampala, Uganda","URL":"https://tinyurl.com/y77etzxk","body":"The East African Community (EAC) in collaboration with leading national, regional and international Partners is organising the first ever \u201c1st EAC Heads of State Summit on Investment in Health and Joint International Health Sector Investors and Donors Round-table Meeting and International Trade Exhibition\u201d as part of proceedings of the 19th Ordinary Summit of the EAC Heads of State, from 27th to 30th November 2017 at the Commonwealth Speke Resort Hotel & Conference Centre, Munyonyo, Kampala, Uganda. The Theme of the Summit and Round-table Meeting and Trade Exhibition is \"Investing in Health Systems, Infrastructure, Health Services and Research for accelerated attainment of Universal Health Coverage (UHC) and health-related Sustainable Development Goals (SDGs) in the EAC by the year 2030\". The event will incorporate an International Trade Fair and Open Air Exhibitions and it will  provide an opportunity for high level discussions among Partner States, national, regional and international Partners, local investors and other stakeholders aimed at focusing attention on the urgent need for major investments in the health sector. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A new portal page being developed on the EQUINET website on resources for Participatory Action Research ","field_subtitle":"TARSC and pra4equity network: To be launched September 2017","URL":"http://www.equinetafrica.org/content/governance-and-participation-health","body":"In the evaluation of the Reader on PAR in Health Systems Research (online on this site) one of the proposals made by many respondents was to have a website to share a range of PAR materials, and information on networks, trainers etc online. People indicated and we also noted that there are many existing resources on PAR but that we need to make it easier for people to find what is out there based on specific needs that they have. In response to this EQUINET is setting up in July/ August a PAR portal page called the \u201cParticipatory Action Research Portal\u201d. The new portal will have a homepage and a series of \u2018subpages\u2019 for Training, resources - which will provide links to online training courses, whole training guides and reports of training activities; Methods, tools and ethics - which will provide links to online specific papers on PAR methods, to specific examples of tools, and to discussions/ guidelines on ethical issues; PAR work \u2013 which will provide links to stories, case studies, briefs, videos, text or photojournalism stories of PAR work, including facilitator reflections; Organisations and networks -  which will provide the name, snippet of information, country and link to organisations and networks involved PAR;   Publications - which will provide published journal papers and reports on PAR through links to the urls or on the EQUINET database and  Other resources - which will provide ad hoc information that doesn\u2019t fit anywhere else. The page is being worked on in July  and August and will be launched in September 2017.  A call has been made for institutions working with PAR to provide information on resources they would like the portal to make links to. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Bill Gates Won\u2019t Save You From The Next Ebola","field_subtitle":"Fortner R; Park A: The World Post, May 2017","URL":"https://tinyurl.com/lzsxcgw","body":"The author points out that no single non-governmental institution or individual wields more influence, and no one\u2019s support is more powerful in global health, than the Gates Foundation and its namesake founders, Bill and Melinda Gates. The foundation has $39.6 billion in assets and spent $2.9 billion on developmental assistance for global health in 2015 alone \u2015 more than every country in the world except the U.S. and the U.K.  The author argues that WHO has frequently fallen short of its goal to protect and promote health of all people, leading some to propose returning to a more philanthropy-focused model. That means private charities such as the Gates Foundation might play an even larger role in protecting public health, which calls for scrutiny of the role that philanthropy has played in recent years. When the Gates Foundation takes aim at a disease, it can elicit billions of dollars from governments and reshape the world\u2019s agenda for scientific research, to the cost of  other diseases.  WHO reliance on voluntary contributions from countries and private donors, including the Gates Foundation, for around 80 percent of its budget is argued to make the organisation vulnerable to outside pressure and funder 'pet programs', which skews global health priorities. The author documents trends post 2014 and argues that the world remains grossly underprepared for outbreaks of infectious disease, which are likely to become more frequent in the coming decades, according to a meta-analysis of post-Ebola studies published in January 2017. The author indicates that public and state funding remains critical for international health efforts and cannot be left to private players to fill the void.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Business and human rights: States\u2019 duties don\u2019t end at the national borders A new UN General Comment","field_subtitle":"UN Committee on Economic, Social and Cultural rights: UN, Geneva, 2017","URL":"http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=E/C.12/GC/24&Lang=en","body":"States should control corporations across national borders to protect communities from the negative impacts of their activities, UN human rights experts have said in an authoritative new guidance * on the Obligations of States parties to the International Covenant on Economic, Social and Cultural Rights (CESCR) in the context of business activities. \u201cStates should regulate corporations that are domiciled in their territory and/or jurisdiction. This refers to corporations which have their statutory seat, central administration or principal place of business on their national territory,\u201d the experts of the UN Committee on Economic, Social and Cultural rights say in the guidance*, officially termed the General Comment, published today. In practice, the Committee expects home States of transnational corporations to establish appropriate remedies, guaranteeing effective access to justice for victims of business-related human rights abuses when more than one country is involved. In light of the practices revealed by the Panama Papers and the Bahamas Leaks, the General Comment emphasizes that States should ensure corporate strategies do not undermine their efforts to fully realize the rights set out in the Covenant. The new General Comment sets out what States can and must do in order to ensure that companies do not violate rights such as the right to food, housing, health or work, which the States themselves are bound to respect: \u201cBusinesses cannot ignore that the expectations of society are changing. The first ones to change shall be rewarded by consumers, whose purchasing choices are increasingly driven by immaterial aspects \u2014 the reputation of the company, and the ethical and sustainability dimensions associated with its products.\u201d  The issue of business and human rights has been addressed recently in different forums, including the Human Rights Council and the International Labour Conference, and through a combination of tools \u2014 regulations, self-imposed codes of conduct, economic incentives and action plans.  Zdzislaw Kedzia, the Vice-Chair of the UN Committee on Economic, Social and Cultural rights noted that \u201cIt may be tempting for States to seek refuge behind the initiatives taken by the corporate sector, rather than adopting the appropriate regulatory and policy initiatives that they must adopt. Our General Comment seeks to recall their obligations under the Covenant and define the role they must assume in regulating corporate conduct.\u201d ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Capacity for diagnosis and treatment of heart failure in sub-Saharan Africa","field_subtitle":"Carlson S; Duber H; Achan J; Ikilezi G; Mokdad A; Stergachis A; Gollum A; Bushman G; Roth G: Heart, doi: http://dx.doi.org/10.1136/heartjnl-2016-310913, 2017","URL":"http://heart.bmj.com/content/early/2017/05/09/heartjnl-2016-310913","body":"Heart failure is a major cause of disease burden in sub-Saharan Africa. The authors aim to provide a better understanding of the capacity to diagnose and treat heart failure in Kenya and Uganda to inform policy planning and interventions. They analysed data from a nationally representative survey of health facilities in Kenya and Uganda (197 health facilities in Uganda and 143 in Kenya)  and report on the availability of cardiac diagnostic technologies and select medications for heart failure. Facility-level data were analysed by country and platform type (hospital vs ambulatory facilities). Functional and staffed radiography, ultrasound and ECG were available in less than half of hospitals in Kenya and Uganda combined. Of the hospitals surveyed, 49% of Kenyan and 77% of Ugandan hospitals reported availability of the heart failure medication package. ACE inhibitors were only available in 51% of Kenyan and 79% of Ugandan hospitals. Almost one-third of the hospitals in each country had a stock-out of at least one of the medication classes in the prior quarter. Few facilities in Kenya and Uganda were prepared to diagnose and manage heart failure. Medication shortages and stock-outs were common. The authors\u2019 findings call for increased investment in cardiac care to reduce the growing burden of heart failure.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"CODESRIA Democratic Governance Institute: Economic Governance and Africa\u2019s Economic Transformation, 4 \u2013 15 September 2017, Dakar, Senegal","field_subtitle":"Call for Resource Persons and Laureates: Application Deadline: 31 July 2017","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) announces a call for submission of proposals from academics and researchers in African universities and Research Centers for the 2017 session of its annual Democratic Governance Institute. The institute will be held in the Council\u2019s headquarters in Dakar, Senegal from 4 \u2013 15 September 2017 on the theme \u201cEconomic Governance and Africa\u2019s Economic Transformation\u2019. The Democratic Governance Institute, launched in 1992 by CODESRIA, is an annual interdisciplinary forum which brings together about fifteen researchers from various parts of the continent and the Diaspora, as well as some non-African scholars engaged in innovative research on topics related to the general theme of governance. An area where Africa\u2019s play a critical role in the global economy is the resource extraction sector. After the resource boom of the 2000-2010 decade and the confidence attending to the \u2018Africa rising\u2019 narratives, a number of countries are experiencing deeper economic regression. Creative ways to support the extraction of resources have not kept pace with demands of Africans for an interrogation of the place of Africa in the global value chain. Fast and fleeting forms of extraction are now being implemented because appetite for Africa\u2019s resources from external markets remains high and continues to grow. While useful provisions to counter the appetite for African resources exist, many intellectuals have not publicized the African Mining Vision of the African Union to reiterate demands for changing the structures of mining and African economies.The theme of \u201cEconomic Governance and Africa\u2019s Economic Transformation\u2019 has been selected with the hope that laureates will have time to reflect in some depth on the contemporary economic trends in the continent and the kind of governance architecture required to insulate African economies from dangerous global economic networks. Applicants who wish to be considered as laureates should be PhD candidates or scholars in their early career with a proven capacity to conduct research on the theme of the Institute. Intellectuals active in the policy process and/or social movements and civil society organizations are also encouraged to apply. The number of places offered by CODESRIA at each session is limited to fifteen (15). Young African academics from the Diaspora and Non-African scholars who are able to fund their participation may also apply for a limited number of places. All applications or requests for additional information should be sent electronically to the email below.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community Health Workers feel unrecognised and undervalued","field_subtitle":"Healthcare Information for All, 19 May, 2017","URL":"http://tinyurl.com/y8ws5kke","body":"Community Health Workers feel unrecognised and undervalued by community leaders and health professionals. This was the central message from a major thematic discussion held on the HIFA forums and sponsored by The Lancet, Reachout Project/Liverpool School of Tropical Medicine, World Vision International and USAID Assist Project. More than 60 HIFA members contributed their experience and expertise to the discussion, including CHW programme managers, researchers and policymakers, as well as a large number of CHWs and ASHAs from India and Uganda. Countries represented included Burundi, Cameroon, Canada, Ethiopia, France, Ghana, India, Iran, Japan, Kenya, Malaysia, Netherlands, New Zealand, Nigeria, Pakistan, Rwanda, Switzerland, Tanzania, Uganda, UK, and USA. Other major concerns were lack of training and supervision; access to healthcare information; remuneration; equipment, medicines, and need for mobile phones/computers. CHWs said they are asked to carry out a wide range and ever increasing number of tasks, but often without the appropriate facilities to enable this. CHWs feel unrecognised and undervalued by official health care providers which not only reduces morale but also creates a disjoint between perceived influence by community, and their actual influence, reducing their respect from the community. Furthermore, this lack of respect is reflected in their lack of training and supervision, and results in a paucity of avenues for them to voice their needs and concerns. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Contraceptive uptake after training community health workers in couples counselling: A cluster randomised trial","field_subtitle":"Lemani C; Tang J; Kopp D; Phiri B; Kumvula C; Chikosi L; Mwale M; Rosenberg N: PLoS One 12(4) e0175879, doi:https://doi.org/10.1371/journal.pone.0175879, 2017 ","URL":"https://tinyurl.com/kndj6mo","body":"Young women in Malawi face many challenges in accessing family planning, including distance to the health facility and partner disapproval. The author\u2019s primary objective was to assess if training Health Surveillance Assistants in couples counselling would increase modern family planning uptake among young women. In this cluster randomised controlled trial, 30 Health Surveillance Assistants from Lilongwe, Malawi received training in family planning. The Health Surveillance Assistants were then randomised 1:1 to receive or not receive additional training in couples counselling. All Health Surveillance Assistants were asked to provide family planning counselling to women in their communities and record their contraceptive uptake over 6 months. Sexually-active women ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Country participatory action research facilitators as participants in a programme to develop online PAR ","field_subtitle":"Call for applicants: Call closes July 7 2017","URL":"http://www.equinetafrica.org/content/grants","body":"In 2017 EQUINET (through TARSC working with Maldaba a web design company) is developing a web platform for participatory action research (PAR) that would allow us to connect across countries on areas of local community level work and action on areas of health, health determinants  and health systems that have wider regional and global relevance or relate to global policies being applied across our countries. In doing this we are building a new tool that will allow  us to share, discuss,  analyse and design actions across countries in the same way we have done so using PAR at local level, that we can use in future for many purposes. TARSC has opened a call for people with experience of PAR working in east and southern Africa who may be interested in being involved in this process.  We will be taking forward the web platform for PAR between July 2017 and December 2019 working with eight sites and health workers and community members in a primary care facility in the site. We will be exploring how disease programme or funding targets  such as for performance based financing are affecting health workers professionals roles and team work; health workers relationships with communities  and the ability to deliver comprehensive primary health care.  We invite people to apply to join the programme as country PAR facilitators. To participate in this programme we invite people who work in an organisation/ programme in a country in an east and southern African country;  have had some exposure to PAR approaches; have access to internet; have ongoing work or interaction with at least one primary care  centre and with the health workers and community members in it, such as through health centre committees, health literacy or other programmes; have primary care level services that are implementing some form of target driven funding or service delivery, such as in performance based financing or specific disease programmes, and are available for the  activities, in the time frames and for the duration noted in the process above. If you are interested please email EQUINET at admin@equinetafrica.org  by July 7th 2017 with your name, organisation, country and email address for communication, and: (1)  list of any prior training received on PAR, with the course, institution providing the course and year; (2) A list of any PAR work you have implemented, with a line for each on what it was about and the year; (3) Confirmation that you have direct access to internet and what it costs you for a one hour session (if provided institutionally through your organisation please indicate this). (4) The name, location and urban/ rural location of a primary care  centre that you regularly interact with, including with the health workers and community members,  and  whether the health workers and / or community members at this centre have access to the internet (not essential but useful). (5) The form of target driven funding or service delivery being implemented at the primary care service, (ie. performance based financing or specific disease programmes specify  for what) and (6) Confirmation that you are available for the  activities, in the time frames and for the duration noted in the process above.  We will provide feedback to applicants who provide the full information above by last week of July.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Current and future availability of and need for human resources for sexual, reproductive, maternal and newborn health in 41 countries in Sub-Saharan Africa","field_subtitle":"Guerra A; Nove A; Michel-Schuldt M; de Bernis L: International Journal of Equity Health 16(1) 69, 2017","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415807/","body":"The World Health Organisation African region, covering the majority of Sub-Saharan Africa, faces the highest rates of maternal and neonatal mortality in the world. This study uses data from the State of the World's Midwifery 2014 survey to cast a spotlight on the World Health Organisation African region, highlight the specific characteristics of its sexual, reproductive, maternal and newborn health (SRMNH) workforce and describe and compare countries' different trajectories in terms of meeting the population need for services. Using data from 41 African countries, this study used a mathematical model to estimate potential met need for SRMNH services, defined as \"the percentage of a universal SRMNH package that could potentially be obtained by women and newborns given the composition, competencies and available working time of the SRMNH workforce.\" The model defined the 46 key interventions included in this universal SRMNH package and allocated them to the available health worker time and skill set in each country to estimate the potential met need. Based on the current and projected potential met need in the future, the countries were grouped into three categories: (1) 'making or maintaining progress' (expected to meet more, or the same level, of the need in the future than currently): 14 countries including Ghana, Senegal and South Africa, (2) 'at risk' (currently performing relatively well but expected to deteriorate due to the health workforce not keeping pace with population growth): 6 countries including Gabon, Rwanda and Zambia, and (3) 'low performing' (not performing well and not expected to improve): 21 countries including Burkina Faso, Eritrea and Sierra Leone. The three groups face different challenges, and the authors argue that policy solutions to increasing met need should be tailored to the specific context of the country and that national health workforce accounts be strengthened so that workforce planning can be evidence-informed.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Decolonizing technology: A reading list","field_subtitle":"Martini B: Tech and Tools for Justice and Rights Blog, 2017","URL":"https://beatricemartini.it/blog/decolonizing-technology-reading-list/","body":"Today, the ways and means of technology access and usage are suggested by the author to be driven by power dynamics centering on the needs of specific demographics and experiences, channeling a colonialist exercise of control, establishing who gets to use a tool or service, and to which extent. A growing number of researchers, scholars, artists and advocates has been looking into how a colonialist approach sits at the core of how a great deal of  digital technology is developed, distributed, and capitalised. This has progressively contributed to a new lens through which to analyse the subject matter, which can be referred to as the concept of decolonizing technology. With the objective to build a resource to inspire new learning and reflections on the concept of decolonizing technology, this post includes a reading list on the topic. This list represents a snapshot of some the work done to date on the concept of decolonizing technology. It aims to inspire further research and discoveries of any other possible resource and initiative delving deeper into this subject, from many more and different perspectives.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Dentistry in crisis: time to change","field_subtitle":"Lois Cohen, Gunnar Dahlen, Alfonso Escobar, Ole Fejerskov, Newell Johnson, Firoze Manji, La Cascada, Colombia","body":"A group of senior scientists\u2014researchers, academics and intellectuals\u2014from various parts of the world, with over 250 years\u2019 combined experience of working to improve the oral health of communities, independent of any institution, government body or corporate entity, met in Colombia in March 2017 and prepared a statement on their analysis of the problem and recommendations about what should be done. This editorial presents paragraphs extracted from the statement. The full statement, referred to as La Cascada Declaration, together with associated papers, is available at https://lacascada.pressbooks.com/front-matter/introduction/. \r\n\r\nWe are concerned that the dental profession, worldwide, has lost its way. \r\n\r\nDespite current knowledge of the causes of oral diseases, globally most people continue to experience significant levels of disease and disability. Although technological and scientific developments over the last 50 years have contributed to improvements in the quality of life for some, oral diseases continue to cause pain, infection, tooth-loss and misery for a vast number of people. While in many middle and high income countries, there have been marked overall improvements in oral health, oral health inequalities both between and within countries are now a major problem. The overall improvements in oral health have been the result of general improvements in living standards and conditions, changing social norms in society (improvements in personal hygiene and reduction in smoking) and the widespread use of fluoride toothpastes, rather than due to the clinical interventions of dentists. \r\n\r\nGlobally the profession has had little direct impact on the scale of the problem. Clinical interventions account for only a small proportion of improvements in the health of populations. This is as true of oral health as of general health.\r\n\r\nThe world has witnessed significant growth in social inequalities between the rich and the poor. \u2026Austerity policies worldwide (commonly referred to as \u2018structural adjustment programs\u2019 in the global South) have diverted social and welfare spending away from the public to the private sector in the belief that \u2018the market\u2019 can meet social needs, despite evidence to the contrary. This has led to the creation of a two-tier health service\u2014one for the rich, and the other, limited and often of poorer quality, for the majority. \r\n\r\nCorporations and insurance companies are increasingly taking over the provision of health services, including dental services, in many countries. The treatment regimens that they promote are designed more to ensure adequate returns on investment for their shareholders than to improve the health status of the community, resulting in a tendency for the provision of excessive and sometimes inappropriate treatments. \r\n\r\nMajor food and beverage companies continue to promote the consumption of refined carbohydrates, free sugars in drinks, confectionary and in processed foods, even though these are major contributory factors for dental decay, not to mention obesity and diabetes. Advertisements of these products frequently and unjustifiably imply health benefits.\r\n\r\nWe believe that the dental profession, as presently constituted, is inappropriately educated for dealing adequately with oral health problems faced by the public. In many countries, there is an overproduction of dentists, most of whom provide services only in the main urban centers where private practice is more lucrative and services often fail to reach those in more remote areas of the country. In some cases, overproduction results in unemployment.\r\n\r\nWhile there is no doubt that the intention of the profession is to improve health, commonly used treatment regimens for tooth decay (drillings and fillings) and gum diseases (scaling and polishing) do not by themselves arrest or control their progression. Furthermore, filling teeth inevitably leads to a cycle of replacements of increasing size, ultimately shortening the life of the dentition. \r\n\r\nDentistry is drifting, it seems, away from its task of prevention and control of the progression of disease and of maintaining health. The mouth has become dissociated from the body, just as oral health care has become separated from general medicine. \r\n\r\nWe believe dentistry is in crisis. Things must change. \r\n\r\nSince clinical interventions account for only a small proportion of health improvements, the dental professions should be in the forefront of efforts that call for a reduction in income disparities and for a more just world in which everyone has access to resources and conditions for good health and well-being. Those industries whose products are harmful to health, especially producers of free sugars in foods, drinks, and producers of foods containing refined carbohydrates, should be required to label their products as harmful (just as has been done in many parts of the world in relation to tobacco and alcohol). The decline in government spending on the social sector cannot be justified in the light of excessive expenditures on war, the military, arms and other destructive initiatives. Corporations and industry should not be permitted to unduly influence research or clinical practice.\r\n\r\nThe dental profession is over-trained for what they do and under-trained for what they should be doing.  Control of the most common oral diseases requires relatively little training and could and should be performed in most cases by community healthcare workers. Demonstration projects on the effectiveness of such approaches are needed.\r\n\r\nDentistry should become a specialism of medicine, just as ENT (ear, nose & throat), ophthalmology, dermatology, etc. are specialisms of medicine. As such, oral health physicians would be responsible for providing leadership of the oral health team, in the management of advanced disease and the provision of emergency care, relief and management of pain, infections and sepsis, management of trauma, diagnosis and management of soft-tissue pathologies and, where justifiable from the point of view of the maintenance of health, interventions to re-establish a functional dentition and orofacial reconstruction. Since the management and control of most common diseases could be undertaken by primary healthcare workers, a relatively small number of such oral health physicians would need to be trained. In addition, a relatively small number of public health dentists would be needed to coordinate oral health needs assessments, implement and evaluate community-based oral health improvement strategies and to act as oral health advocates to ensure the closer integration of oral health into wider policies. \r\n\r\nThe implications of the above recommendations are obvious: changing dentists into oral health physicians necessitates thorough revision of the education profiles of dental schools: an overhaul of the current curriculum for training of dentists; a reduction in the number of dentists trained; and an improvement in the quality of courses, especially ensuring that training is linked to the needs of the population. \r\n\r\nThe current state of dentistry worldwide is dire. It requires radical solutions. This short declaration has been produced to stimulate discussion about what needs to be done in the interest of the health of the majority of humankind. We recognise that the changes may take time to implement. Each country will need to assess how best to bring these about. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Dr Tedros Promises WHO Reform with Human Rights at the Core","field_subtitle":"Health and Human Rights Journal Blog, 23 May 2017","URL":"http://tinyurl.com/y97zwd5b","body":"Dr. Tedros Adhanom Ghebreyesus, newly  elected Director-General of the World Health Organisation (WHO) for the next five years, believes WHO must evolve and adapt to urgent global health challenges, and \u201cput the right to health at the core of its functions, and be the global vanguard to champion them.\u201d Universal health coverage will be his topmost priority. \u201cThe growing momentum around universal health coverage\u2014combined with the global commitment to sustainable development and its motto of \u201cleaving no one behind\u201d\u2014offers unique opportunities to advance equity in health.\u201d In a Q&A with Health and Human Rights Dr Tedros discussed the \u201chundreds of millions of people missing out on essential health care or falling into poverty trying to pay for it. That is a violation of the human right to health that demands our full attention and urgent action.\u201d He acknowledged that implementation of policies to achieve universal health cover is difficult and requires collaboration and partnership across stakeholders. He explained this collaborative approach guided Ethiopia\u2019s pursuit of equitable health access when he was minister of health. Dr Tedros told Health and Human Rights that he is committed to transforming the way that WHO operates with the core principles of health as a human right and universal health coverage for the most vulnerable are at the forefront of all our work. Too often, Dr Tedros noted, human rights and gender equity are secondary considerations when UN organisations develop programming. He stressed that this is outdated and must change.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Dynamic Facilitation Skills for Participatory Processes","field_subtitle":"25 - 27 July 2017, Cape Town","URL":"https://tinyurl.com/yaqoa9hv","body":"The objective of this course is to help sharpen the facilitation techniques of people who use participatory methods for their projects, and who work with groups. This course will deepen their understanding of group processes, and provides a space for facilitators to learn from each other by sharing knowledge and experiences. The training course will be run in a workshop style with a high degree of participant involvement using adult learning methods. Group work and role plays will be interspersed with input sessions combining theory and practice. The trainers are expert facilitators, and will also demonstrate the skills that they share. The course is also designed to include a range of different method that can be used to facilitate group processes. The training course covers essential skills for facilitation, the roles of a facilitator and interpersonal communication and conversation styles in facilitation. Further, the course will introduce participants to skills on how to manage group dynamics & understanding group decision-making processes, how to design a facilitation process and facilitation tools and techniques and how to use them. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Effects of payment for performance on accountability mechanisms: Evidence from Pwani, Tanzania","field_subtitle":"Mayumana I; Borghi J; Anselmi L; Mamdani M; Lange S: Social Science & Medicine 179, 61\u201373, 2017","URL":"https://tinyurl.com/ksv36lz","body":"Payment for Performance (P4P) aims to improve provider motivation to perform better, but little is known about the effects of P4P on accountability mechanisms. The authors examined the effect of P4P in Tanzania on internal and external accountability mechanisms. The authors carried out 93 individual in-depth interviews, 9 group interviews and 19 Focus Group Discussions in five intervention districts in three rounds of data collection between 2011 and 2013. The authors carried out surveys in 150 health facilities across Pwani region and four control districts, and interviewed 200 health workers, before the scheme was introduced and 13 months later. The authors examined the effects of P4P on internal accountability mechanisms including management changes, supervision, and priority setting, and external accountability mechanisms including provider responsiveness to patients, and engagement with Health Facility Governing Committees. P4P had some positive effects on internal accountability, with increased timeliness of supervision and the provision of feedback during supervision, but a lack of effect on supervision intensity. P4P reduced the interruption of service delivery due to broken equipment as well as drug stock-outs due to increased financial autonomy and responsiveness from managers. Management practices became less hierarchical, with less emphasis on bureaucratic procedures. Effects on external accountability were mixed, health workers treated pregnant women more kindly, but outreach activities did not increase. Facilities were more likely to have committees but their role was largely limited. P4P resulted in improvements in internal accountability measures through improved relations and communication between stakeholders that were incentivised at different levels of the system and enhanced provider autonomy over funds. P4P had more limited effects on external accountability, though attitudes towards patients appeared to improve, community engagement through health facility governing committees remained limited. Implementers should examine the lines of accountability when setting incentives and deciding who to incentivise in P4P schemes.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 196: Dentistry in crisis: time to change","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Regional review meeting on health centre committees as a vehicle for social participation June 2017","field_subtitle":"CWGH, TARSC, UCT and LDHMT: June 20-22, Harare","URL":"http://www.equinetafrica.org/content/meetings","body":"Community Working Group on Health in partnership with Training and Research Support Centre, University of Cape Town  School of Public Health, and\r\nthe Lusaka District Health Management Team under the auspices of EQUINET held a regional review meeting on Health Centre Committees as a vehicle for social participation in health systems in East and Southern Africa on 20-22 June in Harare. The meeting was held as part of a programme to\r\nexchange experiences and information on the laws, roles, capacities, training and monitoring systems that are being applied to HCCs in the ESA region. The meeting discussed experiences with laws, policies, guidelines and constitutions on HCCs; shared experiences in using photo voice to enhance the role of HCCs; discussed current training materials and programmes for HCCs in the region and the strengthening of internal capacities of institutions working with HCCs through information exchange and skills inputs. The report will be made available on the EQUINET website.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Equity trends in ownership of insecticide-treated nets in 19 sub-Saharan African countries","field_subtitle":"Taylor C; Florey L; Ye Y:  Bulletin World Health Organisation 95(5) 322\u2013332, 2017","URL":"http://www.who.int/bulletin/volumes/95/5/16-172924.pdf","body":"This study examined the change in equity of insecticide-treated net ownership among 19 malaria-endemic countries in sub-Saharan Africa before and after the launch of the Cover The Bed Net Gap initiative. To assess change in equity in ownership of at least one insecticide-treated net by households from different wealth quintiles, the authors used data from Demographic and Health Surveys and Malaria Indicator Surveys. The authors assigned surveys conducted before the launch (2003\u20132008) as baseline surveys and surveys conducted between 2009\u20132014 as endpoint surveys and did country-level and pooled multi-country analyses, dividing geographical zones into either low- and intermediate-risk or high-risk. To assess changes in equity, they calculated the Lorenz concentration curve and concentration index (C-index). Out of the 19 countries assessed, 13 countries showed improved equity between baseline and endpoint surveys and two countries showed no changes. Four countries displayed worsened equity, two favouring the poorer households and two favouring the richer. The multi-country pooled analysis showed an improvement in equity. Similar trends were seen in both low- and intermediate-risk and high-risk zones. They conclude that the mass insecticide-treated net distribution campaigns to increase coverage, linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of insecticide-treated net ownership across sub-Saharan Africa with significant reduction in inequity among wealth quintiles.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Evaluation of the influenza sentinel surveillance system in Madagascar, 2009\u20132014","field_subtitle":"Rakotoarisoa A; Randrianasolo L; Tempia S; Guillebaud J; Razanajatovo N; Randriamampionona L; Piola P; Halm A; Heraud JM: Bulletin of the World Health Organisation 95(5) 375\u2013381, 2017","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418817/","body":"Evaluation of influenza surveillance systems is poor, especially in Africa. In 2007, the Institut Pasteur de Madagascar and the Malagasy Ministry of Public Health implemented a countrywide system for the prospective syndromic and virological surveillance of influenza-like illnesses. In assessing this system\u2019s performance, the authors identified gaps and ways to promote the best use of resources. The authors investigated acceptability, data quality, flexibility, representativeness, simplicity, stability, timeliness and usefulness and developed qualitative and/or quantitative indicators for each of these attributes. Until 2007, the influenza surveillance system in Madagascar was only operational in Antananarivo and the observations made could not be extrapolated to the entire country. By 2014, the system covered 34 sentinel sites across the country. At 12 sites, nasopharyngeal and/or oropharyngeal samples were collected and tested for influenza virus. Between 2009 and 2014, 177\u2009718 fever cases were detected, 25\u2009809 (14.5%) of these fever cases were classified as cases of influenza-like illness. Of the 9192 samples from patients with influenza-like illness that were tested for influenza viruses, 3573 (38.9%) tested positive. Data quality for all evaluated indicators was categorised as above 90% and the system also appeared to be strong in terms of its acceptability, simplicity and stability. However, sample collection needed improvement. The influenza surveillance system in Madagascar performed well and provided reliable and timely data for public health interventions. Given its flexibility and overall moderate cost, the authors argue that this system may become a useful platform for syndromic and laboratory-based surveillance in other low-resource settings.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Incidence and risk factors for hypertension among HIV patients in rural Tanzania \u2013 A prospective cohort study","field_subtitle":"Rodr\u00edguez-Arbol\u00ed E; Mwamelo K; Kalinjuma A; Furrer H; Hatz C; Tanner M; Battegay M; Letang E; KIULARCO Study Group: Plos One, doi: https://doi.org/10.1371/journal.pone.0172089, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172089","body":"Scarce data are available on the epidemiology of hypertension among HIV patients in rural sub-Saharan Africa. The authors explored the prevalence, incidence and risk factors for incident hypertension among patients who were enrolled in a rural HIV cohort in Tanzania. A prospective longitudinal study including HIV patients enrolled in the Kilombero and Ulanga Antiretroviral Cohort was carried out between 2013 and 2015. Non-ART subjects at baseline and pregnant women during follow-up were excluded from the analysis. Incident hypertension was defined as systolic blood pressure \u2265 140 mmHg and/or diastolic blood pressure \u2265 90 mmHg on two consecutive visits. Cox proportional hazards models were used to assess the association of baseline characteristics and incident hypertension. Among 955 ART-na\u00efve, eligible subjects, 111 (11.6%) were hypertensive at recruitment. Ten women were excluded due to pregnancy. Of the remaining individuals,  9.6% developed hypertension during a median follow-up of 144 days from time of enrolment into the cohort. ART was started in 75.5% of patients, with a median follow-up on ART of 7 months. Cox regression models identified age,  body mass index and estimated glomerular filtration rate  as independent risk factors for hypertension development.  Traditional cardiovascular risk factors predicted incident hypertension, but no association was observed with immunological or ART status. These data support the implementation of routine hypertension screening and integrated management into HIV programmes in rural sub-Saharan Africa.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Interview: How do you quantify malaria\u2019s economic damage?","field_subtitle":"China Global Television Network (CGTN) Africa, April 2017","URL":"http://www.youtube.com/watch?v=Q587OVigbr0&feature=youtu.be","body":"Despite decades of interventions, malaria is still one of the biggest killer diseases in Africa continent. In 2015 alone, an estimated 429 000 people died of malaria according to the World Health Organisation, 90% of them in Africa. Beyond the lives lost, how much economic damage does malaria really do to sub-Saharan economies? That\u2019s a question CGTN's Ramah Nyang explored in conversation with the CEO of the African Medical & Research Foundation.The drug RTSS prevents more than forty strains of malaria in toddlers. It is being rolled out to more than 300 000 children in Kenya, Ghana and Malawi in trials and more vaccines are being tested. It is unlikely that one vaccines will eradicate all malaria, but testing vaccines can significantly reduce the impact of malaria. Malaria was eradicated in Europe and America in the 1930s and many are asking why this cannot be done again in Africa. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"MPhil in Public Mental Health: Call for Applications","field_subtitle":"Deadline for Applications 1 September 2017","URL":"http://www.cpmh.org.za/teaching/mphil-public-mental-health/","body":"The Alan J. Flisher Centre for Public Mental Health (CPMH), a joint initiative of the Psychology Department at Stellenbosch University and the Department of Psychiatry and Mental Health at the University of Cape Town, is an independent inter-disciplinary academic research and teaching centre for public mental health promotion and service development in Africa.  The CPMH is proud to invite applications from across the African continent for the MPhil in Public Mental Health in 2018. A key gap in current mental health professional training in South Africa and elsewhere in Africa is an orientation to public mental health. This means an orientation to the mental health needs of populations, and the policies, laws and services that are required to meet those needs. The training offered by the Centre provides clinicians, health service managers, policy makers and NGO workers with crucial skills to enable them to plan and evaluate the services that they deliver and manage; lobby effectively for mental health; take on leadership roles in the strengthening of mental health systems; and conduct research in various aspects of public mental health in Africa. The MPhil in Public Mental Health is a part-time research degree that aims to develop advanced research skills, enabling participants to undertake their own research projects (such as evaluating services, policies and interventions) as well as interpret research findings for mental health policy and practice.  The programme is designed to be accessible to practitioners who work full-time, and who are from a range of backgrounds: social work, psychology, psychiatry, medicine, occupational therapy, nursing, health economics, public mental health, public health, health service management, policy making and non-governmental organisations (NGOs).  The training aims to build the professional capacity and leadership of the participants in their work, while contributing to knowledge generation in Africa. The degree requires the completion of a 3-week residential training module in research methodology for public mental health in Cape Town and the preparation of a dissertation of a minimum of 20 000 words, in either monograph or publication ready format.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Palm Wine Collectors","field_subtitle":"Weeks K: Lens Culture, June 2017","URL":"http://www.lensculture.com/articles/kyle-weeks-palm-wine-collectors","body":"In Namibia, a generations-long tradition of tapping the sap of palm trees runs counter to recent environmental protection efforts. Is this an essential cultural practice or merely destructive? These striking portraits investigate. The images in this series portray the Himba men who select, prepare and maintain Makalani palms during the sap tapping process. The Himba people from this area have utilised this plant family for generations, passing down the knowledge and technique needed to carry out the process of obtaining the liquid. Although the Makalani palm is a protected tree in Namibia and the tapping of palms a banned practice, the Himba firmly believe that it is their right to continue the tradition. They argue against Western law and instead follow ancient cultural traditions that respect these palms through their utilisation. In turn, they promote their conservation on a local, cultural level.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Participatory evaluation of delivery of animal health care services by community animal health workers in Karamoja region of Uganda","field_subtitle":"Bugeza J; Kankya C; Muleme J; Akandinda A; Sserugga J; Nantima N; Okori E; Odoch T: PLOS One, doi: https://doi.org/10.1371/journal.pone.0179110, 2017","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0179110","body":"An evaluation exercise was carried out to assess the performance of Community Animal Health Workers (CAHWs) in the delivery of animal health care services in Karamoja region, identify capacity gaps and recommend remedial measures. Participatory methods were used to design data collection tools. Questionnaires were administered to 204 CAHWs, 215 farmers and 7 District Veterinary Officers (DVOs) to collect quantitative data. Seven DVOs and 1 Non Government Organisation (NGO) representative were interviewed as key informants and one focus group discussion was conducted with a farmer group in Nakapiripirit to collect qualitative data. Key messages from interviews and the focus group discussion were recorded in a notebook and reported verbatim. 70% of the farmers revealed that CAHWs are the most readily available animal health care service providers in their respective villages. CAHWs were instrumental in treatment of sick animals, disease surveillance, control of external parasites, animal production, vaccination, reporting, animal identification, and performing minor surgeries. Regarding their overall performance 88.8% of the farmers said they were impressed. The main challenges faced by the CAHWs were inadequate facilitation, lack of tools and equipment, unwillingness of government to integrate them into the formal extension system, poor information flow, limited technical capacity to diagnose diseases, unwillingness of farmers to pay for services and sustainability issues. CAHWs remain the main source of animal health care services in Karamoja region and their services are largely satisfactory. The technical deficits identified are argued to require continuous capacity building programs, close supervision and technical backstopping and strategic deployment of paraprofessionals that are formally recognised by the traditional civil service.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The Contributions of Human Rights to Universal Health Coverage","field_subtitle":"Chapman A: Health and Human Rights 18(2) December 2016 ","URL":"https://tinyurl.com/ldpu9bz","body":"Recently, there has been a growing push for countries to achieve universal health coverage (UHC) in order to strengthen health systems and improve health equity and access to health services. Importantly, not all potential paths to a universal health system are consistent with human rights requirements. Simply expanding health coverage, especially if it continues to exclude poor and vulnerable communities, is not sufficient from a human rights perspective. The author in this paper presents the requirements that a human rights approach to UHC imposes. These include locating UHC within the context of a national effort to provide equitable access to the social determinants of health; making access to essential health services and public health protections a legal entitlement, with redress for failures to provide these benefits; paying explicit attention to equity in the design of the universal health system, including in health financing.  There should be opportunities for consultation with and the participation of the population in the design of the path to UHC and the determination of benefits packages. The process for pursuing the progressive realisation of UHC should first expand coverage for high-priority services to everyone, with special efforts to ensure that disadvantaged groups are reached. The author notes that the goal of achieving UHC can generally be realised only in stages, through a long process of gradual realisation, given limitations in resource availability and administrative capacity, and that this imposes difficult trade-offs along the way. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The political argument for investing in global health","field_subtitle":"Martin K; Mullan Z; Horton R: The Lancet Global Health 5(Special Issue) S1-S2, 2017","URL":"https://tinyurl.com/ktere2l","body":"The authors argue that an insular, authoritarian wave has been on the rise that is playing on people's fears and insecurities, undermining democratic institutions that are vital to maintaining the ties of accountability between the elected and the public: and multilateral infrastructures. Global health is argued to rely on an outward-looking, internationalist stance, since the threats that are faced know no borders. So how can global health advance in an era of retreat? Politics drive policies and the public drives the political. All sectors must thus, it is argued, be politically active in order to affect the development and implementation of public policies, including academia and the knowledge it brings. To successfully advance financial and political capital investments in global health, arguments must be framed by how they improve the security and prosperity of citizens and the nation. Investing in global health and multinational actions is a path to address these threats that know no borders. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The social accountability of doctors: a relationship based framework for understanding emergent community concepts of caring","field_subtitle":"Green-Thompson L; McInerney P; Woollard B: Biological Medical Centre Health Services Research 17(269),  doi: 10.1186/s12913-017-2239-7, 2017","URL":"https://tinyurl.com/map4l76","body":"Social accountability is defined as the responsibility of institutions to respond to the health priorities of a community. There is an international movement towards the education of health professionals who are accountable to communities. There is little evidence of how communities experience or articulate this accountability. In this grounded theory study eight community based focus group discussions were conducted in rural and urban South Africa to explore community members\u2019 perceptions of the social accountability of doctors. The discussions were conducted across one urban and two rural provinces. Group discussions were recorded and transcribed verbatim. Initial coding was done and three main themes emerged following data analysis: the consultation as a place of respect (participants have an expectation of care yet are often engaged with disregard); relationships of people and systems (participants reflect on their health priorities and the links with the social determinants of health) and Ubuntu as engagement of the community (reflected in their expectation of Ubuntu based relationships as well as part of the education system). These themes were related through a framework which integrates three levels of relationship: a central community of reciprocal relationships with the doctor-patient relationship as core, a level in which the systems of health and education interact and together with social determinants of health mediate the insertion of communities into a broader discourse. The paper outlines an ubuntu framing in which the tensions between vulnerability and power interact and reflect rights and responsibility as important for social accountability. Communities are argued to bring a richer dimension to social accountability through their understanding of being human and caring.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Three African countries chosen to test first malaria vaccine","field_subtitle":"Prinsloo K: Associated Press, 24 April 2017","URL":"https://www.statnews.com/2017/04/24/african-countries-malaria-vaccine/","body":"Three African countries have been chosen to test the world\u2019s first malaria vaccine, the World Health Organisation announced in April 2017. Ghana, Kenya, and Malawi will begin piloting the injectable vaccine next year with hundreds of thousands of young children, who have been at highest risk of death. The vaccine, which has partial effectiveness, has the potential to save tens of thousands of lives if used with existing measures, the WHO regional director for Africa, Dr. Matshidiso Moeti, said in a statement. The challenge is whether impoverished countries can deliver the required four doses of the vaccine for each child. Malaria remains one of the world\u2019s most stubborn health challenges, infecting more than 200 million people every year and killing about half a million, most of them children in Africa. Bed netting and insecticides are the chief protection. A global effort to counter malaria has led to a 62 percent cut in deaths between 2000 and 2015, WHO said. But the U.N. agency has said in the past that such estimates are based mostly on modelling and that data is so bad for 31 countries in Africa \u2014 including those believed to have the worst outbreaks \u2014 that it couldn\u2019t tell if cases have been rising or falling in the last 15 years. The vaccine will be tested on children five to 17 months old to see whether its protective effects shown so far in clinical trials can hold up under real-life conditions. At least 120,000 children in each of the three countries will receive the vaccine, which has taken decades of work and hundreds of millions of dollars to develop. Kenya, Ghana and Malawi were chosen for the vaccine pilot because all have strong prevention and vaccination programs but continue to have high numbers of malaria cases, WHO said. The countries will deliver the vaccine through their existing vaccination programs. WHO is hoping to wipe out malaria by 2040 despite increasing resistance problems to both drugs and insecticides used to kill mosquitoes. The malaria vaccine has been developed by pharmaceutical company GlaxoSmithKline, and the $49 million for the first phase of the pilot is being funded by the global vaccine alliance GAVI, UNITAID and Global Fund to Fight AIDS, Tuberculosis and Malaria.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Time for a global response to labour rights violations in the manufacture of health-care goods","field_subtitle":"Bhutta M: Bulletin of the World Health Organisation 95(5) 314-314A, 2017 ","URL":"http://www.who.int/bulletin/volumes/95/5/17-193417/en/","body":"This document discusses guidance on ethical procurement for health and for protecting labour rights in medical supply chains. It is an update to an earlier document in response to evidence of abuse of worker rights at several factories manufacturing health-care products destined for global markets. Poor labour conditions should concern all those in health care. Work is inextricably correlated to physical and mental well-being: unsafe working conditions risk bodily injury; inadequate remuneration links to malnutrition, poor housing and lack of opportunity. Long or irregular working hours and a lack of respect at work contribute to stress, anxiety and depression. Working conditions found in the manufacture of some health-care products have been among the worse encountered anywhere. The document reports on the measures taken by other countries and that comply with the International Labour Organisation Declaration on fundamental principles and rights at work, as well as with local employment and health and safety legislation. For example for high-risk products, suppliers are contractually required to allow independent audit of manufacturing sites to identify problems and to oblige remedial action, a measure that  has led to demonstrable improvements in working conditions for the people making products for the health-care system. The paper also notes that there are still limited measures for protection of health and safety in the growing global market for health-care products, estimated to soon be worth over US$ 500 billion annually.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Tobacco use among people living with HIV: analysis of data from Demographic and Health Surveys from 28 low-income and middle-income countries","field_subtitle":"Mdege N; Shah S; Ayo-Yusuf O; Hakim J; Siddiqi K: The Lancet Global Health 5(6), e578-e592, 2017","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30170-5/fulltext","body":"Tobacco use among people living with HIV results in excess morbidity and mortality. However, very little is known about the extent of tobacco use among people living with HIV in low-income and middle-income countries (LMICs). The authors assessed the prevalence of tobacco use among people living with HIV in LMICs. The authors used Demographic and Health Survey data collected between 2003 and 2014 from 28 LMICs where both tobacco use and HIV test data were made publicly available. They estimated the country-specific, regional, and overall prevalence of current tobacco use (smoked, smokeless, and any tobacco use) among 6729 HIV-positive men from 27 LMICs (aged 15\u201359 years) and 11\u2008495 HIV-positive women from 28 LMICs (aged 15\u201349 years), and compared them with those in 193\u2008763 HIV-negative men and 222\u2008808 HIV-negative women, respectively. The authors estimated prevalence separately for males and females as a proportion, and the analysis accounted for sampling weights, clustering, and stratification in the sampling design. They computed pooled regional and overall prevalence estimates through meta-analysis with the application of a random-effects model. They computed country, regional, and overall relative prevalence ratios for tobacco smoking, smokeless tobacco use, and any tobacco use separately for males and females to study differences in prevalence rates between HIV-positive and HIV-negative individuals. The overall prevalence among HIV-positive men was 24\u00b74% for tobacco smoking, 3\u00b74% for smokeless tobacco use, and 27\u00b71% for any tobacco use. The authors found a higher prevalence in HIV-positive men of any tobacco use (risk ratio [RR] 1\u00b741 and tobacco smoking than in HIV-negative men (both p","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Trends in obesity and diabetes across Africa from 1980 to 2014: an analysis of pooled population-based studies","field_subtitle":"NCD Risk Factor Collaboration (NCD-RisC) \u2013 Africa Working Group: International Journal of Epidemiology dyx078, doi: https://doi.org/10.1093/ije/dyx078, June 2017","URL":"http://tinyurl.com/ycwsnv3u","body":"The 2016 Dar Es Salaam Call to Action on Diabetes and Other non-communicable diseases (NCDs) advocates national multi-sectoral NCD strategies and action plans based on available data and information from countries of sub-Saharan Africa and beyond. The authors estimated trends from 1980 to 2014 in age-standardised mean body mass index (BMI) and diabetes prevalence in these countries, in order to assess the co-progression and assist policy formulation. They pooled data from African and worldwide population-based studies which measured height, weight and biomarkers to assess diabetes status in adults aged\u2009\u2265\u200918 years. African data came from 245 population-based surveys (1.2 million participants) for BMI and 76 surveys (182\u2009000 participants) for diabetes prevalence estimates. The age-standardised mean BMI increased from 21.0\u2009kg/m2 to 23.0\u2009kg/m2 in men, and from 21.9\u2009kg/m2 to 24.9\u2009kg/m2 in women. The age-standardised prevalence of diabetes increased from 3.4% to 8.5% in men, and from 4.1% to 8.9% in women. Estimates in northern and southern regions were mostly higher than the global average; those in central, eastern and western regions were lower than global averages. A positive association was observed between mean BMI and diabetes prevalence in both sexes in 1980 and 2014. These estimates, based on limited data sources, confirm the rapidly increasing burden of diabetes in Africa. This rise is being driven, at least in part, by increasing adiposity, with regional variations in observed trends. African countries\u2019 efforts to prevent and control diabetes and obesity should integrate the setting up of reliable monitoring systems, consistent with the World Health Organisation\u2019s Global Monitoring System Framework.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Watch The Movements Of Every Refugee On Earth Since The Year 2000","field_subtitle":"Peters A: Fast Company, 31 May 2017","URL":"http://tinyurl.com/y8vshbp7","body":"In 2016, more refugees arrived in Uganda\u2013including nearly half a million people from South Sudan alone\u2013than crossed the Mediterranean Sea to Europe. While the numbers in Africa are increasing, the situation isn\u2019t new: As the world continues to focus on the European refugee crisis, an equally large crisis has been unfolding in Africa. A new visualization shows the flow of refugees around the world from 2000 to 2015, and makes the lesser-known story in Africa\u2013and in places like Sri Lanka in 2006 or Colombia in 2007\u2013as obvious as what has been happening more recently in Syria. Each yellow dot represents 17 refugees leaving a country, and each red dot represents refugees arriving somewhere else.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Women who live on the margin of society: A dialogue with Tshepo Jamillah Moyo","field_subtitle":"Mogami G: Africa In Dialogue, 7 June 2017","URL":"http://tinyurl.com/ydcahs3c","body":"Born 1994, Tshepo Jamillah Moyo (TJ) is an unapologetic black Pan African Inter-sectional Feminist performance artist. Her work centres on the exploration of black African womanhood. In this conversation, she discusses her provocation at a recent march in Botswana on the 3rd of June where human rights and gender activists, and fellow women marched in the RIGHT TO WEAR WHAT I WANT walk, which aimed to highlight that no one has the right to violate another human being based on what they are wearing. Moyo argues that there is a need for an intersectional feminism that thinks about every single woman, and all the intersections of her life  where oppression derives from. ","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"\u201cGuilty until proven innocent\u201d: the contested use of maternal mortality indicators in global health","field_subtitle":"Storeng K; B\u00e9hague D: Critical Public Health 27(2), doi: http://dx.doi.org/10.1080/09581596.2016.1259459 , 2016","URL":"http://www.tandfonline.com/doi/full/10.1080/09581596.2016.1259459","body":"The maternal mortality ratio (MMR) has risen from obscurity to become a major global health indicator, even appearing as an indicator of progress towards the global Sustainable Development Goals. This has happened despite intractable challenges relating to the measurement of maternal mortality. Even after three decades of measurement innovation, maternal mortality data are widely presumed to be of poor quality, or, as one leading measurement expert has put it, \u2018guilty until proven innocent\u2019. This paper explores how and why leading epidemiologists, demographers and statisticians have devoted the better part of the last three decades to producing ever more sophisticated and expensive surveys and mathematical models of globally comparable MMR estimates. The development of better metrics is publicly justified by the need to know which interventions save lives and at what cost. The authors show, however, that measurement experts\u2019 work has also been driven by the need to secure political priority for safe motherhood and by donors\u2019 need to justify and monitor the results of investment flows. They explore the many effects and consequences of this measurement work, including the eclipsing of attention to strengthening much-needed national health information systems. the authors analyse this measurement work in relation to broader political and economic changes affecting the global health field, not least the incursion of neoliberal, business-oriented funders who have introduced new forms of administrative oversight and accountability that depend on indicators.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"\u201cIf my husband leaves me, I will go home and suffer, so better cling to him and hide this thing\u201d: The influence of gender on Option B+ prevention of mother-to-child transmission participation in Malawi and Uganda","field_subtitle":"Flax V; Yourkavitch J; Okello E; Kadzandira J; Katahoire A; Munthali A: PLOS One, doi: https://doi.org/10.1371/journal.pone.0178298, 2016","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178298","body":"The role of gender in prevention of mother-to-child transmission (PMTCT) participation under Option B+ has not been adequately studied, but it is critical for reducing losses to follow-up. This study used qualitative methods to examine the interplay of gender and individual, interpersonal, health system, and community factors that contribute to PMTCT participation in Malawi and Uganda. The authors conducted in-depth interviews with women in PMTCT, women lost to follow-up, government health workers, and stakeholders at organisations supporting PMTCT as well as focus group discussions with men. They analysed the data using thematic content analysis. The authors found many similarities in key themes across respondent groups and between the two countries. The main facilitators of PMTCT participation were knowledge of the health benefits of ART, social support, and self-efficacy. The main barriers were fear of HIV disclosure and stigma and lack of social support, male involvement, self-efficacy, and agency. Under Option B+, women learn about their HIV status and start lifelong ART on the same day, before they have a chance to talk to their husbands or families. Respondents explained that very few husbands accompanied their wives to the clinic, because they felt it was a female space and were worried that others would think their wives were controlling them. Many respondents said women fear disclosing, because they fear HIV stigma as well as the risk of divorce and loss of economic support. If women do not disclose, it is difficult for them to participate in PMTCT in secret. If they do disclose, they must abide by their husbands\u2019 decisions about their PMTCT participation, and some husbands are unsupportive or actively discouraging. To improve PMTCT participation, the authors propose that Ministries of Health use evidence-based strategies to address HIV stigma, challenges related to disclosure, insufficient social support and male involvement, and underlying gender inequality.","php":"","field_issue_date":"2017-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Abstract Submission Open For The 13th International AIDSimpact Conference","field_subtitle":"Deadlines for abstracts:10 July 2017","URL":"http://www.aidsimpact.com/?utm_source=MG&utm_medium=Email&utm_campaign=MarchMailOut","body":"Stellenbosch University and the Human Sciences Research Council will jointly host the 13th AIDSImpact Conference at the Century City Conference Centre, Cape Town South Africa. Each AIDSImpact meeting attracts delegates new to the field as well as a core group of loyal psychosocial and behavioral researchers, prevention workers, community members and policy makers from universities and institutes across all five continents who use the biannual meeting to present their studies, interventions and prevention schemes. AIDSImpact has evolved as one of the leading platforms for understanding, updating and debating the behavioral, psychosocial and community facets of HIV in light of changing social conditions and medical advances. A review of past AIDSImpact scientific programs reveals the evolution of the psychosocial and behavioral response to the HIV epidemic over the past 25 years. The 2017 Cape Town conference will promote pioneering work on understanding the dynamics of a changing epidemic. A key focus will be consideration of new choices for HIV - for prevention, treatment, care and strategic planning.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African app cuts medical costs with community \"virtual pharmacy\" ","field_subtitle":"Reuters: Times Live, February 2017","URL":"https://tinyurl.com/ky7jjwd","body":"A mobile app in Senegal helps families save money and reduce waste through a \"virtual pharmacy\" where users can exchange leftover medication for new prescriptions. JokkoSante is scaling up after a two-year pilot phase in one Senegalese town. It aims to reach 300,000 families in the West African nation by the end of the year. The app allows users to trade in unused, packaged medicine for points which can go toward the purchase of new medicine when they need it. All of the exchanges are done at health centres or pharmacies by licensed professionals. Users can send points to family members and friends, and donors can buy points for people in need. The project has been driven by telecoms companies. It reaches a certain demographic, such as women in their thirties, and if a matching user doesn't have enough points to pay for a prescription she will receive a text saying which company donated to complete her purchase.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Call for Proposals: Support to Doctoral schools, Re-building scholarly infrastructures and academic communities in the Social Sciences and Humanities in African Universities","field_subtitle":"Deadline for applications: 15 June 2017","URL":"http://codesria.org/spip.php?article2726&lang=en","body":"With funding support from the Andrew W. Mellon Foundation, the Council for the Development of Social Science Research in Africa, CODESRIA, announces a call for proposals for a new intervention targeting support to doctoral schools and rebuilding scholarly communities in the social sciences and humanities in African universities. The overall goal is to engender a generation of academics and knowledge that can enable the people of the continent critically (re) imagine and (re) create better, freer, more sustainable, and more inclusive communities and worlds. Proposals to be supported under this call are those submitted by individual/ groups of graduate/doctoral schools, SSH faculties, including research and teaching units dealing with higher education studies. Proposals should focus on issues to do with curricular reform, doctoral student supervision practices and mentoring of faculty in graduate supervision; interventions to rebuild/recreate scholarly infrastructures and academic communities through holding faculty seminars, strengthening faculty journals and conferences, systems to recreate strong workshop and seminar cultures; support for scholarly writing and academic publishing workshops especially targeting doctoral students and early career academics.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call For Speakers And Papers: Radical Transformations In Africa Today, Interventions From The Left","field_subtitle":"Deadlines for abstracts: Accra meeting \u2013 June 2017, Dar es Salaam \u2013 November 2017, Johannesburg \u2013 January 2018.","URL":"https://tinyurl.com/mwr4rkb","body":"This is an opportunity for activists and scholars to contribute to a series of three linked workshops in Africa. Each two-day meeting will debate current challenges and prospects for Left analysis and action. The organisers are seeking both key speakers and offers of papers, with a plan to publish a selection in the Review of African Political Economy. The workshops are scheduled in November 2017 in Accra, Ghana; April 2018 in Dar es Salaam, Tanzania; June 2018 in Johannesburg, South Africa; September 2018 at the African Studies Association in the UK. These workshops will link analysis and activism in contemporary Africa from the perspective of radical political economy, and will be organised around three linked themes: Africa in a \u2018post-crisis\u2019 world, economic strategy, industrialisation and the agrarian question and resistance and social movements in Africa.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Campaigning for a fact-based approach to health journalism","field_subtitle":"Fleck F: Bulletin of the World Health Organisation 95(4)248\u2013249, 2017","URL":"http://www.who.int/bulletin/volumes/95/4/17-030417/en/","body":"This article reports on the work of HealthNewsReview.org to monitor the quality of health and medical news coverage. To combat inaccuracies, HealthNewsReview requires three reviewers to assess each article, applying 10 criteria. These include whether the journalists have adequately considered the cost of the intervention, its potential harms and benefits, whether they had compared new ideas with existing alternatives, and whether they solely relied on a press release or used independent sources. Projecting forward, the author observes that there should be room for promoting health literacy, for example, explaining that people should focus on absolute not relative risk reduction. People should not be amazed by claims that a drug reduced the risk of a problem by 50% (relative risk reduction) when that may mean that the absolute risk reduction was only from 2 in 100 in the untreated group to 1 in 100 in the treated group \u2013 a 1% absolute risk reduction. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Community health worker perspectives on a new primary health care initiative in the Eastern Cape of South Africa","field_subtitle":"Austin-Evelyn K; Rabkin M; Macheka T: PLoS ONE 12(3) 2017, doi: https://doi.org/10.1371/journal.pone.0173863","URL":"https://tinyurl.com/ll4ww4t","body":"In 2010, South Africa\u2019s National Department of Health launched a national primary health care initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care, aims to provide a preventive and health-promoting community-based Primary Health Care model. A key component is the use of community-based outreach teams staffed by generalist community health workers. The authors conducted focus group discussions and surveys on the knowledge and attitudes of 91 Community Health Care Workers working on community-based teams in Eastern Cape Province. The community health workers who were studied enjoyed their work and found it meaningful, as they saw themselves as agents of change. They also perceived weaknesses in the implementation of outreach team oversight, and desired field-based training and more supervision in the community. The authors propose providing community health workers with basic resources like equipment, supplies and transport to improve their acceptability and credibility to the communities they serve.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Corporate taxation key to protecting human rights in the global economy","field_subtitle":"Centre for Economic and Social Rights: CESR, USA, 2017","URL":"http://www.cesr.org/corporate-taxation-key-protecting-human-rights-global-economy","body":"In February 2017, the Committee on Economic, Social and Cultural Rights \u2013 a UN human rights body \u2013 held a discussion of its draft General Comment on State obligations in the context of business activities. This General Comment \u2013 as an authoritative interpretation of States\u2019 duties under the International Covenant on Economic, Social and Cultural Rights (ICESCR) \u2013 will fill an important gap in applying human rights law to situations of business-related abuses of these rights occurring within States\u2019 territory as well as overseas. Corporate taxation remains an under-explored yet critical piece of the business and human rights puzzle, as confirmed by various participants in the discussion. Alongside the more direct ways businesses can adversely impact human rights (such as labor abuses, water pollution, etc.), the amount of tax corporations pay, and where they pay them, has profound human rights implications. As detailed in a factsheet co-authored by CESR, tax dodging by multinational copper firms in Zambia are estimated to amount to as much as $326 million annually, equivalent for example to about 60 percent of the country\u2019s health budget. This raises governments\u2019 responsibilities as State parties to international human rights treaties such as the ICESCR, and the phenomenon of tax avoidance and evasion. The ICESR General Comment early draft states that raising revenue through corporate taxation is an important part of the State\u2019s duty to fulfil ESCR in its territory as the realisation of ESCR is dependent upon public resources that can, for example, pay for hospitals, schools and water systems. These resources will be raised from a variety of sources (including aid in some countries), but in all contexts progressive taxation is a lynchpin of public revenue raising. The report argues that those who can most afford to pay (including profitable multinational corporations and their executives and shareholders) must pay their fair share, and loopholes which allow them to escape tax should be closed.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Country-specific data on the contraceptive needs of adolescents","field_subtitle":"Hindin M; Kalamar A: Bulletin of the World Health Organisation 95(166) 2017","URL":"http://www.who.int/bulletin/volumes/95/3/16-189829/en/","body":"As the sustainable development goals (SDGs) require country-level tracking of indicators related to contraception, including met need, a key question is \u201cWhat can be done to support adolescents to prevent unintended pregnancy? To answer this question, the authors developed country-specific fact sheets describing adolescent contraceptive use and non-use in 58 low- and middle-income countries spanning all six World Health Organisation Regions. The authors report the top three reasons adolescent girls give for why they are not currently using contraception, even though they do not want to become pregnant in the next two years. The data are based on responses from 15\u201319 year old adolescent girls, and are presented separately for those unmarried and sexually active and those in a union. Reasons for non-use vary considerably but among the most common reported are, being \u201cnot married\u201d and infrequent sexual relations for unmarried, sexually active adolescents. In contrast, currently breastfeeding or postpartum abstinence are among the most common reasons for non-use reported by adolescents in a union. Fear of side-effects or health concerns was commonly reported by both groups of adolescent girls.The authors report on the two most common sources from which adolescents who are currently using a modern method most recently obtained that contraceptive method. The sources are driven by the types of contraceptive methods available, as well as those that are easy for adolescents to access. In some settings most sources are in the formal sector, including government facilities, private facilities and pharmacies. In other settings most adolescents obtain contraceptive commodities in the informal sector, such as shops, kiosks or roadside stands, or from friends. The data from the fact sheets indicate where best to target investments to improve access to \u2013 and quality of \u2013 contraceptive services for adolescents. The data provided in these fact sheets are disaggregated by age and marital status to address the calls for ensuring that no one is left behind. These data can help policy-makers and programme planners reduce inequities in service provision and access, and to make evidence-based decisions about how to better address adolescents\u2019 contraceptive needs.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Deepening understanding about the politics of health policy change in low and middle income countries: A PhD mentoring programme for low and middle income (LMIC) students registered in LMIC universities","field_subtitle":"Deadline for applications: 30 June 2017","body":"Health Policy Analysis (HPA), seeks to understand and explain the policy process. The Alliance for Health Policy and Systems Research is supporting a fellowship programme in HPA for 2017-18, for PhD students, or those registered for an equivalent degree, based in LMICs who seek to research the politics of health policy change \u2013 focussed, for example, on agenda setting, an aspect of policy formulation, an experience of policy implementation, the politics of policy evaluation/learning, or another, relevant, area. The PhD ideas must also be nested in relevant policy, political science, public administration and/or organisational theory. Proposed applicants must be a national of an LMIC already registered or be currently finalising registration for a PhD, or equivalent, in an LMIC university, and at a stage where they have NOT yet finalised their study protocol or started data collection. Those selected as HPA fellows under this programme will be supported to conduct their PhD research and will be required to attend 2 week-long thesis workshops during this time \u2013 broadly, to support the finalisation of their protocol (year 1) and a related paper (year 2). HPA fellows will receive distance learning support between workshops and  receive bursary support for their PhD research, linked to the preparation and completion of workshop-related outputs. Applicants must submit the following: a full and complete CV, with copies of all post-graduate university level academic certificates; a 1-2 page motivational statement for your application, indicating how this programme will fit with their existing PhD plans and timelines; a 4-5 page note outlining the work which they hope/plan to do, the theoretical base and methodology and justifying its significance in terms of current HPA work in LMICs; a letter of support from their supervisor (on their university letterhead), and a brief CV of their supervisor; evidence of registration (completed or in progress) for a PhD or equivalent, at an LMIC university, including the disciplinary area of study, year of entry, expected graduation data and current phase of studies; and the name and contact details of 3 referees, with clarification of their relationship to each; of whom at least 2 should have supervised the applicant an academic capacity. Preference will be given to women candidates, those under 40 years of age and to candidates from low income countries (LICs). ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Docubox","field_subtitle":"East African Documentary Film Fund, Kenya, 2017","URL":"http://mydocubox.org/about-us/","body":"Docubox was launched in 2012 as a documentary film fund that \u201csupports intimate, character-driven storytelling and encourages new forms of ownership and authorship in East Africa because we believe that true stories well told make the world a better place to live\u201d. Docubox exists to enable talented, driven, focused and accountable East African artists to produce unique films that unearth new realities and cross trans-national boundaries. Through training, development and production grants, screenings for people who love documentary films, it promotes East African filmmakers to share their stories with the world through creative documentary. Docubox believe good documentaries are intimate observations of the world\u2019s identities and people captured by talented, driven, creative filmmakers \u2013films able to uncover new realities because they are authored by authentic local voices, films that offer viewers new perspectives of society. Docubox want to create an authentic body of work that provides personalised glimpses into world, issues and lives that would ordinarily remain undocumented. They want to create a movement that will challenge ideas and assumptions about the world as it is known and provoke healthy, democratic dialogue and debate between our fellow citizens. Docubox believe that to change and inspire society, there is a need to support films that can spark off debate, films that get talked about, films that contribute to the formation of a vibrant documentary film movement across eastern Africa. Docubox want to do this because they believe that stories well told can make the world a better place to live.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"East Central and Southern Africa (ECSA) Health Community Strategic Plan 2017-2022","field_subtitle":"ECSA Health community: Arusha, 2017","URL":"https://tinyurl.com/lfk8q5w","body":"This presentation of the ECSA strategic plan provides a situation analysis of the trends in health affecting the region, and health services trends, including a continued inadequacy of human resources for health and high level of out-of-pocket expenditure on health, above 30% of total health expenditure in most countries in the region. The strategic plan seeks to contribute to the health status in the ECSA region by providing leadership towards attainment of the Sustainable Development Goals (SDGs). The plan covers six strategic areas. It includes measures to support and promote efforts to build human resources for health and human capacity development; to strengthen health systems towards Universal Health Coverage and to assist countries to develop capacity to implement reproductive and maternal and child health strategies. It seeks to reduce communicable and non-communicable diseases, chronic conditions, injuries and all forms of malnutrition, and to promote the generation, management and utilisation of knowledge to inform decision making and programming in health. A final objective for the ECSA health community in the plan is to set a regional health policy agenda and foster strategic partnerships and collaboration towards achieving of international commitments, including of the SDGs. Several enabling factors are identified, including continued support from the member states as shown through ownership of ECSA resolutions and activities and the remittance of subscriptions; and a diversified funding base through securing new funders and income generation activities such as training. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Engaging with complexity to improve the health of indigenous people: a call for the use of systems thinking to tackle health inequity","field_subtitle":"Hern\u00e1ndez A; Ruano A; Marchal B; San Sebasti\u00e1n M; Flores W: International Journal for Equity in Health 16(26) 2017, doi: 10.1186/s12939-017-0521-2","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-017-0521-2","body":"Indigenous people remain on the margins of society in high, middle and low-income countries, and bear a disproportionate burden of poverty, disease, and mortality compared to the general population. These inequalities have persisted, and in some countries have even worsened, despite the overall improvements in health indicators. The social determinants of health framework has enriched the understanding of the complex conditions that give rise to inequalities in indigenous health, including the structural and socio-political factors, and the intersecting conditions of poverty, social and political exclusion, discrimination and land loss that shape indigenous people\u2019s health. The authors report in this paper the conditions of marginalisation that impact indigenous health from their work in Guatemala and argue for a citizen-led initiative for state accountability for the right to health in rural indigenous municipalities. The authors argue that the challenge of engaging with the conditions underlying inequalities and promoting transformational change means that equity-oriented research and practice in the field of indigenous health requires: engaging power, context-adapted strategies to improve service delivery, and mobilising networks of collective action.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET congratulates the first WHO Director General from Africa","field_subtitle":"EQUINET steering committee","body":"The World Health Organisation has its first ever director-general from Africa, after the election of Dr Tedros Adhanom Ghebreyesus, the former Ethiopian health minister, who will begin his term in July 2017.  In a speech to the World Health Assembly Dr Tedros Adhanom talked about growing up in Ethiopia, saying he comes from a background of \u201cknowing survival cannot be taken for granted, and refusing to accept that people should die because they are poor.\u201d He spoke about the need for universal access to health care, a better response to health emergencies and the need to tackle gender-based violence, as well as threats to global health like climate change. He wrote in his application \"\u201cI envision a world where everyone can lead healthy and productive lives, regardless of who they are or where they live.\u201d  We look forward to contributing to what this implies for health equity, globally and in our region.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 195: Improving emergency care in our region is vital for our rights and protection","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Global Health Diplomacy and regional health standards in the extractive sector, Session Report, 10 April 2017","field_subtitle":"ECSA Health Community; EQUINET: Arusha, Tanzania, 2017","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/GHD%20session%20report2017.pdf","body":"This 2017 session within the Regional ECSA HC Best Practices Forum was convened by ECSA HC and EQUINET in line with HMC Resolution \u2013 ECSAHMC50/R2 and with proposals from the 2016 Regional meeting on GHD. The objectives of the meeting were to a. To share information on progress in the ECSA HC GHD programme and issues for policy dialogue and follow up work b. To present and discuss evidence supporting and proposals for harmonised regional standards on health in the extractive sector c. To review and discuss positions on selected agenda items in the 2017 World Health Assembly (WHA) agenda The meeting recommendations were further summarised and reviewed in the Best Practices Forum and then in the Directors Joint Consultative conference, where the outcome of what was formally recommended is separately reported by ECSA HC. Delegates were provided with specific background materials through distributed publications. The report is organised by theme, with the presentation and group discussions on each area shown together.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Governing multisectoral action for health in low- and middle-income countries","field_subtitle":"Rasanathan K; Bennett S; Atkins V; et al: : PloS Medicine 14(4) e1002285, 2017","URL":"https://tinyurl.com/mjahcql","body":"The health sectors of most countries focus almost exclusively on health care services. The potential of multi-sectoral collaboration thus remains untapped in many low- and middle-income countries. Different sectors have different contributions to make towards solving specific health problems. The authors argue that in each case, the profile, interests, incentives, and relationships of key individuals and sectors must be mapped and analysed to inform the design of approaches and systems to tackle a shared problem. The authors argue that collaborative and distributed leadership is key for effective governance of multi-sectoral action, with a need to build leadership capacity across sectors and levels of government and cultivate champions in different sectors who can agree on common objectives. They present options for countries to take a multi-sectoral approach for health, including ensuring that the universal health coverage agenda addresses the capacity of the health sector to work with other sectors, learning from multi-sectoral efforts that do not involve the health sector, improving the capacity of global institutions to support countries in undertaking multi-sectoral action, and developing a clear implementation research agenda for multi-sectoral action for health.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health workforce metrics pre- and post-2015: a stimulus to public policy and planning","field_subtitle":"Pozo-Martin F, Nove A, Castro Lopes S, et al.: Human Resources for Health 15(11), 3, 2017","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0187-2","body":"In low- and middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services. The authors take a labour market approach to project the future health workforce demand using an economic model based on projected economic growth, demographics, and health coverage, and using health workforce data (1990\u20132013) for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker \u201cneeds\u201d as estimated by WHO to achieve essential health coverage. The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and ageing. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, which are estimated to be far below what will be needed to achieve adequate coverage of essential health services. In many low-income countries, demand may stay below projected supply, leading to the paradoxical phenomenon of unemployed (\u201csurplus\u201d) health workers in those countries facing acute \u201cneeds-based\u201d shortages. Opportunities exist to bend the trajectory of the number and types of health workers that are available to meet public health goals and the growing demand for health workers.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Impact of telemonitoring approaches on integrated HIV and TB diagnosis and treatment interventions in sub-Saharan Africa: a scoping review","field_subtitle":"Yah S;  Tambo E; Khayeka-Wandabwa C; Ngogang J: Health Promotion Perspectives 7(2) 60-65, 2017","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350551/pdf/hpp-7-60.pdf","body":"This paper explores telemonitoring/mhealth approaches as a promising real time and contextual strategy in HIV and TB interventions access and uptake, retention, adherence and coverage impact in endemic and prone-epidemic prevention and control in sub-Sahara Africa. A scoping review was applied to identify relevant articles on the theme. The authors found tele monitoring/mhealth approach as a more efficient and sustained proxy in HIV and TB risk reduction strategies for early diagnosis and prompt quality clinical outcomes. It was found to significantly contribute to decreasing health systems/patients cost, long waiting time in clinics, hospital visits, travels and time off/on from work. Improved integrated HIV and TB telemonitoring systems sustainability are thus argued to hold promise in health systems strengthening, including patient-centred early diagnosis and care delivery systems, uptake and retention to medications/services and improving patients\u2019 survival and quality of life. Tele monitoring/mhealth (electronic phone text/video/materials messaging) acceptability, access and uptake are reported to be crucial in monitoring and improving uptake, retention, adherence and coverage in both local and national integrated HIV and TB programs and interventions. Telemonitoring is also argued to be crucial in patient-providers-health professional partnership, real-time quality care and service delivery, antiretroviral and anti-tuberculous drugs improvement, susceptibility monitoring and prescription choice, reinforcing cost effective HIV and TB integrated therapy model and survival rate.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Improving emergency care in our region is vital for our rights and protection","field_subtitle":"I Rusike, E Sharara, C Chimhete, T Munouya, Community Working Group on Health, Zimbabwe ","body":"\r\nIn front of us in one of our rural districts is a road accident with injured passengers including children. They are distressed - the local public hospital has no ambulance and they are trying to find enough money to assure the private ambulance service that they will be able to pay the fee before they will send the ambulance. The fee is more than they can afford, but if they don\u2019t find someone to pay and get people to care quickly the injured people could have complications or suffer avoidable deaths. \r\n\r\nThis is not the only problem people who have emergencies face. Ambulances can take long to respond. Many ambulances too do not have basic equipment or adequately trained staff to take care of patients during transit, also complicating their recovery or risking fatalities in transit. Emergency departments are under resourced, without adequate equipment and staff to cope with the critically ill patients coming to them, including patients who have delayed seeking care until they have an acute emergency. In some countries in our region, a critical shortage of doctors and other skilled health workers has affected the quality of the response to emergencies. Yet in others, like South Africa and Uganda, ambulances are better equipped and staffed, and people arriving at emergency facilities find doctors and nurses on stand-by and ready to receive patients and give them prompt care. \r\n\r\nThis situation is compounded by conditions that increase the risk of traumatic injury. For example, the state of our roads in Zimbabwe\u2019s road network raises concern, especially when  they are further damaged by heavy rains and other climate disasters. Poor roads not only raise the risk of accidents, but also mean that ambulances cannot easily access patients in need. During the rainy season, rural roads become even more impassable, making access for emergency services even more difficult.  While communities assist with emergencies where they can, local transport operators sometimes take advantage of poor conditions to overcharge desperate patients in need of acute care, including pregnant women, carers of sick children and elderly people. In the absence of adequate investment in roads and services, poor people pay the price. Allocating funds to improve road systems will prevent accidents and also make it easier for ambulances to reach emergencies. Yet in 2017, of the US$15 million that the Harare City Council said it needed to improve the road network in Harare alone, it received only US1.2m from the Zimbabwe National Road Administration (Zinara). \r\n\r\nThe situation may be even worse when air rescue emergency services are needed, as a key component of an effective emergency care system. Yet air rescue emergency services are an even more scarce healthcare resource, and as in Zimbabwe, the only public service for this may be the Air Force.  There are private services for those able to afford the costs of private insurance or providers, but these are unaffordable for the majority, and thus only used by a minority of people.  \r\n\r\nIn the common discussions on universal health coverage and emergency responses, it is important that we at minimum ensure availability, accessibility and affordability of effective and good quality emergency medical services for everyone in the public. Good quality emergency medical services provide an immediate response to a variety of illnesses and injuries and the treatment and transportation of people in health situations that may be life threatening. They should provide universal quality care to all those who need it at the time they need it to save their lives, prevent suffering or disability. Although the current situation varies from country to country in the region, for many this is not yet delivered. \r\n\r\nThe situation contradicts the fact that in Zimbabwe, as for seven other countries of the region, according to EQUINET policy brief 27, the constitution guarantees citizens the right to health care, including emergency medical services. Section 76 (3) of Zimbabwe\u2019s Constitution states this as, \u201cNo person may be refused emergency medical treatment in any health care institution.\u201d  Of course no service would refuse care, but a situation of inadequate investment in affordable, accessible and good quality emergency services, including ambulances can be understood to be a form of denial, or refusal. The Zimbabwe Constitution makes this clear in stating that the state must take reasonable legislative and other measures, within the limits of the resources available to it, to achieve the progressive realization of this right. Whilst public emergency services offered by state-owned health institutions, the air force, the police and fire brigade are weak and poorly resourced, people\u2019s rights are violated and they are exposed to high payments for private services, or worse still disability or death.\r\n\r\nIt is evident that this is a core duty of the state and must be adequately funded. When public emergency care services are not adequately funded, staffed or provided, it leads to a growth of commercial and privatized services. While this is a private sector response to demand, and can help to minimize morbidity and mortality if of good quality and properly regulated and monitored, it is not appropriate to rely on the private sector for this service, and leads to inequities in access to care. The driving force of private provision is maximizing profits and not the needs of the most disadvantaged members of society. A trend towards privatization of emergency medical services thus has highest burdens for the poorest, adding to the stresses in often tough economic environments of accessing services and meeting medical bills.  A 2016 study by the Zimbabwe Coalition on Debt and Development on a public-private partnership in one major central hospital in Zimbabwe found that residents faced challenges in realizing their right to health care, due to the high cost of services, unfair treatment of those who cannot pay, \u2018\u2026deepening inequality between the haves and have-nots\u2019 and report of corruption in the demand by staff  for differing levels of cash payments. They attributed this violation of rights to health care to the \u2018private vendor profit motive\u2019 and diminished public control. \r\n\r\nBeyond improving public funding of emergency care services, we can also take advantage of technology advances. For example, health facilities have used mobile phones to alert ambulance services and to support those attending to patients whilst waiting for an ambulance or medical personnel, improving the possibility of  improved outcomes for patients. A \u2018Dial-a-Doc\u2019 initiative by one mobile operator in Zimbabwe works with enlisted services of medical practitioners at a call center to respond to phone-in requests for information and help from the public. A similar service is available in South Africa, Zambia and Malawi.\r\n\r\nAt the same time, we cannot keep relying on the health services to manage growing risks in the environments we live and work in. Death and disability from traumatic injuries from road traffic accidents on poor roads, from climate disasters and other accidents, and acute health crises in pregnancy, for children and others, and due to unsafe working conditions are largely preventable and should not be filling our health services. We need to have a commitment from all sectors that play a role to identify and reduce their role in traumatic injury and illness. \r\n\r\nAs economies improve they should show marked reductions in such trauma, but even under challenging economic conditions, adequate, affordable and accessible public emergency care services must be secured.\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org.  ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Individual and contextual factors associated with appropriate healthcare seeking behavior among febrile children in Tanzania","field_subtitle":"Adinan J; Damian D; Mosha N; Mboya I; Mamseri R; Msuya S: PLoS ONE 12(4) 2017, doi; https://doi.org/10.1371/journal.pone.0175446, ","URL":"https://tinyurl.com/mw9mk9t","body":"Fever in malaria endemic areas, has been shown to strongly predict malaria infection and is a key symptom influencing malaria treatment. WHO recommended confirmation testing for Plasmodium spp. before initiation of antimalarials due to increased evidence of the decrease of morbidity and mortality from malaria, decreased malaria associated fever, and increased evidence of high prevalence of non-malaria fever. To immediately diagnose and promptly offer appropriate management, caretakers of children with fever should seek care where these services can be offered; in health facilities. This study was conducted to describe healthcare seeking behaviours among caretakers of febrile under five years, in Tanzania, and to determine children\u2019s, household and community-level factors associated with parents\u2019 healthcare seeking behaviour in health facilities. Of the 8573 children under the age of five years surveyed, 19.5% had a history of fever two weeks preceding the survey. Of these, 56.8% sought appropriate healthcare. Febrile children aged less than a year have 2.7 times higher odds of being taken to the health facilities compared to children with two or more years of age. Febrile children from households headed by female caretakers have almost three times higher odds of being taken to the health facilities compared to households headed by men. Febrile children with caretakers exposed to mass media (radio, television and newspaper) have more than two times higher odds of being taken to health facilities compared to those not exposed to mass media. Febrile children from regions with malaria prevalence above national level have 41% less odds of being taken to health facilities compared to those febrile children coming from areas with malaria prevalence below the national level. Furthermore, febrile children coming from areas with higher community education levels have 57% higher odds of being taken to health facilities compared to their counterparts coming from areas with low levels of community education. To effectively and appropriately manage and control febrile illnesses, the authors propose that the low proportion of febrile children taken to health facilities by their caretakers should be addressed through frequent advocacy of the importance of appropriate healthcare seeking behaviour, using mass media particularly in areas with high malaria prevalence. They recommend that a multifaceted approach be used in malaria control and eradication as multiple factors are associated with appropriate healthcare seeking behaviour.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Malaria Prevention Works: Let's close the gap","field_subtitle":"World Health Organisation: WHO Geneva, 2017","URL":"https://tinyurl.com/l9obbkv","body":"On World Malaria Day the World Health Organisation (WHO) released a publication entitled \"Malaria Prevention Works\". Filled with eye-catching infographics, it presents WHO's recommended malaria prevention tools in a simple and digestible manner. It is divided into two parts: the first chapter focuses on core vector control measures, and the second on preventive treatment strategies for the most vulnerable groups. It touches on a key biological threat, mosquito resistance to insecticides and highlight the need for new anti-malaria tools. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Open letter to WHO DG candidates: keep policy and priority setting free of commercial influence","field_subtitle":"Brown K; Rundall P; Lobstein T; Mwatsana M; Jeffery B: The Lancet 389(10082) 1879, May 2017","URL":"https://tinyurl.com/mq25qvf","body":"An open letter was submitted by the authors on behalf of 61 signatories for the election of the new WHO Director General (DG) to take into account how the new leadership will ensure appropriate interactions with alcohol, food, pharmaceutical, and medical technology industries. In May 2016, WHA adopted the Framework of Engagement with Non-State Actors (FENSA), a policy due to be fully operational by May, 2018. While FENSA envisages that WHO will \u201cexercise particular caution\u2026when engaging with private sector entities \u2026whose policies or activities are negatively affecting human health..\u201d, the rhetoric and direction of WHO's reform process as well as WHO's chronic funding challenges are argued to have left the signatories concerned rather than reassured. They fear that instead of protecting WHO's mandate, FENSA risks relegating WHO to a limited role, unable to stand up for human rights and democratic decision making. The signatories draw attention to the conflict of interest statement signed by more than 175 NGOs and networks representing more than 2000 groups and first launched at the UN High-Level Meeting on Non-communicable Diseases in 2011: \u201cThe policy development stage should be free from industry involvement to ensure a \u2018health in all policies\u2019 approach, which is not compromised by the obvious conflicts of interests associated with food, alcohol, beverage and other industries, that are primarily answerable to shareholders.\u201d  They indicate that alcohol, food, pharmaceutical, and medical technology industries should comply with policies developed by WHO and its Member States, and that their role is not in public health policy formulation, risk assessments, risk management, or priority setting, nor in determining normative quality standards and legally binding regulations to protect and promote public health. These processes, it is argued, must be undertaken in an environment free of commercial influence. The signatories believe that only a WHO that protects its independence and integrity of decision making will have the ability to fulfil its constitutional mandate.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Quality of Care in Performance-Based Financing: How It Is Incorporated in 32 Programs Across 28 Countries","field_subtitle":"Gergen J; Josephson E; Coe M; Ski S; Madhavan S; Bauhoff S: Global Health: Science and Practice 5(1) 90-107, 2017","URL":"http://www.ghspjournal.org/content/5/1/90","body":"This study describe how quality of care is incorporated into performance-based financing (PBF) programmes, what quality indicators are being used, and how these indicators are measured and verified. An exploratory scoping methodology was used to characterise the full range of quality components in 32 PBF programmes, initiated between 2008 and 2015 in 28 low- and middle-income countries, totalling 68 quality tools and 8,490 quality indicators. The programmes were identified through a review of the peer-reviewed and grey literature as well as through expert consultation with key funder representatives. Most of the PBF programmes were implemented in sub-Saharan Africa and most were funded primarily by the World Bank. On average, PBF quality tools contained 125 indicators predominately assessing maternal, newborn, and child health and facility management and infrastructure. Indicators were primarily measured via checklists which largely (over 90%) measured structural aspects of quality, such as equipment, beds, and infrastructure. Of the most common indicators across checklists, 74% measured structural aspects and 24% measured processes of clinical care. The quality portion of the payment formulas were in the form of bonuses (59%), penalties (27%), or both (hybrid) (14%). The median percentage (of a performance payment) allocated to health facilities was 60%, ranging from 10% to 100%, while the median percentage allocated to health care providers was 55%, ranging from 20% to 80%. Nearly all of the programmes included in the analysis (91%) verified quality scores quarterly (every 3 months), typically by regional government teams. PBF is argued by the authors to be a potentially appealing instrument to link verified performance measurement with strategic incentives and could ultimately help meet policy priorities. They also raise substantial variation and complexity in how PBF programmes incorporate quality of care considerations suggesting a need to further examine whether differences in design are associated with differential programme impacts.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Research Fairness Initiative (RFI) - making research partnerships work for everyone","field_subtitle":"Council on Health Research for Development: COHRED, Geneva, 2017","URL":"http://rfi.cohred.org/","body":"Partnerships are essential to deliver research and innovation for global health and partner development. Sustainable Development Goal 17 is all about this. Yet, COHRED argues that there is no framework, no benchmark, no standard of best practice on which to model governmental, corporate, non-profit, or academic collaborations, particularly not for international collaborative research and innovation involving low- and middle-income countries. This is where the Research Fairness Initiative intends to make a difference: to create a reporting system that encourages governments, businesses, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. COHRED prioritises its application in global health because there are many urgent health-related issues, but it can be applied in any other setting also.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Retention and sustainability of community-based health volunteers' activities: A qualitative study in rural Northern Ghana","field_subtitle":"Chatio S; Akweongo P: PLoS ONE 12(3), 2017, doi:10.1371/journal.pone.0173983","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174002","body":"The shortage of formal health workers has led to the utilisation of Community-Based Health Volunteers to provide health care services to people especially in rural and neglected communities. This study explored factors affecting retention and sustainability of community-based health volunteers\u2019 activities in a rural setting in Northern Ghana, through a qualitative study with thirty-two in-depth interviews with health volunteers and health workers overseeing their activities. Study participants reported that the desire to help community members, prestige and recognition as doctors in the community were key motivations for the health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected their work and discouraged them. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots and bicycles  can help retain community-based health volunteers and also sustain their activities at community level.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Rheumatology in Africa-challenges and opportunities","field_subtitle":"Mody G: Arthritis Research & Therapy 19(49), 2017, doi: https://dx.doi.org/10.1186%2Fs13075-017-1259-3 ","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341350/","body":"Africa faces many health challenges despite sustained growth and development over the past decade. Contributory factors are the lack of financial resources, an inadequate health professional workforce, a high burden of communicable diseases and an increasing burden of non-communicable diseases. Rheumatology services are limited or non-existent in many parts of sub-Saharan Africa. Over the past decade, partnerships with international academic institutions have resulted in some progress in the training of rheumatologists and health professionals and development of rheumatology services in countries such as Kenya, Nigeria, and Zambia. Basic diagnostic tests, biological agents and arthroplasty are either unavailable or not affordable by the majority of the population. Urbanisation has resulted in a change in the epidemiology of rheumatic diseases with an increase in the prevalence of gout, rheumatoid arthritis, systemic lupus erythematosus, and scleroderma over the past four decades. Future growth of rheumatology services will depend on identifying committed individuals in underserved countries for training and supporting them to educate medical students, physicians, and health professionals in their home countries. The author raises that there is a need to develop models of care using all categories of health workers and identify prevention strategies and cost-effective management programs for low resource settings. Africa affords an opportunity for collaborative research, including genetic and epigenetic studies, to improve regional understanding of many of the rheumatic diseases.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"SA AIDS","field_subtitle":"13 - 16 June 2017, International Convention Centre, Durban, South Africa","URL":"http://www.saaids.co.za/index.html","body":"In the 8th Southern African Conference delegates will find the latest advances in basic sciences alongside an emphasis on how to be part of lasting change to prevent new infections. South Africa\u2019s National Strategic plan includes whole sections on prevention and structural change  policies such as the National Liquor Norms and Standards, the National AIDS Council of the National Sex Worker HIV Plan, will be discussed with other measures to take control of the epidemic. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines","field_subtitle":"Kennedy C; Yeh P; Johnson C; Baggaley R: AIDS Care, 2017, doi: 10.1080/09540121.2017.1317710.","URL":"http://www.tandfonline.com/doi/full/10.1080/09540121.2017.1317710","body":"The authors conducted a systematic review of studies evaluating HIV testing services (HTS) by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. The authors also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomised trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%). In Malawi, a pre/post study showed increases in HTS sites and tests after delegation to lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity between them. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Social and Economic Impacts of Public Private Partnership Agreements to the Realisation of the Right to Health: The Case of Chitungwvza Central Hospital ","field_subtitle":"Zimbabwe Coalition on Debt and Development (ZIMCODD), Harare,  2017","URL":"https://tinyurl.com/mfmpzpw","body":"Zimbabwe's  health sector has been under-funded for some time causing public health service providers, including Chitungwiza Central Hospital (CCH), to operate below capacity despite the increasing patient demand. CCH entered into a Public Private Partnership (PPP) agreement, now a Joint Venture Partnership,  to upgrade quality and availability of health services. However, in this report the authors argue that the intended benefits of the PPP are not being realised because the poor people face increasing fee barriers due to the demand for upfront payment. A survey in 2016 included key informant interviews, client interviews and focus group discussions. It found that the majority of respondents have below poverty monthly household incomes. Most users did not understand the PPP model, and indicated that the hospital did\tnot consult residents on the adoption of the PPP model. Two thirds of respondents felt that services were better before the adoption of the PPP model. Poorer respondents mainly raised the fact that they could not afford services after the PPP due to fee charges, while those with higher incomes felt services had improved due to improved availability of medicines and other supplies. The respondents perceived that not accessing services due to cost barriers for example violated their right to health. The authors note that while there are opportunities to adopt PPP models in sectors such as transport for the construction of roads, rails, and toll gates, these models should not be used in health sectors and other essential services where commoditisation of public services affects access. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Social innovation for health-care delivery in Africa","field_subtitle":"Keeton C: Bulletin of the World Health Organisation 95(4)246\u2013247, 2017","URL":"http://www.who.int/bulletin/volumes/95/4/17-020417/en/","body":"Millie Balamu goes from door to door providing life-saving health care for about 200 households in the Wakiso district of Uganda. Villagers call her masawu (\u201cdoctor\u201d in the local Luganda language), but she is a community health worker.  She has tests and drugs with her to diagnose and treat malaria, diarrhoea and pneumonia and uses her mobile phone to diagnose these diseases and register pregnant women for follow up. This paper reports on the Social Innovation in Health Initiative. The concept of social innovation is taken from economics and business studies and refers to efforts to mobilise and incentivise communities. In health, social innovation may refer to low-fee private delivery of health care, using mobile phone applications \u2013 such as the one Balamu uses to diagnose common childhood diseases \u2013 and other novel ways to make health-care delivery more accessible and affordable in low-income communities. According to a working paper presenting the results of a randomised controlled trial in Uganda of more than 8000 households, published in 2016 the social innovation project helped to reduce child mortality across those households by 27% between 2011 and 2013.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"South Africa sets up program to break the link between HIV and violence","field_subtitle":"Westcott L: Newsweek, April 2017","URL":"https://tinyurl.com/kugaccr","body":"South Africa has piloted a new program, 'Safe and Sound' to reduce the common risk of violence against pregnant women in South Africa. Most women were found to not speak about the violence they endure. In addition to rape and sexual violence, coercive or controlling behaviour, such as a man refusing to use a condom or restricting other forms of birth control, is argued to increase the risk of contracting HIV. Women who are HIV-positive and experience intimate partner violence are reported by the author to be half as likely to take their HIV medications as women in nonviolent relationships, leaving them in much poorer health. The author urges that countries adopt programs like Safe and Sound because violence against women, including HIV positive women, can lead to a deterioration in their mental health, with some women stopping their medication and developing suicidal tendencies. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Status of Occupational Health and Safety and Related Challenges in Expanding Economy of Tanzania","field_subtitle":"Mrema E; Ngowi A; Mamuya S: Annals of Global Health 81(4), 538-547, 2015","URL":"http://www.annalsofglobalhealth.org/article/S2214-9996(15)01237-0/fulltext","body":"This study describes the status of occupational health and safety in Tanzania and the challenges in provision of occupational health services in an expanding economy, with growth being driven by communications, transport, finance services, construction, mining, agriculture, and manufacturing. The workers exposed to hazards from these activities are found suffer from illness and injuries, but to not access adequate occupational health services, with services limited to a few enterprises that can afford it. Existing laws and regulations are reported by the authors to not cover the entire population and implementation to be weak. The authors argue for an occupational health and safety services strategy, backed by legal review, training and the necessary skills, financial and technological resources to cover the whole working population, to match the growing economy.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The Importance of Health and Safety at African Mine Sites","field_subtitle":"Bocoum B: World Bank, Live Wire 2017/70, doi: http://hdl.handle.net/10986/25997","URL":"https://openknowledge.worldbank.org/handle/10986/25997","body":"This brief observes that equity and shared prosperity calls for a closer look at the working and living conditions of millions of mine workers in Africa, where tuberculosis (TB) imposes a high burden on mining economies and constitutes a regional public health crisis. Health hazards are reported to be perpetuated by poor enforcement of mining legislation, limited application of best international practices, weak institutions, and inadequate equipment and skills. In uncontrolled mining operations and communities of the type common in Africa, several factors are argued to combine to form a perfect storm for TB infection and transmission. They argue that the practice of allowing mining companies to self-report on health issues should be eliminated and that legislation on the health aspects of mining operations in Africa must be developed in line with international standards and best practices. The continent\u2019s regional development communities should act urgently to establish public-private partnerships capable of ensuring that mining in fact benefits the region\u2019s people in their path toward sustainable development. The goal should be the adoption of preventive measures to avoid further damage to the region\u2019s health and skilled human capital. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"The occupational safety and health of workers in coal mines: filling in the lacuna in Kenyan legislation","field_subtitle":"Muhindi I: Strathmore Law School, Dissertation, 2016","URL":"https://su-plus.strathmore.edu/handle/11071/4822","body":"This research assessed the extent to which the occupational safety and health act in Kenya safeguards the safety and health of workers in its coal mines. From a comparison with law in other countries, the author identifies gaps and recommends that Kenya should enact more comprehensive clauses for occupational safety and health of coal mine workers, should revise the compensation amounts provided for by the Work Injury Benefits Act; set guidelines and directions encompassing duties of employers and employees in mining and  provide for medical services in coal mines. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Tobacco growing and the sustainable development goals, Malawi","field_subtitle":"Kulik M; Bialous S;  Munthali S; Max W: Bulletin of the World Health Organization 95(5) 362-367, 2017","URL":"http://www.who.int/bulletin/volumes/95/5/16-175596/en/","body":"Malawi is the world\u2019s largest producer of burley tobacco and its population is affected by the negative consequences of both tobacco consumption and production. In producer countries, tobacco control involves control of the whole tobacco supply chain, rather than only control of consumption. The authors reviewed the impact of tobacco cultivation in Malawi to illustrate through this example the economic, environmental, health and social issues faced by low- and middle-income countries that still produce significant tobacco crops. The authors placed these issues in the context of the sustainable development goals (SDGs), particularly goal 3a, which calls on all governments to strengthen the implementation of the World Health Organisation Framework Convention on Tobacco Control. Other goals address the negative effects that tobacco cultivation has on development. The authors suggest that without external assistance, Malawi has relatively limited capacity to develop alternatives to tobacco production that are economically viable, but could benefit greatly from becoming a party to the FCTC to receive assistance through the incorporation of the FCTC into the SDGs.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Universal Access to Sexual and Reproductive Health: Realising Health and Human Rights","field_subtitle":"United Nations Research Institute for Social Development: UNRISD, Geneva, 2017","URL":"http://tinyurl.com/kh8zwam","body":"At an official side event of the 34th Session of the Human Rights Council, panelists discussed how people\u2019s sexual and reproductive health rights (SRHRs) around the world could be better protected and promoted. This report presents perspectives raised on challenges and good practices in ensuring full access to SRHRs, environmental dimensions of family planning, the linkages between a human rights-based social protection framework and access to these rights, and current global trends, and what these mean for implementation of the SDGs and their achievement by 2030. Men, women and gender non-conforming persons are all entitled to SRHRs and require these services. And while everyone is affected by limited access to these rights, individuals from already marginalized groups such as children and adolescents, lesbian, gay and trans persons, men who have sex with men, sex workers, drug users, indigenous peoples, and people living in poverty were reported to be the most affected, sometimes fatally.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Using Policy dialogue to Strengthen Health Centre Committees as a Vehicle for Social Participation in Health System in East and Southern Africa. Report of Policy dialogue workshop","field_subtitle":"Zambia Ministry of Health; Lusaka District Health Office; TALC, CWGH","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Zambia%20Policy%20dialogue%20meeting%20Rep2016.pdf","body":"In a regional EQUINET programme led by Community Working Group on Health (CWGH) on health centre committees as a vehicle for social participation in health system in east and southern Africa, Lusaka DHO is building capacities and learning for the district and the wider country programme on policy and legal guidelines to support the effective interaction of communities in health centre committees (HCCs) that can be shared regionally. A workshop was held on 7th January 2016 in Lusaka to support and inform the objectives for the Zambia work, viz: 1.To compile and exchange information on the current laws and legal guidelines on the role and functioning of HCCs. 2.To develop through regional dialogue a model HCC guideline to be tabled and reviewed regionally. 3.To analyse and document how current laws compare to this guideline. 4.To advocate for strengthening of law and guidelines in regional and national policy forum.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Where do the three candidates for the next WHO Director General stand on the most challenging global health issues of the decade?","field_subtitle":"AE Birn, YG Pillay, TH Holtz: PLOSBLOGS, 4 May 2017","URL":"https://tinyurl.com/lanlqh9","body":"PLOSBLOGS hosted a question and answer with the three final candidates for the World Health Organisation (WHO) Director General being directly elected by countries in the 2017 World Health Assembly.  The article provides the questions and interview responses in full.  The authors note in an analysis of the candidates\u2019 responses that none of the candidates discussed issues of social justice in their responses regarding the societal determinants of health or mentioned the recommendations of the WHO Commission on Social Determinants of Health on global power asymmetries, specifically the need to \u201ctackle the inequitable distribution of power, money, and resources.\u201d In terms of the role of non-state actors in neutering public accountability at WHO, none of the candidates articulated the intrinsic differences in power and access between public-interest entities and corporate/philanthropic actors under the non-state actor rubric. All three seem to think FENSA will resolve the problems of private influence on the WHO agenda, which the authors of the article doubt. To improve health and health equity, all three candidates invoked Universal Health Coverage without specifying the role of public provision, comprehensive coverage, and equity in access, quality, and financing for health care systems. In relation to health equity and social determinants of health, all three candidates mentioned intersectoralism and social inclusion, partnerships, and WHO technical expertise, but did not give attention to the political context of these challenges.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Who Really Governs Urban Ghana?","field_subtitle":"Awal M; Paller J: Africa Research Institute, UK, 2016","URL":"http://www.africaresearchinstitute.org/newsite/publications/who-really-governs-urban-ghana/","body":"In the past three decades in Ghana, the number of city dwellers has risen from four to 14 million; more than 5.5 million of whom live in slums. Urban growth exerts intense pressure on government and municipal authorities to provide infrastructure, affordable housing, public services and jobs. It has exacerbated informality, inequality, underdevelopment and political patronage. Some commentators warn of an impending urban crisis. Policymakers and international donors continue to prescribe better urban planning, slum upgrading, infrastructure investment and \u201ccapacity building\u201d to \u201cfix\u201d African cities. While these are necessary, the authors argue that the success of any urban strategy depends on an informed appraisal of the political dynamics of urban neighbourhoods that define governance in Ghana\u2019s cities and slums, in the interaction between politicians, entrepreneurs, traditional authorities and community leaders. The authors note that informal networks pervade formal political institutions and shape political strategy, and that political clientelism and the role of informal institutions are deepening alongside the strengthening of formal democratic institutions, but are often overlooked. ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"World Bank declares itself above the law","field_subtitle":"Dolack P: Counterpunch, March 2017","URL":"http://www.counterpunch.org/2017/03/24/world-bank-declares-itself-above-the-law/","body":"The author argues that destruction of the environment, human rights abuses and mass displacement have been ignored in the name of \u201cdevelopment\u201d that works to intensify neoliberal inequality. In response to legal attempts to hold it to account, the author argues that the World Bank has declared itself above the law. The latest attempt at accountability is a lawsuit filed in the U.S. federal court in Washington by EarthRights International, a human rights and environmental non-governmental organisation, charging that the World Bank has turned a blind eye to systematic abuses associated with palm-oil plantations in Honduras that it has financed. EarthRights International alleges that the World Bank has \u201crepeatedly and consistently provided critical funding to Dinant, Honduran palm oil companies, knowing that Dinant was waging a campaign of violence, terror, and dispossession against farmers, and that their money would be used to aid the commission of gross human rights abuses.\u201d  The lawsuit reports that the International Finance Corporation\u2019s ombudsman said the World Bank division \u201cfailed to spot or deliberately ignored the serious social, political and human rights context.\u201d These failures arose \u201cfrom staff incentives \u2018to overlook, fail to articulate, or even conceal potential environmental, social and conflict risk\u2019 and \u2018to get money out the door.\u2019 \u201d Despite this internal report, the suit says, the World Bank continued to provide financing and that the ombudsman has \u201cno authority to remedy abuses.\u201d  ","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"World Report on Health Policy and Systems Research","field_subtitle":"Alliance for Health Policy and Systems Research, World Health Organisation: WHO, Geneva","URL":"http://apps.who.int/iris/bitstream/10665/255051/1/9789241512268-eng.pdf?ua=1","body":"The first-ever, World Report on Health Policy and Systems Research, was launched recently by the Alliance for Health Policy and Systems Research. The report provides practical recommendations on how to reorient health research to more effectively address public health challenges on a national and global level. It describes the evolution of the field and provides figures on the number of publications produced, funding trends and institutional capacity in LMICs to conduct health policy and systems research. Low- and middle-income countries now have guidance for not only being users of research, but also producers. The report describes the state of the HPSR field in 1996, identifying three broad challenges to its progress that were clearly visible at that time. In the mid-1990s there were three principal challenges to the growth of the field of HPSR: (i) the fragmentation and lack of a single agreed definition of the field; (ii) the ongoing dominance of biomedical and clinical research; and (iii) a lack of demand for HPSR. Cross-cutting all these challenges was the problem of relatively limited capacity to undertake high-quality health policy and systems research. Subsequent sections then analyse how these challenges have been addressed over the intervening 20 years, resulting in greater recognition of and investment in HPSR. The report raises challenges to be addressed, including confronting the dominance of biomedical and clinical research as the primary channel for health research investments through a sustained advocacy campaign; seeking to clarify the scope and methods of the field; and finally nurturing closer collaboration with research users, in particular by capitalizing on the growth of interest in evidence-informed policy. It also collects together for the first time figures on various significant aspects of health policy and systems research: growth in the number of publications, collaboration between researchers in different parts of the world, funding trends and institutional capacities in low- and middle-income countries.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"XMINUSY Grants","field_subtitle":"Deadlines for applications: 30 June 2017","URL":"https://www.xminy.nl/english/","body":"IXminusY supports social movements, action groups and change makers who are fighting for a fair, democratic, sustainable and tolerant world. Projects that are supported by XminusY can take place on a broad variety of topics. But more important than the topic, is that the people involved take action themselves to change their own society. An application needs to have background information, concrete data, your planned activities and a detailed budget up to 3,000 euros. XminY doesn't support conferences, seminars, debates or other meetings unless they clearly aim to prepare for actions. In Africa, XminY only supports groups that can supply at least two references from other organisations or individuals.","php":"","field_issue_date":"2017-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"'Those were taken away and given money': power and reward expectations' influence in the selection of village health teams in rural Uganda","field_subtitle":"Turinawe E: Rural and Remote Health 16(3856), 2016","URL":"http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=3856","body":"With the renewed call for community participation in health interventions after the Alma Ata Declaration, interest has been raised in volunteer community health workers (CHWs) acting as representatives of local communities. This study interrogates the dynamic interface between local communities and the government in the selection of CHW volunteers in a rural community. Data were collected through participant observation of community events, 35 in-depth interviews, 20 focus groups and 15 informal conversations and review of documents about Luwero district. Ambiguous national guidelines and poor supervision of the selection process enabled the powerful community leaders to influence the selection of village health teams (VHTs). Intended to achieve community involvement, the selection process was found to produce a disconnect in the local community where many members saw the selected VHTs as having been \u2018taken away\u2019. The authors argue that community involvement in the selection of VHTs took a form that, instead of empowering the local community, reinforced the responsibility of those in power and thus maintained the asymmetrical status quo.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"10 Ways to improve the quality of care in health facilities","field_subtitle":"World Health Organisation: WHO Geneva, 2017 ","URL":"https://tinyurl.com/kqdsdbx","body":"In this article, a photo story is used to describe some of WHO\u2019s recommendations on how countries can improve quality of care in their health facilities and prevent maternal and newborn deaths, based on its standards for improving quality of maternal and newborn care in health facilities. The photo story shows that health facilities must have an appropriate physical environment and that communication with women and their families must be effective and respond to their needs. The story shows further that women and newborns who need referrals should obtain them without delay, no woman should be subjected to harmful practices during labour, childbirth and the early postnatal period, and that health facilities need well-trained and motivated staff consistently available to provide care. Lastly, the story presents images showing that every woman and newborn should have a complete, accurate, and standardised medical record. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Abstract submission open for the 13th International AIDSImpact Conference","field_subtitle":"Deadlines for abstracts:10 July 2017","URL":"http://www.aidsimpact.com/?utm_source=MG&utm_medium=Email&utm_campaign=MarchMailOut","body":"Stellenbosch University and the Human Sciences Research Council will jointly host the 13th AIDSImpact Conference at the Century City Conference Centre, Cape Town South Africa. Each AIDSImpact meeting attracts delegates new to the field as well as a core group of loyal psychosocial and behavioral researchers, prevention workers, community members and policy makers from universities and institutes across all five continents who use the biannual meeting to present their studies, interventions and prevention schemes. AIDSImpact has evolved as one of the leading platforms for understanding, updating and debating the behavioral, psychosocial and community facets of HIV in light of changing social conditions and medical advances. A review of past AIDSImpact scientific programs reveals the evolution of the psychosocial and behavioral response to the HIV epidemic over the past 25 years. The 2017 Cape Town conference will promote pioneering work on understanding the dynamics of a changing epidemic. A key focus will be consideration of new choices for HIV - for prevention, treatment, care and strategic planning.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"An African lens on the World Health Assembly 2017","field_subtitle":"Dr E Makasa, Counsellor-Health, Permanent Mission of the Republic of Zambia, Dr R Loewenson, TARSC ","body":"\r\nThe 2017 World Health Assembly (WHA70) will be held in Geneva from 22 to 31 May 2017. The agenda and initial documents are being made available at http://apps.who.int/gb/e/e_wha70.html. \r\n\r\nWHA70 has a wide ranging agenda, including the election of a new Director General; the management of emergency responses and antimicrobial resistance; research and development (R&D) for neglected diseases; the capacities for and evaluation of preparedness for the International Health Regulations (IHR) 2005, migrant health; and the Sustainable Development Goals (SDGs), amongst other items. It will discuss progress in the implementation of resolutions from prior WHAs and the governance and programmes of the World Health Organisation (WHO).\r\n\r\nThe WHA is being held at a time when military conflict has terrorized populations and forced displacement internally and across borders, disrupting lives, livelihoods and food supplies, and heightening the risk of epidemic outbreaks. African migrants leaving due to conflict or to seek economic opportunity face many health challenges, including physical and psychological stress and abuse, and poor access health services. Migrancy affects transmission of infectious diseases, including to northern countries now experiencing warmer temperatures due to climate change. WHO has proposed migrant-sensitive health policies that incorporate a public health approach, with universal, equitable access to quality health services that would also assist in surveillance, detection and control of infectious and other health problems and financial protection for migrants. However, there is a wide gap between this and the situation in practice.\r\n\r\nProgress has been made in the development of a vaccine against Ebola and control of the yellow fever epidemic in central Africa. The accelerated process for use of the former as an experimental vaccines in health care and frontline workers has raised ethical and equity concerns, while non availability of yellow fever vaccine stocks in the latter case led to fractional dosing (of one fifth of the normal vaccine dose) to stretch resources as an emergency response, which, as indicated by WHO, does not confer longer term protection and is not a measure for routine vaccination. These issues and a Zika virus disease outbreak recently reported in Angola from the Aedes vector responsible for transmitting dengue fever, yellow fever and chikungunya virus infections points to the need for strengthened public health measures to prevent, detect and control communicable diseases, within and across countries. Although much attention has been given to acute infectious disease emergencies, the rising level of non-communicable diseases (NCDs) in ESA countries, including trauma/injuries and cancers represents a major immediate and long term challenge, driven largely by conditions and policies outside the health sector, with health systems that are poorly equipped to detect, prevent and manage them.\r\n\r\nThese health threats take place against the backdrop of underfunded health systems and inadequate skilled health workers and medicines in our region, particularly in areas of high health need. While 18 million workers are estimated to be needed globally to achieve Universal Health Coverage and maintain pace with SDGs, by 2030 Africa is projected to have a shortage of 6 million health workers. Inadequate and increasingly costly medicines and health technologies undermine equitable access, in a global environment of growing microbial resistance and one that still raises investment, technology transfer and intellectual property barriers to development and production in areas of high health need. This directly links measures to combat antimicrobial resistance to those that ensure community health literacy and equitable access at affordable cost to good quality old and new antibiotics, vaccines and diagnostic tools, and measures for public investment in R&D, local production, pooled procurement and the lifting in practice of intellectual property barriers affecting public health. \r\n\r\nThere has been progress, particularly in emergency responses. For example, the WHO has set up a Health Emergencies Programme to co-ordinate emergency prevention and response; a collaboration agreement with the Africa Centre for Disease Control (AU-CDC) has stimulated work to build a regional health workforce for emergencies. Incident Management Systems have been established in a number of African countries to strengthen coordination of responses to emergencies and nine African countries have implemented Joint External Evaluations of their IHR core capacities. The WHO Contingency Fund for Emergencies and the Africa Public Health Emergency Fund have been established and have enabled quick response to zika, cholera and yellow fever outbreaks, although with challenges to address, including their alignment to national resources and delays in operationalising and slow disbursement of these funds.  \r\n\r\nThis investment in detection and control of epidemics is welcomed, but the concern in the region is also to prevent epidemics from occurring in the first place. This needs continuous strengthening of health information systems and population surveys to map disease risks and burdens and assess vulnerabilities in the region, to raise and ensure that African priorities are planned for and responded to at local, national, regional and global level. \r\n\r\nAn East Central and Southern African Health Community (ECSA HC) April 2017 meeting of senior officials and technical actors with input from Geneva-based diplomats in the Africa Group of Health Experts noted that this calls for a pooling of efforts, to respond to emergencies, to co-ordinate R&D and to share capacities and experience in building integrated health systems. Such comprehensive measures recognise that health systems are not simply technical in nature, but signal our social values, including for example in the way migrants are treated, or in how the health workers in conflict and emergency zones are cared for and protected.\r\n\r\nDelegates at the ECSA HC meeting called for integrated systems and a one-health approach, rather than a proliferation of new silo\u2019ed vertical programmes and committees. Health for population groups like mothers and children or for settings like urban health should not be treated as another vertical programme, but addressed through making clear linkages with comprehensive health systems and \u2018health-in-all-policies\u2019. After a long period of investment in specific disease programmes, investments are now seen to be needed in the institutional arrangements, processes and information systems that support coordination, collaboration and integration of actions within health systems, with other sectors and within and across countries. \r\n\r\nA focus on prevention demands action upstream, to map and identify risk and vulnerability and to control vectors and risk environments, both for infectious and non-infectious risks, including those related to chemicals, radiation and food safety. Integration calls for resources and strategies for prevention and response to epidemics and emerging challenges such as NCDs to be linked to broader measures applied to build robust, competent and comprehensive health systems that enroll and involve their communities. It calls for measures to reduce the costs of health technologies and treatment programmes, and to strengthen the independent country and regional regulatory agencies, databases and public health agencies needed to inform and support responses within and across countries.\r\n\r\nThis resonates with the WHO 2030 agenda calling for a One World One Health approach, that involves strengthening health systems for universal health coverage and inter-sectoral action for health. However two years from the declaration of the SDGs, it is surely time to focus attention on moving from pronouncements to what actions have been taken to implement the SDGs, particularly in terms of the public health issues that are a priority for the region. These are issues for whoever is elected as the new DG, whether from Africa or not. How far are the necessary actions being financed and delivered? What progress has been made in equitable development of and access to research and innovation? What progress is WHO making in reclaiming its leading role in health within the United Nations system, backed by the necessary increase in fixed contributions from countries to ensure its autonomy as global public health authority? What progress have countries made in improving progressive financing and reducing dependence on out of pocket funding? How far have all countries put in place the integrated, comprehensive primary health care oriented systems and public health leadership and capacities needed to meet these challenges and to progressively meet the right to health, leaving no-one behind?\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Antimicrobial resistance: translating political commitment into national action","field_subtitle":"Inoue H; Minghui R: Bulletin of the World Health Organisation 95(4) 241-312, 2017","URL":"http://www.who.int/bulletin/volumes/95/4/17-191890/en/","body":"Antimicrobial resistance is one of the most complex global health challenges today. Worsening antimicrobial resistance could have serious public health, economic and social implications around the world and could cause as much damage to the global economy as the 2008 financial crisis. Since May 2015, progress has also been made in the implementation of global commitments in this area. Over one hundred countries have completed, or are about to complete, their national multi-sectoral action plans. WHO has established a global antimicrobial resistance surveillance system to track which drug-resistant pathogens are posing the biggest challenge. Based on a review and analysis of national guidelines and prescribing practices for 20 common syndromes, WHO is revising the antibiotics included in the WHO model list of essential medicines. The organisation has also rolled out a global awareness-raising campaign targeting policy-makers, health and agriculture workers and communities. To scale up activities, the authors suggest that governments can build on existing regulatory frameworks, surveillance systems, laboratory and infection control infrastructure and human resources that are already in place to manage drug resistance in tuberculosis, HIV and malaria. Both at global and country level, much more still needs to be done. An ad hoc interagency coordination group is being established by the United Nations (UN) Secretary-General, in consultation with WHO, the Food and Agriculture Organisation of the UN and the World Organisation for Animal Health. WHO is preparing proposals for a global development and stewardship framework to support the development, control, distribution and appropriate use of new antimicrobial medicines, diagnostic tools, vaccines and other interventions. By May 2017, all countries should have their national action plans ready, as called for by World Health Assembly resolution 68.7. To see tangible progress, the authors argue that these global commitments must be translated into coherent regional and national action across the entire spectrum of diseases and pathogens.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital","field_subtitle":"Bebell L; Ngonzi J; Bazira J et al.: PLoS ONE 12(4) 2017, doi: https://doi.org/10.1371/journal.pone.0175456 ","URL":"https://tinyurl.com/mmgo9g2","body":"Puerperal sepsis causes 10% of maternal deaths in Africa, but prospective studies on incidence, microbiology and antimicrobial resistance are lacking. The authors performed a prospective cohort study of 4,231 Ugandan women presenting to a regional referral hospital for delivery or postpartum care. The study found for women in rural Uganda with postpartum fever, a high rate of antibiotic resistance among cultured urinary and bloodstream infections, including cephalosporin-resistant Acinetobacter species. They recommend that increasing availability of microbiology testing to inform appropriate antibiotic use, development of antimicrobial stewardship programs, and strengthening infection control practices should be high priorities.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for speakers and papers: Radical transformations in Africa today, interventions from the left","field_subtitle":"Deadlines for abstracts: Accra meeting \u2013 June 2017, Dar es Salaam \u2013 November 2017, Johannesburg \u2013 January 2018.","URL":"https://tinyurl.com/mwr4rkb","body":"This is an opportunity for activists and scholars to contribute to a series of three linked workshops in Africa. Each two-day meeting will debate current challenges and prospects for Left analysis and action. The organisers are seeking both key speakers and offers of papers, with a plan to publish a selection in the Review of African Political Economy. The workshops are scheduled in November 2017 in Accra, Ghana; April 2018 in Dar es Salaam, Tanzania; June 2018 in Johannesburg, South Africa; September 2018 at the African Studies Association in the UK. These workshops will link analysis and activism in contemporary Africa from the perspective of radical political economy, and will be organised around three linked themes: Africa in a \u2018post-crisis\u2019 world, economic strategy, industrialisation and the agrarian question and resistance and social movements in Africa.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Do Ugandan mining companies ignore the social license to operate? Reflecting on community perspectives","field_subtitle":"Namusobya S: Oped Space, Uganda, 2015","URL":"http://tinyurl.com/m4y9r4c","body":"During a recent civil society consultative meeting held in Karamoja sub-region in North Eastern Uganda to discuss with locals the review of mining law and policy in Uganda, participants from the community made statements about mining operations in the region: One participant stated; \u201cAs we talk here trucks and trucks ferry marble and the people of Rupa swallow dust.\u201d Another participant said; \u201c they come here and cordon off large pieces of land beyond what is allowed under their licenses and the locals have nowhere to graze their cattle. They forget we are a pastoralist community. No one asks us whether we want the mining in the first place. We just see companies show up in our midst.\u201d Karamoja sub-region in Uganda is endowed with a number of minerals including gold, marble limestone, gemstones and silver among others, and plays host to roughly 20 companies involved in the mining sector at different stages. However, this report suggests that there is a disconnect between local communities and the mining companies. Community members said they had very limited information about the sector, and complained of lack of consultation, exploitation and human rights abuses by the mining companies. The authors argue that local communities and indigenous people have the right to be consulted about mining projects because they bear the brunt of the negative impacts of mining, and as prior, informed consent is now a well recognised international best practice. This should, they propose, be included in law. They point, for example, to the Tanzania Mining Act 2010 that ensures that no discussions of mining can be engaged in without the representation of civil society and local small scale miners. In Ghana, New Mont Gold Company has adopted the use of community agreements, while the World Bank has published a Source Book \u2013 Mining Community Development Agreements, 2012 on how to develop and implement such community agreements.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"e-Learning Course on Health Financing Policy for Universal Health Coverage (UHC)","field_subtitle":"WHO: Geneva 2017","URL":"http://www.who.int/health_financing/training/e-learning-flyer.pdf?ua=1","body":"The first e-learning course on health financing policy for universal health coverage has now been launched. This e-learning course comprises six modules which cover the core functions of health financial policy as conceptualised by WHO. Each module is divided into a number of sub-topics. This is a foundational course which targets participants of various levels of experience and expertise. The course is designed to be used in a variety of ways: as preparation for those who will attend a WHO face-to-face course, for those who are for various reasons unable to attend a face-to-face course, and for those who have already attended courses and wish to refresh their knowledge. Individual modules can also be used as part of a programme of blended capacity building. The course will work on a range of devices, operation systems and browsers. The introductory module covers the goals of UHC and health financing. Module 2 addresses revenue raising and module 3 discusses the desirable characteristics of pooling revenues. Module 4 addresses the purchasing of health services and module 5 discusses benefit package design including coverage choices and how to promote UHC through benefit package choices. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Ecological and human health risks associated with abandoned gold mine tailings contaminated soil","field_subtitle":"Ngole-Jeme V; Fantke P: PLoS One, 2017, doi: https://doi.org/10.1371/journal.pone.0172517","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172517","body":"Studies were carried out in Krugersdorp, South Africa, to evaluate the ecological and human health risks associated with exposure to metals and metalloids in contaminated soils in mine tailings from gold mining. Human health risk was assessed using Hazard Quotient (HQ), Chronic Hazard Index (CHI) and carcinogenic risk levels, where values of HQ > 1, CHI > 1 and carcinogenic risk values > 1\u00d710\u22124 represent elevated risks. Values for HQ indicated high exposure-related risk for arsenic, chromium, nickel, zinc and  manganese. Children were more at risk from heavy metal and metalloid exposure than adults. Cancer-related risks associated with metal and metalloid exposure among children were also higher than in adults.  The authors identify that there is significant potential ecological and human health risk associated with metal and metalloid exposure from contaminated soils around gold mine tailings dumps. They note that this could be a potential contributing factor to poor health of residents in informal settlements in the mining area, particularly for those whose immune systems are already compromised by HIV.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Economic burden of family caregiving for elderly population in southern Ghana: the case of a peri-urban district","field_subtitle":"Nortey S; Aryeetey G; Aikins M; Amendah D; Nonvignon J: International Journal Equity Health 16(16), 2017, doi: 10.1186/s12939-016-0511-9.","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237474/","body":"Close-to-client community-based approaches are argued by the authors to be a low-cost way of providing basic care and social support for elderly populations in such resource-constrained settings and that family caregivers play a crucial role in that regard. However, family caregiving duties are often unpaid and their care-related economic burden is often overlooked, despite this knowledge being important in designing or scaling up effective interventions. This study, therefore, estimated the economic burden of family caregiving for the elderly in southern Ghana. It used a retrospective cross-sectional cost-of-care design in 2015 among family caregivers for elderly registered for a support group in a peri-urban district in southern Ghana. A simple random sample of 98 respondents representative of the support group members completed an interviewer-administered questionnaire. Costs were assessed over a 1-month period. Direct costs of caregiving (including out-of-pocket costs incurred on health care) as well as productivity losses (i.e. indirect cost) to caregivers were analysed. The estimated average cost of caregiving per month was US$186.18, 66% of which was a direct cost. About 78% of the family caregivers in the study reported a high level of caregiving burden with females reporting a relatively higher level than males. Further, about 87% of the family caregivers reported a high level of financial stress as a result of caregiving for their elderly relative. The study shows that support/caregiving for elderly populations imposes economic burden on families, potentially influencing the economic position of families with attendant implications for equity and future family support for such vulnerable populations.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Environmental and health impacts of mining in Africa","field_subtitle":"Mapani B; Kribek B: Proceedings of the annual workshop IGCP/SIDA No. 594, Windhoek, Namibia, 2012","URL":"http://tinyurl.com/l2jkfvj","body":"As the demand for mineral resources and fossil fuels continues to grow worldwide, the impact of mining will be an increasingly important concern. In Africa, local communities have been exposed to the detrimental effects of contamination arising from mining and its effects on public health, agriculture and the environment. The legacy of mining has left thousands of sites in Africa contaminated by mining and associated mine dumps such as tailings and slag material. The number of studies focused on the impacts of mining on the environment and human health in Africa have increased during the last decade. This paper reports on a project designed to correlate and integrate the results of multidisciplinary studies carried out in contaminated sites and areas using the best contemporary procedures for statistical analysis, management and compilation of the geochemical data; to strengthen the capacity of African institutions in environmental geochemistry, to raise public awareness of the impacts of mining on the environment and human health and to facilitate cooperation among geoscientists and medical scientists.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 194: An African lens on the World Health Assembly 2017","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evidence for scaling up HIV treatment in sub-Saharan Africa: A call for incorporating health system constraints","field_subtitle":"Mikkelsen E; Hontelez J; Jansen M et al.: PLoS Medical Journal 14(2), 2017, doi:10.1371/journal.pmed.1002240","URL":"https://tinyurl.com/m4gymwe","body":"The scale-up of antiretroviral therapy (ART) for HIV-infected people in sub-Saharan Africa (SSA) over the past 15 years is one of the most remarkable achievements in public health. With approximately 12 million people on treatment in 2015, life expectancy on the subcontinent has vastly improved. Nevertheless, ART coverage in SSA is still suboptimal, HIV incidence remains high, and improved survival due to ART implies ever increasing numbers of people on treatment. Substantial additional resources are needed to further scale up ART, yet funding has recently levelled off, increasing the need to optimise the allocation of limited resources. This presents local policy makers with complex dilemmas. The authors argue that the current evidence base for prioritising ART scale-up strategies leads to recommendations that are theoretically optimal but practically infeasible to implement. They argue that cost-effectiveness analyses of scaling up ART in SSA take into account the local health system by integrating supply- and demand-side constraints in mathematical models and improving the dialogue between researchers and policy makers.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Global Trends: Challenges and Opportunities in the Implementation of the Sustainable Development Goals","field_subtitle":"Dugarova E; G\u00fclasan N: United Nations Development Programme (UNDP) and United Nations Research Institute for Social Development (UNRISD), Geneva, 2017","URL":"http://tinyurl.com/mnyg7l5","body":"This joint UNDP-UNRISD report reviews recent trends in six areas that are fundamentally important to achieving the 2030 Agenda. These six \u201cmega-trends\u201d relate to (i) poverty and inequalities, (ii) demography, (iii) environmental degradation and climate change, (iv) shocks and crises, (v) development cooperation and financing for development, and (vi) technological innovation. The report explores whether these trends are having positive or negative effects on development and discusses policy implications for the implementation of the 2030 Agenda. The report raises that some of the trends displayed currently are positive and supportive, including in the reduction of absolute poverty and technological innovation. Yet negative trends in several of the other target areas pose a significant risk to the realisation of the SDGs. They suggest that evidence-generating processes should be designed so as to take interactions between areas into account, whether that be through the use of interdisciplinary teams who can bring different insights to research, or through modelling and simulations of complex interactions. The potential for policy coherence manifests itself in two ways in the 2030 Agenda. First, there is a need to pursue progress across goals at the same time (e.g. employment guarantee programmes that focus on the provision of the safeguarding of environmental goods and services), while recognising and minimising the negative interactions. Second, there is the issue of coherence at different levels of decision-making and implementation, primarily local, national, regional and global\u2014for example, whether local policies on education service provision are supported by fiscal policies at the national level, especially the decentralisation of tax policy.  All of the issues discussed in the report are argued to point to the need for collective action so as to maximise the positive dynamics in these areas and minimise risk, and for processes that build trust and inclusiveness of participation.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Global Tuberculosis Report 2016","field_subtitle":"World Health Organisation: WHO, Geneva, 2016","URL":"https://tinyurl.com/lozhszh","body":"The Global Tuberculosis Report provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels. This global TB report provides an assessment of the TB epidemic and progress in TB diagnosis, treatment and prevention reports, as well as an overview of TB-specific financing and research. It also discusses the broader agenda of universal health coverage, social protection and other SDGs that have an impact on health. Data were available for 202 countries and territories that account for over 99% of the world\u2019s population and TB cases. Six countries accounted for 60% of the new cases: India, Indonesia, China, Nigeria, Pakistan and South Africa. Global progress is argued to depend on major advances in TB prevention and care in these countries. Worldwide, the rate of decline in TB incidence remained at only 1.5% from 2014 to 2015. This needs to accelerate to a 4\u20135% annual decline by 2020 to reach the first milestones of the End TB Strategy. TB treatment averted 49 million deaths globally between 2000 and 2015, but important diagnostic and treatment gaps persist. US$ 6.6 billion was available for TB care and prevention in low and middle-income countries in 2016, of which 84% was from domestic sources. Nonetheless, national TB programmes in low-income countries continue to rely on international funders for almost 90% of their financing. The report notes that investments in low and middle-income countries fall almost US$ 2 billion short of the US$ 8.3 billion needed in 2016. This annual gap will widen to US$ 6 billion in 2020 if current funding levels do not increase. Despite some progress in the pipeline for new diagnostics, drugs and regimens, and vaccines, TB research and development is also argued to remain severely underfunded.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Gold mining pollution and the cost of private healthcare: The case of Ghana","field_subtitle":"Akpalu W; Normanyo A: United Nations University, WIDER Working Paper 2016/121, 2016","URL":"https://www.wider.unu.edu/sites/default/files/wp2016-121.pdf","body":"To attract greater levels of foreign direct investment into their gold mining sectors, the authors observe that many mineral-rich countries in sub-Saharan Africa have been willing to overlook serious instances of mining company non-compliance with environmental standards, and that these lapses in regulatory oversight and enforcement have led to high levels of pollution in many mining communities. This is argued to raise the risk of pollution-related sicknesses, such as skin infections, upper and lower respiratory disorders, and cardiovascular diseases, will necessitate increasingly high healthcare expenditures in affected communities. In this study, the authors propose and estimate a model that relates healthcare expenditure to the degree of residents\u2019 exposure to mining pollution using data obtained on gold mining in Ghana. The empirical results confirm that, after controlling for factors such as current and long-term health status, increased mining pollution leads to higher healthcare expenditure.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Hope for HIV control in southern Africa: The continued quest for a vaccine","field_subtitle":"Bekker Linda-Gail; Gray G, PLoS Med 14(2) 2017, doi: https://doi.org/10.1371/journal.pmed.1002241","URL":"https://tinyurl.com/n3cqsd6","body":"Southern and eastern Africa, with 6.2% of the world\u2019s population, bear a disparate half of the world\u2019s HIV infection burden and would benefit greatly from inexpensive innovations aimed at curtailing the epidemic. A recent modelling study showed that introducing a partially (30%) effective vaccine for HIV in resource-limited settings such as southern Africa would result in an estimated 67% reduction in HIV incidence compared to a non-vaccine scenario. As sub-Saharan Africa has the highest incidence of HIV infection in the world, that the introduction of a vaccine with only partial efficacy could have such a dramatic effect, despite the existing availability of comprehensive prevention methods, is argued by the authors to be strongly persuasive for the pursuit of a vaccine-based approach. Whilst there is great optimism that increasing access to antiretroviral treatment in the region will reduce infection incidence, there is also recognition that epidemic control will not be achieved without a substantial and sustained scale-up of additional primary prevention resources. There are challenges to HIV prevention in resource-limited settings that a vaccine alone is seen to be well positioned to meet. These include the rate of HIV infections and the scale and complexity of the HIV epidemic in the region, juxtaposed with ailing health systems ill equipped to respond effectively. Challenges with antiretroviral drug therapy adherence, poor linkage to care following diagnosis, multiple and diverse vulnerable populations who require population-specific services (such as women, adolescents, and men who have sex with men, stigma, and discrimination, as well as generally limited health care facilities and health personnel impair the region\u2019s capacity to manage the scale of the epidemic. Even with the success of pre-exposure prophylaxis demonstration projects and the encouraging results emerging, the extent of protection relies on fidelity to adherence, continuous uninterrupted access, and sustainable resources for provision. It is well documented that in resource-restricted areas, where education levels and access to health care are low, reliance on behavioural and structural support is also an enormous challenge. A vaccine, even if partially effective, is argued by the authors to be a way of filling these prevention gaps in a cost-effective manner. Whilst countries in this region must find ways to access all the available opportunities that the modern HIV prevention toolkit has on offer, such a vaccine is seen to potentially change the prevention landscape.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Intellectual property rights initiative (IPRI-Africa): Partial scholarship announcement","field_subtitle":"Deadlines for applications: 15 May 2017","URL":"https://media.wix.com/ugd/9854aa_f08ddb96c4744c7c80479aeb6f349b18.pdf","body":"IPRI-Africa has announced partial scholarship opportunities for three upcoming courses: 1. \"Negotiations, Drafting and Management of Contracts\"- July 10-14, 2017;  2. \u201cIntellectual Property Law and Practice in the World Today\" - Aug 1-5, 2017; and 3. \"Mediation, Arbitration and ADRs\" - Aug 7-11, 2017. The courses are being held in Kampala, Uganda and cover up to half of the full $1200 tuition fees including lunch, tea, refreshments, receptions, IPRI-Africa certification, course materials (soft and hard copy), and links to legal updates. It does not include airfare or accommodation.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Is Socio-Economic Status a Determinant of HIV-Related Stigma Attitudes in Zimbabwe? Findings from Project Accept","field_subtitle":"Mateveke K; Singh B; Chingono A; et al.: Journal of Public Health in Africa 7(1), 2016, doi: http://dx.doi.org/10.4081/jphia.2016.533","URL":"http://www.publichealthinafrica.org/index.php/jphia/article/view/533","body":"HIV related stigma and discrimination is a known barrier for HIV prevention and care. The authors aimed to assess the relationship between socio-economic status (SES) and HIV related stigma in Zimbabwe, using data from a project that examined the impact of community-based voluntary counselling and testing intervention on HIV incidence and stigma. A total of 2522 eligible participants responded to a psychometric assessment tool, which assessed HIV related stigma and discrimination attitudes on 4 point Likert scale. The tool measured three components of HIV related stigma: shame, blame and social isolation, perceived discrimination, and equity. Participants\u2019 ownership of basic assets was used to assess the socio-economic status. Shame, blame and social isolation component of HIV related stigma was found to be significantly associated with medium and low SES indicating more stigmatising attitudes by participants belonging to medium and low SES in comparison to high SES. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Kenyan medical students are learning through a community outreach model","field_subtitle":"Mining S: The Conversation, March 2017","URL":"http://tinyurl.com/mqgyu8o","body":"This is a time of unprecedented change in medical education globally. Medical schools, postgraduate bodies and other organisations are responding to rapid advances in medicine and changes in health care delivery. New education approaches are being adopted to exchange information. This enables the institutions to produce relevant health professionals. There are a number of innovations and models that are being explored to improve the learning of students studying medicine and public health. This Kenyan case study reports on how partnerships between the higher education institution and the community are working. It gives an account of the Moi University community programme that uses adaptive instruction for health trainees in the schools of medicine and public health. Adaptive instruction is a student centred approach where they are given real life cases to solve health problems theoretically as tutorial cases. This discussion, with the guidance of a tutor, promotes active learning. The model encourages active learner participation in the provision of health services. It introduces the students to a community health framework where they work in rural health facilities as part of their continuous assessment. It means that graduates entering the profession are able to apply and practise knowledge and skills beyond the theory learnt at the university. The students diagnose issues affecting the local community, develop a research proposal, work with district health management teams and implement activities. They conduct surveillance and monitor diseases and in the event of an epidemic, they are expected to respond effectively. They master the principles of how rural health facilities are run. The programme is divided into five phases: Introduction to the community, Community diagnosis,  Writing a research proposal, Investigation executing the research plan, District health service attachment.  The research projects designed and implemented in phase three and four have produced fascinating reports with research topics that address issues affecting the communities. It takes 20% to 30% of curriculum content and makes the graduand socially responsible and accountable team players in health care delivery. The authors hope that other tutors in Kenya, Eastern Africa and beyond the continent will benefit from this model. The experience provides tutorial guidance towards building a resilient and experienced crop of health professionals at par with global health training standards.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Knowledge, attitudes and practices of South African healthcare workers regarding the prevention and treatment of influenza among HIV-infected individuals","field_subtitle":"Duque J; Gaga S; Clark D et al.: PLoS ONE 12(3) 2017, doi:10.1371/journal.pone.0173983","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173983","body":"The South African Department of Health publishes annual guidelines identifying priority groups, including immunosuppressed individuals and healthcare workers (HCW), for influenza vaccination and treatment. How these guidelines have impacted HCW and their patients, particularly those infected with HIV, remains unknown. The authors aimed to describe the knowledge, attitudes and practices regarding influenza and the vaccine among South African HCW. Surveys were distributed by two local non-governmental organisations in public health clinics and hospitals in 21 districts/municipalities (5 of 9 provinces). There were 1164 respondents. One-third (34%) of HCW reported getting influenza vaccine and most (94%) recommended influenza vaccine to patients infected with HIV. The ability to get vaccine free of charge and having received influenza government training were significantly associated with self-reported vaccination in 2013/2014. Self-reported vaccination and availability of influenza vaccine during the healthcare visit were significantly associated with recommending influenza vaccine to patients infected with HIV/AIDS. Free and close access to influenza vaccine were associated with a higher likelihood of getting vaccinated. HCW who reported getting the influenza vaccine themselves, had vaccine to offer during the patient consult and were familiar with guidelines and training were more likely to recommend vaccine to HIV-infected patients.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Mining and Risk of Tuberculosis in Sub-Saharan Africa","field_subtitle":"Stuckler D; Basu S; McKee M; Lurie M: American Journal of Public Health 101(3), 524-530, 2105","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036676/","body":"This paper aimed to investigate the relationship between mining and tuberculosis (TB) in sub-Saharan Africa. The authors used multivariate regression to estimate the contribution of mining activity to TB incidence, prevalence, and mortality, as well as rates of TB among people living with HIV, with control for economic, health system, and population confounders.  Mining production was associated with higher population TB incidence rates, with an increase of mining production of 1 SD corresponding to about 33% higher TB incidence or 760 000 more incident cases, after adjustment for economic and population controls. Similar results were observed for TB prevalence and mortality, as well as with alternative measures of mining activity. Independent of HIV, there were significant associations between mining production and TB incidence in countries with high HIV prevalence and between log gold mining production and TB incidence in all studied countries. The authors conclude that mining is a significant determinant of countrywide variation in TB among sub-Saharan African nations. Comprehensive TB control strategies should explicitly address the role of mining activity and environments in the epidemic.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Power and glory: applying participatory action research in public health","field_subtitle":"Baum F: Gaceta Sanitaria 30(6) 405\u2013407, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S0213911116301194","body":"Participatory action research seeks to understand and improve the world by changing it. At its heart is collective, self-reflective enquiry that researchers and participant\u2019s undertake so they can understand and improve upon the practices in which they participate and the situation in which they find themselves. This article describes that ways PAR has been applied to a wide range of issues in public health, including in community asset mapping, participatory evaluation of public health programs, community monitoring of health service quality, research documenting and advocating to remove threats to health including poor water and sanitation and environmental pollution and participatory health policy research. A systematic review indicated most health service PAR has been conducted in low and middle income countries. In high income countries it is often used as a method to empower groups who are excluded and hold little power including Roma peoples in Europe and Indigenous peoples in Canada and Australia. PAR is often not reported in the academic literature despite its application in local projects. The most important aspect of PAR is that it relies on a cycle of reflection, planning, acting, further observing and reflection, then new plans and action. This reflexivity is central and is deeply relational in that the researchers and the other actors (community members or service or policy players) are engaging together in these processes. The author  observes that PAR holds great, and as yet largely unrealised promise, to create greater mobilisation and community interest and action on health inequities and action on the social determinants of health.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Progress in promoting data sharing in public health emergencies","field_subtitle":"Littler K; Boon W; Carson G et al.: Bulletin of the World Health Organisation 95(4) 2017","URL":"http://www.who.int/bulletin/volumes/95/4/17-192096/en/","body":"In February 2016, the World Health Organisation (WHO) declared the Zika virus-related cluster of microcephaly cases and other neurological disorders reported in Brazil, a Public Health Emergency of International Concern (PHEIC). Following the declaration, over 30 global health bodies issued a joint statement committing to data sharing to ensure that the global response to the Zika virus and future emergencies, could be informed by the best and most current evidence. The statement represented a concerted effort by those involved to address past failures of timely access to relevant data. It also highlighted the lack of a clear path to implementation for data sharing during public health emergencies. In March 2016, the Global Research Collaboration for Infectious Disease Preparedness established a data-sharing working group which has been working in coalition with other stakeholders including WHO, scientists, nongovernmental organisations, journals and other agencies. This group is working to identify barriers to data sharing in public health emergencies that should be addressed to better prepare for any future epidemic. The experiences from the 2013\u20132016 Ebola virus disease outbreak and the 2015 Zika virus outbreak demonstrated the importance of research in public health emergencies and the difficulties associated with sharing research findings rapidly and outside of conventional scientific publications. The WHO consensus and policy statements called for a paradigm shift in information sharing in public health emergencies and described the particularities to consider in dealing with different data types. Despite these efforts, rapid data sharing during public health emergencies remains challenging for various reasons. First, there are limited incentives for researchers and other people responding to the emergency to share data. Second, there is a lack of appropriate infrastructure for data sharing such as repositories and information technology platforms. Such rapid data sharing requires a clear governance structure that ensures a balance between privacy and access, as well as adheres to national and international ethical and legal requirements. The GloPID-R working group has developed, and requests comment on, a set of principles to underpin future implementation of timely data sharing. These new principles draw on others, such as the FAIR Guiding Principles for scientific data management and stewardship, and are intended to provide an initial framework for discussion. The collective work is intended to support WHO\u2019s Research and Development Blueprint and include other stakeholders, such as the Global Outbreak Alert and Response Network and the Coalition for Epidemic Preparedness. Effective data sharing requires flexibility by all stakeholders to adapt to unforeseen events and challenges. A data-sharing system needs to allow collaboration between stakeholders in the absence of pre-existing relationships and all collaborators need to adhere to fundamental ethical principles of data use. Above all, it must ensure that people in all affected countries benefit from timely access to evidence-based interventions in emergencies.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Revolutionary Change in Africa: an Interview with Samir Amin","field_subtitle":"Zeilig L: Review of African Political Economy, March 2017","URL":"http://roape.net/2017/03/16/revolutionary-change-africa-interview-samir-amin/","body":"Samir Amin is one of Africa's foremost radical thinkers. In this interview  organised by African Research and Cooperation for Endogenous Development Support, Amin reflects on a life spent at the cutting edge of radical theory and practice and African politics. Amin questions what social progressive change means today. He argues that there needs to be a strengthening of socialist consciousness - instead of \u2018moving up\u2019 within capitalism, people need to orientate in the opposite direction, and intensify the contradictions between an anti-capitalist alternative and what capitalism can offer. He argues against the concept of a single \u2018revolution\u2019, preferring instead to talk about advances and changes which create the possibility of later, further advances. He also rejects the view that it is possible to produce change without political and state power. Amin notes that all the peoples of Africa are today facing a big challenge.  African societies are integrated in a form of  globalisation that is damaging for the continent. He argues that Africans must 'delink\u2019 from it and reject the logic of unilateral adjustment to the needs of further capitalist and imperialist expansion, starting at national level. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Significance of informal (on-the-job) learning and leadership development in health systems: lessons from a district finance team in South Africa","field_subtitle":"Choonara S; Goudge J; Nxumalo N; Eyles J: BMJ Global Health 2 (e000138); 2017, doi: 10.1136/bmjgh-2016-000138","URL":"http://gh.bmj.com/content/bmjgh/2/1/e000138.full.pdf","body":"Effective district management, particularly leadership is considered to be crucial element of the district health system. Internationally, the debate around developing leadership competencies such as motivation or empowerment of staff, managing relationships, being solution driven as well as fostering teamwork are argued to be possible through formal and informal training. This paper reports findings on the significance of informal learning and its practical value in developing leadership competencies. A qualitative case study was conducted in one district in the Gauteng province, South Africa. Purposive and snowballing techniques yielded a sample of 18 participants, primarily based at a district level. Primary data collected through in-depth interviews and observations (participant and non-participant) were analysed using thematic analysis. Results indicate the sorts of complexities, particularly financial management challenges which staff face and draws attention to the use of two informal learning strategies\u2014learning from others (how to communicate, delegate) and fostering team-based learning. Such strategies played a role in developing a cadre of leaders at a district level who displayed essential competencies such as motivating staff, and problem solving. It is crucial for health systems, especially those in financially constrained settings to find cost-effective ways to develop leadership competencies such as being solution driven or motivating and empowering staff. The authors note that the study illustrates that it is possible to develop such competencies through creating and nurturing a learning environment (on-the-job training) which could be incorporated into everyday practice.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Slum Upgrading and Health Equity","field_subtitle":"Corburn J; Sverdlik A: International Journal of Environment Research and Public Health 14(4), 2017","URL":"http://www.mdpi.com/1660-4601/14/4/342/htm","body":"Informal settlement upgrading is widely recognised for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. The authors conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment and adopting an urban health in all policies framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"South Africa District Health Barometer 2015/16","field_subtitle":"Massyn N; Peer N; English R; Padarath A; Barron P; Day C: Health Systems Trust, South Africa, 2016","URL":"https://tinyurl.com/mbh6pp5","body":"The District Health Barometer (DHB) 2015/16, in its 11th edition, seeks to highlight, health system performance, inequities in health outcomes, and health-resource allocation and delivery, and to track the efficiency of healthcare delivery processes across all provinces and districts in South Africa. It has become a planning and management resource for health service providers, managers, researchers and policy-makers. This DHB contains 44 indicators, with trend illustrations and health profiles across South Africa\u2019s nine provinces and 52 health districts. It includes a chapter on the burden of disease, as well as seven additional indicators, including: inpatient under 5 years death rate, percentage of ideal clinics, percentage of assessed PHC facilities with patients who have access to a medical practitioner and the MDR-TB treatment success rate. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The Africa Mining Vision:  A Long Overdue Ecofeminist Critique","field_subtitle":"Valiani S: WoMin Analytical Paper, South Africa, 2015","URL":"https://womin.org.za/images/docs/analytical-paper.pdf","body":"The Africa Mining Vision (AMV) signed in 2009 by African Ministers responsible for mineral resources development throughout the continent, and its accompanying policy framework, Minerals and Africa\u2019s Development, provide a comprehensive strategy for mineral and other natural resource extraction to be used in manufacturing within the continent, rather than exported from Africa for the industrial development of other continents. The authors note that while comprehensive and bold, it does not incorporate the effects of such a development strategy on African women, even though extraction primarily affects rural populations and particularly women. They note the mounting drought in the continent and other consequences of climate change attributing it in part to excessive, worldwide extraction and combustion of minerals and fossil fuels. Showcasing seven community based studies in sub-Saharan Africa, this paper aims to fill this gap. The authors argue from the evidence in the case studies that mineral and oil-based development undervalues community wealth, food production systems and female labour. They make two policy recommendations: Firstly in order to enable meaningful public participation in the policy framework and vision provided in the AMV  they call on the African Union to make public the number of displacements estimated for the African continent over the next half-century. They estimate that as many as 90 million displaced across the continent. Secondly, they call on African states to carry out national studies of the socioeconomic, environmental and thus human impacts of existing and abandoned mineral and oil-based development projects post-independence period, with active participation of women\u2019s organisations, mining affected communities, policy think tanks, and academics in the fields of social and human development.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The coping mechanisms of women in the mining industry","field_subtitle":"Mokotong R: University of Pretoria, South Africa, 2016, doi: http://hdl.handle.net/2263/53441","URL":"http://www.repository.up.ac.za/handle/2263/53441","body":"Internationally, the involvement of women working underground is a relatively new phenomenon. In South Africa, women were recently allowed to work in the underground mines. However, the challenges of women and men are different and their coping mechanisms are not the same. This research investigated how women cope under the occupational and labour culture, and health and physical demands inherent to this type of work. By means of the non-probability sampling method, ten (10) women were purposively selected and a qualitative collective case study design was used. The findings illustrate that women in the mining industry experience challenges with regard to labour, health, occupational challenges, work-life balance, sanitation facilities and sexual harassment. They were found to use different mechanisms to cope with the challenges they face on a daily basis. The authors call for the mining industry management to devise ways to meet the needs of women and offer support in response to their daily challenges.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The cost of free health care for all Kenyans: assessing the financial sustainability of contributory and non-contributory financing mechanisms","field_subtitle":"Okungu V; Chuma J; McIntyre D: International Journal for Health in Equity 16(1), 2017, doi: 10.1186/s12939-017-0535-9","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327514/","body":"In many developing countries where the majority of the population works in the informal sector, there are critical debates over the best financing mechanisms to progress towards UHC. In Kenya, government health policy has prioritized a contributory financing strategy (social health insurance) as the main financing mechanism for UHC. However, there are currently no studies that have assessed the cost of either social health insurance (SHI) as the contributory approach or an alternative financing mechanism involving non-contributory (general tax funding) approaches to UHC in Kenya. This study critically assessed the financial requirements of both contributory and non-contributory mechanisms to financing UHC in Kenya in the context of large informal sector populations, to provide estimates of financial resource needs for UHC over a 17-year period (2013-2030). The 17-year period was necessary because the Government of Kenya aims to achieve UHC by 2030. The results show that SHI is financially sustainable (that is expenditure does not outstrip revenue) within the first five years of implementation, but it becomes less sustainable with time. Modelling for a non-contributory scenario, on the other hand, showed greater sustainability both in the short- and long-term. The financial resource requirements for universal access to health care through general government revenue are compared with a contributory health insurance scheme approach. Although both funding options would require considerable government subsidies, given the magnitude of the informal sector in Kenya and their limited financial capacity, a tax-funded system would be less costly and more sustainable in the long-term than an insurance scheme approach. However, more innovative financing for health care as well as giving the health sector higher priority in government expenditure will be required to make the non-contributory financing mechanism more sustainable.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Extractive Industries Transparency Initiative Standard 2016","field_subtitle":"EITI International Secretariat:  EITI Norway, 2016","URL":"https://eiti.org/sites/default/files/migrated_files/english_eiti_standard_0.pdf","body":"The Extractive Industries Transparency Initiative (EITI) Standard is in its fifth version since the first principles were agreed in 2003. The principles on which the EITI is based state that the wealth from a country\u2019s natural resources should benefit all its citizens and that this requires high standards of transparency and accountability. Revenue transparency remains a fundamental aspect of the EITI. The requirements follow the extractive value chain order and cover: first oversight by the multi-stakeholder group, then legal and institutional frameworks, exploration and production, revenue collection, revenue allocation, and finally social and economic spending and outcomes. It encourages countries to make use of existing reporting systems for EITI data collection and make the results transparent at source, with recommendations on the actions to take and the plans for taking them. It raises that the identity of the real owners \u2013 the \u2018beneficial owners\u2019 \u2013 of the companies that have obtained rights to extract oil, gas and minerals will have to be disclosed from 2020. It introduces a new validation system which aims to better recognise efforts to exceed the EITI requirements and sets out fairer consequences for countries that have not yet achieved compliance.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The impact of multi-morbidity on disability among older adults in South Africa: do hypertension and socio-demographic characteristics matter?","field_subtitle":"Waterhouse P; van der Wielen N; Banda P; Channon A: International Journal Equity Health 16(62), 2017, doi: 10.1186/s12939-017-0537-7","URL":"https://tinyurl.com/m3kjyug","body":"This study in South Africa investigated the association between multi-morbidity and disability among older adults; and whether hypertension (both diagnosed and undiagnosed) mediates this relationship. The authors consider whether the impact of the multi-morbidity on disability varies by socio-demographic characteristics. Data were drawn from Wave 1 (2007-08) of the South African Study on Global Ageing and Adult Health. Disability was measured using the 12-item World Health Organisation Disability Assessment Schedule (WHODAS) 2.0.  Nearly half of the respondents had a hypertensive blood pressure when measured during the interview, but had not been previously diagnosed. A further third self-reported they had been told by a health professional they had hypertension. The logistic regression showed in comparison to those with no chronic conditions, those with one or two or more had significantly higher odds of severe disability. Hypertension was insignificant and did not change the direction or size of the effect of the multi-morbidity measure substantially. The interactions between number of chronic conditions with wealth were significant. The diagnosis of multiple chronic conditions, can be used to identify those most at risk of severe disability and to prioritise limited resources for such individuals for preventative, rehabilitative and palliative care.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The imperative for systems thinking to promote access to medicines, efficient delivery, and cost-effectiveness when implementing health financing reforms: a qualitative study","field_subtitle":"Achoki T; Lesego A: International Journal for Equity in Health 16(53) 2017 doi: 10.1186/s12939-017-0550-x","URL":"https://tinyurl.com/lvydq4f","body":"Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance is being promoted in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualised to many African health systems. The authors interviewed 37 key informants drawn from public, private and civil society organisations involved in health service delivery in Botswana. They aimed to determine the potential health system impacts that would result from expanding the health insurance scheme covering public sector employees. Study participants were selected through purposeful sampling, stakeholder mapping, and snowballing. The authors thematically synthesised their views, focusing on the key health system areas of access to medicines, efficiency and cost-effectiveness, as intermediate milestones towards universal health coverage. Participants suggested that expansion of health insurance would be characterised by increased financial resources for health and catalyse an upsurge in utilisation of health services particularly among those with health insurance cover. As a result, the health system, particularly within the private sector, would be expected to see higher demand for medicines and other health technologies. However, majority of the respondents cautioned that, realising the full benefits of improved population health, equitable distribution and financial risk protection, would be wholly dependent on having sound policies, regulations and functional accountability systems in place. It was recommended that, health system stewards should embrace efficient and cost-effective delivery, in order to make progress towards universal health coverage. Despite the prospects of increasing financial resources available for health service delivery, expansion of health insurance is reported to come with many challenges. They argue that decision-makers keen to achieve universal health coverage, must view health financing reform through the holistic lens of the health system and its interactions with the population, in order to anticipate its potential benefits and risks. Failure to embrace this comprehensive approach, would potentially lead to counterproductive results.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The right to health of non-nationals and displaced persons in the sustainable development goals era: challenges for equity in universal health care","field_subtitle":"Brolan C; Forman L; Dagron S; et al.: International Journal for Health in Equity 16(14), 2017, doi: 10.1186/s12939-016-0500-z.","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319040/","body":"Under the Millennium Development Goals (MDGs), United Nations Member States reported progress on the targets toward their general citizenry. This focus repeatedly excluded marginalised ethnic and linguistic minorities, including people of refugee backgrounds and other vulnerable non-nationals that resided within a States' borders. The Sustainable Development Goals (SDGs) aim to be applied to all, nationals and non-nationals alike. Global migration and its diffuse impact has intensified due to escalating conflicts and the growing violence in many countries. This massive migration and the thousands of refugees crossing borders in search for safety led to the creation of two-tiered, ad hoc, refugee health care systems that have added to the sidelining of non-nationals in reporting frameworks. The authors have identified four ways to promote the protection of vulnerable non-nationals' health and well-being in States' application of the post-2015 SDG framework: In setting their own post-2015 indicators states should explicitly identify vulnerable migrants, refugees, displaced persons and other marginalised groups in the content of such indicators. The authors\u2019 recommend that communities, civil society and health justice advocates vigorously engage in country's formulation of post-2015 indicators and that the inclusion of non-nationals be anchored in the international human right to health, which in turn requires appropriate financing allocations as well as robust monitoring and evaluation processes that can hold technocratic decision-makers accountable for progress.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Shuttleworth Foundation Fellowship Program","field_subtitle":"Deadlines for applications: 14 May 2017","URL":"https://www.shuttleworthfoundation.org/apply/","body":"The Shuttleworth Foundation offers fellowships to individuals to implement their innovative idea for social change. They are most interested in exceptional ideas at the intersection between technology, knowledge and learning, with openness being the key requirement. Applications are invited from people from all over the world regardless of gender, age, nationality or experiences. The Foundation invite individuals with a fresh approach to solving a social challenge, using openness, to apply.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Voter Sentiment on Governance in South Africa ","field_subtitle":"Good Governance Africa: GGA, South Africa, 2017","URL":"http://www.gga.org/wp-content/uploads/2017/03/LocGov-VSS-full-Analysis-1-1.pdf","body":"In 2015 Good Governance Africa (GGA), in conjunction with specialist researchers MarkData, conducted a survey to test public attitudes towards key aspects of governance in South Africa. In 2016 GGA commissioned MarkData to conduct a Voter Sentiment Survey. Respondents were selected using a random multistage sampling process. The survey findings are to some extent in line with the 2011 South African Reconciliation Barometer. The survey showed that in cases relating to government performance, the widely held view was that all areas (administration, economic development and service delivery) required attention and improvement. Participants suggested that service delivery is the priority, followed by economic development and then administration. It was also found that more voters are deploying their vote strategically in relation to their perceptions of governance, despite feeling that they have little say in how they are governed. The authors argue that this reinforces the need for further research and for greater engagement with the voters on the ground, particularly in areas where poor local government performance has been detected.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"World TB Day: Campaign Materials","field_subtitle":"Stop TB Partnership, March 2017","URL":"http://www.stoptb.org/events/world_tb_day/2017/materials.asp","body":"This year's Stop TB Partnership campaign runs under the tagline \"Unite to End TB!\". This campaign draws on the goals set out in the Global Plan to End TB, the roadmap to accelerating impact on the TB epidemic and reaching the targets of the WHO End TB Strategy. To amplify the message the Stop TB Partnership has developed a set of campaign materials, which are free to use. The campaign materials include a \u2018Call to Action\u2019 logo, a \u2018World TB Day\u2019 logo, social media tiles and e-cards, posters, t-shirts and pin templates and identity guidelines for communities. ","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"XminusY grants","field_subtitle":"Deadlines for applications: 30 June 2017","URL":"https://www.xminy.nl/english/","body":"IXminusY supports social movements, action groups and change makers who are fighting for a fair, democratic, sustainable and tolerant world. Projects that are supported by XminusY can take place on a broad variety of topics. But more important than the topic, is that the people involved take action themselves to change their own society. An application needs to have background information, concrete data, your planned activities and a detailed budget up to 3,000 euros. XminY doesn't support conferences, seminars, debates or other meetings unless they clearly aim to prepare for actions. In Africa, XminY only supports groups that can supply at least two references from other organisations or individuals.","php":"","field_issue_date":"2017-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"10th ECSA Best Practices Forum and 26th Directors Joint Consultative Committee Meeting","field_subtitle":"ECSA HC: 10 to 12 April 2017, Arusha, Tanzania","URL":"http://www.ecsahc.org/wp-content/uploads/2017/02/Announcement_BPF-and-DJCC-2017-2-1.pdf","body":"The East, Central and Southern Africa Health Community (ECSA-HC) will host the\r\n10th Best Practices Forum and 26th Directors Joint Consultative Committee from 10 to 12 April 2017 in Arusha, Tanzania. The theme is Promoting Multi-Sectoral Collaboration for Health through Sustainable Development Goals. The Conference will address its Theme through the following sub-themes:\r\n1. Good Governance and Leadership Practices in the Health sector\r\n2. Mitigating the Impact of emerging and re-emerging diseases.\r\n3. Multi-Sectoral responses to Non-communicable Diseases.\r\n4. Accountability for Women\u2019s, Children\u2019s and Adolescent Health post-2015\r\nThe scientific papers and best practices will form the basis for the recommendations that will be presented to the Health Ministers for further deliberation and adoption as resolutions. Further information is available on the website. EQUINET has a formal association with ECSA HC and will be represented at the meeting. EQUINET will host a joint session at the Best Practices Forum on Global Health Diplomacy including inputs on health standards in the extractive industries and on the forthcoming World Health Assembly agenda.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"3rd Board Meeting of the African Platform on Human Resources for Health (APHRH)","field_subtitle":"APHRH: Kampala, Uganda, 2016","URL":"http://www.aphrh.com/3rd-board-meeting-of-the-african-platform-on-human-resources-for-health/","body":"The Board of the APHRH met on the 30th Nov 2016 in Kampala to discuss key issues that concerning the Health Workforce in Africa. A resolution was made to convene a regional consultation meeting of key stakeholders and networks to develop a consensus on ways to accelerate advocacy for a strengthened health workforce in Africa.  The Board made a number of decisions to initiate acceleration of the work of the platform at all levels and enhance lobby and advocate for the prioritization of the Health Workforce agenda in Africa, outlined in this document, including: to request the WHO Regional Director for Africa to urgently consider an enhanced technical support program to African countries to strengthen country level health workforce development and management departments, especially at the ministries of health headquarters of member states; to support African Member states in translating for action key regional and global policies including the African Health Strategy, the Global Health Workforce Strategy and Sustainable Development Goals (SDGs) and to fast track the strengthening of Health Workforce information systems of countries to manage workforce inflows, stock and outflow by implementation of the WHO code on International Recruitment and track progress of strengthening through improved reporting on the code at the 3rd round due in 2018.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"4th Global Forum on Human Resources for Health","field_subtitle":"Dublin, Ireland, 13-17 November 2017","URL":"http://www.who.int/hrh/events/4th-global-forum-hrh/en/","body":"The 4th Global Forum on Human Resources for Health will be held in Dublin, Ireland from 13-17 November 2017 hosted by the World Health Organization, the Global Health Workforce Network, Trinity College, Dublin, Irish Aid and the Department of Health. The Forum represents a unique opportunity to engage a multisectoral group of actors across the education, finance, health and labour sectors; multilateral and bilateral agencies; academic institutions; health professional associations and civil society, in a coherent advocacy platform. The Forum will be an occasion to address the health workforce agenda with a multisectoral lens. The theme of the 4th Global Forum is achieving the Global Strategy on Human Resources for Health milestones and the Commission\u2019s recommendations. The Forum will: take stock of progress since the 3rd Global Forum; inform on innovations in workforce policy and practice; engage with and capture the views of various stakeholder groups on advancing implementation to reach the agreed GSHRH milestones by 2020 and 2030; promote collective actions across various stakeholder groups to accelerate implementation towards achieving global and national priorities and targets; and promote learning, sharing, networking, and collaboration among HRH stakeholders. The Forum will also facilitate special sessions to debate and discuss issues of global relevance such as, but not limited to, emergency preparedness & response, antimicrobial resistance, 90-90-90 and others.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"5th Forum of the African Platform on Human Resources for Health","field_subtitle":"Kampala, Uganda, 19-21 April 2017","body":"The African Platform on Human Resources for Health will hold its 5th Forum in Kampala, Uganda, from Wednesday 19th to Friday 21st April 2017. The African Platform is the regional arm of the Global Health Workforce Network (GWN) that was launched in Geneva last December, 2016 as the successor the Global Health Workforce Alliance (GHWA). The Forum will review the status of implementation of the \u201cRoad map for scaling up human resources for health for improved health service delivery in the African Region 2012\u20132025\u201d that was launched in 2012; build understanding  of relevant recent developments such as  the \u201cGlobal strategy on human resources for health: (Workforce 2030)\u201d; the African Health Strategy.; the Five-Year Action Plan to implement the recommendations of the High-Level Commission on Health Employment and Economic Growth; and discuss the implications for African countries of the establishment of the Global Health Workforce Network (GHWN), at the WHO secretariat in Geneva. The forum will review the role of the health workforce (HWF) in Africa in advancing the movement towards Universal Health Coverage, as a part of the means to attain the Sustainable Development Goals (SDGs). The Forum will be conducted through Plenary, Break out and Poster sessions under the following five thematic streams: HWF Education and Training;       Preparing the African HWF for Universal Health Coverage ; Leadership for Development, Management and Regulation; Nursing; as the Backbone of the Health and HWF Migration. Participation is open to a broad range of stakeholders especially from the African region.  ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa","field_subtitle":"Opoku D; Stephani V; Quentin W: BMC Medicine 15(24), 2017, doi: 10.1186/s12916-017-0782-z","URL":"https://tinyurl.com/m3zjsqr","body":"The prevalence of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa. At the same time, the use of mobile phones is rising, expanding the opportunities for the implementation of mobile phone-based health (mHealth) interventions. This review aims to understand how, why, for whom, and in what circumstances mHealth interventions against NCDs improve treatment and care in sub-Saharan Africa. Four main databases and references of included articles were searched for studies up to March 2015  reporting effects of mHealth interventions on patients with NCDs in sub-Saharan Africa. All studies published up until May 2015 were included in the review. Following a realist review approach, middle-range theories were identified and integrated into a 'Framework for Understanding the Contribution of mHealth Interventions to Improved Access to Care for patients with NCDs in sub-Saharan Africa'. The main indicators of the framework consist of predisposing characteristics, needs, enabling resources, perceived usefulness, and perceived ease of use. Studies were analysed in depth to populate the framework. The search identified 6137 titles for screening, of which 20 were retained for the realist synthesis. The contribution of mHealth interventions to improved treatment and care is that they facilitate (remote) access to previously unavailable (specialised) services. Three contextual factors (predisposing characteristics, needs, and enabling resources) influence if patients and providers believe that mHealth interventions are useful and easy to use. Only if they believe mHealth to be useful and easy to use, will mHealth ultimately contribute to improved access to care. The analysis of included studies showed that the most important predisposing characteristics are a positive attitude and a common language of communication. The most relevant needs are a high burden of disease and a lack of capacity of first-contact providers. Essential enabling resources are the availability of a stable communications network, accessible maintenance services, and regulatory policies. Policy makers and program managers should consider predisposing characteristics and needs of patients and providers as well as the necessary enabling resources prior to the introduction of an mHealth intervention. The authors argue that researchers would benefit from placing greater attention on the context in which mHealth interventions are being implemented instead of focusing (too strongly) on the technical aspects of these interventions.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa","field_subtitle":"Opoku D; Stephani V; Quentin W: BMC Medicine 15 (24), doi: 10.1186/s12916-017-0782-z, 2017","URL":"http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0782-z","body":"The prevalence of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa. At the same time, the use of mobile phones is rising, expanding the opportunities for the implementation of mobile phone-based health (mHealth) interventions. This review aims to understand how, why, for whom, and in what circumstances mHealth interventions against NCDs improve treatment and care in sub-Saharan Africa. Four main databases (PubMed, Cochrane Library, Web of Science, and Google Scholar) and references of included articles were searched for studies reporting effects of mHealth interventions on patients with NCDs in sub-Saharan Africa. All studies published up until May 2015 were included in the review. Following a realist review approach, middle-range theories were identified and integrated into a Framework for Understanding the Contribution of mHealth Interventions to Improved Access to Care for patients with NCDs in sub-Saharan Africa. The main indicators of the framework consist of predisposing characteristics, needs, enabling resources, perceived usefulness, and perceived ease of use. Studies were analyzed in depth to populate the framework. The search identified 6137 titles for screening, of which 20 were retained for the realist synthesis. The contribution of mHealth interventions to improved treatment and care is that they facilitate (remote) access to previously unavailable (specialized) services. Three contextual factors (predisposing characteristics, needs, and enabling resources) influence if patients and providers believe that mHealth interventions are useful and easy to use. Only if they believe mHealth to be useful and easy to use, will mHealth ultimately contribute to improved access to care. The analysis of included studies showed that the most important predisposing characteristics are a positive attitude and a common language of communication. The most relevant needs are a high burden of disease and a lack of capacity of first-contact providers. Essential enabling resources are the availability of a stable communications network, accessible maintenance services, and regulatory policies. The authors propose that policy makers and program managers consider predisposing characteristics and needs of patients and providers as well as the necessary enabling resources prior to the introduction of an mHealth intervention. They argue that researchers would benefit from placing greater attention on the context in which mHealth interventions are being implemented instead of focusing (too strongly) on the technical aspects of these interventions.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Adapting global health aid in the face of climate change","field_subtitle":"Gupta V, Mason-Sharma A, Caty S, KerryV: Lancet Global health Volume 5, No. 2, e133\u2013e134, 2017","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30002-5/fulltext","body":"WHO estimates an additional 250\u2008000 mortalities between 2030 and 2050 will be attributable to climate-associated increases in malnutrition, malaria, diarrhoea, respiratory disease, water inaccessibility, and heat stress. Spillover effects on state and regional security are argued to be inevitable. The World Economic Forum has identified climate change as the single greatest threat to global stability because of its considerable consequences on the health and stability of developing nations. The complex interaction between climate change, health system burdens, and poor health outcomes, and their subsequent impact on politics, security, and society can be captured within the concept of a so-called climate-health-security nexus. Many of the world's poorest and most politically fragile nations lie at the centre of this nexus. Within this nexus, poverty, state fragility, poor pre-existing health outcomes, and high susceptibility to climate change converge to amplify the effects of future famines, droughts, and neglected tropical diseases. This amplification subsequently leads to worsened economies, social instability, and reliance on external support. The nations most at risk for climate-triggered health crises are primarily scattered throughout sub-Saharan Africa and south Asia and are already afflicted by the highest rates of disease burden globally (table, appendix). Notably, most of these countries are low-income nations without the resources to adequately contend with climate-related challenges.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Advancing the right to health: the vital role of law","field_subtitle":"Magnusson R: World Health Organization, Geneva, 2017","URL":"http://www.hst.org.za/publications/advancing-right-health-vital-role-law","body":"This report aims to raise awareness about the role that the reform of public health laws can play in advancing the right to health and in creating the conditions for people to live healthy lives. By encouraging a better understanding of how public health law can be used to improve the health of the population, the report aims to encourage and assist governments to reform their public health laws in order to advance the right to health. The report highlights important issues that may arise during the process of public health law reform. It provides guidance about issues and requirements to be addressed during the process of developing public health laws. It also includes case studies and examples of legislation from a variety of countries to illustrate effective law reform practices and some features of effective public health legislation.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"As New AU Chair Mahamat Takes Office: The African Union\u2019s Financing Headache, In Two Charts","field_subtitle":"Mungai C: Africapedia, March 2017","URL":"http://www.africapedia.com/2017/03/20/au-financing-headache-two-charts/","body":"The new chairperson of the African Union (AU) Commission Moussa Faki Mahamat formally took office in Addis Ababa in March, outlining his top priorities for his four-year tenure. Mahamat said he would focus on implementing structural and financial reforms at the AU, place women and youth at the centre of Africa\u2019s development agenda, accelerate intra-African trade and free movement of people, goods and services in the continent, silence the guns by 2020 and strengthen Africa\u2019s voice in the global arena. However, it is the financing plan that is likely to get the most attention in the short term. It was unveiled at the 2015 AU summit in Kigali by Donald Kaberuka, former president of the African Development Bank (AfDB). As of 2015, more than half of the African Union\u2019s budget is funded by outside funders, compromising the independence of the organisation. The Kaberuka plan is intended to change that, and would see member states finance 100% of the AU\u2019s operating budget, three-quarters of the programmes budget and a quarter of the peace and security budget, starting from January 2016 and phased in incrementally over five years.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Assessment of the World Health Organisation\u2019s HIV Drug Resistance Early Warning Indicators in Main and Decentralised Outreach Antiretroviral Therapy Sites in Namibia","field_subtitle":"Mutenda N; Bukowski A; Nitschke A; et al.: PLoS ONE 11(12): e0166649, 2016, doi:10.1371/journal.pone.0166649","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166649","body":"The World Health Organization early warning indicators (EWIs) of HIV drug resistance (HIVDR) assess factors at individual ART sites that are known to create situations favourable to the emergence of HIVDR. In 2014, the Namibia HIV care and treatment program abstracted adult and paediatric EWIs from all public ART sites (50 main sites and 143 outreach sites) related to on-time pill pick-up, retention in care, pharmacy stock-outs, dispensing practices, and viral load suppression. Comparisons were made between main and outreach sites and between 2014 and 2012. The national estimates were: On-time pill pick-up 81.9% for adults and 82.4% for paediatrics, Retention in care 79% retained on ART after 12 months for adults and 82% for paediatrics, Pharmacy stock-outs 94% of months without a stock-out for adults and 88% for paediatrics. Viral load suppression was significantly affected by low rates of viral load completion. Main sites had higher on-time pill pick-up than outreach sites for adults and paediatrics and no difference between main and outreach sites for retention in care for adults or paediatrics. From 2012 to 2014 in adult and paediatric sites, on-time pill pick-up, retention in care and pharmacy stock-outs worsened. Results of EWIs monitoring in Namibia provide evidence about ART programmatic functioning and contextualise results from national surveys of HIVDR. These results are worrisome as they show a decline in program performance over time. The national ART program is taking steps to minimise the emergence of HIVDR by strengthening adherence and retention of patients on ART, reducing stock-outs, and strengthening ART data quality.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Call for a consultant to facilitate a review and organisation development process with the Community of Practitioners on Accountability and Social Action in Health","field_subtitle":"Deadline for Applicants: 15 April 2017","URL":"http://www.copasah.net/uploads/1/2/6/4/12642634/copasah_od_tor.pdf","body":"The Community of Practitioners on Accountability and Social Action in Health (COPASAH) is a global network of community of practitioners who share a people\u2013centric vision and human rights based approach to health, health care and human dignity. COPASAH\u2019s Steering Committee, represented by the COPASAH Global Secretariat, is seeking a resource person to facilitate a review and Organisation Development (OD) process. The primary task of the consultant will be to determine the value-addition and impact of COPASAH\u2019s activities for the network\u2019s membership base, examine its organisational structure, and advise on the future structure, strategies and activities within the context of the broader field of social action and accountability for health. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for proposals for edited volume on: Making visible the invisible: African women in mining","field_subtitle":"Deadline for submission of abstracts: 20 April 2017","body":"Scholars working on Women in Mining across Africa  are invited to contribute to an edited book volume which aims to focus on contributions (through labour and otherwise) and roles (through social reproduction or resistance struggles) played by African women in mining/ extractive industries. African mining historiography has largely erased or silenced women and neglected their contribution in mining. In this literature and popular culture, mineworkers are almost always seen as men, as though mines are, and have always been, inhabited by men. This is despite evidence from as early as the 1500s which shows women as \u2018pit people\u2019. Scholarship which acknowledges women\u2019s presence tends to portray women as outsiders who inhabit the \u2018peripheries\u2019 of mining and hardly as \u2018centres\u2019 or key players in their own right. This book project aims to address this bias by revisiting and interrogating, from a feminist perspective, the contributions of women in mining and the historiography of mining in Africa, as a way of re-claiming \u201cher-story\u201d and re-insert it into \u2018hi-story\u2019 of mining, to recover and resurrect women\u2019s voices, centre their role and attest to their presence and make visible their contributions in mining. The gaps the editors seek to address include; different roles played by women who work/worked in mining (underground, open cast, artisanal and alluvial mines) and the invisible social reproduction work done by women in mining communities. The editors are also interested in chapters that revisit and critically re-examine archival material, and insert African women in the dominant mining historiography which currently excludes and or marginalises them. Authors who are interested in submitting a paper should, in the first instance, send a short abstract-length proposal (not more than 500 words) outlining the scope of their paper and its novelty by the 20th of April 2017. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for speakers and papers: Radical transformations in Africa today, interventions from the left","field_subtitle":"Deadlines for abstracts: Accra meeting \u2013 June 2017, Dar es Salaam \u2013 November 2017, Johannesburg \u2013 January 2018","URL":"https://tinyurl.com/mwr4rkb","body":"This series of meetings is an opportunity for activists and scholars to contribute to three linked workshops in Africa. Each two-day meeting will debate current challenges and prospects for analysis and action. The organisers are seeking speakers and offers of papers, with a plan to publish a selection in the Review of African Political Economy. The workshops are scheduled in November 2017 in Accra, Ghana; April 2018 in Dar es Salaam, Tanzania; June 2018 in Johannesburg, South Africa; and September 2018 at the African Studies Association in the UK. These workshops will link analysis and activism in contemporary Africa from the perspective of radical political economy, and will be organised around three linked themes: (1) Africa in a \u2018post-crisis\u2019 world, (2) Economic strategy, industrialisation and (3) The agrarian question and resistance and social movements in Africa.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community health worker perspectives on a new primary health care initiative in the Eastern Cape of South Africa","field_subtitle":"Austin-Evelyn K; Rabkin M; Machete T; Mutiti A; Mwansa-Kambafwile J; Dlamini T; El-Sadr W: PLoS ONE 12(3) 2017, doi:10.1371/journal.pone.0173983","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173863","body":"In 2010, South Africa\u2019s National Department of Health launched a national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to provide a preventive and health-promoting community-based PHC model. A key component of rPHC is the use of community-based outreach teams staffed by generalist community health workers (CHWs). The authors conducted focus group discussions and surveys on the knowledge and attitudes of 91 CHWs working on community-based rPHC teams in the King Sabata Dalindyebo (KSD) sub-district of Eastern Cape Province. The CHWs studied enjoyed their work and found it meaningful, as they saw themselves as agents of change. They also perceived weaknesses in the implementation of outreach team oversight, and desired field-based training and more supervision in the community.  The authors find that there is a need to provide CHWs with basic resources like equipment, supplies and transport to improve their acceptability and credibility to the communities they serve.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Does health-related content in a major Ugandan newspaper reflect the changing burden of disease in East Africa?","field_subtitle":"Cooper M; Aiyer R; Sornalingam S; Lawrence D: International Journal of Communication and Health 10, 2016","URL":"http://tinyurl.com/za5vnwx","body":"The disease burden in urban sub-Saharan Africa is changing rapidly. Mortality and morbidity from chronic physical disease (heart, disease, stroke and cancer) is rising rapidly and believed to equal that from infections. Other increasing disease burdens in sub Saharan Africa include mental illness, substance abuse and accidents, especially road traffic collisions (RTC). Newspaper readership is rising in Uganda. This study used content analysis to examine health-related coverage in one major Ugandan newspaper (New Vision). Twenty-nine consecutive paper copies from September/October 2013 were examined independently by two researchers. Health-related articles were identified, counted and coded according to clinical content. Clinical and healthcare-related coverage was present in every edition and represented approximate proportions of 2.6% and 0.4% respectively of total newspaper content. Of 214 news articles identified, these covered the following clinical themes: general well-being (15.4%), healthcare services (14.5%), HIV (12.1%), violence/accidents (11.2%), chronic physical disease (11.2%), sexual, maternal and reproductive health (SMRH) (10.8%), non-HIV infective diseases (10.8), malnutrition (7.9%), substance misuse (3.3%) and mental health (2.8%). Coverage of RTCs, alcohol, smoking, and cancers other than of the breast and cervix was minimal. Health-related content was dominated by infections, healthcare quality, general wellbeing, SMRH and malnutrition. This does not represent the changing burden of disease in Uganda. There may be scope for targeted interventions with editors to promote coverage of growing challenges, including lifestyle advice to prevent chronic diseases.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 193: From \u2018resource curse\u2019 to fair benefit? Protecting health in the extractive sector ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Policy brief 42: Harmonising regional standards for extractive industry responsibilities for health in east and southern Africa","field_subtitle":"Loewenson R; Hinricher J; Papamichail A: TARSC, EQUINET, Harare","URL":"http://tinyurl.com/gr6yyza","body":"This brief aims to inform policy dialogue on the protection of health in extractive industries (EIs) in the mining sector in east and southern Africa (ESA). It outlines on pages 5-7 a proposal for a \u2018Regional guidance on minimum standards for the duties and responsibilities of parties in the extractive sector for health and social protection\u2019. EIs play a key economic role, but also bring health, environmental and social risks. International codes and guidance exist on the duties of corporate actors to control these risks and contribute to health. ESA country laws provide for some health protection in EIs, but all have gaps in legal provisions. In line with the intentions of the Southern African Development Community (SADC) and other regional economic communities, standards and laws for the sector should be harmonised and brought in line with international standards. The proposal for regional guidance draws clauses from current laws in ESA countries, suggesting the feasibility of their wider application across the region.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Establishing the Africa Centres for Disease Control and Prevention: responding to Africa's health threat","field_subtitle":"Nkengasong J; Maiyegun O; Moeti M: The Lancet Global Health 5(3), e246-247, 2017","URL":"https://tinyurl.com/mq6yoma","body":"On Jan 31, 2017, heads of states and governments of the African Union and the leadership of the African Union Commission officially launched the Africa Centres for Disease Control and Prevention (Africa CDC) in Addis Ababa, Ethiopia. As detailed in the African Union's Africa Agenda 2063\u2014a roadmap for the development of the continent\u2014some of the concerns that justified the establishment and initiation of an Africa-wide public health agency include rapid population growth; increasing and intensive population movement across Africa, with increased potential for new or re-emerging pathogens to turn into pandemics; existing endemic and emerging infectious diseases, including Ebola; antimicrobial resistance; increasing incidence of non-communicable diseases and injuries; high maternal mortality rates; and threats posed by environmental toxins.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Fair publication of qualitative research in health systems: a call by health policy and systems researchers","field_subtitle":"SHaPeS thematic working group of Health Systems Global, EQUINET, and Emerging Voices for Global Health, Daniels K; Loewenson R et al.: International Journal for Equity in Health 2016 15:98 doi:10.1186/s12939-016-0368-y","URL":"https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0368-y","body":"An open letter from Trisha Greenhalgh et al. to the editors of the British Medical Journal (BMJ) triggered wide debate by health policy and systems researchers globally on the inadequate recognition of the value of qualitative research and the resulting deficit in publishing papers reporting on qualitative research. One key dimension of equity in health is that researchers are able to disseminate their findings and that they are taken into account in a fair and just manner, so that they can inform health policy and programmes. While the 170 researcher cosignatories to this paper work on different aspects of health systems, all feel that more serious recognition of the value of qualitative research is required, including to disseminate evidence and contribute voice to advance equity in health. The researchers are particularly disenchanted by a general experience of the limited and often inadequate publication of qualitative research in the major health and medical journals, and the resultant loss of important insights for those working in, or concerned with, health services and systems, including around clinical decision-making. The article reports on the value of qualitative research to health systems and the ways it should be given greater profile in research publications.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Free Zimbabwean contraceptives smuggled for sale in South Africa","field_subtitle":"K Mutandiro: Groundup, Times Live, March  2017","URL":"http://tinyurl.com/knagnpq","body":"This article tells a story of Nancy (not her real name), who every month travels to Zimbabwe to stock up on Marvelon family planning pills distributed at hospitals\u201a clinics and pharmacies through the Family Planning Council of Zimbabwe. She smuggles them back into South Africa\u201a where she sells them at a healthy profit to other Zimbabweans who for various reasons don\u2019t want the contraceptive pills dispensed in South African clinics. Nancy\u2019s suppliers are hospital staff in Zimbabwean hospitals who sell the pills to her for R5 a blister pack. If she runs short of stock\u201a she buys packets for R10 from a \u201cwholesale\u201d supplier in Johannesburg who also illegally imports the pills from Zimbabwe. Nancy says she has a 100 customers a month in Springs alone\u201a and she sells the packets for R20 to bulk buyers or R30 to individuals. By contrast\u201a Marvelon tablets were reported to be sold for about R130 per 28 tablets in Johannesburg pharmacies","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"From resource curse to fair benefit? Protecting health in the extractive sector ","field_subtitle":"Rene Loewenson, Training and Research Support Centre","body":"\r\nThe African Union (AU) African Mining Vision envisages a mining sector on the continent that contributes to the continent\u2019s development, not only in terms of its economic growth, but also through mining processes that are \u201csafe, healthy, gender and ethnically inclusive, environmentally friendly, socially responsible and appreciated by surrounding communities.\u201d  An increasing number of multinational companies from all regions globally are extracting mineral resources in east and southern Africa (ESA), but how far are these extractive industries (EIs) delivering on this vision of flourishing, healthy communities in their vicinity? \r\n\r\nNotwithstanding the price fluctuations in the sector, EI exports have yielded significant returns, with oil, gas and mineral exports from the continent estimated in 2009 to be worth roughly five times the value of international aid inflows. They have, however, been associated with rapid but unsustainable growth and high levels of inequality, especially where they have limited forward or backward linkages into the national economy, and where they do not adequately invest in or protect the social and economic development of local communities.  \r\n\r\nA demand for socially responsible EI practice has already led to over 25 international standards, codes, performance standards and guidance documents from United Nations (UN) institutions, international agencies, including the International Finance Corporation, civil society and from business itself.  The standards relate to business and human rights, to labour, health, environmental and social obligations, to socially responsible investment and practice and to transparency in governance of the sector. The international standards relating to health in EIs are detailed in a recent EQUINET report (Discussion paper 108) and policy brief available on the EQUINET website. As a condition for granting mining or prospecting rights, they cover duties to assess and prevent health, social and environmental risks and to ensure fair process and health, social and livelihood protections for communities that are relocated due to mining. During the mining processes, they include prevention of harm to the health of workers and surrounding communities, making fair fiscal contributions to health care and ensuring fair benefit and transparency in their operations. They also include post closure obligations in relation to any longer term health and social harm.\r\n \r\nRecognising regional need and benefits, African states have resolved to harmonise standards and laws for the sector at sub-regional level, in west Africa, through ECOWAS, and southern Africa, through SADC.  A number of ESA countries, such as South Africa, Mozambique, Zambia and Kenya, have also set in place initiatives to bring local standards and practice for EIs in line with global best practices. \r\n\r\nThe rapid expansion of the sector into new areas, the legislative gaps in countries with newer sectors, the differences in power between multinational actors and under-resourced states and communities, amongst other factors, have led to various areas of harm and conflict that call for such rights and duties to be made clear. Notwithstanding the employment, income and fiscal contributions they bring, EIs have been reported to bring health risks for workers and surrounding communities. These risks arise from hazardous working conditions and degraded or polluted environments, from the displacement of local people, several thousand in some cases, without adequate replacement of living conditions, resources, services and livelihoods, and from generous tax exemptions that limit EI contributions to social services. The EQUINET discussion paper summarises some of this published evidence. It also reports evidence of discontent or protest from local communities, who feel excluded from decisions and frustrated by grievance handling mechanisms. Indeed, the African Commission on Human and People\u2019s Rights has established a Working Group on Extractive Industries, Environment and Human Rights Violations in Africa to examine and propose measures to prevent and provide reparation for such negative impacts, while civil society campaigns, like \u2018Publish  what you pay\u2019 have sought greater transparency in EI operations. These conditions suggest that it would be timely to give more attention to realising the intentions to harmonise regional standards on EIs and to ensure that health is included within this.  \r\n\r\nAn analysis of the laws on EIs and health in the ESA region in Discussion paper  108 indicates some general findings across the region: There is generally protection in current ESA laws of occupational health for workers employed by EIs, of duties to the environment, and of fiscal and post mine closure duties. There is, however, weaker protection in current ESA laws of the health and social wellbeing of communities displaced by mines, of families living around mines and of health duties post-closure, such as in relation to chronic diseases. In the laws analysed, fewer countries included duties on forward and backward links with local sectors, communities  and services. \r\n\r\nIt was however a positive finding that where there are gaps in the law, there are also clauses in the law of one or more individual ESA countries that are aligned to international standards that may guide what may be included in the laws of others. \r\n\r\nSuch \u2018good practice\u2019 clauses could inform the content of harmonised regional standards. Their origin from ESA countries of different size and income also suggests that it would be feasible to apply them more widely across the region. The EQUINET discussion paper and policy brief  at http://tinyurl.com/gr6yyza  present suggested clauses for regional guidance on health in EIs (and the laws they derive from), in line with international and continental standards. \r\n\r\nImplementing the vision of a socially responsible, healthy and inclusive mining sector clearly calls for more than law. In relation to health, there is evidence of the need for strengthened enforcement and practice, such as to revisit over-generous fiscal exemptions, to integrate health more centrally in tools for and approvals from impact assessment, to strengthen public sector co-ordination and capacities to monitor and prevent health risks, and to provide public information and meaningful mechanisms for community voice and agency in measures to protect their health. However, having harmonised regional standards may help to raise awareness and understanding amongst the different public sectors, private actors and communities of their roles, rights and duties in relation to health in EIs, and give support to the social and institutional processes and measures needed to promote healthy practice. \r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. You can read further evidence in EQUINET Discussion paper 108 Corporate responsibility for health in the extractive sector in East and Southern Africa at  http://tinyurl.com/zm7afbk  and  Policy brief 42 at  http://tinyurl.com/gr6yyza ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Global Health Workforce Labor Market Projections for 2030","field_subtitle":"Liu J; Goryakin Y; Maeda A; Bruckner T; Scheffler R: Human Resources for Health 15(11) 3, 2017","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0187-2","body":"In low- and middle-income countries, scaling essential health interventions to achieve health development targets is constrained by the lack of skilled health professionals to deliver services. The authors project the future health workforce demand based on projected economic growth, demographics and health coverage. They used health workforce data  for 1990\u20132013 for 165 countries from the WHO Global Health Observatory. The demand projections are compared with the projected growth in health worker supply and the health worker \u201cneeds\u201d as estimated by WHO to achieve essential health coverage. The model predicts that, by 2030, global demand for health workers will rise to 80 million workers, double the current (2013) stock of health workers, while the supply of health workers is expected to reach 65 million over the same period, resulting in a worldwide net shortage of 15 million health workers. Growth in the demand for health workers will be highest among upper middle-income countries, driven by economic and population growth and ageing. This results in the largest predicted shortages which may fuel global competition for skilled health workers. Middle-income countries will face workforce shortages because their demand will exceed supply. By contrast, low-income countries will face low growth in both demand and supply, both of which are estimated to be far below what will be needed to achieve adequate coverage of essential health services. This may lead to the paradoxical phenomenon of unemployed (\u201csurplus\u201d) health workers in those countries facing acute \u201cneeds-based\u201d shortages. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Global inequality: Bridging the gap - Counting the Cost","field_subtitle":"Riley G: tutor2u, Video feature, January 2017","URL":"https://www.youtube.com/watch?v=xzN5YKHL3jE","body":"A new Oxfam report claims that the scale of wealth inequality has grown and that eight people in the world have as much wealth as the poorest fifty per cent of the global population. This video presents the information from the report in a video overview.  ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Global Observatory on Health R&D","field_subtitle":"WHO: WHO Geneva online resource, 2017","URL":"http://www.who.int/research-observatory/en/","body":"The Global Observatory on Health R&D (hereafter called \u2018the Observatory\u2019) is a global-level initiative that aims to help identify health R&D priorities based on public health needs, by: consolidating, monitoring and analysing relevant information on the health R&D needs of developing countries; building on existing data collection mechanisms; and supporting coordinated actions on health R&D. Investments in health R&D are still insufficiently aligned with global public health demands and needs. As little as 1% of all funding for health R&D is allocated to diseases such as malaria and tuberculosis (diseases that are predominantly incident in developing countries), despite these diseases accounting for more than 12.5% of the global burden of disease. Governments, policy-makers, funders and researchers need an accurate picture of the current situation so as to spot R&D gaps and ensure that funds and resources are used in the best possible way. The primary scope of the Observatory as outlined by Member States in World Health Assembly resolution WHA69.23 is: type II and type III diseases (i.e. diseases incident in both rich and poor countries, especially the latter; the specific R&D needs of developing countries in relation to type I diseases; potential areas where market failures exist and antimicrobial resistance and on emerging infectious diseases likely to cause major epidemics.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Gold Mining in Uganda","field_subtitle":"Berry I: Magnum Pro, March 2017","URL":"http://tinyurl.com/mfyhkt7","body":"The author argues that fair trade isn\u2019t only about coffee and bananas. The Fairtrade Foundation points out that it doesn\u2019t matter what the commodity is, people should get a fair price for the work they do. African gold miners are often exploited, but the author argues that workers do not have a choice; it\u2019s dig or starve and it\u2019s accept a pittance for their labors or work harder the following day. The Fairtrade Foundation is reported to have intervened and to be gradually improving conditions on mines. In this photo - essay Ian Berry reflects on the Ugandan gold trade as efforts are made to encourage fairer trading practices. He follows the gold from Ugandan mines to the London workshops of jewellers. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Impoverishing effects of catastrophic health expenditures in Malawi","field_subtitle":"Mchenga M; Chirwa G; Chiwaula L: International Journal for Health in Equity 16(25), 2017","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5251219/","body":"Out-of-pocket (OOP) health spending can potentially expose households to risk of incurring large medical bills, and this may impact on their welfare. This work investigates the effect of catastrophic OOP on the incidence and depth of poverty in Malawi. The paper is based on data that was collected from 12,271 households that were interviewed during the third Malawi integrated household survey (IHS-3). The paper considered a household to have incurred a catastrophic health expenditure if the share of health expenditure in the household's non-food expenditure was greater than a given threshold ranging between 10 and 40%. As the authors increase the threshold from 10 to 40%, they found that OOP drives between 0.73%-9.37% of households into catastrophic health expenditure. The extent by which households exceed a given threshold (mean overshoot) drops from 1.01% of expenditure to 0.08%, as the threshold increased. When OOP is accounted for in poverty estimation, an additional 0.93% of the population is considered poor and the poverty gap rises by 2.54%. The authors\u2019 analysis suggests that people in rural areas and middle income households are at higher risk of facing catastrophic health expenditure. The authors conclude that catastrophic health expenditure increases the incidence and depth of poverty in Malawi. They call for financing measures to minimise the incidence of catastrophic health expenditure especially to the rural and middle income population.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Incentives to change: effects of performance-based financing on health workers in Zambia","field_subtitle":"Shen G; Nguyen H; Das A; Sachingongu N; Chansa C; Qamruddin J; Friedman J: Human Resources for Health 15(20), 2017, doi: 10.1186/s12960-017-0179-2","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0179-2","body":"Performance-based financing (PBF) has been implemented in a number of countries with the aim of transforming health systems and improving maternal and child health. This paper examines the effect of PBF on health workers\u2019 job satisfaction, motivation, and attrition in Zambia. It uses a randomised intervention/control design to evaluate before\u2013after changes for three groups: intervention (PBF) group, control 1 (C1; enhanced financing) group, and control 2 (C2; pure control) group. Mixed methods were employed. The quantitative portion comprises of a baseline and an endline survey. The survey and sampling scheme were designed to allow for a rigorous impact evaluation of PBF or C1 on several key performance indicators. The qualitative portion sought to explain the pathways underlying the observed differences through interviews conducted at the beginning and at the three-year mark of the PBF program. Econometric analysis shows that PBF led to increased job satisfaction and decreased attrition on a subset of measures, with little effect on motivation. The C1 group also experienced some positive effects on job satisfaction. The null results of the quantitative assessment of motivation cohere with those of the qualitative assessment, which revealed that workers remain motivated by their dedication to the profession and to provide health care to the community rather than by financial incentives. The qualitative evidence also provides two explanations for higher overall job satisfaction in the C1 than in the PBF group: better working conditions and more effective supervision from the District Medical Office. The PBF group had higher satisfaction with compensation than both control groups because they have higher compensation and financial autonomy, which was intended to be part of the PBF intervention. While PBF could not address all the reasons for attrition, it did lower turnover because those health centres were staffed with qualified personnel and the personnel had role clarity. In Zambia, the implementation of PBF schemes brought about a significant increase in job satisfaction and a decrease in attrition, but had no significant effect on motivation. Enhanced health financing also increased stated job satisfaction.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program","field_subtitle":"Feldacker C; Bochner A; Herman-Roloff A et al.: PLoS ONE 12(3), 2017, doi:10.1371/journal.pone.0174047","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174047","body":"In 2013, Zimbabwe\u2019s voluntary medical male circumcision (VMMC) program adopted performance-based financing (PBF) to speed progress towards ambitious VMMC targets. The PBF intended to encourage low-paid healthcare workers to remain in the public sector and to strengthen the public healthcare system. The majority of the incentive supports healthcare workers who perform VMMC alongside other routine services; a small portion supports province, district, and facility levels. This qualitative study assessed the effect of the PBF on healthcare worker motivation, satisfaction, and professional relationships. The study objectives were to: 1) Gain understanding of the advantages and disadvantages of PBF at the healthcare worker level; 2) Gain understanding of the advantages and disadvantages of PBF at the site level; and 3) Inform scale up, modification, or discontinuation of PBF for the national VMMC program. Sixteen focus groups were conducted: eight with healthcare workers who received PBF for VMMC and eight with healthcare workers in the same clinics who did not work in VMMC and, therefore, did not receive PBF. Fourteen key informant interviews ascertained administrator opinion. Findings suggest that PBF appreciably increased motivation among VMMC teams and helped improve facilities where VMMC services are provided. However, PBF appears to contribute to antagonism at the workplace, creating divisiveness that may reach beyond VMMC. PBF may also cause distortion in the healthcare system: Healthcare workers prioritised incentivised VMMC services over other routine duties. To reduce workplace tension and improve the VMMC program, participants suggested increasing healthcare worker training in VMMC to expand PBF beneficiaries and strengthening integration of VMMC services into routine care. In the low-resource, short-staffed context of Zimbabwe, PBF enabled rapid VMMC scale up and achievement of ambitious targets; however, side effects make PBF less advantageous and sustainable than envisioned. Careful consideration is warranted in choosing whether, and how, to implement PBF to prioritise a public health program.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Kenyan doctors\u2019 strike: Why the centre can no longer hold","field_subtitle":"Oyoo S: Pambuzuka News, February 2017","URL":"http://tinyurl.com/mv44coe","body":"The doctors\u2019 strike now in its third month in Kenya has caused great suffering to the majority poor people who cannot afford medical care in private hospitals. The author writes that the strike is not merely about the welfare of the healthcare workers, but about a public health system crumbling under deliberate state neglect and corruption. By mid-February Kenyan doctors had been on strike for over two months. They have made several demands including: better remuneration, availability of more doctors in public hospitals, better equipment and availability of drugs in these facilities, and more allocation of funds to health research. They are, according to the author, demanding better healthcare for all Kenyan citizens. The author comments that the doctors\u2019 demands have been spurned by government, and the media to some extent, in what is part of a wider effort to portray the doctors as greedy individuals. The negotiation process has been long and tortuous, with the government side not keen on implementing a Collective Bargaining Agreement (CBA) it signed with the doctors in 2013. Private healthcare providers on the other hand are argued to stealthily lie like vultures \u2013 waiting for the public healthcare system to implode so they can expand their \u2018investments\u2019 in Kenya, a country that\u2019s been described as \u2018a lucrative market for private healthcare service provision\u2019. One can almost imagine that this is part of a wider scheme to privatise the Kenyan healthcare system, a move which would drive the cost of treatment beyond reach of the majority. Kenya was ranked 145 out of 176 in Transparency International\u2019s corruption perception index in 2016. The author writes that it is no longer possible to stand by and watch as up to a third of the Kenyan budget is lost to corruption, and disappears into the pockets of a select few. Kenyans can no longer stand by and watch the state audaciously claim it cannot pay their doctors. Kenyans just cannot afford to be spectators in such a matter of life and death.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Negotiating better contracts in collaborative research partnerships","field_subtitle":"Council on Health Research for Development (COHRED): Geneva, 2017","URL":"http://frc.cohred.org/","body":"Fair Research Contracting equips research partners with key resources on how to build sustainable, equitable global research partnerships. The rise in international research partnerships means that developing countries need to be better positioned to deal with complexities in collaborative research contracting. COHRED argues that better contract negotiation expertise in LMIC institutions will help improve the distribution of benefits of collaborative research, such as overhead costs, data ownership, institutional capacity in research management, technology transfer, and intellectual property rights. With this in mind, COHRED has developed guidance aimed at optimising research institution building through better contracts and contracting in research partnerships. The guidance highlights the key issues for consideration when entering into formalised research partnerships, and provides tools and resources for negotiating fairer research contracts. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"New Open Access Book: Sustainable Food Systems: The Role of the City","field_subtitle":"Biel R: UCL Press, UK, December 2016","URL":"http://tinyurl.com/kyx84fv","body":"Faced with a global threat to food security, it is perfectly possible that society will respond by reasserting co-operative traditions. This open access book, by a leading expert in urban agriculture, proposes a solution to today\u2019s global food crisis. By contributing more to feeding themselves, it argues that cities can allow breathing space for the rural sector to convert to more organic sustainable approaches. Biel\u2019s approach connects with current debates about agroecology and food sovereignty. It asks key questions, and proposes lines of future research. He suggests that today\u2019s food insecurity \u2013 manifested in a regime of wildly fluctuating prices \u2013 reflects not just temporary stresses in the existing mode of production, but more profoundly the troubled process of generating a new one. He argues that the solution cannot be implemented at a merely technical or political level: the force of change can only be driven by the kind of social movements which are now daring to challenge the existing unsustainable order. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Online course on Global Adolescent Health","field_subtitle":"Enrolment open: Course begins 22 May 2017","URL":"https://www.coursera.org/learn/youth-health","body":"The University of Melbourne is offering an online course that will explore the factors affecting the health and wellbeing of young people around the world. The course will be relevant for anyone with an interest in the health and wellbeing of young people. Applicants don't need to be of any particular personal or professional background to benefit from this course, but having some basic undergraduate study experience will be helpful for learning. Financial support is available for learners who cannot afford the fee.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Primer In Systematic Reviews  Online Short-Course May 2017","field_subtitle":"Closing date for Bursary applications 14 April 2017","URL":"http://southafrica.cochrane.org/news/cochrane-sa-fellowship-programme","body":"Cochrane South Africa, in its role as coordinating unit of the Cochrane African Network, has bursaries available to participate in the Primer in Systematic Reviews online short-course, running from 1 May to 14 July or 1 October to 8 December 2017. This course is being offered by the Centre for Evidence-based Health Care in collaboration with Cochrane South Africa, as part of the Effective Health Care Research Consortium. It aims to build capacity of participants to find, appraise, interpret and consider the use of systematic reviews of effects of interventions. If you would like to apply for a bursary please complete the application form and submit to ameer.hohlfeld@mrc.ac.za by 14 April 2017. The Primer in Systematic Reviews online short-course duration is 6 weeks (excluding orientation) and requires up to 4 hours of effort a week.  The course is purely online and uses an e-learning platform called SUNLearn. At the end of the course participants should be able to: 1. Outline the rationale for research synthesis and phrasing questions 2. Identity the principles of randomised controlled trials and risk of bias 3. Find, read and appraise systematic reviews (SRs) 4. Interpret findings of reviews of effects, including statistical interpretation of meta-analysis 5. Be able to interpret a  GRADE profile and Summary of Findings table 6. Outline key components of a systematic review of effects that need to be considered in applying to health policy and practice. See website for application information.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Safe and inclusive cities survey","field_subtitle":"Institute of Environmental Studies, University of Zimbabwe, 2015","URL":"http://www.searcwl.ac.zw/downloads/Safe-and-inclusive-2015.pdf","body":"The proportion of people worldwide living in urban areas has been increasing over the past century. Southern Africa is one of the least urbanised but fastest urbanising region. The pace of urbanisation in sub-Saharan Africa is twice the global average, making it the highest in the world. The urban population annual growth rate for the region is pegged at 3.75%. South Africa and Botswana have urban populations of more than 60% and Zimbabwe 33%. The survey was conducted in 4 purposively sampled urban high density suburbs. A multi-stage random sampling was then used to select households in the 4 suburbs. The sampling frame for selecting households was obtained from ZIMSTAT, the country\u2019s statistical office. Data was collected over a period of a week in each of the sampled suburbs. During the week the enumerators would conduct household interviews in the Enumeration Areas (EAs). Household questionnaire were used to collected data from the sampled households.  The questionnaire covered: characteristics of household members; availability of and access to shelter, water and sanitation; energy sources; income sources; assets. Results shows that where the council provided the houses, the critical services were provided and water, electricity and sanitation were not an issue. The urban councils developed the properties, but their role was not clear in the new urban landscape. Issues of restitution in the event of evictions in these areas were grey areas and people did not know where to go to get assistance when evicted, to where to access legal advice. Residents wanted advice on issues to do with access to land for vending, law enforcement and women empowerment, on land tenure and how to get title deeds. Most lease agreements and title deeds were in the name of the husband, giving men more access to land for housing than women. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"SexRightsAfrica Network ","field_subtitle":"Regional Sexual and Reproductive Health and Rights Fund: South Africa ","URL":"http://www.sexrightsafrica.net/","body":"The SexRightsAfrica Network brings together organisations and individuals working to realise Sexual and Reproductive Health Rights across Eastern and Southern Africa, and beyond. It is intended to complement, promote and strengthen existing networks and knowledge management platforms. It provides a meeting and referral point at the busy intersection of HIV and AIDS, health and well-being, and economic, social and cultural rights. There are many ways to participate in the network.  This website is the platform for the network, as a regional networking hub to share evidence and strengthen action to realise sexual and reproductive health rights. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Sexual and reproductive health services utilization by female sex workers is context-specific: results from a cross-sectional survey in India, Kenya, Mozambique and South Africa","field_subtitle":"Lafort Y; Greener R: Roy A: et al.: Reproductive Health 14 (13) DOI: 10.1186/s12978-017-0277-6, 2017","URL":"http://tinyurl.com/jjya8vv","body":"Female sex workers (FSWs) are extremely vulnerable to adverse sexual and reproductive health (SRH) outcomes. To mitigate these risks, they require access to services covering not only HIV prevention but also contraception, cervical cancer screening and sexual violence. To develop context-specific intervention packages to improve uptake, this paper identified gaps in service utilization in four different.  A cross-sectional survey was conducted, as part of the baseline assessment of an implementation research project. FWSs were recruited in Durban, South Africa (n\u2009=\u2009400), Mombasa, Kenya (n\u2009=\u2009400), Mysore, India (n\u2009=\u2009458) and Tete, Mozambique (n\u2009=\u2009308), using respondent-driven sampling (RDS) and starting with 8-16 \u2018seeds\u2019 identified by the peer educators. FSWs responded to a standardised interviewer-administered questionnaire about the use of contraceptive methods and services for cervical cancer screening, sexual violence and unwanted pregnancies.  Current use of any modern contraception ranged from 86.2% in Tete to 98.4% in Mombasa (p\u2009=\u20090.001), while non-barrier contraception (hormonal, IUD or sterilisation) varied from 33.4% in Durban to 85.1% in Mysore (p\u2009","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Size of Cabinets in Africa, as Ghana\u2019s Akufo-Addo Names \u2018Elephant\u2019 Team of 110 Ministers, and Counting","field_subtitle":"Mungai C: Africapedia, March 2017","URL":"http://www.africapedia.com/2017/03/18/cabinets-africa-ghana-akufo-addo/","body":"Ghana\u2019s president Nana Akufo-Addo came under fire for naming what has been described as an \u2018elephant\u2019 cabinet \u2013 with 31 cabinet portfolios, several ministries have two or more deputies, bringing the total size of cabinet to 110 ministers and perhaps more. Such a large team may have significant financial implications, in a country where the debt-to-GDP ratio is about 74%, with a $1 billion bailout from the International Monetary Fund (IMF) in 2015. Looking at Africa more broadly, the median size of cabinets is 30 (excluding deputies). The largest such cabinet is in Cameroon with 63 ministers. Uganda\u2019s cabinet has 31 full cabinet ministers and 49 ministers of state, bringing the total number to 80. In Africa, larger cabinets are more common in post-conflict countries that are trying to build a broader national consensus, especially in countries with high political or ethnic fragmentation, as ministerial appointments are an easy way to build loyalty to the regime of the day. The author indicates that they are also common in resource-rich countries, and in those that have had long-serving heads of state, which tend to have heavy patronage networks. In that way, they serve an important political, if not economic or technocratic function \u2013 they create compromise and cohesion within the political class.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Social Accountability Dialogue Series 2017","field_subtitle":"Community of Practitioners on Accountability and Social Action in Health (COPASAH):2017","URL":"http://www.copasah.net/uploads/1/2/6/4/12642634/copasah_announcement_2.pdf","body":"COPASAH is a global network of accountability practitioners who share a people centric vision and human rights based approach to health, health care and human dignity.  COPASAH is holding a series of social accountability online dialogues to further share mutual learning through the use of virtual platforms and communication technologies. The online platform will support different streams of accountability practice - such as budget monitoring, struggle based health rights groups, health movements and technical resource groups on community monitoring \u2013 to interact and share experiences.  COPASAH is looking for partners to facilitate online Social Accountability Dialogues, to facilitate discussions on a range of health rights themes. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review","field_subtitle":"Allen L; Williams J; Townsend N; Mikkelsen B; Roberts N; Foster C; Wickramasinghe K: The Lancet Global Health, 5(3), 2017","URL":"https://tinyurl.com/kaoh6u4","body":"This study aimed to review evidence on the association between socioeconomic status and harmful use of alcohol, tobacco use, unhealthy diets, and physical inactivity within low-income and lower-middle-income countries (LLMICs). The authors searched 13 electronic databases, grey literature, and reference lists for primary research published between Jan 1, 1990, and June 30, 2015.  They used a piloted version of the Cochrane Effective Practice and Organisation of Care Group data collection checklist to extract relevant data at the household and individual level from the included full text studies including study type, methods, outcomes, and results. Low socioeconomic groups were found to have a significantly higher prevalence of tobacco and alcohol use than high socioeconomic groups. These groups also consumed less fruit, vegetables, fish, and fibre than those of higher socioeconomic status. Groups at higher socioeconomic status were found to be less physically active and to consume more fats, salt, and processed food than individuals of low socioeconomic status. Despite significant heterogeneity in exposure and outcome measures, the evidence shows that behavioural risk factors are affected by socioeconomic position within LLMICs. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The conceptualization of family care during critical illness in KwaZulu-Natal, South Africa ","field_subtitle":"de Beer J; Brysiewicz P: Health SA Gesondheid (22), 2017, doi: http://dx.doi.org/10.1016/j.hsag.2016.01.006","URL":"http://www.sciencedirect.com/science/article/pii/S1025984816300436","body":"In recent years there has been a movement to promote patients as partners in their care. However, in the case of critically ill patients, who are often sedated and mechanically ventilated, family members may be more involved in the care of the patient. To date, this type of care has been represented by three dominant theoretical conceptualisations and frameworks one of which is family centred care. There is, however, a lack of consensus on the definition of family centred care. This study explored the meaning of family care within a South African context. This study adopted a qualitative approach and a grounded theory research design by Strauss and Corbin (1990). Participants from two hospitals: one private and one public were selected to participate in the study. There was a total of 31 participants (family members, intensive care nurses and doctors) who volunteered to participate in the study. Data collection included in-depth individual interviews. The findings of this study revealed that family care is conceptualised as togetherness, partnership, respect and dignity. During a critical illness, patients' families fulfil an additional essential role for patients who may be unconscious or unable to communicate or make decisions. Family members not only provide vital support to their loved one, but also become the \"voice\" of the patient.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The health impact of sexual violence among women in a platinum mining belt","field_subtitle":"Zhang M; Steele S; Shroud A; Van Cutsem G; Khan J; Barnwell G; Hill J; Duncan K: Medecins Sans Fronti\u00e8res, 2017","URL":"http://tinyurl.com/kccwg7c","body":"New analysis of data detailing the extent of sexual violence in the Rustenburg area indicates that one in five HIV infections (approximately 6,765 of all female cases) and one in three cases of depression among women (5,022 cases) are attributable to rape and intimate-partner violence (IPV), while one in three women inducing abortion (1,296 cases) was pregnant as a result of sexual violence.  These results have emerged from an in-depth 2015 survey conducted by  Medecins Sans Frontiers (MSF) among more than 800 women living in communities along the mining belt where the health consequences of sexual violence remain largely unaddressed and demand urgent action. Much additional suffering could have been prevented if survivors had been able to access a basic package of healthcare services, but opportunities are missed each day to prevent HIV infection, psychological trauma, and unwanted pregnancy for victims of sexual violence in on the platinum mining belt, because there are too few health facilities with the capacity to provide essential care. As South Africa finalises its next five-year National Strategic Plan (NSP) on HIV, TB and STIs (2017-2022), MSF is calling for the inclusion of ambitious targets for increasing sexual violence survivors\u2019 access to medical and psychosocial services at all health facilities. Key interventions include providing post-exposure prophylaxis (PEP) to prevent HIV and other sexually transmitted infections, psychosocial support including trauma counselling, emergency contraception, other basic medical services (e.g. first aid), and the option of forensic examination.. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The Mozambican debt crisis: How a sovereign state was sold","field_subtitle":"Serumaga M: Pambazuka news 808, February 2017","URL":"http://tinyurl.com/j3njnu2","body":"The author reports on 2013 loans taken without parliament approval in Mozambique totaling $2 billion. External funders suspended credit to Mozambique because of the loans, and the national currency fell by 70% in 2016. Restructuring the loans means imposed austerity on a population already living in extreme austerity and eventually repaying the creditors from revenues derived from Mozambique\u2019s natural gas deposits that come on the market in 2023. The author presents information on the case, the funders and the implications for other African countries. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The Second National Burden of Disease Study for South Africa: Cause of death profile Report, 1997 \u2013 2012","field_subtitle":"Msemburi W; Pillay-van Wyk V; Dorrington RE et al: South African Medical Research Council: Cape town, 2016 ","URL":"http://www.mrc.ac.za/bod/SouthAfrica2012.pdf","body":"This report estimates consistent and coherent cause-specific death rates for the period 1997\u20132012 and identifies the leading causes of death and premature mortality for South Africa, taking into consideration and adjusting for the data deficiencies. The report used the methodology of the Global Burden of Disease Study 2005 in secondary analysis of data obtained from Statistics South Africa (Stats SA), the Injury Mortality Survey 2009 (IMS) and National Injury Surveillance System 2000 (NIMSS). For the non-communicable diseases, there was an increasing trend in numbers over the whole period while the trends for communicable disease combined with maternal causes, perinatal conditions and nutritional deficiencies, remained fairly stable between 1997 and 2009, decreasing slightly thereafter. HIV/AIDS and TB increased between 1997 and 2006, where it peaked at 687 deaths per 100,000 population and then decreased steadily each subsequent year. The report points to a considerable burden from non-communicable diseases and concerning signs of an increase in diabetes mortality. The authors say that efforts targeting prevention and management of non-communicable diseases and their risk factors need to be scaled up.\r\n","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Urban Health Research in Africa: Themes and Priority Research Questions","field_subtitle":"Oni T; Smit W; Matzopoulos R; Adams J et al.: Initiative for Cities and Health (RICHE) members: Journal of Urban Health 93(4) 722-730, 2016","URL":"http://tinyurl.com/glbu63x","body":"In Africa, urbanisation and urban growth are dramatically restructuring the nature of cities. The growing majority of urban dwellers now live in informal conditions that, without access to basic services or public amenities, expose residents to greater health risk, and health-care systems are unable to provide affordable or comprehensive cover. The differential exposure to these urban conditions is compounded by social and economic vulnerability, resulting in health inequities. Yet despite pressing needs driven by Africa\u2019s considerable and complex burden of disease and high levels of health inequity, urban health and urban health equity have not yet emerged as major research and policy priorities in Africa. This commentary presents a conceptual framework, using a public health approach, for interdisciplinary research aimed at contributing to the understanding and mitigation of urban health issues and challenges in Africa. It identifies downstream and upstream factors, based on published literature, associated with key determinants in each theme. It represents a collective effort by interdisciplinary academics from public health; anthropology; civil engineering; architecture, planning and geomatics; human biology; psychiatry and mental health; medicine; pathology; and paediatrics, from the Research Initiative for Cities and Health (RICHE), University of Cape Town, to generate African perspectives on urban health and urban health equity. The six focus areas identified as important include obesity and food insecurity, the urban context as a tool for health promotion, urban health governance and policy, community strengthening for healthy inclusive cities, health systems in an urbanising context and migration, urbanisation and health. The authors argue that a complex systems approach is required to investigate and improve understanding of health and well-being in a changing urban context with a view to developing sustainable and cost-effective interventions. This acknowledges the different dimensions of determinants that influence health and understands the need to address gaps in data and access to information from across these dimensions, and to engage all relevant stakeholders across sectors prioritise the interventions to improve health.  ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Urban Studies Foundation International Fellowships for Early to Mid-Career Urban Scholars from the Global South","field_subtitle":"Deadline for applications: 28 April 2017","URL":"http://www.urbanstudiesfoundation.org/funding-opportunities/","body":"Applications are invited for an International Fellowship for urban scholars on any theme pertinent to a better understanding of urban realities in the global south funded by the Urban Studies Foundation. The Fellowship covers the costs of a sabbatical period at a university of the candidate\u2019s choice in either the global north or the global south (facilitating south-south exchange) for the purpose of writing up the candidate\u2019s existing research findings in the form of publishable articles or a book under the guidance of a chosen mentor in their field of study. Funding is available for a period ranging between 3-9 months. Applicants must be early career urban scholars with a PhD obtained within the preceding 5 years who currently work in a university or other research institution within the global south. Candidates must also be nationals of a country in the global south. Preference may be given to candidates from least or low-income countries but middle-income developing countries are not excluded if the need for support is justified. The candidate must make suitable arrangements to be mentored by a suitably experienced senior urban scholar at his/her chosen research institution. The application must include: an outline of the planned research, demonstrating its originality, rigour and value to the field of urban studies; with a statement of the intended research outputs; and further information provided on the website. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient\u2013Provider Communication in the START Study","field_subtitle":"Hirsch-overman Y; Daftary A; Yuengling K; Saito S; Ntoane M; Frederix K; Maama B;  Howard A: Journal of Acquired Immune Deficiency Syndromes 74, S37\u2013S43, 2017","URL":"http://tinyurl.com/zoxja3t","body":"mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). The authors describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analysed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualised by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilisation. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"What Does the End of Africa's Boom Mean for Universal Health Coverage?","field_subtitle":"Russo, G; Bloom, G: IDS Rapid Response Briefing 16, 2017","URL":"http://tinyurl.com/jc8klep","body":"According to the authors, achieving universal health coverage by 2030, as stated in UN Global Goal 3, will require substantial increases in health spending and the proportion funded through taxation or social insurance to make health care affordable for all. Not only will institutions need to be established to ensure sustainable arrangements for social finance, it will also be vital to ensure that health financing is resilient to economic and other shocks if Global Goal 3 is to be realised. This is argued to present a major challenge in Africa, where an economic downturn is projected in a number of resource-dependent countries, such as Mozambique and Guinea Bissau and where countries such as Sierra Leone have weakened health systems. The response to these challenges by governments and development partners, will have important effects on how well people, and the health services on which they rely, cope in the short term and longer-term evolution of health coverage.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"World Malaria Report 2016","field_subtitle":"World Health Organization: WHO Geneva, 2016","URL":"http://apps.who.int/iris/bitstream/10665/252038/1/9789241511711-eng.pdf?ua=1","body":"The World Malaria Report, published annually by WHO, provides an in-depth analysis of progress and trends in the malaria response at global, regional and country levels. It is the result of a collaborative effort with ministries of health in affected countries and many partners around the world. The 2016 report spotlights a number of positive trends, particularly in sub-Saharan Africa, the region that carries the heaviest malaria burden. It shows that, in many countries, access to disease-reducing measures is expanding at a rapid rate for those most in need. The proportion of the population at risk in sub-Saharan Africa sleeping under an insecticide-treated mosquito net (ITN) or protected by indoor residual spraying (IRS) is estimated to have risen from 37% in 2010 to 57% in 2015. The proportion of the population at risk in sub-Saharan Africa who are infected with malaria parasites is estimated to have declined from 17% in 2010 to 13% in 2015. Further data on malaria prevention, treatment and outcomes are presented.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Young people building a new vision for Port Elizabeth : Young Urbanists meet in Nelson Mandela Bay","field_subtitle":"Coetzee L: Future Cape Town, 2016","URL":"http://tinyurl.com/z8ktmmx","body":"In 2016, a hundred-strong group of young Port Elizabethans gathered at the Athenaeum in Central, for the city\u2019s first YOUNGURBANISTS meeting. A historic building and national monument situated on the corner of Castle Hill and Belmont Terrace, the Athenaeum is not a typical art gallery. It has reinvented itself as a community hub for emerging creatives in Nelson Mandela Bay and surrounds. Set in the heart of the \u2018old city,\u2019 the Athenaeum sets out to be a tangible example of a reimagined, multi-use urban space \u2013 a fitting location for a Young Urbanists event. Speakers included Oyama Vanto, project leader in Development and Infrastructure for the Mandela Bay Development Agency (MBDA), who introduced the audience to the MBDA\u2019s goals of reversing urban decay and attracting people and businesses back into the inner city, and to its current projects:  the resurrection of Zola Nqiri Square, the development of Vuyisile Mini Square and the extension of Route 67. Oyama\u2019s passion for the democratization for city spaces resonated clearly in his talk, and he called out for a safer city for women and children as the starting point in enabling a more inclusive city. The audience were invited to share their vision for the future of our city, and to record it on a piece of paper and placed into a box. Young urbanists in attendance voiced their ideas and their concerns, calling for clear objectives through which they could move Nelson Mandela Bay forward as a model for future cities. One issue in particular was to identify the many pockets of multidisciplinary communities in our cities, with the hope of promoting synergy and fostering a participatory environment. Grand visions in place, the attendees are reported to now be reflecting on the ways that they can begin to take steps towards making such visions a reality, and dwell on the question of how, as young urbanists of PE, they can collectively propel a momentum shift and foster a culture of pride in their city.","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"\u2018You must carry your wheelchair\u2019 \u2013 barriers to accessing healthcare in a South African rural area","field_subtitle":"Vergunst R; Swartz L; Mji G; MacLachlan M; Mannan H: Global Health Action 8(1); http://dx.doi.org/10.3402/gha.v8.29003, 2017","URL":"http://www.tandfonline.com/doi/full/10.3402/gha.v8.29003","body":"There is international evidence that people with disabilities face barriers when accessing primary healthcare services and that there is inadequate information about effective interventions that work to improve the lives of people with disabilities, especially in low-income and middle-income countries. Poor rural residents generally experience barriers to accessing primary healthcare, and these problems are further exacerbated for people with disabilities. This study explored the challenges faced by people with disabilities in accessing healthcare in Madwaleni, a poor rural Xhosa community in South Africa. Purposive sampling was done with 26 participants, using semi-structured interviews and content analysis to identify major themes. The study showed a number of barriers to healthcare for people with disabilities. These included practical barriers, including geographical and staffing issues, and attitudinal barriers. ","php":"","field_issue_date":"2017-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"10th ECSA Best Practices Forum and 26th Directors Joint Consultative Committee Meeting","field_subtitle":"ECSA HC: 10 to 12 April 2017, Arusha, Tanzania; Submission of Abstracts deadline: March 17, 2017 ","URL":"http://www.ecsahc.org/wp-content/uploads/2017/02/Announcement_BPF-and-DJCC-2017-1.pdf","body":"The East, Central and Southern Africa Health Community (ECSA-HC) will host the\r\n10th Best Practices Forum and 26th Directors Joint Consultative Committee from 10 to 12 April 2017 in Arusha, Tanzania. The theme is Promoting Multi-Sectoral Collaboration for Health through Sustainable Development Goals. The Conference will address its Theme through the following sub-themes:\r\n1. Good Governance and Leadership Practices in the Health sector\r\n2. Mitigating the Impact of emerging and re-emerging diseases.\r\n3. Multi-Sectoral responses to Non-communicable Diseases.\r\n4. Accountability for Women\u2019s, Children\u2019s and Adolescent Health post-2015\r\nThe ECSA-HC is inviting abstracts of best practices and scientific papers that are relevant to the conference sub themes. The scientific papers and best practices should consist of case studies and evidence based programme experiences that are innovative, unique or have added value and new thinking in health. The abstracts and scientific papers will form the basis for the recommendations that will be presented to the Health Ministers for further deliberation and adoption as resolutions. Further information is available on the website. EQUINET has a formal association with ECSA HC and will be represented at the meeting. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Addressing Health Inequities Conference","field_subtitle":"Century City Conference Venue, Cape Town, South Africa. 10-12 February 2017","URL":"http://www.hst.org.za/events/addressing-health-inequities-conference","body":"This conference is a Joint initiative of the South African Medical Association (SAMA), World Medical Association (WMA) and the School of Public Health at the University of Witwatersrand. The keynote speaker is Sir Michael Marmot, ex-Chair of the WHO Commission on Social Determinants of Health.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Antibiotic Resistance in the Food Chain: A Developing Country-Perspective","field_subtitle":"Founou L; Founou R; Essack S: Frontiers in Microbiology, 2016","URL":"http://journal.frontiersin.org/article/10.3389/fmicb.2016.01881/full","body":"Food animals are considered as key reservoirs of antibiotic-resistant bacteria with the use of antibiotics in the food production industry having contributed to the actual global challenge of antibiotic resistance (ABR). There are no geographic boundaries to impede the worldwide spread of ABR. If preventive and containment measures are not applied locally, nationally and regionally, the limited interventions in one country, continent and for instance, in the developing world, could compromise the efficacy and endanger ABR containment policies implemented in other parts of the world, the best-managed high-resource countries included. Multifaceted, comprehensive, and integrated measures complying with the One Health approach are thus imperative to ensure food safety and security, effectively combat infectious diseases, curb the emergence and spread of ABR, and preserve the efficacy of antibiotics for future generations. The World Health Organisation, World Organisation for Animal Health, and the Food and Agriculture Organisation recommend implementing national action plans encompassing human, (food) animal, and environmental sectors to improve policies, interventions and activities that address the prevention and containment of ABR from farm-to-fork. This review covers (i) the origin of antibiotic resistance, (ii) pathways by which bacteria spread to humans from farm-to-fork, (iii) differences in levels of antibiotic resistance between developed and developing countries, and (iv) prevention and containment measures of antibiotic resistance in the food chain.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Assessing fiscal space for health expansion in low- and middle-income countries: a review of the evidence","field_subtitle":"Barroy H; Sparkes S; Dale E: Working Paper, World Health Organisation, WHO/HIS/HGF/HF Working Paper/16.3, 2016 ","URL":"http://tinyurl.com/gl69wvk","body":"Despite the proliferation of the term \u2018fiscal space for health\u2019 in recent years, there has been no comprehensive review of how the concept can be applied to assess and support the expansion of resources for the health sector. There is also a certain amount of confusion regarding the conceptual underpinnings and application of fiscal space for health analysis, notably regarding the way in which such analysis can help countries realise potential fiscal space for health expansion. In this paper, a qualitative review of 35 studies was undertaken in four stages to identify all fiscal space for health studies and to systematically assess their findings and methods. These four stages involved a literature search, crowd-sourcing techniques, data extraction, and comprehensive qualitative analysis. The study shows that economic growth, budget re-prioritisation and efficiency improving measures are the main drivers of fiscal space for health expansion. There is scarce evidence regarding the prospective role of earmarked funds, and development assistance for health in expanding fiscal space for the sector. The lack of standardised methods and metrics to systematically assess fiscal space for health results in variations in the analytical approaches used, and limits study relevance and applicability for policy reform. The paper concludes that a more contextualised approach to fiscal space analysis is required, which focuses on key sources of fiscal space for health expansion and includes efficiency enhancements. Fiscal space analysis should be systematically embedded in domestic budgeting processes and explicitly consider both technical and political feasibility of assessed options. Adopting this approach could offer considerable potential for optimising government budget and expenditure decisions and more effectively support progress toward UHC.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Atlas of health and climate","field_subtitle":"Department of Public Health and Environment: World Health Organisation, Geneva","URL":"http://www.who.int/globalchange/publications/atlas/en/","body":"Human health is profoundly affected by weather and climate. Extreme weather events kill tens of thousands of people every year and undermine the physical and psychological health of millions. Droughts directly affect nutrition and the incidence of diseases associated with malnutrition. Floods and cyclones can trigger outbreaks of infectious diseases and damage hospitals and other health infrastructure, overwhelming health services just when they are needed most.  The Atlas of health and climate is a product of a unique collaboration between the meteorological and public health communities. It provides sound scientific information on the connections between weather and climate and major health challenges. It outlines the consequences for a range from diseases of poverty to emergencies arising from extreme weather events and disease outbreaks.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Building Children's Nursing for Africa Conference","field_subtitle":"28 - 30 March 2017, Cape Town, South Africa","URL":"http://www.buildingchildrensnursing.co.za/index.php/tophome","body":"The theme for the 2017 conference is \u2018Pillars of Practice\u2019 in paediatric and children\u2019s nursing and will showcase recent research, clinical practice projects, education and leadership initiatives. The organisers are excited about showcasing good clinical nursing. More and more research confirms the parents vital role in improving outcomes for children, so workshops and conversations about collaboration and innovative strategies of enrolling people are anticipated. The conference themes cover what nurses measure - how and why - and how this is turned into data, clinical leadership, establishing families into the care hub, clinically relevant teaching and sustainable innovation in paediatrics. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers: Law and the New Urban Agenda, 4th Annual International & Comparative Urban Law Conference","field_subtitle":"Deadline for proposal submissions:  March 6, 2017","URL":"http://www.urbanlawcenter.org/sacallforpapers","body":"The Fordham Urban Law Center, in conjunction with the University of Cape Town (UCT), is pleased to announce a call for participation in the 4th Annual International and Comparative Urban Law Conference, to be held on Monday July 17th and Tuesday July 18th, 2017. The Conference will be held at UCT in Cape Town, South Africa. The Conference will provide a dynamic forum for legal and other scholars to engage and generate diverse international, comparative, and interdisciplinary perspectives in the burgeoning field of urban law. The Conference will explore overlapping themes, tensions, and opportunities for deeper scholarly investigation and practice with a comparative perspective. The Conference is open to urban law topics across a broad spectrum, such as: Structure and workings of local authority and autonomy; urban and metropolitan governance and finance; economic and community development; housing and the built environment; unique challenges facing cities in developing nations and the global south; urban public health; migration and citizenship; urban equity and inclusion and sustainability and resilience. While the Conference will foster a broad dialogue about cities and legal systems in comparative and international perspective, we specifically invite submissions to focus on the role of law in New Urban Agenda adopted this past October by the United Nations at the Habitat III Conference in Quito, Ecuador. In keeping with this framework, the conference seeks to investigate the role of laws in promoting the New Urban Agenda in a manner that is democratic, sustainable and equitable.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Can the private sector help achieve universal health coverage?","field_subtitle":"Nishtar S: World Economic Forum, 2016","URL":"http://tinyurl.com/hfpefyx","body":"When the world committed to ending poverty, protecting the planet and ensuring prosperity for all with the 17 Sustainable Development goals, we knew no single entity would be able to achieve such lofty goals \u2013 it would take collaboration. \u201cA successful sustainable development agenda requires partnerships between governments, the private sector and civil society,\u201d Goal 17 stated. The author argues that in  few areas is that more obvious than in the fight to achieve universal health coverage, which falls under Goal 3 of Good Health and Wellbeing. If universal health coverage in all countries is to be achieved, even those where privately-financed market delivery is predominant, this will depend on the ability of governments to harness their potential. In such contexts, she observes, it is critical to build the stewardship capacity of public agencies so that they can frame and implement rules that define the environment and the incentives that guide the behaviours of health system players. Rather than focusing on privatisation, marketisation or the scaling up of private provision, the idea would be to get private actors involved in the pursuit of universal health coverage and financial protection goals. Although the private sector often has a dominant role in the provision of healthcare, too often governments do not know enough about how these providers operate, and there is little, if any, regulation in place. She recommends that countries examine if service delivery models incorporating tools such as franchising and social marketing and utilising economies of scale, standardisation, and/or market incentives can enable universal health coverage within their respective health systems. In recent years, public ownership and not-for-profit service provision and autonomous governance arrangements have been promoted over publicly financed, owned and operated models. However, gains due to hospital autonomy should go beyond revenues for hospitals and incentives for staff and must also enhance quality and equity. New frameworks of participatory governance and appropriate channels of accountability and regulation need to be established. She notes however that the commercial presence of a foreign service provider could create a dual market structure, with high-quality services being provided to affluent consumers to the detriment of the healthcare needs of poorer people. Additionally, the movement of healthcare providers and brain drain \u2013 both internal and external \u2013 can lead to a loss of trained healthcare providers in the home country. Policy safeguards will be needed to prevent this type of situation.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Change a life with just one swipe!","field_subtitle":"Matroos J: Design Indaba, 2016","URL":"http://www.designindaba.com/videos/creative-work/change-life-just-one-swipe","body":"The Radi-Aid Awards celebrates creativity in fundraising campaigns worldwide. Specifically, it challenges the perception of the global south as helpless victims who are dependent on donations from the West. The initiative is best known for its videos that debunk and poke fun at the stereotypes perpetuated by aid campaigns. This recent video, \u201cThe Radi-Aid App: Change A Life With Just One Swipe\u201d flips the script on the usual aid campaign. In it Africans are asked to donate to the cold citizens of Norway, challenging the notion that  the material circumstances of others are easily fixed by single interventions and raising that   perpetuating stereotypes can do more harm than good. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Civil Society Scholar Awards 2017 -2018","field_subtitle":"Open Society Scholarship Programs, Deadline 31 March 2017","URL":"https://www.opensocietyfoundations.org/grants/civil-society-scholar-awards-20170123","body":"The Civil Society Scholar Awards (CSSA) support international academic mobility to enable doctoral students and university faculty to access resources that enrich socially-engaged research and critical scholarship in their home country or region. Civil Society Scholars are selected on the basis of their outstanding contributions to research or other engagement with local communities, to furthering debates on challenging societal questions, and to strengthening critical scholarship and academic networks within their fields. The Awards are open to the following academic populations:\r\n\u2022 Doctoral students of eligible fields studying at accredited universities inside or outside of their home country; or\r\n\u2022 Full-time faculty members (must have a minimum of a master\u2019s degree) teaching at universities in their home country;\r\nWho are citizens of: Afghanistan, Albania, Angola, Azerbaijan, Belarus, Bosnia and Herzegovina, Cambodia, Democratic Republic of Congo, Republic of Congo, Egypt, Equatorial Guinea, Eritrea, Ethiopia, Guinea, Haiti, Kosovo, Laos, Libya, Macedonia, Moldova, Mongolia, Myanmar/Burma, Nepal, Palestine, Papua New Guinea, Serbia, Sudan, South Sudan, Syria, Swaziland, Tajikistan, Tunisia, Turkmenistan, Uzbekistan, or Yemen. See more information on the website.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 192: The World Health Organisation should counter the privatization of health governance, but does it?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Food security and coping strategies of an urban community in Durban","field_subtitle":"Mtolo A: Durban University of Technology Thesis, 2016","URL":"http://ir.dut.ac.za:8080/handle/10321/1736","body":"This study determined the food security status, coping strategies, food intake and the nutritional status of the Kenneth Gardens community, in urban KwaZulu-Natal. Residents are low income bracket earners and many rely on state disability and pension grants for survival. The research tools included; a food security questionnaire, anthropometric measurements, a socio-demographic questionnaire, a food frequency questionnaire, and 24-hour recall questionnaires conducted in triplicate. The most commonly used coping strategy during periods of food scarcity was \u201cRely on less expensive and preferred food\u201d. The second used coping strategy was \u201cReduce the number of meals eaten in a day\u201d , followed by \u201cContribute to a food stokvel in order to ensure food over a scarce period\" and \u201cRestrict consumption by adults in order for small children to eat\u201d. Utilisation of these food coping strategies indicate a degree of food insecurity. Low income and high unemployment increased the prevalence of food insecurity, leading to the coping strategies reported. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"From Corn to Popcorn? Urbanisation and food consumption in Sub-Sahara Africa: Evidence from rural-urban migrants in Tanzania","field_subtitle":"Cockx L; De Weerdt J: 2016 AAAE Fifth International Conference Paper Number 249270, 2016","URL":"https://ideas.repec.org/p/ags/aaae16/249270.html","body":"Sub-Saharan Africa is currently in the midst of an unprecedented wave of urbanisation that is expected to have wide-ranging implications for food and nutrition security. Though this spatial transformation of the population is increasingly put forward as one of the main drivers of changes in food consumption patterns, empirical evidence remains scarce and the comparative descriptive design of existing research is prone to selection bias as urban residence is far from random. Based upon longitudinal data from the Tanzania National Panel Survey and the Kagera Health and Development Survey, this study is the first to assess the impact of urbanisation on food consumption through comparing individuals\u2019 food consumption patterns before and after they have migrated from rural to urban areas. The authors find that even after controlling for individual fixed heterogeneity, baseline observable characteristics and initial household fixed effects, urbanisation is significantly associated with important changes in dietary patterns, including a shift away from traditional staples towards more processed and ready-to-eat foods. While there is some evidence of changes that can be deemed beneficial from a nutritional point of view - including increased consumption of vegetables and animal source foods - the results also largely confirm concerns about the association between urbanisation and heightened consumption of sugar and fats. In addition, the authors find no support for the hypothesis that urbanisation is associated with more diverse diets. Finally, the results indicate that rural-urban migration significantly contributes to reducing volatility in food consumption.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Health system learning sites: understanding health systems through research collaboration and engagement","field_subtitle":"Resilient and Responsive Health Systems (RESYST), 2016","URL":"http://tinyurl.com/zsse5nj","body":"Health policy and systems research is centrally concerned with people, their relationships and the actions that they take towards strengthening health systems. To understand complex health systems, researchers must actively engage with system actors, ranging from health managers to service users, learning from their tacit knowledge and about their experience. In Kenya and South Africa, researchers have established learning sites specifically to support a wide range of research focused on health systems governance issues at the district level. Both countries have devolved government structures and county (Kenya) and provincial and district (South Africa) managers now play a pivotal role in the development, management and delivery of health services. Learning sites provide unusual opportunities to learn about the daily processes of decision-making that comprise health system governance, and to support managers in taking action to strengthen them. This brief covers: What is a learning site? How did learning sites emerge? What happens in a learning site? What is the value of learning sites for researchers and health managers? and what small-scale steps are being taken to strengthen the health system?","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis","field_subtitle":"Mugisha J; Abdulmalik J; Hanlon C; Petersen I; Lund C; Upadhaya N; Ahuja S; Shidhaye R; Mntambo N; Alem A; Gureje O; Kigozi F: International Journal of Mental Health Systems 11(7), 2017","URL":"http://ijmhs.biomedcentral.com/articles/10.1186/s13033-016-0114-2","body":"Mental, neurological and substance use disorders contribute to a significant proportion of the world\u2019s disease burden, including in low and middle income countries. In this study, the authors focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. A checklist guided by the World Health Organisation Assessment Instrument for Mental Health Systems was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium. The documents reviewed were from the following domains: mental health legislation, health policies/plans and relevant country health programs. Data were analysed using thematic content analysis. Three of the study countries (Ethiopia, Nepal, Nigeria, and Uganda) were working towards developing mental health legislation. South Africa and India were ahead of other countries, having enacted recent Mental Health Care Act in 2004 and 2016, respectively. Among all the 6 study countries, only Nepal, Nigeria and South Africa had a standalone mental health policy. However, other countries had related health policies where mental health was mentioned. The lack of fully fledged policies is likely to limit opportunities for resource mobilisation for the mental health sector and efforts to integrate mental health into PHC. Most countries were found to be allocating inadequate budgets from the health budget for mental health, with South Africa (5%) and Nepal (0.17%) were the countries with the highest and lowest proportions of health budgets spent on mental health, respectively. Other vital resources that support integration such as human resources and health facilities for mental health services were found to be inadequate in all the study countries. Monitoring and evaluation systems to support the integration of mental health into PHC in all the study countries were also inadequate. Integration of mental health into PHC will require addressing the resource limitations that have been identified in this study. There is a need for up to date mental health legislation and policies to engender commitment in allocating resources to mental health services.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Immunisation drive hailed as watershed for Africa as leaders target public health","field_subtitle":"Kodal H: The Guardian, February 2017","URL":"https://www.theguardian.com/global-development/2017/feb/01/africa-public-health-immunisation-african-union","body":"In a double move hailed as a milestone for public health, African leaders have launched an agency to tackle global threats such as Ebola and pledged to make immunisation available throughout the continent by 2020. Under the twin commitments, African heads of state will establish regional health centres around the continent, increase funding for immunisation, improve supply chains and delivery, and prioritise vaccines as part of broader efforts to strengthen health systems. At the heart of the new health push will be the Africa Centres for Disease Control and Prevention, which will help countries across the continent to deal with major health emergencies by establishing systems for early warning and response surveillance. Based in Addis Ababa, the new organisation will liaise with regional centres in Zambia, Gabon, Kenya, Nigeria and Egypt. Dr Matshidiso Moeti, the World Health Organization\u2019s (WHO) regional director for Africa, said the announcements, made on Tuesday at the African Union summit in Addis Ababa, demonstrated a strong commitment by African leaders to \u201csave lives across the continent\u201d. \u201cThis is a very important milestone,\u201d said Moeti. \u201cWe are extremely excited to have got here with the immunisation declaration. It\u2019s something we worked on for quite a few months with a range of partners, and it includes commitments with heads of state and partners in mobilising finances for the vaccines.\r\n\u201cIt shows leaders reiterating their commitments to saving the lives of children across the continent, and contributing their own funding, as they transition into middle-income states.\u201d","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Limits and opportunities to community health worker empowerment: A multi-country comparative study.","field_subtitle":"Kane S; Kok M; Ormel H; Otiso L; et al.: Social Science & Medicine 164, 2016, doi: http://dx.doi.org/10.1016/j.socscimed.2016.07.019","URL":"http://www.sciencedirect.com/science/article/pii/S0277953616303732","body":"In LMICs, Community Health Workers (CHW) increasingly play health promotion related roles involving 'empowerment of communities'. To be able to empower the communities they serve, the authors argue, it is essential that CHWs themselves be, and feel, empowered. The authors present here a critique of how diverse national CHW programs affect CHW's empowerment experience. They present an analysis of findings from a systematic review of literature on CHW programs in LMICs and 6 country case studies (Bangladesh, Ethiopia, Indonesia, Kenya, Malawi, Mozambique). Lee & Koh's analytical framework (4 dimensions of empowerment: meaningfulness, competence, self-determination and impact), is used. CHW programs empower CHWs by providing CHWs, access to privileged medical knowledge, linking CHWs to the formal health system, and providing them an opportunity to do meaningful and impactful work. However, these empowering influences are constantly frustrated by - the sense of lack/absence of control over one's work environment, and the feelings of being unsupported, unappreciated, and undervalued. CHWs expressed feelings of powerlessness, and frustrations about how organisational processual and relational arrangements hindered them from achieving the desired impact. While increasingly the onus is on CHWs and CHW programs to solve the problem of health access, attention should be given to the experiences of CHWs themselves. CHW programs need, it is argued, to move beyond an instrumentalist approach to CHWs, and take a developmental and empowerment perspective when engaging with CHWs. CHW programs should systematically identify disempowering organisational arrangements and take steps to remedy these. Doing so will not only improve CHW performance, it will pave the way for CHWs to meet their potential as agents of social change, beyond perhaps their role as health promoters.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Monitoring the implementation of the right to health under the constitution of Kenya: A training manual","field_subtitle":"Kenya Legal & Ethical Issues Network (KELIN): Nairobi 2016","URL":"http://tinyurl.com/jo43jbn","body":"This training manual is intended to enhance the role of civil society in promoting and protecting of the right to health under the Constitution. It will play an integral part in ensuring that civil society organisations have the knowledge and skills to hold duty bearers accountable to effective and efficient health service delivery. Schedule Four of the Kenya Constitution creates two levels of governance with distinct functions. The national government is mandated to formulate health policy and manage national referral health facilities while the county government is responsible for delivery of health services at the local level. The civil society groups that are working on health issues must therefore understands the roles and responsibilities of the different actors at both levels if they are to meaningfully engage in national and county processes. The manual is presented in four modules. The first module outlines the constitutional provisions on the right to health and what these provisions mean to the implementation of health as a right. The second module addresses the substance of the right to health including the international standards developed for the implementation of this right. The third module outlines the systems and structures of the devolved government and the role of the different state organs and agencies at national and county level in health service delivery. The fourth module then focuses on the role of the civil society in monitoring the implementation of the right to health. It also highlights the key issues concerning the right to health and outlines the specific responsibilities of civil society in holding each level of government to account for their mandates to deliver on the right to health.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"New WHO data portal to help track progress towards universal health coverage","field_subtitle":"WHO: Geneva, December 2016","URL":"http://apps.who.int/gho/cabinet/uhc.jsp","body":"The World Health Organisation (WHO) has launched a new data portal to track progress towards universal health coverage (UHC) around the world. The portal shows where countries need to improve access to services, and where they need to improve information. The portal features the latest data on access to health services globally and in each of WHO\u2019s 194 Member States, along with information about equity of access. In 2017 WHO will add data on the impact that paying for health services has on household finances. The portal shows that less than half of children with suspected pneumonia in low income countries are taken to an appropriate health provider. Of the estimated 10.4 million new cases of tuberculosis in 2015, 6.1 million were detected and officially notified in 2015, leaving a gap of 4.3 million. High blood pressure affects 1.13 billion people. Over half of the world's adults with high blood pressure in 2015 lived in Asia. Around 24% of men and 21% of women had uncontrolled blood pressure in 2015.  About 44% of WHO\u2019s member states report having less than 1 physician per 1000 population. The African Region suffers almost 25% of the global burden of disease but has only 3% of the world\u2019s health workers.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Participatory Slum Upgrading Programme","field_subtitle":"Okello M; Oenga I; Chege P: Practical Action, 2017","URL":"http://tinyurl.com/zarp23z","body":"Launched in 2008, the Participatory Slum Upgrading Programme (PSUP) is a joint effort of the  African, Caribbean and Pacific (ACP) Group of States, the European Commission (EC) and UN-Habitat. To date, the programme has reached out to 35 countries, 160 cities, and 2 million slum dwellers. The approach is grounded in integrating slum dwellers into the broader urban fabric using city-wide participatory planning methods. In practical terms, PSUP puts slums on the \u2018urban\u2019 maps and facilitates dialogue at local, national and regional levels that is necessary for a \u2018mind-set change\u2019, key for inclusive urbanisation. PSUP provides tools and practical experience of inclusive integrated slum upgrading through which all stakeholders learn key lessons. It builds confidence in participatory planning; institutionalises partnerships and improved governance arrangements, equips government with key financing mechanisms for slum upgrading including mechanisms to engage and empower slum dwellers themselves to advance delivery of relevant, community led improved infrastructure in slums. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Patterns and determinants of malaria risk in urban and peri-urban areas of Blantyre, Malawi","field_subtitle":"Mathanga D; Tembo A; Mzilahowa T; Bauleni A; Mtimaukenena K; Taylor T; Valim C; Walker E; Wilson M: Malaria Journal 15(590), 2016","URL":"https://malariajournal.biomedcentral.com/articles/10.1186/s12936-016-1623-9","body":"Although malaria disease in urban and peri-urban areas of sub-Saharan Africa is a growing concern, the patterns and drivers of transmission in these settings remain poorly understood. Factors associated with variation in malaria risk in urban and peri-urban areas were evaluated in this study. A health facility-based, age and location-matched, case\u2013control study of children 6\u201359 months of age was conducted in four urban and two peri-urban health facilities (HF) of Blantyre city, Malawi. Children with fever who sought care from the same HF were tested for malaria parasites by microscopy and PCR. Those testing positive or negative on both were defined as malaria cases or controls, respectively. A total of 187 cases and 286 controls were studied. In univariate analyses, higher level of education, possession of TV, and electricity in the house were negatively associated with malaria illness; these associations were similar in urban and peri-urban zones. Having travelled in the month before testing was strongly associated with clinical malaria, but only for participants living in the urban zones. Use of long-lasting insecticide nets the previous night was not associated with protection from malaria disease in any setting. In multivariate analyses, electricity in the house, travel within the previous month, and a higher level of education were all associated with decreased odds of malaria disease. Only a limited number of Anopheles mosquitoes were found by aspiration inside the households in the peri-urban areas, and none was collected from the urban households. Travel was the main factor influencing the incidence of malaria illness among residents of urban Blantyre compared with peri-urban areas. Identification and understanding of key mobile demographic groups, their behaviours, and the pattern of parasite dispersal is argued to be critical to the design of more targeted interventions for the urban setting.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Psychosocial risk and protective factors associated with perpetration of gender-based violence in a community sample of men in rural KwaZulu-Natal, South Africa ","field_subtitle":"Mngoma N; Fergus S; Jeeves A; Jolly R: The South African Medical Journal 106(12), 2016 ","URL":"http://www.samj.org.za/index.php/samj/article/view/11600/7748","body":"Rates of gender-based violence (GBV) in South Africa (SA) are among the highest in the world. In societies where social ideals of masculinity encourage male dominance and control over women, gender power imbalances contribute to male perpetration and women\u2019s vulnerability. The drivers that cause men to perpetrate GBV and those that lead to HIV overlap and interact in multiple and complex ways. Multiple risk and protective factors for GBV perpetration by males operate interdependently at a number of levels; at the individual level, these include chronic anxiety and depression, which have been shown to lead to risky sexual behaviours.  This study examined psychosocial risk factors (symptoms of anxiety and depression) as well as protective factors (social support and self-esteem) as self-reported by a cohort of males in rural KwaZulu-Natal (KZN) Province, SA; to determine whether there are differences in anxiety, depression, social support and self-esteem between perpetrators and non-perpetrators. A cross-sectional study using quasi-probability cluster sampling was done in 13 wards in Harry Gwala District, KZN. Participants were then randomly chosen from each ward proportionate to size.  The participants were relatively young (median age 22 years); over half were schoolgoers, and 91.3% had never married. Over 43% of the sample reported clinical levels of anxiety and depressive symptoms on the Brief Symptom Inventory. Rates of GBV perpetration were 60.9%, 23.6% and 10.0% for psychological abuse, non-sexual physical violence and sexual violence, respectively. GBV perpetration was associated with higher depression, higher anxiety, lower self-esteem and lower social support.  The authors propose that interventions to address GBV need to take modifiable individual-level factors into account. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level","field_subtitle":"Lu C; Black M; Richter L: The Lancet 4 (12) e916\u2013e922, 2016","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30266-2/fulltext","body":"In this paper the authors used 2010 estimates to assess how many children aged younger than 5 years were exposed to stunting or extreme poverty. The authors used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, the authors excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, the authors also used moderate poverty measures. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279 million in 2004 to 249 million in 2010; and the prevalence of children at risk fell from 51% to 43% globally. Sub-Saharan Africa had the highest prevalence in both years, however. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Socioeconomic and modifiable predictors of blood pressure control for hypertension in primary care attenders in the Western Cape, South Africa ","field_subtitle":"Folb N; Bachmann M; Bateman E; Steyn K; Levitt N;  Timmerman V; Lombard C; Gaziano T; Fairall L: The South African Medical Journal 106(12), 2016","URL":"http://www.samj.org.za/index.php/samj/article/view/11603/7751","body":"There are few reports of the effect of socioeconomic and potentially modifiable factors on the control of hypertension in South Africa (SA). This study investigated associations between patients\u2019 socioeconomic status and characteristics of primary healthcare facilities, and control and treatment of blood pressure in hypertensive patients. The authors enrolled hypertensive patients attending 38 public sector primary care clinics in the Western Cape, SA, in 2011, and followed them up 14 months later as part of a randomised controlled trial. Blood pressure was measured and prescriptions for antihypertension medications were recorded at baseline and follow-up. Blood pressure was uncontrolled in 60% of patients at baseline, less likely in patients with a higher level of education or in English compared with Afrikaans respondents. Treatment was intensified in 48% of patients with uncontrolled blood pressure at baseline, more likely in patients with higher blood pressure at baseline, concurrent diabetes, more education and those who attended clinics offering off-site drug supply, with a doctor every day or with more nurses.  Patient and clinic factors influence blood pressure control and treatment in primary care clinics in SA. Potential modifiable factors include ensuring effective communication of health messages, providing convenient access to medications, and addressing staff shortages in primary care clinics. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"South Centre Statement on the Amendment to the WTO TRIPS Agreement to Ease Access to Affordable Medicine  ","field_subtitle":"South Centre: Geneva, January 2017","URL":"https://www.southcentre.int/statement-january-2017/","body":"An amendment to the TRIPS Agreement that aims to facilitate the access to affordable medicines has entered into force upon approval by two thirds of the WTO members. The amendment reflects the recognition by WTO Members of the need for the continued enhancement of global intellectual property rules to allow Members to systematically take measures to protect public health. The United Nations Secretary General\u2019s High Level Panel on Access to Medicines has highlighted the importance of designing legislation that allows for quick, fair, predictable and implementable compulsory licenses for legitimate public health needs, and recommended WTO Members to revise the paragraph 6 system in order to find a solution that enables a swift and expedient export of pharmaceutical products produced under compulsory license. The South Centre stresses the continued importance for Least-Developed Countries (LDCs) to make full use of the special status they enjoy in not being required to adopt rules on patent protection and most other rules of the TRIPS Agreement, in order to build their technological capabilities and reduce obstacles to affordable access to medicines. The LDCs would not need, in this case, to make use of the system. Close attention will need to be paid to the design of national implementing legislations and the feedback from potential user entities of the system on any hurdles they may face that diminish interest in its use. The evaluation of the system must continue in the TRIPS Council.  The South Centre offers to provide assistance to countries in examining national implementing legislations, and providing information to potential interested parties. Templates for facilitated implementation and meeting of conditions required under the system may be provided. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Strategising national health in the 21st century: a handbook","field_subtitle":"World Health Organisation, 2016","URL":"http://www.who.int/healthsystems/publications/nhpsp-handbook/en/","body":"This handbook is designed as a resource for providing up-to-date and practical guidance on national health planning and strategising for health. It establishes a set of best practices to support strategic plans for health and represents the wealth of experience accumulated by WHO on national health policies, strategies and plans (NHPSPs). WHO has been one of the leading organisations to support countries in the development of NHPSPs. The focus on improving plans has grown in recent years, in recognition of the benefits of anchoring a strong national health sector in a written vision based on participation, analysis, and evidence.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Sub-Saharan Africa\u2019s \u2018exceptional\u2019 progress against HIV \u2013 surveys","field_subtitle":"African Medical Media Digest: Medical Brief, December 2016","URL":"http://tinyurl.com/zletkfz","body":"National surveys in Zimbabwe, Malawi, and Zambia reveal exceptional progress against HIV, with decreasing rates of new infection, stable numbers of people living with HIV, and more than half of all those living with HIV showing viral suppression through use of antiretroviral medication. For those on antiretroviral medication, viral suppression is close to 90%. These data are the first to emerge from the Population HIV Impact Assessment (PHIA) Project, a unique, multi-country initiative funded by the US President\u2019s Emergency Plan for AIDS Relief (PEPFAR). The project deploys household surveys, which measure the reach and impact of HIV prevention, care and treatment programs in select countries. The data demonstrate that the 90-90-90 global targets set forth by UNAIDS in 2014 are attainable, (that is for 90% of people with HIV to be diagnosed, 90% of those diagnosed to receive HIV treatment, and 90% of those on treatment to be effectively treated and achieve suppression of their infection). This would translate to 73% of all HIV-positive people being virally suppressed. The data show that once diagnosed, individuals are accessing treatment, staying on treatment, and their viral load levels are suppressed to levels that maintain their health and dramatically decrease transmission to others. Preliminary data analyses show that, as of 2016: In Zimbabwe, among adults ages 15 to 64, HIV incidence is 0.45%; HIV prevalence is 14.6% (16.7% among females and 12.4% among males); 60.4% of all HIV-positive people are virally suppressed, and 86% of those on treatment are virally suppressed. In Malawi, among adults ages 15 to 64, HIV incidence is 0.37%; HIV prevalence is 10.6% (12.8% among females and 8.2% among males); 67.6% of all HIV-positive people are virally suppressed, and 91% of those on treatment are virally suppressed. In Zambia, among adults ages 15 to 59 years, HIV incidence is 0.66%; HIV prevalence is 12.3% (14.9% among females and 9.5% among males); 59.8% of all HIV-positive people are virally suppressed, and 89% of those on treatment are virally suppressed. The results from the first three PHIA surveys are argued to compel the global community to strengthen its efforts to reach those who have yet to receive an HIV test and to engage, support, and enable those who test HIV-positive to start and stay on effective treatment in order to achieve long-term viral suppression.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Sugar tax could make SA a world leader in obesity prevention \u2013 WHO","field_subtitle":"Medical Brief: African Medical Digest February 2017.","URL":"http://www.medicalbrief.co.za/archives/sugar-tax-make-sa-world-leader-obesity-prevention/","body":"South Africa could prevent almost half-a-million deaths over 40 years by introducing its proposed tax on sugary drinks, according to the World Health Organisation (WHO). \u201cNo country in the world has hit obesity with a 20% tax, so South Africa could be a world leader and reduce childhood obesity,\u201d said the WHO\u2019s Dr Temo Waqanivalu. He was speaking at the recent public hearing on the proposed tax on sugary drinks, convened by parliament\u2019s committees of finance and health. \u201cA child eating burger and chips, washed down with sugary drink and followed by crisps and chocolate bar, would have to run a half-marathon to get rid of the effects. You cannot out-exercise a bad diet,\u201d said Waqanivalu. The report says at the packed meeting, all parties agreed that South Africa had a significant problem with obesity but while academics praised the tax, industry players pleaded for other measures. Treasury has proposed a tax of 2.29c per gram of sugar on soft drinks, which would work out to be about a 20% tax on a Coca Cola.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme \u2013 a qualitative assessment of four countries","field_subtitle":"Blas E; Ataguba J;  Huda TM; Bao GK; Rasella D; Gerecke MR: Global Health Action 9 (1)  http://dx.doi.org/10.3402/gha.v9.29002, 2017","URL":"http://www.tandfonline.com/doi/full/10.3402/gha.v9.29002","body":"ince the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development goals (SDGs) reflect an attempt to bring together these themes and the complexities involved in defining a comprehensive development framework. However, to date, much less has been done to address the monitoring challenges, that is, how data generation, analysis and use are to become routine tasks. In an attempt to explore these monitoring challenges, indicators covering a wide range of social determinants were tested in four country case studies (Bangladesh, Brazil, South Africa, and Vietnam) for their technical feasibility, reliability, and validity, and their communicability and usefulness to policy-makers. Twelve thematic domains with 20 core indicators covering different aspects of equity, human rights, gender, and SDH were tested through a review of data sources, descriptive analyses, key informant interviews, and focus group discussions. To test the communicability and usefulness of the domains, domain narratives that explained the causal pathways were presented to policy-makers, managers, the media, and civil society leaders. For most countries, monitoring is possible, as some data were available for most of the core indicators. However, a qualitative assessment showed that technical feasibility, reliability, and validity varied across indicators and countries. Producing understandable and useful information proved challenging, and particularly so in translating indicator definitions and data into meaningful lay and managerial narratives, and effectively communicating links to health and ways in which the information could improve decision-making. This exercise revealed that for monitoring to produce reliable data collection, analysis, and discourse, it will need to be adapted to each national context and institutionalised into national systems. This will require that capacities and resources for this and subsequent communication of results are increased across countries for both national and international monitoring, including the successful implementation of the SDGs.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The influence of power and actor relations on priority setting and resource allocation practices at the hospital level in Kenya: a case study","field_subtitle":"Barasa E; Cleary S; Molyneux S; English M: BMC Health Services Research, 2016, doi: 10.1186/s12913-016-1796-5","URL":"http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1796-5","body":"Priority setting and resource allocation in healthcare organisations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organisations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya. The authors used a qualitative case study approach to examine priority setting and resource allocation practices in two public hospitals in coastal Kenya. They collected data by a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n\u2009=\u200972), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations in case study hospitals over a period of 7 months. The authors applied a combination of two frameworks, Norman Long\u2019s actor interface analysis and VeneKlasen and Miller\u2019s expressions of power framework to examine and interpret findings. The interactions of actors in the case study hospitals resulted in socially constructed interfaces between: 1) senior managers and middle level managers 2) non-clinical managers and clinicians, and 3) hospital managers and the community. Power imbalances resulted in the exclusion of middle level managers (in one of the hospitals) and clinicians and the community (in both hospitals) from decision making processes. This resulted in, amongst others, perceptions of unfairness, and reduced motivation in hospital staff. It also puts to question the legitimacy of priority setting processes in these hospitals. The authors suggest that designing hospital decision making structures to strengthen participation and inclusion of relevant stakeholders could improve priority setting practices. This should however, be accompanied by measures to empower stakeholders to contribute to decision making. They also suggest that strengthening soft leadership skills of hospital managers could also contribute to managing the power dynamics among actors in hospital priority setting processes.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review","field_subtitle":"Shoman H; Karafillakis E; Rawaf S: Globalization and Health 13(1), 2017","URL":"http://tinyurl.com/jpqewpq","body":"This study determined the effects of health systems\u2019 organisation and performance on the West African Ebola outbreak in Guinea, Liberia and Sierra Leone and lessons learned. The WHO health system building blocks were used to evaluate the performance of the health systems in these countries. A systematic review of articles published from inception until July 2015 was conducted following the PRISMA guidelines. Electronic databases including Medline, Embase, Global Health, and the Cochrane library were searched for relevant literature. Grey literature was also searched through Google Scholar and Scopus. Articles were exported and selected based on a set of inclusion and exclusion criteria. Data was then extracted into a spreadsheet and a descriptive analysis was performed. Each study was critically appraised using the Crowe Critical Appraisal Tool. The review was supplemented with expert interviews where participants were identified from reference lists and using the snowball method. Thirteen articles were included in the study and six experts from different organisations were interviewed. A shortage of health workers had an important effect on the control of Ebola but also suffered the most from the outbreak. This was followed by information and research, medical products and technologies, health financing and leadership and governance. Poor surveillance and lack of proper communication also contributed to the outbreak. Lack of available funds jeopardised payments and purchase of essential resources and medicines. Leadership and governance had least findings but an overarching consensus that they would have helped prompt response, adequate coordination and management of resources. Ensuring an adequate and efficient health workforce is thus judged to be of high importance to ensure a strong health system and a quick response to new outbreaks. Adequate service delivery results from a collective success of the other blocks. Health financing and its management is crucial to ensure availability of medical products, fund payments to staff and purchase necessary equipment. The authors also note that leadership and governance needs to be explored for their role in controlling outbreaks.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The World Health Organisation should counter the privatization of health governance, but does it?","field_subtitle":"Claudio Schuftan, Peoples Health Movement, Ho Chi Minh City","body":"While economics is not World Health Organisation (WHO)\u2019s core expertise, the impact of poverty and income maldistribution on population health clearly justifies the organisation working with other agencies within or outside the UN system to focus much more attention on questions of disparity. Things being the way they are right now, it is thus difficult to make sense of the shrinking scope of WHO\u2019s role in global health governance. \r\n\r\nOne factor could be the wide and ambiguous use of slogans about \u2018stakeholders\u2019 and the fait-accompli of \u2018multi-stakeholder platforms\u2019 and \u2018public-private partnerships\u2019. The term \u2018stakeholders\u2019, bundling together public interest civil society organizations with international NGOs, private sector enterprises and philanthropies under the term \u2018non-state actors\u2019, appears to endow all of these private \u2018stakeholders\u2019 with the right to a \u2018seat at the table\u2019, with only the tobacco and arms industries declared off limits. Such \u2018sitting rights\u2019 jeopardize people\u2019s human rights as enshrined in various instruments, including the right to health. \r\n\r\n\u2018Donor\u2019 countries (the US in particular) continue to push the WHO towards working with industry through such \u2018multi\u2010stakeholder partnerships\u2019, rather than giving it the chance to implement regulatory and fiscal strategies that could make a real difference. Bilateral funders and big philanthropies demand that WHO provide data according to their particular interests, beyond the compilation of country-reported statistics. They focus on providing technical interventions, and introduce a bias away from interventions on the right to health or social determinants. \r\n\r\nThis treatment of WHO is part of a wider onslaught on the UN system generally. The whole UN system is held hostage to short-term, unpredictable, funding. The freezing and periodic withholding of countries\u2019 assessed contributions and tightly earmarked voluntary contributions creates dependence on private philanthropy. It applies a sustained pressure to adopt the multi\u2010stakeholder partnership model of program design and implementation that gives global corporations an undeserved \u2018seat at the table\u2019. \r\n\r\nIf the WHO reform is to realise the vision of its Constitution, it will require a global mobilization around the democratization of global health governance, within the wider global mobilization for human rights and equity in global economic and political governance.  Globalization has created new collective health needs that cross old spatial, temporal and political boundaries. In response, we need global health governance institutions that represent the many, not the few; and that are sufficiently agile to act effectively in a fast-paced world and capable of bringing together the best ideas and boundary-shattering knowledge available. \r\n\r\nYet the WHO seems strangely detached from the broader political turmoil and changes unfolding around the world. WHO may point to its 193 member states and claim to be universally representative, but it is far from politically inclusive. Like the alienation felt by millions around the world, many members of the global health community have turned elsewhere to move issues forward and get things done. We thus see a steady decline of WHO, clinging to obsolete political institutions and bureaucratic models, yet kept alive by member states as an essential public institution. This decline is not because WHO is not needed, but because it has not adapted to and is not publicly financed for a changing world. It is not the WHO that we need today. \r\n\r\nPolitical innovation must thus become a fundamental part of the process of WHO reform. We need to think: How might virtual and interactive town halls improve communication between global health policy-makers and the constituencies they serve? How might the closed world of global policy-making be opened up and strengthened through virtual public consultations, feedback and monitoring systems? How might the concept of global citizenship become institutionalized within our global health institutions, especially WHO? \r\n\r\nWe also need to challenge the re-legitimation of the \u2018free trade agenda\u2019 in health that has strengthened intellectual property (patent) protection regimes despite their well-known negative consequences for public health. We need to question the mantra of the \u2018realistic costing of outputs\u2019 that prescribe programme implementation models where programmes comprise a set of planned outputs from prescribed activities with known costs. This approach leaves little, if any, room for flexibly managing complexity in planning and implementing systems. It makes health actors, including WHO, wary of the longer term implementation processes needed in health systems, partly because they disrupt \u2018production schedules\u2019 demanded by funders. \r\n\r\nThese models also contradict our understanding that health care is just one of the factors influencing health and can only be considered part of the solution. As the 2008 WHO Commission on the Social Determinants of Health stated, \u201cSocial injustice is killing people on a grand scale and constitutes a greater threat to public health than a lack of doctors, medicines or health care services\u201d. The conditions under which people live and work, their socioeconomic development, education, housing and other conditions have a major impact on health behaviours and outcomes.  A robust analysis of the root causes of the preventable global disease burden is thus essential to understand which \u2018stakeholders\u2019, or duty bearers, are part of the problem and which are part of the solution. Consistent with human rights principles and the findings of the 2008 Commission report, such analysis enables us to identify which can be trusted to have a seat at the policy table. \r\n\r\nThis influence of social injustice on health and the analysis of root causes of preventable disease appears most obscured in the influence of external funders over health ministries in the global south. It keeps them focused slogans such as \u2018development assistance\u2019 and \u2018public-private partnerships\u2019 that in their design serve the agenda of the richest 1%. In so doing it sustains a world view of the beneficence of private enterprise and that accepts as natural and unchanging conditions of global inequality and environmental degradation. \r\n\r\nThis editorial draws on points raised in the work of PHM and other colleagues, including  K Detavernier, M Kok, K Lee, D Legge and E Pisani.  For further information visit the PHM website at http://www.phmovement.org/ . Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Transactional sex and risk for HIV infection in sub-Saharan Africa: a systematic review and meta-analysis","field_subtitle":"Wamoyi J; Stoebenau K; Bobrova N; Abramsky T; Watts C: Journal of the International Aids Society 19(20992)  2016","URL":"http://www.jiasociety.org/index.php/jias/article/view/20992/pdf_1","body":"Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women\u2019s heightened risk, but evidence on the association between transactional sex and HIV has not yet been synthesised. The authors set out to systematically review studies that assess the relationship between transactional sex and HIV among men and women in sub-Saharan Africa and to summarise the findings through a meta-analysis. Nineteen papers from 16 studies met the inclusion criteria. Of these 16 studies, 14 provided data on women and 10 on men. The authors found a significant, positive, unadjusted or adjusted association between transactional sex and HIV in 10 of 14 studies for women, one of which used a longitudinal design. Out of 10 studies involving men, only two indicate a positive association between HIV and transactional sex in unadjusted or adjusted models. The meta-analysis confirmed general findings from the systematic review. Transactional sex is associated with HIV among women, whereas findings for men were inconclusive. Given that only two studies used a longitudinal approach, there remains a need for better measurement of the practice of transactional sex and additional longitudinal studies to establish the causal pathways between transactional sex and HIV. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"TRIPS amendment on access to cheaper drugs comes into force","field_subtitle":"Third World Network: SUNS #8387 January 2017 ","URL":"http://www.twn.my/title2/health.info/2017/hi170103.htm","body":"A protocol amending the WTO TRIPS Agreement that would enable developing countries with insufficient or no manufacturing capacities in the pharmaceutical sector to import cheaper generic medicines produced under compulsory licencing came into force on Monday, 23 January. The annex to the protocol amending the TRIPS Agreement contains a new Article which contains five paragraphs on the  obligations of exporting Members in relation to compulsory licences, AND the modification of  obligations to the extent necessary to enable a pharmaceutical product produced or imported under a compulsory licence to other countries within a regional trade agreement. \"This is an extremely important amendment. It gives legal certainty that generic medicines can be exported at reasonable prices to satisfy the needs of countries with no pharmaceutical production capacity, or those with limited capacity,\" said WTO Director-General Roberto Azevedo. Ambassador Modest Mero of Tanzania, Chair of the TRIPS Council, underlined the importance of the entry into force of the first-ever amendment of the multilateral agreements administered by the WTO but also a concrete response by trade ministers to address the concerns in the area of public health.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Using Minecraft for Youth Participation in Urban Design and Governance","field_subtitle":"Banks N: Global Development Institute, 2015","URL":"https://vimeo.com/116674116","body":"UN-Habitat believes that ICT can be a catalyst to improve governance in towns and cities and help increase levels of participation, efficiency and accountability in public urban policies, provided that the tools are appropriately used, accessible, inclusive and affordable. Research shows that ICT use by youth can have a direct impact on increasing civic engagement, giving them new avenues through which to become informed, shape opinions, get organised, collaborate and take action. Youth are at the centre of the ICT revolution, both as drivers and consumers of technological innovation. They are almost twice as networked as the global population as a whole, with the ICT age gap more pronounced in least developed countries where young people are up to three times more likely to be online than the general population. This video shows UN-Habitat\u2019s approach to using Minecraft  to encourage youth participation in urban design and governance, to design and present their vision for public spaces in the city, as an input to planning.  UN-Habitat\u2019s experiences of using the video game Minecraft as a community participation tool for public space design is reported to show that providing youth with ICT tools can promote improved civic engagement. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Walter Rodney and the racial underpinnings of global inequality","field_subtitle":"Paschal T: Pambazuka News, January 2017","URL":"http://tinyurl.com/h59v2pu","body":"While inequality has become a topic of increased popularity and politicization in recent years, most of the attention has focused on how 1% own an increasingly large share of the world\u2019s wealth, rather than on inequalities between nations. In a global context in which national borders and citizenship pose few barriers to the mobility of capital, the reality is also a story of the world\u2019s richest nations continuing to reap a disproportionate amount of the globe\u2019s profits. Contemporary analyses of global inequality, capitalism, and development would benefit from the lessons of earlier works concerned with similar questions decades before. One example is the classic work written by Walter Rodney, How Europe Underdeveloped Africa. While some contemporary accounts recognise that the problems of African countries do not lie exclusively in Africa, they do not go far enough. Piketty\u2019s discussion of the extraction of wealth from the African continent, for example, is largely independent from his analysis of the accumulation of wealth in other parts of the globe. For Rodney, it was impossible to explain development and the accumulation of wealth in one region without deeply understanding its relations to other regions of underdevelopment and the extraction of wealth. This relation, he argued was not accidental; it was endemic to capitalism itself.","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"\u2018Why do an MPH?\u2019 Motivations and intentions of physicians undertaking postgraduate public health training at the University of Cape Town","field_subtitle":"Zweigenthal VE, Marquez E; London L: Global Health Action, 9(1) http://dx.doi.org/10.3402/gha.v9.32735, 2017","URL":"http://www.tandfonline.com/doi/full/10.3402/gha.v9.32735","body":"Public health (PH) approaches underpin the management and transformation of health systems in low- and middle-income countries. Despite the Master of Public Health (MPH) rarely being a prerequisite for health service employment in South Africa, many physicians pursue MPH. This study identified their motivations and career intentions and explored MPH programme strengths and gaps in under- and post-graduate PH training. A cross-sectional study using an online questionnaire was completed by physicians graduating with an MPH between 2000 and 2009 and those enrolled in the programme in 2010 at the University of Cape Town. Nearly a quarter of MPH students were physicians. Of the 65 contactable physicians, 48% responded. They were mid-career physicians who wished to obtain research training (55%), who wished to gain broader perspectives on health (32%), and who used the MPH to advance careers (90%) as researchers, policy-makers, or managers. The MPH widened professional opportunities, with 62% changing jobs. They believed that inadequate undergraduate exposure should be remedied by applying PH approaches to clinical problems in community settings, which would increase the attractiveness of postgraduate PH training. The MPH was found to allow physicians to transition from pure clinical to research, policy and/or management work, preparing them to innovate changes for effective health systems, responsive to the health needs of populations. ","php":"","field_issue_date":"2017-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"#KnowYourCity website","field_subtitle":"Slum Dwellers International, 2017","URL":"http://knowyourcity.info/explore-our-data/","body":"Know Your City is a global campaign of Slum Dwellers International (SDI) and UCLG-A. Around the world, slum dwellers collect city-wide data and information on informal settlements. This work creates alternative systems of knowledge that are owned by the communities and have become the basis of a unique social and political argument that supports an informed and united voice of the urban poor. SDI\u2019s databases are becoming the largest repositories of informal settlement data in the world and the first port of call for researchers, policy makers, local governments and national governments.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"A memo from the virtual desk of the Department of Urban Rights, Southern Africa, 2036","field_subtitle":"Thandiwe Loewenson, PhD student, Bartlett School of Architecture","body":"Comrades, colleagues, citizens\r\n\r\nAs we prepare to host the UN Habitat 4 it is timely to reflect on the declarations made and the journey we've taken since the last conference in Quito, Ecuador in October 2016. (Is really it only the fourth conference - many of us weren't even born when the first was held in 1976!) We are fortunate here in Harare to be part of a regional movement, together with our strategic partner cities, towards more equitable and inclusive urban environments. Habitat 3 gave early voice to many of the changes that were nascent in our cities at the time: greater networking between cities, space for people to influence urban design in their cities, a consciousness of climate challenges and an awareness of the intertwined fortunes between urban and rural areas. Our cities today are not isolated. Whilst retaining their unique qualities and idiosyncrasies, they are part of highly globalised, networked ecosystems where our futures are deeply connected.    \r\n\r\nOur archives reveal that the atmosphere in Quito was aspirational. From the records excavated after the Great Data Crash of 2025, we reconstructed video footage of Habitat 3.  The voice in it of the then Secretary-General of United Cities and Local Governments Africa, Jean Pierre Elong Mbassi still rings clear: \u201cLocal authorities are now on the map, what we want next is to be around the table\u2026we hope that people will realise that without local authorities, there\u2019s no way we can implement the global agendas adopted in 2015 and 2016\u201d.  This was echoed by the World Mayor\u2019s Assembly who asserted two key demands: The first that city, metropolitan and regional governments be involved in UN negotiations, with powers to make decisions independent of national government; and the second that mayors have access to international finance and that instruments such as a Green Climate Fund also be allocated to and handled directly by cities. \r\n\r\nIn 2036, with collective, participatory urban budgeting now commonplace and seamless networks between cities, it is easy to forget that only a few decades ago cities were primarily considered national hubs, managed by nation states. We in East and Southern Africa have especially benefited from the Ore to Information Fund through which finance raised from the last mining operations was invested in open access technology infrastructure. This has allowed us to have the fastest data connectivity in the world, bringing huge benefits for technological innovation and education, access to health information, for the reach of health and economic services and capacities and new resources for community dialogue and action.   \r\n\r\nThis month we celebrate 68 years since the principle of the \u2018right to the city\u2019 was first proposed by Henri Lefebvre. UN Habitat 3 was a critical marker for those campaigning for this right. We take it as commonplace today, but respect that those early struggles were not easily won.\r\n\r\nChampioned by Brazil and Ecuador, the ratification at Habitat3 of a New Urban Agenda (NUA) made this the first internationally negotiated document to reference the right to the city and encourage nation states to enshrine it in their laws.  Under the slogan \u201cCities for people, not for profit!\u201d civil society from various campaigns against gentrification, privatisation of public space and criminalisation of homeless and vulnerable citizens lobbied for the inclusion of the right.  They called for governments to put citizens before private sector interests in the city, building on the 2004 World Charter on the Right to the City and the 2010 UN World \u201cRight to the City\u201d Urban Forum in Brazil.\r\n\r\nAt that time, Brazil and Ecuador were the only two countries to have this right enshrined in law. Still the Habitat3 negotiations saw large parts of the right to the city excluded from the final document. It did not mention the \u2018social function of land\u2019 or \u2018participatory approaches at all stages of the urban policy and planning processes\u2019. These clauses were struck off during the drafting.  The NUA was also non-binding. As we look back in 2036, we owe a debt to the global Right to the City movement that brought together civil society, local government and other actors around the world, including from health, who picked up the baton after Quito, to implement the principles of equity and inclusivity in the 2016 NUA.  Women in Informal Employment Globalizing and Organizing had already by 2016 publicised the economic, social and environmental contribution to cities of women informal sector workers and Colombia\u2019s waste pickers had already won a court ruling to block a waste management contract that did not provide opportunities for informal recyclers. We have seen others follow suit, including those living in slums, health activists from communities affected by pollution and urban waste, increasingly bringing previously excluded groups to the policy making and planning table, affirming their rights to a city that ensures wellbeing for all.  This has not been easy, especially given the legacies we inherited from the early years of the 21st century of  unpredictable weather, rising sea levels, pollution and waste threatening the ecosystems of all in  our cities, of massive socio-economic inequalities, of destructive wars and of big population movements across countries. However we now fully understand that inclusion and investment in wellbeing is not only as a matter of rights and justice, but is vital for our collective survival.\r\n\r\nWe were fascinated to find in our excavated websites an account by Barcelona's first female Mayor (to think - that city is now on its fifth female mayor!). Writing after Quito, Ms Colau said that Habitat 3 saw women coming to the forefront of political change. She noted that \u201cthe 21st Century is the century of cities - in part because this is a moment of great political uncertainty at many levels. But within that uncertainty, we see empowered citizens asking to be protagonists, and the city is the place to do this.\u201d \r\n \r\nWe are looking forward to hosting Habitat 4 this year here in our region in real and virtual space. We welcome all joining us in our increasingly inclusive understanding of \u2018the city\u2019 with all the people and connected spaces that are critical to healthy urban life. As we gather to debate new challenges, we are fortunate to reflect on the debates, advances and still unresolved issues from Habitat 3 that we have found, to reflect on where we reached in 2030 with our sustainable development goals, and to bring in the voice of all to craft our Agenda for Habitat 4. \r\n\r\nThis oped was sent in response to our invitation for reflections post Habitat III. This issue provides a range of resources and publications related to urban health. Please send feedback or queries on the issues raised to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Antibiotic Resistance in the Food Chain: A Developing Country-Perspective","field_subtitle":"Founou L; Founou R; Essack S: Frontiers in Microbiology, 2016, doi: https://doi.org/10.3389/fmicb.2016.01881","URL":"http://journal.frontiersin.org/article/10.3389/fmicb.2016.01881/full","body":"Food animals are considered as key reservoirs of antibiotic-resistant (ABR) bacteria with the use of antibiotics in the food production industry having contributed to the global challenge. There are no geographic boundaries to impede the worldwide spread of ABR, and limitations in the interventions in one country could compromise the efficacy and endanger containment policies implemented in other parts of the world. Multifaceted, comprehensive, and integrated measures complying with the One Health approach are argued to be imperative to ensure food safety and security, effectively combat infectious diseases, curb the emergence and spread of ABR, and preserve the efficacy of antibiotics for future generations. Countries are urged to follow the World Health Organisation, World Organisation for Animal Health, and the Food and Agriculture Organisation of the United Nations recommendations to implement national action plans encompassing human, (food) animal, and environmental sectors to improve policies, interventions and activities that address the prevention and containment of ABR from farm-to-fork. This review covers (i) the origin of antibiotic resistance, (ii) pathways by which bacteria spread to humans from farm-to-fork, (iii) differences in levels of antibiotic resistance between developed and developing countries, and (iv) prevention and containment measures of antibiotic resistance in the food chain.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Building Children's Nursing for Africa Conference","field_subtitle":"28 March - 30 March 2017, Cape Town, South Africa","URL":"http://www.buildingchildrensnursing.co.za","body":"The theme for the 2017 Building Children's Nursing for Africa Conference is \u2018Pillars of Practice\u2019 in paediatric and children\u2019s nursing and will showcase recent research, clinical practice projects, education and leadership initiatives.  The Child Nurse Practice Development Initiative is an established and strategically significant nurse-led programme which is now the main training hub for children\u2019s nursing on the African continent. The conference themes include establishing families as the care hub, clinically relevant teaching: breaking the mould of parrot-style learning, sustainable innovation in paediatrics, thinking nurses who collaborate across disciplines, and examining what nurses measure - how and why?","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers: Law and the New Urban Agenda, 4th Annual International & Comparative Urban Law Conference","field_subtitle":"Deadline for proposal submissions:  March 6, 2017","URL":"http://www.urbanlawcenter.org/sacallforpapers","body":"The Fordham Urban Law Center, in conjunction with the University of Cape Town (UCT), is pleased to announce a call for participation in the 4th Annual International and Comparative Urban Law Conference, to be held on Monday July 17th and Tuesday July 18th, 2017.  The Conference will be held at UCT in Cape Town, South Africa. The Conference will provide a dynamic forum for legal and other scholars to engage and generate diverse international, comparative, and interdisciplinary perspectives in the burgeoning field of urban law. The Conference will explore overlapping themes, tensions, and opportunities for deeper scholarly investigation and practice with a comparative perspective.  The Conference is open to urban law topics across a broad spectrum, such as: Structure and workings of local authority and autonomy;Urban and metropolitan governance and finance; Economic and community development; Housing and the built environment; Unique challenges facing cities in developing nations and the Global South; Urban public health; Migration and citizenship; Urban equity and inclusion; Sustainability and resilience. While the Conference will foster a broad dialogue about cities and legal systems in comparative and international perspective, we specifically invite submissions to focus on the role of law in New Urban Agenda adopted this past October by the United Nations at the Habitat III Conference in Quito, Ecuador. In keeping with this framework, the conference seeks to investigate the role of laws in promoting the New Urban Agenda in a manner that is democratic, sustainable and equitable.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community ART Support Groups in Mozambique: The Potential of Patients as Partners in Care","field_subtitle":"Jobarteh K; Shiraishi R; Malimane I; Samo Gudo P; Decroo T; Auld A; Macome V; Cuoto A: PLoS ONE 11(12): e0166444. doi:10.1371/journal.pone.0166444","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166444","body":"High rates of attrition are weakening Mozambique\u2019s national HIV Program\u2019s efforts to achieve 80% treatment coverage. In response, Mozambique implemented a national pilot of Community Adherence and Support Groups (CASG). CASG is a model in which antiretroviral therapy (ART) patients form groups of up to six patients. On a rotating basis one CASG group member collects ART medications at the health facility for all group members, and distributes those medications to the other members in the community. Patients also visit their health facility bi-annually to receive clinical services. A matched retrospective cohort study was implemented using routinely collected patient-level data in 68 health facilities with electronic data systems and CASG programs. A total of 129,938 adult ART patients were registered in those facilities. Of the 129,938 patients on ART, 6,760 were CASG members. A propensity score matched analysis was performed to assess differences in mortality and loss to follow-up (LTFU) between matched CASG and non-CASG members. Non-CASG participants had higher LTFU rates than matched CASG participants; however, there were no significant mortality differences between CASG and non-CASG participants. Compared with the full cohort of non-CASG members, CASG members were more likely to be female, tended to have a lower median CD4 counts at ART initiation and be less likely to have a secondary school education. ART patients enrolled in CASG were significantly less likely to be LTFU compared to matched patients who did not join CASG. CASG appears to be an effective strategy to decrease LTFU in Mozambique\u2019s national ART program.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Crisis and resilience at the frontline: Coping strategies of Kenyan primary health care managers in a context of devolution and uncertainty","field_subtitle":"Nyikuri M; Barasa E; Molyneux S; Tsofa B: Kemri Wellcome Trust Research Programme, Kenya, 2016","URL":"http://tinyurl.com/zbj8ay4","body":"Primary health care (PHC) plays a vital role in maintaining population health, preventing suffering and providing coverage of essential services. In Kenya, primary health centres and dispensaries are often managed by the most senior clinical staff member at the facility who is responsible for performing both clinical and managerial duties. PHC managers, also known as in-charges, play a key role in the functioning of health services on a day-to-day basis. KEMRI-Wellcome Trust has conducted research in one of the 47 counties in Kenya to better understand the role and responsibilities of PHC managers and their coping strategies within the context of devolution and uncertainty. The key findings from the research are set out in this brief, as well as recommendations to support PHC managers. The research found that PHC managers carry out a variety of tasks to ensure facilities can function effectively. These include: developing annual work plans, ensuring coverage and delivery of services, providing leadership and management to frontline staff. Despite the challenges faced by PHC managers in the period since devolution, facilities remained open and functioning. A key support system for in-charges was the sub-county managers, some of whom had played the role of line managers to in- charges for decades. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 191: A memo from the virtual desk of the Department of Urban Rights, Southern Africa, 2036","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Header"}},{"node":{"title":"Financing the HIV response in sub-Saharan Africa from domestic sources: Moving beyond a normative approach","field_subtitle":"Remme M; Siapka M; Sterck O; Ncube M; Watts C; Vassalla A: Social Science & Medicine 169, 66\u201376, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S0277953616305342","body":"This paper examines the potential to expand public HIV financing, and the extent to which governments have been utilising these options. First, with data from the 14 most HIV-affected countries in sub-Saharan Africa, the authors estimate the potential increase in public HIV financing from economic growth, increased general revenue generation, greater health and HIV prioritisation, as well as from more unconventional and innovative sources, including borrowing, health-earmarked resources, efficiency gains, and complementary non-HIV investments. The authors then adopt a novel empirical approach to explore which options are most likely to translate into tangible public financing, based on cross-sectional econometric analyses of 92 low and middle-income country governments' most recent HIV expenditure between 2008 and 2012. If all fiscal sources were simultaneously leveraged in the next five years, public HIV spending in these 14 countries could, it is estimated, increase from US$3.04 to US$10.84 billion per year. This could cover resource requirements in South Africa, Botswana, Namibia, Kenya, Nigeria, Ethiopia, and Swaziland, but not even half the requirements in the remaining countries. The empirical results suggest that, in reality, even less fiscal space could be created (a reduction by over half) and only from more conventional sources. International financing may also crowd in public financing. The authors observe that most HIV-affected lower-income countries in sub-Saharan Africa will not be able to generate sufficient public resources for HIV in the medium-term, even if they take very bold measures. Considerable international financing will be required for years to come. HIV funders will need to engage with broader health and development financing to improve government revenue-raising and efficiencies","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"From global health security to global health solidarity, security and sustainability","field_subtitle":"Antoine Flahault, Didier Wernli, Patrick Zylberman, Marcel Tanner: Bulletin of the World Health Organization 2016;94:863.","body":"The concept of global health security underpins the current framework for global preparedness and response to emerging infectious diseases. The Global Health Security Agenda \u2013a collaboration between governments\u2013 was launched in 2014, aiming to make our interconnected world safe from infectious disease threats. The governments involved in the Global Health Security Agenda focus on strengthening their countries\u2019 capacities for detection, response and prevention.\r\n\r\nIn the context of public health emergencies, the Agenda has received financial and political support from international organizations and almost 50 countries. However, there is tension between the aims of global health security and governments\u2019 mandate to ensure national security. The 1994 United Nations Development Programme\u2019s Human Development Report first introduced the concept of human security, referring to security of citizens as individuals rather than that of the states in which they live. We posit that the use of the term global health security can have a negative unintended effect on the ultimate goal of improving health for all. There are three reasons why this term potentially privileges the security of the state rather than the security of individuals.\r\n\r\nFirst, global health security, in its current use, is largely focused on protecting high-income countries against public health threats coming from low- and middle-income countries. Ebola virus, Marburg, Zika virus, dengue, chikungunya, Rift Valley and Lassa fevers, originated in low- and middle-income countries. If the Agenda is used to prioritize global health risk depending on the origin of infections, resource allocation may become even more skewed towards high-income settings. To ensure that a health security agenda is an integral part of national and foreign policy of each country, political attention and coordination between national ministries is needed as well as support from the national security budget.\r\n\r\nSecond, global health security tends to emphasize disease containment to protect national security rather than the prevention of future local outbreaks. Disease containment is common practice in the control of emerging infectious diseases. A national security perspective often results in unilateral, neo-colonial and/or short-term solutions designed to protect national borders. For example, many countries and airline companies imposed travel restrictions during the 2013\u20132016 Ebola virus disease outbreak in western Africa, contrary to World Health Organization recommendations.\r\n\r\nThird, we argue that respect for human rights and values such as equity and solidarity should underlie each national security agenda. Such values are consistent with the motives of many people who provide health services in public health emergencies. Health security agendas should aim to build resilience to future outbreaks of infectious diseases, and require a long-term systems approach based on surveillance and national health system strengthening.\r\n\r\nProtecting the world from infectious disease threats requires that national governments share the responsibility of serving those most in need, wherever they live. We believe that the concept of global health security should be expanded to include solidarity and sustainability. In this way, we will be able to develop a long-term approach and overcome the limitations of current responses to global health emergencies.\r\n\r\nThis editorial appeared first as an open access editorial in the WHO Bulletin in December 2016 at n/volumes/94/12/16-171488/en/.  ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Global Health Watch 5: A Call for Case Studies","field_subtitle":"Deadline for Submissions: 31 March 2017","URL":"http://tinyurl.com/zdljpfo","body":"The Global Health Watch is an alternative World Health Report that incorporates the voices of marginalised people and civil society into discussions around social justice and global health. The Global Health Watch aims to monitor the activities of global institutions, shift the health policy agenda to recognise the political, social and economic determinants of health, provide a forum for global civil society to question and challenge the influence of neoliberalism on health and global health policy and make recommendations for change and highlight alternatives. Global Health Watch (GHW) have identified broad areas to be covered in the 5th issue of the Watch, which is officially scheduled for release in the end of 2017. GHW are now seeking your assistance in sourcing case studies that can add value to each of these important topics. These case studies and testimonies will form part of the electronic accompaniment to the development of the Watch and in some cases may also appear in the electronic or print edition of the Watch. The case studies will amplify and give a more personal voice to the contents of the Watch. They will also make the issues more accessible and meaningful to readers who may be able to see their own experiences reflected in the experiences of others.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Guidelines on HIV self-testing and partner notification: Supplement to consolidated guidelines on HIV testing services","field_subtitle":"World Health Organisation: Geneva December 2016","URL":"http://www.who.int/hiv/pub/vct/hiv-self-testing-guidelines/en/","body":"In an effort to support countries, programme managers, health workers and other stakeholders seeking to achieve national and international HIV goals, this 2016 update of the WHO guidelines issues new recommendations and additional guidance on HIV self-testing (HIVST) and assisted HIV partner notification services. The guidelines support the routine offer of voluntary assisted HIV partner notification services as part of a public health approach and provide guidance on how HIVST and assisted HIV partner notification services could be integrated into both community-based and facility-based approaches and be tailored to specific population groups. The guidelines support the introduction of HIVST as a formal intervention using quality-assured products that are approved by WHO and official local and international bodies. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Health as the Pulse of the New Urban Agenda","field_subtitle":"World Health Organisation: United Nations Conference on Housing and Sustainable Urban Development, 2016","URL":"http://apps.who.int/iris/bitstream/10665/250367/1/9789241511445-eng.pdf?ua=1","body":"For the Third United Nations Conference on Housing and Sustainable Urban Development, Habitat III agenda for the next 20 years of urban development to succeed, the health of the nearly four billion people who dwell in cities today must be a central concern. Decisions related to urban planning and governance can create or exacerbate major health risks \u2013 or they can foster healthier environments and lifestyles, that in turn reduce the risks of both communicable and noncommunicable diseases. The New Urban Agenda adopted at Habitat III, clarifies that health is not only about the provision of health care services, recognising that the shape and form of urban development influences the health of city residents. Those who design, plan, build and govern cities exercise great influence over the basic ingredients of a healthy life, including access to decent housing, clean air and water, nutritious food, safe transport and mobility, opportunities for physical activity, and protection from injury risks and toxic pollutants. Cities that offer these fundamentals can dramatically reduce the incidence and associated costs of a wide range of diseases \u2013 from heart disease and stroke, to vector-borne diseases and childhood illnesses \u2013 while improving health equity for those most often exposed to such risks, such as children, older people, women, people with disabilities, and the poor. Cities that offer health-enabling environments and coordinated support for healthy lifestyles can ensure that their citizenry are not only healthier and happier, but more economically productive, with far lower costs to both families and societies due to work-related illnesses and injuries. This paper clarifies these and other critically important connections between health and urban policies. It also provides a detailed vision for integrating health into urban planning and governance, and offers practical guidance on health-promoting approaches for those tasked with implementing the New Urban Agenda in the years to come.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"How can health systems research reach the worst-off? A conceptual exploration","field_subtitle":"Pratt B; Hyder A: BMC Health Services Research 16(1868), 2016 ","URL":"http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1868-6","body":"Health systems research is increasingly being conducted in low and middle-income countries (LMICs). Such research should aim to reduce health disparities between and within countries as a matter of global justice. For such research to do so, ethical guidance that is consistent with egalitarian theories of social justice proposes it ought to (amongst other things) focus on worst-off countries and research populations. Yet who constitutes the worst-off is not well-defined. By applying existing work on disadvantage from political philosophy, the paper demonstrates that (at least) two options exist for how to define the worst-off upon whom equity-oriented health systems research should focus: those who are worst-off in terms of health or those who are systematically disadvantaged. The paper describes in detail how both concepts can be understood and what metrics can be relied upon to identify worst-off countries and research populations at the sub-national level (groups, communities), considering real-world cases of health systems research in Uganda and India in 2011. It is recommended that health researchers (or other actors) should use the concept that best reflects their moral commitments\u2014namely, to perform research focused on reducing health inequalities or systematic disadvantage more broadly. If addressing the latter, it is recommended that they rely on the multidimensional poverty approach rather than the income approach to identify worst-off populations.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"How do community health committees contribute to capacity building for maternal and child health? A realist evaluation protocol","field_subtitle":"Gilmore B; McAuliffe E; Larkan F; Conteh M; Dunne N; Gaudrault M; Mollel H; Tumwesigye N; Valli\u00e8res F: BMJ Open 6(11), 2016","URL":"http://bmjopen.bmj.com/content/6/11/e011885.full","body":"This study aims to identify key context features and underlying mechanisms through which community health committees build community capacity within the field of maternal and child health. Since such groups typically operate within or as components of complex health interventions, they require a systems thinking approach and design, and thus so too does their evaluation. Using a mixed methods realist evaluation with intraprogramme case studies, this protocol details a proposed study on community health committees in rural Tanzania and Uganda to better understand underlying mechanisms through which these groups work (or do not) to build community capacity for maternal and child health. It follows the realist evaluation methodology of eliciting initial programme theories to inform the field study design. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Improving priority setting practices in Kenya's hospitals: Recommendations for county decision-makers and hospital managers","field_subtitle":"Barasa E; English M: Kemri Wellcome Trust, Kenya, 2016","URL":"http://tinyurl.com/hv89e3l","body":"KEMRI-Wellcome Trust has conducted research to understand how county hospitals in Coastal Kenya set priorities and allocate resources between services. Data was collected in 2012 and 2013. This brief presents the key findings from the research, showing how hospital managers set priorities and the reasons behind their decisions. Even though the study was conducted pre-devolution, findings remain relevant post-devolution, especially in counties where hospitals still enjoy financial autonomy and as they plan ways to structure hospital financing and priority setting. The brief provides recommendations for county departments of health to improve hospital financing and budgeting, and for hospital managers to improve priority setting and ensure a fair allocation of resources between services. Key messages from the report included that hospitals lack explicit processes for setting healthcare priorities; this provides room for the use of inappropriate priority setting criteria such as lobbying and favouritism. Evidence is not used in decision- making.  Hospitals are severely under-resourced and depend on user fee revenues. This has turned hospitals into revenue-maximisers whereby managers prioritise services that generate revenue through user-fees and overlook services with limited moneymaking potential, including those for young children and disabled people.  Many key stakeholders including middle level managers, clinicians and community members, are not included in priority setting processes. It is important for hospital managers to institute clearly defined procedures and ensure that priority setting is inclusive.  Hospital managers are often clinicians with limited training and skills in management and leadership. Many did not choose to become leaders. Educational institutions and county departments of health both have a role to play in strengthening management and leadership capacity, as well as incentivising hospital managers. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Innov8 approach for reviewing national health programmes: Promoting Health Through Life Course","field_subtitle":"World Health Organisation: Geneva 2016","URL":"http://www.who.int/life-course/partners/innov8/en/","body":"The Innov8 approach is a resource that supports the operationalisation of the Sustainable Development Goal (SDGs) commitment to \u201cleave no one behind\u201d. Innov8 is an 8-step analytic process undertaken by a multidisciplinary review team. It results in recommendations to improve programme performance through concrete action to address health inequities, support gender equality and the progressive realisation of universal health coverage and the right to health, and address critical social determinants of health. The Innov8 Technical Handbook is a user-friendly resource that includes background readings, country examples and analytical activities to support a programmatic review process. The Technical Handbook will be complemented by the release of a wider set of materials currently under development by WHO as part of the Innov8 resource package.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Is social cohesion relevant to a city in the global South? ","field_subtitle":"Barolsky V: SA Crime Quarterly 55, 2016, doi: http://dx.doi.org/10.17159/2413-3108/2016/v0n55a753 ","URL":"http://journals.assaf.org.za/sacq/article/view/753/967","body":"The concept of social cohesion is increasingly being used in local and international policy discourse and scholarship. The idea of collective efficacy, defined as \u2018social cohesion among neighbours combined with their willingness to intervene on behalf of the common good\u2019, has been posited as having an important protective effect against violence. This article investigates the relevance of international framings of social cohesion and collective efficacy, - largely conceptualised and tested in the global North - to the conditions of social life and violence prevention in a city in the global South. These circumstances are interrogated through an ethnographic study conducted in Khayelitsha township in the Western Cape, where a major internationally funded and conceptualised violence prevention intervention, Violence Prevention through Urban Upgrading (VPUU), has been implemented. The ethnographic material contests some of the key assumptions in international discourses on social cohesion and the manner in which social cohesion has been interpreted and effected in the violence prevention initiatives of the VPUU. Khayelitsha communitarian world views support forms of mutual sociality that are underpinned by a philosophy of ubuntu in which personhood is achieved through social relations rather than through individual empowerment. However, these communitarian networks and \u2018ways of life\u2019 are argued to be under social and structural strain and can be conduits not only for reciprocity, but also for violence. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Male circumcision in Uganda will only improve if local beliefs are considered","field_subtitle":"Mbonye M; Seeley J; Kuteesa M: The Conversation, 4 December 2016","URL":"http://tinyurl.com/zz69ypq","body":"For the past 10 years voluntary medical male circumcision has been recommended as a way of reducing female-to-male transmission of HIV. Estimates show that it could reduce infections by 60%. Several sub-Saharan African countries with high rates of HIV prevalence but low rates of male circumcision have rolled out the procedure as part of their HIV prevention initiatives. Since 2007 more than 9 million circumcisions have been performed in eastern and southern Africa. But to cover more than 80% of men on the continent by 2025, about 20 million more men need to be circumcised. If this happens about 3.4 million new HIV infections could be averted, reducing the number of people who would need HIV treatment and care. While circumcision has been encouraged there are many places where it has faced challenges. This is linked to misconceptions about the purpose of circumcision as well as religious and cultural concerns which prevent men from getting circumcised. Uganda is argued in this article to be a case in point. By the end of 2015 the country\u2019s health ministry aimed to circumcise 80% \u2013 or 4.2 million \u2013 men aged between 15 and 49. But between 2008 to 2013 the country only managed to circumcise 50% of this population. Most of these were young boys. This research found that religious and cultural beliefs compete with the messages about the purpose of circumcision. The authors found that this got in the way of men deciding whether or not to be circumcised medically and also affected the way they behaved afterwards. When medical circumcision is introduced in settings where there are high rates of HIV, the authors argue that it must take into account local beliefs about circumcision and local religious and social group leaders and women must be involved in the roll-out.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Many Voices Make a City","field_subtitle":"Collaborative Media Advocacy Platform, Port Harcourt, 2016","URL":"http://www.cmapping.net/many-voices-make-a-city-market-woman-2/","body":"Many Voices Make a City is a series of mini-dramas written, performed and produced by Chicoco Radio trainees, each explores an aspect of participatory urban design. This episode features a starchitect, a celebrity engineer and feisty market woman who knows what she wants. For those who need a little help with Pidgin English, this version is subtitled. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Marketing of breast-milk substitutes: national implementation of the international code: status report 2016","field_subtitle":"World Health Organisation: WHO Geneva, 2016","URL":"http://tinyurl.com/z7rofpj","body":"This report provides updated information on the status of implementing the International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly resolutions (\u201cthe Code\u201d) in and by countries. It presents the legal status of the Code, including - where such information is available - to what extent Code provisions have been incorporated in national legal measures. The report also provides information on the efforts made by countries to monitor and enforce the Code through the establishment of formal mechanisms. Its findings and subsequent recommendations aim to improve the understanding of how countries are implementing the Code, what challenges they face in doing so, and where the focus must be on further efforts to assist them in more effective Code implementation.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Participatory Urban Planning Toolkit Based On The Kitale Experience: A guide to Community-Based Action Planning for Effective Infrastructure and Services Delivery","field_subtitle":"Okello M; Oenga I; Chege P: Practical Action, 2005","URL":"https://practicalaction.org/docs/ia3/participatory-urban-planning-toolkit-kitale.pdf","body":"Whilst the peoples\u2019 right to participate in making decisions that affect them, many governments and development agencies still apply top- down development paradigms. This toolkit's strength is the fact that it has been developed based on empirical project work undertaken in Kitale, a secondary town in Kenya. It is targeted at social workers, planners, development workers, community groups and development agencies operating at the micro-level through existing government structures, in this case the local authority. As a tool, it is intended to mobilise and create synergy with local residents, local development institutions and development agency workers; and demonstrate how locally available resources and experiences may be harnessed in order to improve access to basic infrastructure and services for improved urban livelihoods. The toolkit has been divided into three parts; the first part looks at the philosophical foundation, origin, development and strengths of participatory planning methodologies globally, regionally and locally; the second part looks at the processes that are mandatory in any given participatory planning exercise; while the third gives an empirical and step wise account of the Kitale projects implementation processes; key milestones, challenges faced, innovations and/or best practices, and lessons learnt. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Pearls of wisdom for the young health systems researchers","field_subtitle":"Khalid F: International Health Policies, 2017","URL":"http://tinyurl.com/jjovh3m","body":"Faraz Khalid, a 2016 Emerging Voice for Global Health, a PhD candidate at Tulane School of Public Health and Tropical Medicine, USA, and a health financing consultant with the Prime Minister National Health Insurance Program, Pakistan, shares quotes from senior researchers gathered at meetings and conferences attended throughout the year, including the Emerging Voices in Global Health 2016 training program preceding the Global Symposium on Health Systems Research 2016 in Vancouver. These include Gorik Ooms, Professor at London School of Hygiene and Tropical Medicine (LSHTM) who notes \u201cIf one accepts that health is a human right, one can only assess the present situation of global health (and its enormous inequalities) as a massive and continued human rights violation. Young (and older) health systems researchers must find a middle ground between assuming that states will continue to behave more or less as they currently are (which leaves little room for improvement), or assuming that states will live up to their domestic and international responsibilities (which seems unlikely to happen). In this uncomfortable position, it is important to be aware that whatever solutions we recommend, they will shape the future, one way or the other.\u201d ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Picture a Poverty Free City, Tanzania","field_subtitle":"Mtwapa Participatory Slum Upgrading Programme, 2015","URL":"https://vimeo.com/116674116","body":"What would a city free from poverty really look like for urban youth in Tanzania? Dr Nicola Banks, ESRC Future Research Leader, in this video presented information from local research on young people\u2019s vision for a poverty-free city in Tanzania.  The video reports evidence from participatory discussion with youth. Urban youth make up a huge proportion of city populations- and the video highlights the economic and social opportunities Tanzanian youth raised in their discussions.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Predictors of nurses\u2019 and midwives\u2019 intentions to provide maternal and child healthcare services to adolescents in South Africa","field_subtitle":"Jonas K; Reddy P; van den Borne B; Sewpaul R; Nyembezi A; Naidoo P; Crutzen R: BMC Health Services Research 16(658) 2016","URL":"http://tinyurl.com/gtwsd3e","body":"This study was conducted to gain an understanding of nurses\u2019 and midwives\u2019 intentions to provide maternal and child healthcare and family planning services to adolescents in South Africa. A total of 190 nurses and midwives completed a cross-sectional survey. The survey included components on demographics, knowledge of maternal and child healthcare (MCH) and family planning (FP) services, attitude towards family planning services, subjective norms regarding maternal and child healthcare and family planning services, self-efficacy with maternal and child healthcare and family planning services, and intentions to provide maternal and child healthcare and family planning services to adolescents. Self-efficacy to conduct MCH and FP services and years of experience as a nurse- midwife were associated with stronger intentions to provide the services. Self-efficacy had a strong and positive association with the intentions to provide both MCH and FP services, while there is a moderate association with attitude and norms. The authors argue that there is a need to improve and strengthen nurses\u2019 and midwives\u2019 self-efficacy in conducting both MCH and FP services in order to improve the quality and utilisation of the services by adolescents in South Africa.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Psychosocial risk and protective factors associated with perpetration of gender-based violence in a community sample of men in rural KwaZulu-Natal, South Africa ","field_subtitle":"Mngoma N; Fergus S; Jeeves A; Jolly R: South African Medical Journal 106(12) 2016","URL":"http://www.samj.org.za/index.php/samj/article/view/11600/7748","body":"Rates of gender-based violence (GBV) in South Africa (SA) are among the highest in the world. In societies where social ideals of masculinity encourage male dominance and control over women, gender power imbalances contribute to male perpetration and women\u2019s vulnerability. The drivers that cause men to perpetrate GBV and those that lead to HIV overlap and interact in multiple and complex ways. Multiple risk and protective factors for GBV perpetration by males operate interdependently at a number of levels; at the individual level, these include chronic anxiety and depression, which have been shown to lead to risky sexual behaviours. This study examined psychosocial risk factors (symptoms of anxiety and depression) as well as protective factors (social support and self-esteem) as self-reported by a cohort of males in rural KwaZulu-Natal (KZN) Province, SA; and to determine whether there are differences in anxiety, depression, social support and self-esteem between perpetrators and non-perpetrators. The participants were relatively young (median age 22 years); over half were school goers, and 91% had never married. Over 43% of the sample reported clinical levels of anxiety and depressive symptoms. Rates of GBV perpetration were 61%, 24% and 10% for psychological abuse, non-sexual physical violence and sexual violence, respectively. GBV perpetration was associated with higher depression, higher anxiety, lower self-esteem and lower social support.  Interventions to address GBV need to take modifiable individual-level factors into account. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Scoping review: national monitoring frameworks for social determinants of health and health equity","field_subtitle":"Pedraza L; Pamponet M; Walker R; Costa F; Rasella D: Global Health Action 9(10.3402), 2016","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744868/","body":"The strategic importance of monitoring social determinants of health (SDH) and health equity and inequity has been a central focus in global discussions. This study aims to define a framework for monitoring SDH and health equity. This review provides a global summary and analysis of the domains and indicators that have been used in recent studies covering the SDH. It describes the range of international and national studies and the types of indicators most frequently used; reports how they are used in causal explanation of the SDH; and identifies key priorities and challenges reported in current research for national monitoring of the SDH. The authors conducted a scoping review of published SDH studies in PubMed 2004-2014 to obtain evidence of socio-economic indicators. The final sample consisted of 96 articles. SDH monitoring is well reported in the scientific literature independent of the economic level of the country and magnitude of deprivation in population groups. The research methods were mostly quantitative and many papers used multilevel and multivariable statistical analyses and indexes to measure health inequalities and SDH. In addition to the usual economic indicators, a high number of socio-economic indicators were used. The indicators covered a broad range of social dimensions, which were given consideration within and across different social groups. The authors identified a need to make indicators more wide-ranging in order to include a broader range of social conditions, and for WHO to provide intersectoral and interdisciplinary means of building a more comprehensive standardised approach to monitoring the SDH and improving equity in health.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya","field_subtitle":"Barasa E; Cleary S; Molyneux S; English M: Health Policy and Planning, 2016, doi: 10.1093/heapol/czw132","URL":"http://tinyurl.com/zqthaap","body":"This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. The authors used a qualitative case study approach to examine these processes in two hospitals in Kenya and collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n\u2009=\u200972), by a review of documents, and non-participant observations within the hospitals over a 7 month period. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. The hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to procedures, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the procedures were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonising these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequences (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation of decisions), and procedures (stakeholder engagement and empowerment, transparency, use of evidence, revisions, enforcement, and incorporating community values).","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Sexuality, Poverty and Politics in Rwanda","field_subtitle":"Haste P; Gatete K: Institute of Development Studies, Evidence Report No 131, 2015","URL":"http://tinyurl.com/jrkc62h","body":"Recent legislative developments in Africa have focused international attention on the legal status of lesbian, gay, bisexual and transgender (LGBT) people in the continent. Attempts by various African governments to revise or introduce new legislation on same-sex sexual conduct and marriage, and the response of the international community, has sparked extensive coverage of the associated political, social and cultural controversies. Away from the headlines are several African countries that have never criminalised same- sex sexual conduct and that are outliers to the apparent \u2018trend\u2019 of discriminatory legislation in the continent. One of these is Rwanda. Compared with the situation in neighbouring countries, state-sponsored homophobia appears negligible in Rwanda, and violent attacks are minimal. In the international arena, Rwanda has emerged as an unlikely champion for LGBT rights, and domestically has designated sexual orientation as a \u2018private matter\u2019. This study explores Rwanda\u2019s relatively progressive position on LGBT-related issues and its implications for Rwandan civil society. It examines the strategies employed by national as well as international actors to advance LGBT rights and to address social and economic marginalisation. The study questions assumptions about the uniformity of the \u2018African experience\u2019 and seeks to enhance understanding of the nuance and diversity that exists both within and between countries on the continent.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Skills building on methods and tools for learning from action in participatory action research: Building action learning within affected actors and communities","field_subtitle":"Loewenson R; Flores W; Amaya A; London L; Koffa Kun K: Report of the workshop at the Global Symposium for Health Systems Research, November 2016","URL":"http://tinyurl.com/j5ved9c","body":"This three hour participatory skills session discussed methods/ tools to build learning from action  as a key element of participatory action research (PAR) and briefly the implications for what this means for an understanding of \u2018resilience\u2019 in health systems.  It was held as a satellite session at the 2016 Global Symposium on Health Systems Research. The session drew on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. It integrated input from two rounds of moderated discussion on these questions held on the pra4equity list prior to the Global Symposium. The EQUINET,TARSC, AHPSR, WHO, IDRC  Methods Reader on PAR was also distributed. The session was attended by 62 delegates from all regions of the world. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Social cohesion: The missing link in overcoming violence and inequality?","field_subtitle":"University of Western Cape: HumanSciencesRCSA, South Africa, 2016","URL":"https://www.youtube.com/watch?v=KX5sFeRg9Ic","body":"The study reported in this video sought to understand the role of strong social cohesion in the cities of Cape Town and Rio de Janeiro, both of which suffer from high levels of inequality, poverty, and violence. In response, local governments and non-governmental organisations in both cities have tried to counteract these phenomena through a variety of strategies, programs, and projects. This work explored the role played by social cohesion in the cycle of inequality, poverty, and violence, noting that social cohesion can act as one of a number of violence-prevention factors.  The project provides theoretical, methodological, and practical insights, which contribute to better public policies in the domain of poverty and violence reduction, replicable in other regions.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Socioeconomic and modifiable predictors of blood pressure control for hypertension in primary care attenders in the Western Cape, South Africa","field_subtitle":"Folb N; Bachmann M; Bateman E; et al: South African Medical Journal 106(12), 2016","URL":"http://www.samj.org.za/index.php/samj/article/view/11603/7751","body":"This study investigated associations between patients\u2019 socioeconomic status and characteristics of primary healthcare facilities, and control and treatment of blood pressure in hypertensive patients in South Africa. The authors enrolled hypertensive patients attending 38 public sector primary care clinics in the Western Cape, SA, in 2011, and followed them up 14 months later as part of a randomised controlled trial. Blood pressure was measured and prescriptions for anti-hypertension medications were recorded at baseline and follow-up. Logistic regression models assessed associations between patients\u2019 socioeconomic status, characteristics of primary healthcare facilities, and control and treatment of blood pressure. Blood pressure was uncontrolled in 60% of patients at baseline, which was less likely in patients with a higher level of education and in English compared with Afrikaans respondents. Treatment was intensified in 48% of patients with uncontrolled blood pressure at baseline, which was more likely in patients with higher blood pressure at baseline, concurrent diabetes, more education, and those who attended clinics offering off-site drug supply, with a doctor every day, or with more nurses. Patient and clinic factors influence blood pressure control and treatment in primary care clinics in SA. Potential modifiable factors include ensuring effective communication of health messages, providing convenient access to medications, and addressing staff shortages in primary care clinics. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Sub-Saharan Africa\u2019s \u2018exceptional\u2019 progress against HIV \u2013 surveys","field_subtitle":"Medical Brief, Online African Medical Media digest, December 2016","URL":"http://www.medicalbrief.co.za/archives/sub-saharan-africas-exceptional-progress-hiv-surveys/","body":"National surveys in Zimbabwe, Malawi, and Zambia reveal exceptional progress against HIV, with decreasing rates of new infection, stable numbers of people living with HIV, and more than half of all those living with HIV showing viral suppression through use of antiretroviral medication. For those on antiretroviral medication, viral suppression is close to 90%. These data are the first to emerge from the Population HIV Impact Assessment (PHIA) Project, a multi-country initiative funded by the US President\u2019s Emergency Plan for AIDS Relief (PEPFAR). The project deploys household surveys, which measure the reach and impact of HIV prevention, care and treatment programs in select countries. Importantly, the data positively demonstrate that the 90-90-90 global targets set forth by UNAIDS in 2014 are attainable, even in some of the poorest countries in the world. The data show that once diagnosed, individuals are accessing treatment, staying on treatment, and their viral load levels are suppressed to levels that maintain their health and dramatically decrease transmission to others. In Zimbabwe, among adults ages 15 to 64, HIV incidence is 0.45%; HIV prevalence is 14.6% (16.7% among females and 12.4% among males); 60.4% of all HIV-positive people are virally suppressed, and 86% of those on treatment are virally suppressed. In Malawi, among adults ages 15 to 64, HIV incidence is 0.37%; HIV prevalence is 10.6% (12.8% among females and 8.2% among males); 67.6% of all HIV-positive people are virally suppressed, and 91% of those on treatment are virally suppressed. In Zambia, among adults ages 15 to 59 years, HIV incidence is 0.66%; HIV prevalence is 12.3% (14.9% among females and 9.5% among males); 59.8% of all HIV-positive people are virally suppressed, and 89% of those on treatment are virally suppressed. The results from the first three PHIA surveys compel the global community to strengthen its efforts to reach those who have yet to receive an HIV test and to engage, support, and enable those who test HIV-positive to start and stay on effective treatment in order to achieve long-term viral suppression.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review","field_subtitle":"George A; Scott K; Mehra V; Sriram V: BMC Health Services Research 2016 16(Suppl 7) 2016","URL":"http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1860-1","body":"Community capability is the combined influence of a community\u2019s social systems and collective resources that can address community problems and broaden community opportunities. The authors frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. The authors sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs). The authors searched for journal articles published between 2000 and 2012 related to the concepts of \u201ccommunity\u201d, \u201ccapability/participation\u201d, \u201chealth systems research\u201d and \u201cLMIC.\u201d They identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community participation, critical thinking, problem solving and ownership. Although there are many quantitative scales measuring community capability, health systems research engaged with community participation has rarely made use of these tools or the concepts informing them. Overall, the amount of information related to elements of community capability reported by these articles was low and often of poor quality.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The Paradox of a Global Urban Agenda Led by Nations, Not Cities","field_subtitle":"Poon L: The Atlantic CityLab, 2016","URL":"http://tinyurl.com/h8sze42","body":"The author claims that the battle for global sustainability will be won or lost in cities. Yet the UN\u2019s Habitat III conference was argued in a 10-point manifesto that resulted from a convening of the Second World Assembly of Local and Regional Governments to miss the voices of the individuals and groups who actually run those cities. Mayors and other leaders from more than 500 cities formed a collective voice calling for \u201cA Seat at the Global Table.\u201d Their manifesto lays out why local governments need to be integrated into international talks traditionally reserved for national policymakers. With support from key figures such as UN Secretary General Ban Ki-moon, the assembly pushed for a \u201cparadigm shift in global governance\u201d that would give local leaders more say in what strategies to implement and how. sign and adopt it. The UCLG named Parks Tau, the former mayor of Johannesburg, as their new head.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Slum Dwellers","field_subtitle":"Skoll Foundation, November 2016","URL":"https://vimeo.com/191067281","body":"Jockin Arputham from the Indian slums came up with an idea to organise marginalised communities in slums to improve conditions for themselves, in the form of a Slum Dwellers union. This organisation now exists in over 30 countries: This video describes how it works in Kenya.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The South African Health Review\u2019s Emerging Public Health Practitioner Award (EPHPA) 2017","field_subtitle":"Deadline for applications: 28 February 2017","URL":"http://tinyurl.com/zmeuast","body":"The South African Health Review\u2019s Emerging Public Health Practitioner Award (EPHPA) is open to young public health practitioners or student researchers in the fields health sciences, medicine or public health who are currently studying for their Masters or Honours degree, or are in the final year of their Bachelor\u2019s degree. Individuals seeking to publish a paper dealing with public health policy development or implementation in a respected and widely read South African peer-reviewed journal are encouraged to apply. The South African Health Review\u2019s Emerging Public Health Practitioner Award is offered to South African citizens or permanent residents who are under the age of 35 on 28 February 2017. The applicant must be first author on the paper. Any other authors may only be cited in a supervisory capacity. To apply, submit a complete chapter along with a copy of your ID and EPHPA Entry form. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Towards the Human City","field_subtitle":"Collaborative Media Advocacy Platform: Port Harcourt, Nigeria","URL":"http://www.cmapping.net/the-human-city-project","body":"The Human City Project is a community-driven media, architecture, urban planning and human rights movement in Port Harcourt, Nigeria. It is a collaboration between local and international community organisers, filmmakers, broadcasters, urban planners, architects, designers, university researchers and ordinary people from across Port Harcourt\u2019s informal settlements. Those involved share skills and technologies for communities to record their experiences, tell their stories and change their lives. They are moved by the conviction that democratic design principles can make cities more creative and just. Based on community mapping of needs and priorities, a community radio station was started \u2013 Chicoco Radio \u2013 formally owned by Chicoco Community Media Initiative, an incorporated board of trustees drawn from communities across the city.  With a campaign of 'the people live here' communities in the informal settlements in Port Harcourt have resisted eviction, and are carrying out activities to map and make visible their conditions and needs, develop their voice and capacity to participate meaningfully in the shaping of their city, including to change the way the city is imagined and inhabited on principles of social justice and equity. With the means to tell their stories on film, on air and in court, charting their reality on maps and describing their visions in urban action plans, these communities are changing their lives and shaping their city.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Trends in Between-Country Health Equity in Sub-Saharan Africa from 1990 to 2011: Improvement, Convergence and Reversal","field_subtitle":"Jin J; Liang D; Shi L; Huang J: International Journal of Environmental Research and Public Health 13(6), 620; 2016","URL":"http://www.mdpi.com/1660-4601/13/6/620/htm","body":"It is not clear whether between-country health inequity in Sub-Saharan Africa has been reduced over time due to economic development and increased foreign investments. The authors used the World Health Organization\u2019s data about 46 nations in Sub-Saharan Africa to test if under-5 mortality rate (U5MR) and life expectancy (LE) converged or diverged from 1990 to 2011. The authors explored whether the standard deviation of selected health indicators decreased over time (i.e., sigma convergence), and whether the less developed countries moved toward the average level in the group (i.e., beta convergence). The variation of U5MR between countries became smaller from 1990 to 2001. Yet this trend did not continue after 2002. Life expectancy in Africa from 1990\u20132011 demonstrated a consistent convergence trend, even after controlling for initial differences of country-level factors. The lack of consistent convergence in U5MR partially resulted from the fact that countries with higher U5MR in 1990 eventually performed better than those countries with lower U5MRs in 1990, constituting a reversal in between-country health inequity. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Unearthing exclusions: Towards more inclusive Zimbabwean cities","field_subtitle":"Institute of Environmental Studies, University of Zimbabwe, Kadoma Research Report: 2013","URL":"http://www.searcwl.ac.zw/downloads/Unearthing-exclusions-kadoma.pdf","body":"The Zimbabwean study on safe and inclusive cities seeks to research on manifestations of urban violence, poverty exclusion and inequalities informed by the following underlying research questions: Can the State in terms of both its direct and indirect actions, be implicated in promoting urban violence when its role in addressing issues of urban poverty, inequality and exclusion is examined? Has the state embraced laws and policies founded on continuities of inequalities, rather than a focus on structural change in framing state urban policy in townships, in a manner which does not address those factors that link poverty, inequality and exclusion to urban violence? At municipal level, have laws and policies consolidated rather than shifted gender inequalities in urban townships, thereby continuing to contribute to women\u2019s vulnerability to urban poverty, inequality, exclusion and urban violence? Have communities participated in addressing these problems? The research into context and lived realities took place in Kadoma, Zimbabwe, drawing on the services of 38 masters in women\u2019s law research students who worked in six groups in four broad thematic areas: poverty families and employment, urban environmental health issues, security challenges in Kadoma especially for women girls and access to courts and access to justice. The Women\u2019s law approach assessed the gap between what laws such as Legal Aid Act; Maintenance Act, Administration of Estates Act and Domestic Violence Act against women\u2019s lived experiences and impact of such laws on issues of equality, exclusion and poverty related issues.  The human rights approach sought to understand the role of the state in practice against human rights standards as provided in selected human rights instruments on matters such as social and economic rights particularly relating to matters such as the right to housing, the right to work; the right to health; the right to food and equality before the law and fair representation. ","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Unlocking community capabilities for improving maternal and newborn health: participatory action research to improve birth preparedness, health facility access, and newborn care in rural Uganda","field_subtitle":"Ekirapa-Kiracho E; Namazzi G; Tetui M; et al: BMC Health Services Research 16(Suppl 7) 2016","URL":"http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1864-x","body":"This paper reflects on gains, challenges and lessons learnt from working with communities to improve maternal and newborn health in rural Uganda. A participatory action research project was supported from 2012 to 2015 in three eastern districts. This project involved working with households, saving groups, sub county and district leaders, transporters and village health teams in diagnosing causes of maternal and neonatal mortality and morbidity, developing action plans to address these issues, taking action and learning from action in a cyclical manner. This paper draws from project experience and documentation, as well as thematic analysis of 20 interviews with community and district stakeholders and 12 focus group discussions with women who had recently delivered and men whose wives had recently delivered. Women and men reported increased awareness about birth preparedness, improved newborn care practices and more male involvement in maternal and newborn health. However, additional direct communication strategies were required to reach more men beyond the minority who attended community dialogues and home visits. Saving groups and other saving modalities were strengthened, with money saved used to meet transport costs, purchase other items needed for birth and other routine household needs. Saving groups required significant support to improve income generation, management and trust among members. Linkages between savings groups and transport providers improved women\u2019s access to health facilities at reduced cost. Although village health teams were a key resource for providing information, their efforts were constrained by low levels of education, inadequate financial compensation and transportation challenges. Ensuring that the village health teams and savings groups functioned required regular supervision, review meetings and payment for supervisors to visit. This participatory program, which focused on building the capacity of community stakeholders, was able to improve local awareness of maternal and newborn health practices and instigate local action to improve access to healthcare. Collaborative problem solving among diverse stakeholders, continuous support and a participatory approach that allowed flexibility were essential project characteristics that enabled overcoming of challenges faced.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Video: The role of private nurse training institutions in the production of nurses in Kenya","field_subtitle":"Mwita N; Ngwawe C; Okaro S: AMREF Health Africa, Kenya, 2016","URL":"http://tinyurl.com/zr3hdfa","body":"Kenya faces severe health workforce shortages, especially at the primary health care level. Currently, the density of nurses per 100,000 of the population is 103.4, far below the World Health Organisation minimum target threshold of 500 nurses per 100,000 required to provide sufficient coverage for essential interventions. RESYST research has shown that private and faith-based training institutions currently make up 30% of admissions for nursing courses in Kenya, and are increasingly being considered an important way of increasing nurse production. Students from private nursing institutions are much more likely to graduate than public sector students; of which up to 40% do not successfully complete their training. The curriculum of private institutions, however, is more limited with less focus on public health issues such as health equity and the social determinants of health. Whilst Kenya has increased capacity to train nurses in recent years, severe blockages remain in the system, including in nurses\u2019 employment prospects upon graduation. This video is based on research carried out as part of the RESYST health workforce theme, which looks at the role of the private sector in addressing human resource constraints in Kenya.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"\u201cLike we don\u2019t have enough on our hands already!\u201d: the story of the Kenyan slum youth federation","field_subtitle":"Makau J: Environment & Urbanization 23(1) 203\u2013206, 2011 ","URL":"http://knowyourcity.info/wp-content/uploads/2015/04/EU2011231Makau2.pdf","body":"Slum dweller federations, like many other social movements, cater for the youth in their constituencies. This is critical to their relevance as agents of change and contributes to the sustainability of the movements. This story is a case study of the youth federation that is aligned to Kenya\u2019s slum dwellers federation.  At the slum level, the youth had organized themselves into junior councils that discussed various issues, like how to gain access to football pitches in neighbouring schools. When the annual Youth Council elections came around that year, for the first time slum youth showed up in great numbers and elected their own for all the posts, including junior mayor.   From its beginnings in a couple of slums, the movement spread to slums in four of the city\u2019s eight divisions, and the youth called it \u201cMwamko wa Vijana\u201d (\u201cYouth Awakening\u201d). Three years after it was initiated, a range of activities are underway: a football team, acrobatic and dance troupes, a study group, and a waste collection business. They note: \u201cWe share issues in common that we can federate around \u2013 education, recreation, income generation and mentoring.\u201d The prospect of renewing the youth federation every year is a daunting task but each year new youth come in that are charged up and compelling in their aspirations, so that there is little choice but to do it again.","php":"","field_issue_date":"2017-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Alliance for Health Policy and Systems Research Essay Competition","field_subtitle":"Deadline for submissions: 31 January 2017","URL":"http://tinyurl.com/zdg96ho","body":"The Alliance for Health Policy Systems Research (AHPSR) is pleased to announce its first ever essay competition on the future of health policy and systems research. The winning paper will be published as a background paper for a high level conference on \u201cHealth Policy and Systems Research: 20 years on\u201d that will take place in Stockholm Sweden, in April 2017. In addition, a cash prize of USD $7,500 will be awarded to the authors of the winning paper. Prizes of USD $2,500 and USD $1,000 will be awarded to the authors of the 2nd and 3rd place papers. Much has changed in the 20 years since the WHO Ad-Hoc Committee on Health Research highlighted the need to strengthen Health Policy and Systems Research which was followed by an international consultation in Lejondal, Sweden in 1997 that led to the establishment of the AHPSR. Today as the world transitions from the MDGs to the SDGs, and in light of recent crises resulting from outbreaks, disasters, and conflicts, the need for health policy and systems research in ensuring resilient health systems and improving health is increasingly recognised. How the field can continue to evolve to respond to these and other needs, as well as the role that international entities can play in shaping this evolution, is the topic to be addressed by this essay. In no more than 5000 words, essays \u2013 written in English, should reflect on the role and contributions of Health Policy and Systems Research in strengthening health systems and future challenges in the context of Agenda 2030; identify strategies and innovative approaches to ensure the greater use of health policy and systems research by relevant actors and stakeholders; and explore opportunities to further strengthen the position and role of the AHPSR  in advancing the field.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"An assessment of private General Practitioners contracting for public health services delivery in O.R. Tambo District, South Africa","field_subtitle":"Hongoro C; Funani I; Chitha W; Godlimpi L: Journal of Public Health in Africa 6(2) doi: http://dx.doi.org/10.4081/jphia.2015.525","URL":"http://www.publichealthinafrica.org/index.php/jphia/article/view/525/264]","body":"Low- and middle-income countries are striving towards universal health coverage in a variety of ways. Achieving this goal requires the participation of both public and the private sector providers. The study sought to assess existing capacity for independent general practitioner contracting in primary care, the reasons for the low uptake of government national contract and the expectations of general practitioners of such contractual arrangements. This was a case study conducted in a rural district of South Africa. The study employed both quantitative and qualitative data collection methods. Data were collected using a general practitioner and practice profiling tool, and a structured questionnaire. A total of 42 general practitioners were interviewed and their practices profiled. Contrary to observed low uptake of the national general practitioner contract, 90% of private doctors who had not yet subscribed to it were actually interested in it. Substantial evidence indicated that private doctors had the capacity to deliver quality care to public patients. However, low uptake of national contract related mostly to lack of effective communication and consultation between them and national government which created mistrust and apprehension amongst local private doctors. Paradoxically, these general practitioners expressed satisfaction with other existing state contracts. An analysis of the national contract showed that there were likely to benefit more from it given the relatively higher payment rates and the guaranteed nature of this income. Proposed key requisites to enhanced uptake of the national contract related to the type of the contract, payment arrangements and flexibility of the work regime, and prospects for continuous training and clinical improvements. Low uptake of the national General Practitioner contract was due to variety of factors related to lack of understanding of contract details. Such misunderstandings between potential contracting parties created mistrust and apprehension, which are fundamental antitheses of any effective contractual arrangement. The authors suggest that the idea of a one-size-fits-all contract was probably inappropriate.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review","field_subtitle":"Keynejad R; Semrau M; Toynbee M; et al.: BMC Health Services Research 16(601), 2016","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1853-0","body":"Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). The authors conducted a systematic review with the primary aim of identifying and synthesising the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. The authors searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesised into a narrative review. Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Civil society petition to Kenyatta for decisive action against corruption","field_subtitle":"Kenya Civil Society: Pambuzuka News, November 2016","URL":"http://tinyurl.com/grfszyu","body":"After a series of multi-million-dollar scandals recently unearthed in Kenya, the Auditor General\u2019s report for 2015 says only 1% of the national budget was properly accounted for. In this letter, civil society organisations (CSOs) in Kenya express deep concern and consternation for the worrying escalation of corruption scandals in Kenya in the recent past with little or no consequences for perpetrators, many of whom are reported by the author to have been heavily mentioned in a series of scandals and continue to unashamedly occupy, and therefore bring dishonour, to public office. The CSOs rebuke what they cite as the culture of impunity that continues owing to an apparent lack of political will to address corruption. They make 14 demands to the president and government including the immediate sacking of state and public officers within the Executive adversely mentioned in corruption scandals, initiating legal process of freezing of bank accounts of all those implicated in grand corruption scandals pending investigations, instantaneously stopping and recovering salaries paid illegally to officers who have been suspended or removed from public service on graft allegations","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Community-Based ART Programs: Sustaining Adherence and Follow-up","field_subtitle":"Mukherjee W; Barry D; Weatherford R; Desai I; Farmer P: Current HIV/AIDS Reports 13(6) 359\u2013366, 2016","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106499/","body":"The advent of antiretroviral therapy (ART) in 1996 brought with it an urgent need to develop models of health care delivery that could enable its effective and equitable delivery, especially to patients living in poverty. Community-based care, which stretches from patient homes and communities\u2014where chronic infectious diseases are often best managed\u2014to modern health centres and hospitals, offers such a model, providing access to proximate HIV care and minimising structural barriers to retention. In this paper the authors first review the recent literature on community-based ART programs in low- and low-to-middle-income country settings and document two key principles that guide effective programs: decentralisation of ART services and long-term retention of patients in care. They then discuss the evolution of the community-based programs of Partners In Health (PIH), a nongovernmental organisation committed to providing a preferential option for the poor in health care, in Haiti and several countries in sub-Saharan Africa, Latin America, Russia and Kazakhstan. As one of the first organisations to treat patients with HIV in low-income settings and a pioneer of the community-based approach to ART delivery, PIH has achieved both decentralisation and retention through the application of an accompaniment model that engages community health workers in the delivery of medicines, the provision of social support and education, and the linkage between communities and clinics. The authors conclude that PIH has leveraged its HIV care delivery platforms to simultaneously strengthen health systems and address the broader burden of disease in the places in which it works.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 190: Wishing you progress towards health and justice in 2017","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Header"}},{"node":{"title":"eSIP-Sa\u00fade: Mozambique\u2019s novel approach for a sustainable human resources for health information system","field_subtitle":"Waters K; Mazivila M; Dgedge M; Necochea E; Manharlal D; Zuber A; de Faria Le\u00e3o B; Bossemeyer D; Vergara A: Human Resources for Health 14(66), 2016","URL":"http://tinyurl.com/gpa5t3f","body":"Over the past decade, governments and international partners have responded to calls for health workforce data with ambitious investments in human resources information systems (HRIS). However, documentation of country experiences in the use of HRIS to improve strategic planning and management has been lacking. This case presentation documents for the first time Mozambique\u2019s novel approach to HRIS, sharing key success factors and contributing to the scant global knowledge base on HRIS. Core components of the system are a Government of Mozambique (GOM) registry covering all workers in the GOM payroll and a \u201chealth extension\u201d which adds health-sector-specific data to the GOM registry. Separate databases for pre-service and in-service training are integrated through a business intelligence tool. The first aim of the HRIS was to identify the following: who and where are Mozambique\u2019s health workers? As of July 2015, 95 % of countrywide health workforce deployment information was populated in the HRIS, allowing the identification of health professionals\u2019 physical working location and their pay point. HRIS data are also used to quantify chronic issues affecting the Ministry of Health (MOH) health workforce. Examples include the following: HRIS information was used to examine the deployment of nurses trained in antiretroviral therapy (ART) vis-\u00e0-vis the health facilities where ART is being provided. Such results help the MOH align specialized skill sets with service provision. Twenty-five percent of the MOH health workforce had passed the 2-year probation period but had not been updated in the MOH information systems. For future monitoring of employee status, the MOH established a system of alerts in semi-monthly reports. As of August 2014, 1046 health workers were receiving their full salary but no longer working at the facilities. The MOH is now analysing this situation to improve the retirement process and coordination with Social Security. The Mozambican system is an important example of an HRIS built on a local platform with local staff. Notable models of strategic data use demonstrate that the system is empowering the MOH to improve health services delivery, health workforce allocation, and management. Combined with committed country leadership and ownership of the program, this suggests strong chances of sustainability and real impact on public health equity and quality.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"HIV vaccine test hopes for breakthrough in combat against the virus","field_subtitle":"Boseley S: The Guardian, 27 November 2016","URL":"https://www.theguardian.com/society/2016/nov/27/hiv-vaccine-test-hvtn702-virus-aids-southafrica","body":"The first new trial of a potential vaccine against HIV in seven years has begun in South Africa, raising hopes that it will help bring about the end of the epidemic. Although fewer people are now dying from Aids because 18.2 million are on drug treatment for life to suppress the virus, efforts to prevent people from becoming infected have not been very successful. The infection rate has continued to rise and experts do not believe the epidemic will be ended without a vaccine. The vaccine being tested is a modified version of the only one to have shown a positive effect, out of many that have gone into trials. Seven years ago, the vaccine known as RV144 showed a modest benefit of about 31% in a trial in Thailand. The aspiration is to push the effectiveness up from 31% to between 50% and 60% for use in combination with other prevention tools, such as condoms, antiretroviral drugs and circumcision. According to Professor Linda-Gail Bekker, of the University of Cape Town, \u201cWe\u2019ve never treated our way out of an epidemic. There\u2019s no doubt we have to have primary prevention alongside treatment in order to get HIV control, but we are not going to get HIV eradication without a vaccine. That is very clear.\u201d","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Indigenous Sengwer minority in Kenya oppose EU-funded project","field_subtitle":"Sengwer Community Leaders: Pambuzuka News, November 2016","URL":"http://tinyurl.com/zr6ytly","body":"This article outlines the Sengwer Community Leaders position that a water towers project in their area is being implemented without free, prior and informed consent of the community. As a forest community, who have been subject to part evictions, there is fear of more violations under the current project. For instance, during Natural Resources Management Project, a World Bank funded project (2007-2013), Sengwer peoples living in Kapolet and Embobut forests had some community members arrested and taken to police custody and accused of trespass while they were within their ancestral, community land. They report further than a woman was shot by KFS guards in the same Kapolet Forest. In Embobut Forest, the Sengwer write that there have been arrests and evictions (burning of houses and destruction of property). Today, they say that the Sengwer are forced to live in caves, thick inside the forest...as aliens in their own ancestral lands and territory, despite the stipulation of Art. 63 (2) (d) ii of the Constitution of Kenya. This forced some members of the community to file a complaint with the World Bank Inspection Panel which went into full investigation. The authors call on the European Union to suspend the Water Towers Protection and Climate Change Mitigation and Adaptation Programme with immediate effect, carry out adequate, effective and efficient free prior and informed consent (FPIC) with members of Sengwer and let the community make decision after proper understanding of the Water Towers programme. The Singer fully support conservation programmes and projects that recognise, respect, protect and promote their rights as traditional forest indigenous peoples (hunters and gatherers) to live in and own their ancestral lands and territories their community land in forest/protected area sustainably on conservation conditions working closely with state agencies.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Inequalities in full immunization coverage: trends in low- and middle-income countries","field_subtitle":"Restrepo-M\u00e9ndez M; Barros A; Wong K; et al.: Bulletin of the World Health Organisation 94(11) 2016,","URL":"http://www.who.int/bulletin/volumes/94/11/15-162172/en/","body":"This study investigated disparities in full immunisation coverage across and within 86 low- and middle-income countries. In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, the authors investigated inequalities in full immunisation coverage \u2013 i.e. one dose of bacille Calmette-Gu\u00e9rin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine \u2013 in 86 low- or middle-income countries. The authors then investigated temporal trends in the level and inequality of such coverage in eight of the countries. In each of the World Health Organisation\u2019s regions, it appeared that about 56\u201369% of eligible children in the low- and middle-income countries had received full immunisation. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4% in Chad to 90.3% in Rwanda. The authors detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which the authors investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunisation coverage over the last two decades, particularly among the poorest quintiles of their populations. Most low- and middle-income countries are affected by pro-rich and pro-urban inequalities in full immunisation coverage that are not apparent when only national mean values of such coverage are reported.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Integrated agriculture programs to address malnutrition in northern Malawi","field_subtitle":"Kerr R; Chilanga E; Nyantakyi-Frimpong H; Luginaah I; Lupafya E: BMC Public Health 16(1197), 2016","URL":"http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3840-0","body":"In countries where the majority of undernourished people are smallholder farmers, there has been interest in agricultural interventions to improve nutritional outcomes. Addressing gender inequality, however, is a key mechanism by which agriculture can improve nutrition, since women often play a crucial role in farming, food processing and child care, but have limited decision-making and control over agricultural resources. This study examines the approaches by which gender equity in agrarian, resource-poor settings can be improved using a case study in Malawi. A quasi-experimental design with qualitative methods was used to examine the effects of a participatory intervention on gender relations. Thirty married couple households in 19 villages with children under the age of 5 years were interviewed before and then after the intervention. An additional 7 interviews were conducted with key informants, and participant observation was carried out before, during the intervention and afterwards in the communities. The interviews were recorded and transcribed, and analysed qualitatively for key themes, concepts and contradictions. Several barriers were identified that undermine the quality of child care practices, many linked to gender constructions and norms. The dominant concepts of masculinity created shame and embarrassment if men deviated from these norms, by cooking or caring for their children. The study provided evidence that participatory education supported new masculinities through public performances that encouraged men to take on these new roles. Invoking men\u2019s family responsibilities, encouraging new social norms alongside providing new information about different healthy recipes were all pathways by which men developed new \u2018emergent\u2019 masculinities in which they were more involved in cooking and child care. The transformational approach, intergenerational and intra-gendered events, a focus on agriculture and food security, alongside involving male leaders were some of the reasons that respondents named for changed gender norms. Participatory education that explicitly addresses hegemonic masculinities related to child nutrition, such as women\u2019s roles in child care, can begin to change dominant gender norms. Involving male leaders, participatory methods and integrating agriculture and food security concerns with nutrition appear to be key components in the context of agrarian communities.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Interpreting the International Right to Health in a Human Rights-Based Approach to Health","field_subtitle":"Hunt P: Health and Human Rights Journal, December 2016","URL":"http://tinyurl.com/jf7p79l","body":"This article tracks the shifting place of the international right to health, and human rights-based approaches to health, in the scholarly literature and United Nations (UN). From 1993 to 1994, the focus began to move from the right to health toward human rights-based approaches to health, including human rights guidance adopted by UN agencies in relation to specific health issues. There is a compelling case for a human rights-based approach to health, but it runs the risk of playing down the right to health, as evidenced by an examination of some UN human rights guidance. The right to health has important and distinctive qualities that are not provided by other rights\u2014consequently, playing down the right to health can diminish rights-based approaches to health, as well as the right to health itself. Because general comments, the reports of UN Special Rapporteurs, and UN agencies\u2019 guidance are exercises in interpretation, the author discusses methods of legal interpretation. The author suggests that the International Covenant on Economic, Social and Cultural Rights permits distinctive interpretative methods within the boundaries established by the Vienna Convention on the Law of Treaties. The author calls for the right to health to be placed explicitly at the centre of a rights-based approach and interpreted in accordance with public international law and international human rights law.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Litigating the Right to Health in Africa: Challenges and Prospects","field_subtitle":"Durojaye E: Routledge, 2015","URL":"http://tinyurl.com/hc4uxlj","body":"Health rights litigation is still an emerging phenomenon in Africa, despite the constitutions of many African countries having provisions to advance the right to health. Litigation can provide a powerful tool not only to hold governments accountable for failure to realise the right to health, but also to empower the people to seek redress for the violation of this essential right. With contributions from activists and scholars across Africa, the collection includes a diverse range of case studies throughout the region, demonstrating that even in jurisdictions where the right to health has not been explicitly guaranteed, attempts have been made to litigate on this right. The collection focuses on understanding the legal framework for the recognition of the right to health, the challenges people encounter in litigating health rights issues and prospects of litigating future health rights cases in Africa. The book also takes a comparative approach to litigating the right to health before regional human rights bodies. This book will be valuable reading to scholars, researchers, policymakers, activists and students interested in the right to health.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Making health systems research work: time to shift funding to locally-led research in the South","field_subtitle":"Hasnida A; Borst R; Johnson A; Rahmani N; van Esland S; Kok M: The Lancet Global Health, 2016, doi: http://dx.doi.org/10.1016/S2214-109X(16)30331-X","URL":"http://tinyurl.com/h56but5","body":"In November 2016, the global health systems research community gathered in Vancouver, Canada, for the Fourth Global Symposium on Health Systems Research. The current movement for health systems research developed out of a need to strengthen health systems in low-income and middle-income countries. More than 25 years ago, the Commission on Health Research for Development published a report that represented a pivotal change in thinking about health research for development. The main argument of the report was that research contributed little to health in low-income and middle-income countries, because it matched poorly with needs in the global South, was dominated by researchers from the North, and had a narrow biomedical focus. While health systems research has taken off in some high-income countries, progress in low-income and middle-income countries has not kept up. The 2008 Global Ministerial Forum on Research for Health in Bamako, Mali, concluded with the recommendation to increase investments in health systems research and organise a global symposium specifically focused on improving health systems in low-income and middle-income countries. Since then, the field has expanded rapidly. To contribute to the debate concerning the status and future of the health systems research field, the authors assessed the research presented at the previous global symposia. They systematically analysed the 1816 abstracts that were presented at the global symposia in Beijing (2012) and Cape Town (2014) and the participant lists of the Cape Town, Beijing, and Montreux (2010) symposia. The findings present several promising developments but also highlight that research inequities persist. While the authors observe a gender balance (51% of first authors are female) and substantial contributions from countries such as India, China, and South Africa, the North-South imbalance that was described 26 years ago remains.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Maternity waiting homes in Namibia: Hope for the future","field_subtitle":"World Health Organisation Afro: Namibia, 2015","URL":"https://www.youtube.com/watch?v=yiUPw9h4vN8","body":"This documentary \u201cMaternity waiting homes in Namibia: Hope for the future\u201d focuses on one of the core components of PARMaCM, the importance of keeping pregnant women and young mothers safe via the construction of maternity waiting homes in Namibia. PARMaCM stands for \u201cThe Programme for Accelerating the Reduction of Maternal and Child Mortality\u201d and its objective is to accelerate the achievement of MDGs 4 and 5 of reducing child mortality and improving maternal health in Namibia. The movie is the product of concerted efforts of the Namibian TV Production Company Quiet Storm and the three PARMaCM stakeholders, the Ministry of Health and Social Services (MoHSS), the European Union (EU) and the World Health Organization (WHO). It explores why maternal health statistics are not higher given the income and service levels and how these challenges are being addressed.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"MSF Southern Africa: Learning Unit Administration and Resources Officer","field_subtitle":"Closing date:  Tuesday, 10 January, 2017","URL":"http://www.ngopulse.org/opportunity/2016/12/01/learning-unit-administration-and-resources-officer","body":"Doctors without Borders (MSF) is an international, independent, medical humanitarian organisation committed to two objectives: providing medical assistance to people affected by armed conflict, epidemics, healthcare exclusion, natural and man-made disasters; and speaking out about the plight of the populations assisted. MSF offers assistance to people based only on need and irrespective of race, religion, gender or political affiliation. The learning activities of MSF's Southern African Medical Unit (SAMU) have substantially increased in the past 3 years as the demand for learning opportunities as increased in the many projects that SAMU supports. These activities in turn support the requirements of staff that they contribute to achieving operational objectives of MSF mission/projects. The MSF SAMU learning unit\u2019s purpose is to ensure that MSF field projects, HQs and all MSF partners have access to quality learning opportunities in HIV/TB, both programmatically and clinically. Although learning opportunities are often seen as the provision of trainings, they also include managing and making available a range of medical resources such as guidelines, reports, toolkits and journal articles. One of the most important media for this is the SAMU website. The post requires a candidate with a tertiary qualification, a Diploma in Public Relations, Office Management or similar, 5 Years work experience with two years in similar post and experience in organisation and/or coordination of meetings and trainings.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Much shorter TB treatment offers hope","field_subtitle":"Green A: Health E-News, November 2016","URL":"http://www.health-e.org.za/2016/11/03/hope-drug-resistant-tb-shorter-treatment-success/","body":"There is hope for people living with multi-drug resistant tuberculosis (MDR-TB) as the \u201cgruelling\u201d two-year treatment with \u201cterrible side-effects\u201d such as deafness can now be successfully shortened to just nine months. A team of TB experts at the International Union Against Tuberculosis and Lung Disease has announced the final results of the Francophone study which evaluated the efficacy of a shorter MDR-TB treatment regimen in nine African countries. Three quarters of people in the study were cured with the new nine-month regimen. Of the patients who successfully completed the treatment \u2013 the cure rate was almost 90 percent. Only half of patients taking the older regimen can expect to be cured even after taking drugs for over 20 months. Just completing this course, whether it cures one or not, is a feat of sheer determination, according to TB advocates speaking at the 47th Union World Conference on Lung Health. The study was conducted among 1006 people with MDR-TB in Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, C\u00f4te d\u2019Ivoire, Democratic Republic of the Congo, Niger and Rwanda. Based on the preliminary results of this study, in May this year the World Health Organisation (WHO) officially recommended this regimen for MDR-TB patients who have not taken treatment before and who are not resistant to the drugs contained in this regimen. These final results are expected to give countries the data needed to start rolling out the regimen to all eligible patients.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Orange the World: Raise Money to End Violence against Women and Girls in support of the 16 Days of Activism against Gender Based Violence ","field_subtitle":"UNITE: UN Secretary General's campaign to end Violence against women, December 2016","URL":"http://www2.unwomen.org/-/media/headquarters/attachments/sections/what%20we%20do/unite-fundraising-toolkit-2016-en.pdf?v=1&d=20161012T172555","body":"This document is a resource to support resource mobilization efforts for the \u2018Orange the World: Raise Money to End Violence against Women and Girls\u2019 initiative. It provides background information on the UNiTE campaign, the 2016 campaign theme and gives tips and advice on how to make the most of your fundraising activities. All funds raised aim to support UN Women\u2019s Flagship Programmes on ending violence against women \u2013 \u201cPrevention and Essential Services,\u201d \u201cSafe Cities and Safe Public Space\u201d and the UN Trust Fund to End Violence against Women- that challenge harmful norms and practices to break the vicious cycle of violence and expand the provision of services and access to safety for survivors of violence to enable them to speak out and rebuild their lives. ","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The effects of Maternal and Child Health insurance cards on improving equity in access and use of maternal and child health care services in Tanzania: a mixed methods analysis.","field_subtitle":"Kuwawenaruwa A; Mtei G; Baraka J; Tani K: Journal of Health, Population and Nutrition 35(37), 2016","URL":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116140/","body":"Inequity in access and use of child and maternal health services is impeding progress towards reduction of maternal mortality in low-income countries. To address low usage of maternal and newborn health care services as well as financial protection of families, some countries have adopted demand-side financing. In 2010, Tanzania introduced free health insurance cards to pregnant women and their families to influence access, use, and provision of health services. However, little is known about whether the use of the maternal and child health cards improved equity in access and use of maternal and child health care services. A mixed methods approach was used in Rungwe district where maternal and child health insurance cards had been implemented. To assess equity, three categories of beneficiaries\u2019 education levels were used and were compared to that of women of reproductive age in the region from previous surveys. To explore factors influencing women\u2019s decisions on delivery site and use of the maternal and child health insurance card and attitudes towards the birth experience itself, a qualitative assessment was conducted at representative facilities at the district, ward, facility, and community level. A total of 31 in-depth interviews were conducted on women who delivered during the previous year and other key informants. Women with low educational attainment were under-represented amongst those who reported having received the maternal and child health insurance card and used it for facility delivery. Qualitative findings revealed that problems during the current pregnancy served as both a motivator and a barrier for choosing a facility-based delivery. Decision about delivery site was also influenced by having experienced or witnessed problems during previous birth delivery and by other individual, financial, and health system factors, including fines levied on women who delivered at home. To improve equity in access to facility-based delivery care using strategies such as maternal and child health insurance cards it is necessary to ensure beneficiaries and other stakeholders are well informed of the programme, as only giving women insurance cards does not guarantee their access to facility-based delivery.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Uhuru HIV List declared unconstitutional","field_subtitle":"KELIN: KELIN news, Kenya, December 7 2016","URL":"http://www.kelinkenya.org/2016/12/uhuru-hiv-list-declared-unconstitutional/","body":"The High Court in Nairobi has on 7 December 2016 declared unconstitutional a presidential directive seeking to collect names of people living with HIV, including names of school going children among others. The court declared that the directive issued by H.E Uhuru Kenyatta on 23 February 2015 is in breach of the petitioner\u2019s constitutional rights under Articles 31 and 53(2) which safeguard the right to privacy and best interest of the child respectively. The court further declared that the actions and omissions of the respondents in relation to the directive violated fundamental rights and freedoms of the petitioners. The case was filed by KELIN, Children of God Relief Institute (Nyumbani), James Njenga Kamau and Millicent Kipsang challenging the directive in court on the grounds that it was a breach to the right to privacy and confidentiality and was likely to expose persons living with HIV to stigma and discrimination, among other human rights violations.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Universal Health Coverage Data Portal: Supporting the Universal Health Coverage Coalition","field_subtitle":"World Health Organisation: Geneva, December 2016","URL":"http://apps.who.int/gho/cabinet/uhc.jsp","body":"To mark Universal Health Coverage Day, WHO launched a new data portal to track progress towards universal health coverage (UHC) around the world. The portal shows where countries need to improve access to services, and where they need to improve information. The portal features the latest data on access to health services globally and in each of WHO\u2019s 194 Member States, along with information about equity of access. In 2017, WHO will add data on the impact that paying for health services has on household finances. The portal shows that less than half of children with suspected pneumonia in low income countries are taken to an appropriate health provider. Of the estimated 10.4 million new cases of tuberculosis in 2015, 6.1 million were detected and officially notified in 2015, leaving a gap of 4.3 million. High blood pressure affects 1.13 billion people. About 44% of WHO\u2019s member states report having less than 1 physician per 1000 population. The African Region suffers almost 25% of the global burden of disease but has only 3% of the world\u2019s health workers.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Urgent Action Fund-Africa Communications & Knowledge Management Programme Officer","field_subtitle":"Vacancy open until filled","URL":"http://tinyurl.com/jmqc65d","body":"Urgent Action Fund-Africa (UAF-Africa), registered in Nairobi, Kenya. UAF-Africa seeks a Communications & Knowledge Management Programme Officer who will translate UAF-Africa\u2019s strategic plans into effective social justice initiatives and results. Guided by feminist principles and values, the Fund advocates for gender equality, not only as a matter of human rights, but also as a fundamental prerequisite for social change, global security, and sustainable peace. In addition to her core business of Rapid Response Grant making, UAF-Africa also runs alliance building and advocacy initiatives in collaboration with other national, regional and international social justice organisations.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Urgent Action Fund-Africa Partnerships & Development Manager","field_subtitle":"Vacancy open until filled","URL":"http://tinyurl.com/zwebryw","body":"Urgent Action Fund-Africa (UAF-Africa), is a consciously feminist and women\u2019s human rights pan- African Fund, registered in Nairobi, Kenya. UAF-Africa seeks a Partnerships & Development Manager who will translate UAF-Africa\u2019s strategic plans into effective social justice initiatives and results. Guided by feminist principles and values, the Fund advocates for women\u2019s equality, not only as a matter of human rights, but also as a fundamental prerequisite for social change, global security, and sustainable peace. In addition to her core business of Rapid Response Grant making, UAF-Africa also runs alliance building and advocacy initiatives in collaboration with other social justice organisations.","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"WHO recommends tax on sugary drinks","field_subtitle":"Cullinan K: Health E-News, October 2016","URL":"http://www.health-e.org.za/2016/10/14/recommends-tax-sugary-drinks/","body":"The World Health Organisation (WHO) in October 2016 recommended that governments should tax sugary drinks as part of the global campaign against obesity, type 2 diabetes and tooth decay. South Africa\u2019s Treasury plans to introduce a tax on sugary drinks in April 2017, while Ireland announced it would also introduce a sugary drinks tax in 2018. \u201cConsumption of free sugars, including products like sugary drinks, is a major factor in the global increase of people suffering from obesity and diabetes,\u201d said Dr Douglas Bettcher, Director of WHO\u2019s Department for the Prevention of non-communicable diseases (NCDs). \u201cIf governments tax products like sugary drinks, they can reduce suffering and save lives. They can also cut healthcare costs and increase revenues to invest in health services.\u201d Taxes that result in a 20% increase or more in the retail price of sugary drinks would result in proportional reductions in consumption of such products, according to the WHO report, \u201cFiscal policies for Diet and Prevention of Noncommunicable Diseases (NCDs)\u201d. Obesity has more than doubled between 1980 and 2014. By 2014, almost 40% of adults worldwide were overweight, with 15% of women and 11% of men obese. Meanwhile, diabetes has almost quadrupled since 1980, rising from 108 million in 1980 to 422 million in 2014. In 2012, 38 million people lost their lives due to NCDs, 16 million or 42% of whom died prematurely \u2013 before 70 years \u2013 from largely avoidable conditions. More than 80% of people who died prematurely from a NCD were in developing countries. Governments have committed to reduce deaths from NCDs, and the 2030 Sustainable Development Agenda includes a target to reduce premature deaths from diabetes, cancers, heart, and lung diseases by one-third by 2030. ","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Wishing you progress towards health and justice in 2017","field_subtitle":" EQUINET steering committee","body":"\r\nAs usual this is a short newsletter, given the time of year. Our newsletter is now on its 190th issue and we appreciate the range of creative work reported in all the 16 years of its existence. The 245 editorials written by a range of people from community, civil society, parliament, government, technical and research institutions provide comment and reflection on a diversity of health issues and debates. The over 11000 entries in the 190 newsletters all available in a searchable database on the EQUINET website carry a wide range of ideas, experiences, evidence, analysis and voice from and on east and southern Africa. The newsletter database is a rich searchable resource of how policy and publication focus has shifted over nearly two decades and of whether writing on the region is increasingly being led from the region. \r\n\r\nWe continue to encourage you to document your work and to send us send your blogs, and links to your reports, papers, news, conference announcements, videos or other forms of  information so the newsletter can assist to share experience, evidence and learning from work on health equity in the region. As we said last year, 'Until the lions write their story, tales of the hunt will always glorify the hunter'. We encourage you to roar even louder in 2017! \r\n\r\nPlease send your blogs, and links to your reports, papers, news, conference announcements, videos or other forms of  information from your work on health in the region, and we will be happy to share it. \r\n\r\nWe look forward to working with you in the coming year and wish you a healthy 2017, and a thoughtful, steady and exuberant progress in our struggles for health equity. . ","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"World AIDS Day: Lessons for reversing inequality","field_subtitle":"Goldring M: Oxfam UK, Global Health Check, December 2016","URL":"http://www.globalhealthcheck.org/?utm_source=Global%20Health%20Check&utm_campaign=b1a3e0a194-Global%20Health%20Check%20email&utm_medium=email&utm_term=0_89f8d74097-b1a3e0a194-12084821","body":"On World AIDS Day 2016 Mark Goldring Oxfam UK Executive Director reflected on what we have learnt from working to address the inequality challenges of the HIV epidemic. He focuses on 4 lessons. First, that inequality kills. Millions have died because they were too poor to pay the exorbitant prices of medicines and  hospital fees. Investing in public health systems to offer free service as the point of use and in affordable medicines are essential to save lives and tackle inequality \u2013 both health and economic inequality. The second lesson is that inequality in accessing health services needs to be addressed, especially by overcoming impoverishing costs of care, with women bearing the brunt of this burden. \u0650\u0650\u0650\u0650The third less is that access to HIV treatment could not happen without securing adequate financing. The final lesson is that active citizenship \u2013 people\u2019s involvement in decision making - is at the heart of the success in the response to HIV and in applying the lessons on addressing inequality. ","php":"","field_issue_date":"2017-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"A victory today for Universal Health Coverage - Statement from Oxfam","field_subtitle":"Kamal-Yanni M: Global Health Check, November 2016","URL":"http://www.globalhealthcheck.org/?p=1943","body":"Oxfam have announced that it is now possible to count the cost of paying for healthcare for  households around the world. A group of experts tasked with developing the indicator framework to measure progress towards the Sustainable Development Goals (SDGs), have agreed to measure financial risk protection of universal health coverage by \u2018\u2019proportion of the population with large household expenditures on health as a share of total household expenditure or income\u201d. This signals a great shift in from the previous dangerous indicator that would just measure population with access to health insurance or a public health system. The previous indicator was flawed because it did not measure whether or not people were actually financially protected against potentially catastrophic costs for health care. It would have also failed to measure progress across different income groups or by gender. It was also dangerous as it sent a signal to governments around the world that health insurance was the route to achieving Universal Health Coverage despite robust and scientific evidence that many voluntary health insurance schemes have exacerbated inequality. The change to the new indicator that \u2018measures what matters\u2019 was advocated for civil society organisations, academics, development agencies and statistical authorities expressed their deep concerns through letters, lobbying and public statements. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis","field_subtitle":"Zakumumpa H; Bennet S; Ssengooba F: BMC Health Services Research 16(584),2016","URL":"http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1833-4","body":"Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. This study in 2015 identified facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N\u2009=\u200918) were conducted. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers\u2019 ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader \u2018menu\u2019 of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. The authors found that ART program sustainability was embedded in a complex system involving dynamic interactions between internal (program champion, staffing strength, M &E systems, goal clarity) and external drivers (donors, ARVs supply chain, patient demand). ART program sustainability contexts were distinguished by the size of health facility and ownership-type. The study\u2019s implications for health systems strengthening in resource-limited countries are discussed.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"African Guild of Filmmakers and the Pan African Film & Television Festival \u2018Emergence\u2019 on Screen and on Stage, February 27-28, Burkina Faso","field_subtitle":"CODESRIA: Deadline: 27th December 2016","URL":"http://www.codesria.org/spip.php?article2672","body":"CODESRIA\u2019s Program on Humanities is organising a two day workshop on the sidelines of the bi-annual Pan-Africa Film and Television Festival in Ouagadougou, Burkina Faso in partnership with la Guilde Africaine des R\u00e9alisateurs et Producteurs on \u201c\u2018Emergence\u2019 on Screen and on Stage.\u201d It explores the idea of emergence in various forms: the spouse emerging from an abusive marriage, the student emerging from a period of scholarly mediocrity, the person emerging from a life of poverty and hardship, the community finally freeing itself from the oppressive tyrant and the poor society attaining the heights of wealth all embody the idea of the shedding of shackles to achieve better states of being. Practitioners interested in participating in the workshop are invited to send papers of 5000 words and a CV with full contact details including email addresses and phone numbers to CODESRIA no later than December 27. See website for details.\r\n\r\n","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Alliance for Health Policy & Systems Research Essay Competition","field_subtitle":"Deadline 31 January 2017","URL":"http://tinyurl.com/zdg96ho","body":"The Alliance for Health Policy and Systems Research (AHPSR) announces its first ever essay competition on the future of health policy and systems research. The winning paper will be published as a background paper for a high level conference on \u201cHealth Policy and Systems Research: 20 years on\u201d that will take place in Stockholm Sweden, in April 2017. In addition, a cash prize of USD $7,500 will be awarded to the authors of the winning paper. Prizes of USD $2,500 and USD $1,000 will be awarded to the authors of the 2nd and 3rd place papers. Much has changed in the 20 years since the WHO Ad-Hoc Committee on Health Research highlighted the need to strengthen Health Policy and Systems Research  that led to the establishment of the AHPSR. Today as the world transitions from the MDGs to the SDGs, and in light of recent crises resulting from outbreaks, disasters, and conflicts, the need for health policy and systems research is increasingly recognised. The AHPSR invites essays on how the field can continue to evolve to respond to these and other needs, as well as the role that international entities can play in shaping this evolution. Essays should be no more than 5000 words, essays and written in English. They should reflect on the role and contributions of Health Policy and Systems Research in strengthening health systems and future challenges in the context of Agenda 2030; identify strategies and innovative approaches to ensure the greater use of health policy and systems research by relevant actors and stakeholders; and explore opportunities to further strengthen the position and role of the AHPSR in advancing the field.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Area-based units of analysis for strengthening health inequality monitoring","field_subtitle":"Hosseinpoor A; Bergen N: Bulletin of the World Health Organisation 94(11), 2016 ","URL":"http://www.who.int/bulletin/volumes/94/11/15-165266/en/","body":"Inequalities in health persist worldwide and one of the starting points for remedial action is collecting data that reveal patterns of inequality. Yet countries have varying capacities for monitoring health inequality. This is due in part to data-related issues such as weaknesses in the health information systems, especially in many low- and middle-income countries; lack of availability or poor quality of health data; and a limited ability to disaggregate data across all health topics within countries. Overcoming these challenges in the long term requires substantial investments in the health information infrastructure. In the short-term, countries need innovative approaches to best harness the potential of their existing data to improve monitoring efforts. In this article the authors make the case for stratifying data at the level of subnational geographical regions, such as provinces, states or districts. The wider use of an area-based unit of analysis as a complementary way to analyse data at the individual or household level has certain practical advantages that are relevant to low- and middle-income countries as well as high-income countries. First, this approach opens up new possibilities concerning the data that can be used for within-country monitoring, in terms of both health data and data about dimensions of inequality. Second, since interventions to reduce inequities are likely to be implemented at the local administrative level, regional monitoring of health inequalities may be a useful tool for benchmarking, with implications for resource allocation, planning and evaluation.  Third, area-based measures may provide a more intuitive understanding of health inequalities and may help to identify possible points for intervention. Alongside these advantages, some caution is needed when adopting an area-based unit of analysis. There is the risk of committing a so-called ecological fallacy (i.e. making assumptions about individuals based on population-level patterns, or in this case, erroneously drawing conclusions about the health of individuals using area-based data). In many countries, health inequality monitoring systems could be strengthened by expanding the capacity for, and practice of, area-based health inequality monitoring. Adopting an area-based unit to express health inequality has several merits. Monitoring health inequalities by geographically defined subgroups can help to identify disadvantaged regions that are falling behind in terms of health indicators and to guide improvements in these areas.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Beyond Addis: Financing Social Protection in the 2030 Agenda","field_subtitle":"Kaltenborn M: Social Protection and Human Rights, September 2016 ","URL":"http://socialprotection-humanrights.org/expertcom/4258/","body":"the 2030 Agenda for Sustainable Development (2030 Agenda) and the Sustainable Development Goals (SDGs) expressly identifies establishing universal social protection systems as in several of the international community\u2019s new goals. The SDGs, unlike the Millennium Development Goals (MDGs), explicitly state the need for social protection. Target 1.3 calls on states to \u201cimplement nationally appropriate social protection systems and measures for all, including social protection floors (SPFs)1, and by 2030 achieve substantial coverage of the poor and the vulnerable\u201d. SPFs are not only an essential tool in combating poverty, but also form the basis for food security and housing, especially for vulnerable groups; they have the power to promote social cohesion, make an important contribution to helping people into decent employment and enable parents to send their children to school even during economic crises; all goals which are outlined in the Agenda 2030. By securing household incomes, social protection leads to an increase in private consumption and boosts domestic demand. Finally, well-implemented social protection programmes that give households a predictable source of income may also be able to reduce pressures for migration: there is a broad consensus that besides economic growth and investment in human development (in particular in education and health), social protection is one of the core requirements of any poverty reduction strategy, and is an important precondition for an inclusive and cohesive society, and for stabilising fragile states. Consequently, it is also an indispensable instrument in combating the root causes of migration. Establishing SPFs on sound financial footing is primarily a task for the national governments. The ILO Social Protection Floor Recommendation, 2012 (No. 202) urges governments to consider using a variety of methods to mobilise the necessary resources for their nationally-defined social protection floors. Such methods may include effective enforcement of tax and contribution obligations, but also setting new priorities in their spending behaviour. To solve the problem of funding for SPFs, a Global Fund for Social Protection is proposed, with resources from both the high- and low-income countries to close the funding shortfall between what poorer countries can reasonably afford and address funding for emergencies. The author argues also that developed countries have an obligation to support partner countries in their efforts to strengthen their social security systems, while simultaneously ensuring that the partner countries will be able to sustain these systems themselves in the long run.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"BRICS emerges as a global political force","field_subtitle":"Singh S: New Development Bank, October 2016","URL":"http://www.ndb.int/BRICS-emerges-as-a-global-political-force.php","body":"The author argues in relation to the BRICS summit in October 2016, that BRICS is no longer just an economic grouping but is fast emerging as a political force in global decision-making. Having successfully launched its New Development Bank and Contingent Reserve Arrangement, BRICS now plans to launch its own credit rating agency to end the dominance of the likes of Standard & Poor's or Moody's and Fitch and to bring in emerging economies' perspectives to further enhance their standing and competitiveness in international markets. Similarly, learning from the July 12 Arbitration on South China Sea, BRICS Legal Forum endorsed in August 2016 its own robust arbitration mechanisms to address the problem of double standards of advanced nations. In addition to a now-functioning disputes resolution centre in Shanghai, such as a BRICS-wise arrangement will include commercial arbitration allowing BRICS to resolve disputes for foreign investors. Faced with continuing global financial crisis, leaders have also been discussing developing a BRICS bond market to address challenges of debt securities trading to strengthen their existing lack of liquidity making them vulnerable to foreign portfolio investors.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"CBOs are key in promoting sustainable development in Africa","field_subtitle":"Kakonge J: Pambuzuka News, September 2016 ","URL":"http://tinyurl.com/gqgnyav","body":"As special-interest associations, community-based organisations fill an institutional vacuum, providing basic services to ensure a robust response to crises of poverty. It is at this local level that people, however limited their incomes or their assets, tend to reveal their true wealth: the ingenuity that they need to solve their own problems and those of their communities. Community based organisations (CBOs) are locally based membership organisations that work to provide services to their own communities. They have emerged in response to the need for collective social action. Their main characteristic is the importance that they attach to self-help, based on the principle of traditional communal values, reciprocity and interdependence. The author argues that CBOs can serve as a channel through which African governments can facilitate development at the grassroots level. While the CBOs need capacity-building to strengthen their skills in areas such as bookkeeping and accounts, experience indicates that the related needs assessments should be carried out jointly with communities. Examples show considerable grassroots enthusiasm for decentralisation within communities that can be mobilised by winning the confidence and trust of local and traditional communities and their leaders. CBOs are argued to provide the basis for a bottom-up approach in the fight against social exclusion and in national decision-making. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Changing global policy to deliver safe, equitable, and affordable care for women\u2019s cancers","field_subtitle":"Ginsburg O; Badwe R; Boyle P; et al.: The Lancet, 1 November 2016, doi: http://dx.doi.org/10.1016/S0140-6736(16)31393-9","URL":"http://tinyurl.com/jkwqofv","body":"Breast and cervical cancer are major threats to the health of women globally, particularly in low-income and middle-income countries. Radical progress to close the global cancer divide for women requires not only evidence-based policy making, but also broad multisectoral collaboration that capitalises on recent progress in the associated domains of women\u2019s health and innovative public health approaches to cancer care and control. Such multisectoral collaboration can serve to build health systems for cancer, and more broadly for primary care, surgery, and pathology. This Series paper explores the global health and public policy landscapes that intersect with women\u2019s health and global cancer control, with new approaches to bringing policy to action. .","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"COSATU Statement on the SADC Summit: Business unusual or business as usual?","field_subtitle":"Congress of South African Trade Unions (COSATU): South Africa, August 2016 ","URL":"http://www.cosatu.org.za/docs/pr/2016/pr0830c.html","body":"COSATU reflected in relation to the Southern African Development Community (SADC) heads of states summit the need for concrete solutions to the concrete problems faced rather than  policy statements that do not improve the lives of the people. COSATU identifies the following key issues as key for SADC: desperate conditions of poverty, hunger, and unemployment, human rights abuses, exploitation of natural resources and environmental degradation, job losses and starvation wage crisis, policy crisis and poverty. They call for policies for active industrialisation and to tackle underdevelopment, as raised at the 2016 SADC Civil society Apex Forum and the Southern African Peoples Solidarity Forum held on the sidelines of the SADC Summit. Whilst COSATU welcomed small steps towards a paradigm shift in the Industrialisation policy debate, they called for concrete steps to build the regions manufacturing base and industrial capacity to produce goods and services, in order to stimulate economies and create the much needed jobs, enhance decent work and improve the quality of life for the majority of people and called for bold and inspiring leadership.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Countdown to 2015 country case studies: systematic tools to address the \u201cblack box\u201d of health systems and policy assessment","field_subtitle":"Singh N; Huicho  L; Afnan-Holmes H, et al: Countdown to 2015 Health Systems and Policies Technical Working Group: BMC Public Health 16(Suppl 2) (790), 2016 ","URL":"http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3402-5","body":"The tools presented in this publication assess mother and child health (RMNCH) change over time and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, results are presented from Tanzania and Peru. The Policy and Programme Timeline tool shows that Tanzania\u2019s RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Tanzania developed a national RMNCH plan in 2006 but only costed the reproductive health component. All lifesaving RMNCH commodities were included on their essential medicines lists, but the health worker density (7.1/10,000 population), is below the 22.8 WHO minimum threshold. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Discussion Paper 108 Appendices, Corporate responsibility for health in the extractive sector in East and Southern Africa","field_subtitle":"Loewenson R; Hinricher J; Papamichail A: Training and Research Support Centre, EQUINET: Harare, November 2016","URL":"http://tinyurl.com/h5egdsa","body":"This document provides the detailed legal frameworks and relevant legal clauses from 16 East and Southern African countries for Diss paper 108: Corporate responsibility for health in the extractive sector in East and Southern Africa (ESA) produced by EQUINET through Training and Research Support Centre to inform policy dialogue to improve the legal frameworks for the duties and corporate social responsibility of extractive industries in the ESA region.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Discussion Paper 108: Africa Corporate responsibility for health in the extractive sector in East and Southern Africa","field_subtitle":"Loewenson R; Hinricher J; Papamichail A:  Training and Research Support Centre, EQUINET: Harare, November 2016","URL":"http://tinyurl.com/zm7afbk","body":"While international and global guidance documents set out health obligations for extractive industries (EIs), these standards, including UN conventions, may be voluntary if they are not included in national laws, unless the national constitutions specifically provide otherwise. Given the spread of EIs across the ESA region, it would be important to ensure that corporate duties in relation to health are upheld across the region, including through regional guidance to harmonise laws. This document was produced by EQUINET through Training and Research Support Centre and with support from Medico International. It aims to inform policy dialogue to improve the legal frameworks for the duties and corporate social responsibility of EIs in the ESA region. It presents evidence to support policy dialogue and health advocacy. It reviews the literature on EIs and health in ESA countries, explores key guidance principles/ standards on health in EIs, and analyses from review of laws how far they are contained in domestic legislation of ESA countries. Using good practice in existing ESA laws and international guidance, the document proposes the content for regional guidance for policy and law in the region. As is being implemented in other regions of Africa, there is scope for regional guidance and harmonisation of laws relating to EIs, including in relation to health. While no single law in ESA countries addresses all aspects of international guidance on protection and health and social welfare in EIs, in combination the laws in ESA countries provide clauses that could form the basis of such regional guidance. Drawing from different ESA laws legal guidance is proposed for health and social protection covering: 1. Award of prospecting rights/licenses and EI agreements; 2. Resettlement of affected communities due to mining activities; 3. OHS for employed workers and contractors in the mining sector; 4. Health benefits for workers, families and surrounding communities; 5. Environment, health and social protection for surrounding communities; 6. Fiscal contributions towards health and health services; 7. Stimulation of forward and backward links with local sectors and services supporting health; 8. Post-mine closure obligations for public health; and for 9. Governance of these issues, including for good corporate governance practices, public transparency and accountability, constructive dialogue, reporting and oversight, to foster a relationship of confidence and mutual trust between EIs and the societies in which they operate.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 189:  Farewell to a champion of health justice","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Ethical research code influenced by San leader","field_subtitle":"Harmon S: SciDevNet, 20 October, 2016","URL":"http://www.scidev.net/global/ethics/multimedia/ethical-research-code-san-leader.html","body":"The San of South Africa are one of the most researched communities in the world. Their indigenous knowledge and genetic makeup have been of great interest to researchers as they are ancestors of the first hunter-gatherers in Africa. While the media and researchers have continued to want to engage with the community, TRUST, a global initiative which seeks to reduce exploitation in North-South research collaborations, alongside the San Council created a contract to protect the community from exploitation, and to ensure that the San also benefit from any research. This paper outlines a locally driven Code of Ethics for involving San people in research that has been initiated by a range of organisations in Southern Africa. Referencing the original research and media contract, this is now being finalised into the first indigenous-developed ethics code in Africa.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Farewell to a champion of health justice ","field_subtitle":"Editor, EQUINET newsletter","body":"Fidel Castro, leader of the Cuban revolution, passed away on Friday 25 November. He was a towering figure and one of the defining leaders of the 20th century.  Leaders across Latin America sent tribute. Chile's Michelle Bachelet  called him a 'leader for  dignity and social justice in Cuba and Latin America\", while El Salvador's president, Salvador S\u00e1nchez Cer\u00e9n, said \u201cFidel will live forever in the hearts of those of us who fight for justice, dignity and fraternity.\u201d  As China\u2019s official news agency Xinhua noted, he was \u201ca pioneer in battling ... neoliberal globalisation, foreign debt and exploitation of natural resources.\u201d  CLASCO in Argentina pointed to his role, together with the Cuban people, of pointing to an alternative of a world \"without injustices, without exclusions, without exploitation\" (\"Fidel era un hombre, como tantos otros. Pero Fidel se transform\u00f3, y lo hizo junto a las luchas del inmenso pueblo cubano, en un horizonte, en una promesa, en un destino ut\u00f3pico: el de construir un mundo sin injusticias, sin exclusiones, sin explotaci\u00f3n; un mundo emancipado, liberado, solidario\"). \r\n\r\nThe transformation in Cuba was profound. Manuel Garcia Jr reflected the day after Fidel's death on the transformation he experienced first hand in 1959 Havana: \"Every person, every place, every moment exuded the same sense of uplift. I was immersed in a national sense of freedom, and it soaked into my psyche and bones. This experience permanently magnetized my political compass, so that regardless of verbal arguments and logical constructs in later years, my compass always points my sympathies toward freedom for any people\". The nearly 60 years since of struggle  in Cuba, a small island of 11 million people, often battling powerful global forces, unquestionably generated some contradictions. Ahmed Kathrada in the Mail and Guardian notes that \"history will always judge people differently based on who is writing it\". \r\n\r\nHe also notes, however, together with many other voices from Africa, that Fidel Castro came from \"a generation of leaders, who envisioned a more equitable society, based on mutual cooperation, especially between developing nations\" and that he was one of the foremost supporters of Africa's liberation movements and anti-colonial struggles. The internationalism of Cuban people in Africa has been sustained to today: whether in the support by Cuban troops of Angola's resistance to an apartheid military attack in the 1970s, whether through providing medical education in Cuba for thousands of African doctors over many years, or sending many Cuban doctors to African countries, including the many who came to West Africa to help in the efforts to control Ebola in 2014/5. At the same time, Castro also pointed to the rift between rich and poor in African countries, as he did at the speech to the South African parliament in 1998. \r\n\r\nWhatever the context and debates, Fidel was an unwavering champion of health justice, of the right to health and of progress in social determinants like literacy and food security. He was a driving force of a universal health care system in Cuba that is a responsible for making Cubans some of the healthiest people in the world. As the journal MEDICC noted in a tribute the day after his death: \"Over the years, President Castro took an abiding interest in health and was at the forefront of promoting advances in health care, research and medical education: establishing rural hospitals and a national network of hundreds of community-based clinics, making prevention a cornerstone of training and service; generating extraordinary investments in biotechnology to develop novel vaccines and cancer therapies, and specialized services for Cuban newborns with heart disease. Finally, he considered the most significant \u201crevolution within the revolution\u201d to be the creation in the 1980s of the family doctor-and-nurse program, posting their offices on every block and farmland in Cuba. The outcomes of these efforts were not achieved by one man, but by 500,000 Cuban health workers, who were able to count on health as a government priority. Together, they faced dengue and neuropathy epidemics; and the scarcity of medicines, including for HIV-AIDS patients, after the collapse of the socialist bloc and tightening of the US embargo on Cuba in the 1990s. Their dedication has won a healthier nation\".  \r\n\r\nIt falls to us to continue the struggle for health justice with the same compass, solidarity and tenacity. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Gender Assessment Tool for National HIV and TB Responses","field_subtitle":"UNAIDS: Geneva, August 2016","URL":"http://tinyurl.com/z2c4eg5","body":"This  HIV Gender Assessment Tool, published by the Joint United Nations Programme on HIV/AIDS and the Stop TB Partnership, aims to assist countries in assessing their HIV and tuberculosis (TB) epidemics and responses from a gender perspective, to ensure that the responses are gender-sensitive, transformative and effective in responding to HIV and TB and to support countries in the submission of gender-sensitive concept notes to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).  The UNAIDS HIV Gender Assessment tool was developed recognising the need for more systematic data collection on gender equality and HIV, as revealed by the mid-term review of the UNAIDS Agenda for Accelerated Country Action for Women, Girls, Gender Equality and HIV 2010\u2013 201410 and was developed in a UNAIDS Secretariat led consultative, multi-stakeholder process.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health Cooperation: Its relevance, legitimacy and effectiveness  as a contribution to achieving universal access to health","field_subtitle":"Leschhorn M;  van de Pas R; Schwarz T: Medicus Mundi International, October 2016","URL":"http://tinyurl.com/grj25h5","body":"This paper aims at contributing to the debate on ways in which actors in development cooperation such as international NGOs or bilateral agencies could engage in a relevant, legitimate and effective way to achieving universal access to health. MMI identify that relevant, legitimate and effective health cooperation contributes to achieving universal access to health and is fully aware of its structural role, responsibilities and limitations; and continuously reflects on how to improve its approaches and practices. MMI argue that there is still a lack of platforms in which actors in health cooperation can critically reflect their own practices and approaches, share information and experiences, learn from each other and have an opportunity to further develop their institutional and personal skills and practices. They also suggest that a paradigm shift is required that breaks with the continuum process of development cooperation for health as it has been conducted during the last 50 years.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health Systems Global Speaks: Interview with Christina Zarowsky and poster presenters","field_subtitle":"Health Systems Global: Vancouver, 18 November 2016","URL":"https://www.youtube.com/watch?v=608MtWMq8gE&feature=youtu.be","body":"In this video from Health Systems Global, Professor Christina Zarowsky and poster presenters from the symposium explain their understanding of and debates on the concept of resilience.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health system\u2019s barriers hindering implementation of public-private partnership at the district level: a case study of partnership for improved reproductive and child health services provision in Tanzania","field_subtitle":"Kamugumya D; Oliver J: BioMed Central 16(596), 2016","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1831-6","body":"Public-private partnership (PPP) has been suggested as a tool to assist governments in lower to middle income countries fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level \u2013 which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. This case study was conducted in the Bagamoyo district of Tanzania, and employed 30 in-depth interviews, document reviews, and observations methods. A stakeholder analysis was conducted to understand power distribution and the interests of local actors to engage non-state actors. The study findings reveal several forms of informal partnerships, and the untapped potential of non-state actors. Lack of formal contractual agreements with private providers including facilities that receive subsidies from the government is argued to contribute to inappropriate distribution of risk and reward leading to moral hazards. Furthermore, findings highlight weak capacity of governing bodies to exercise oversight and sanctions, which is acerbated by weak accountability linkages and power differences. Disempowered Council Health Services Board, in relation to engaging non-state actors, is shown to impede PPP initiatives. Effective PPP policy implementation at a local level depends on the capacity of local government officials to make choices that would embrace relational elements dynamics in strategic plans. Orientation towards collaborative efforts that create value and enable its distribution is argued to facilitate healthy partnership, and in return, strengthen a district health system. This study highlights a need for new social contracts that will support integrative collaboration at the local level and bring all non-state actors to the centre of the district health system.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Male involvement in the National Health Insurance Fund (NHIF/KfW) prepaid insurance card for pregnant women in Pangani District, Tanzania","field_subtitle":"Kassimu T: Resilient and responsive health systems (RESYST) blog, Muhimbili University of Health and Allied Sciences, Tanzania, September 2016","URL":"http://tinyurl.com/hmt5m75","body":"In Tanzania, reasons for low use of maternal care are complex, including shortage of resources, long distances to services, high costs and low capacity to provide services. \u2018Gender exclusion\u2019, in this case the exclusion of men in planning or implementing interventions, is also identified to be a major barrier to achieving improved maternal and child health. The author reports that men were involved in the implementation of Tanzania's NHIF/KfW prepaid health insurance card scheme in various ways: during its design; inauguration; registration; and in community sensitisation at the village level and health facilities. At the health care facilities, women are encouraged to attend with their partners during antenatal visits. This is to ensure they are all tested together for HIV, as well as educated on how to take care of the pregnancy and prepare for delivery. This encouraged male involvement and payment of because of any costs of using services. Women had a different views with regard to men\u2019s involvement in the provision of reproductive and child health care services. Participants identified strategies to improve male involvement in the implementation of NHIF/KfW prepaid insurance card in Pangani District. Communication between partners was one of the ways to increase their men\u2019s involvement. In the villages, there are routine meetings every three months. During the meeting, participants discussed various topics and made decisions together for the betterment of the whole community. Men pointed out that giving them more knowledge about health care services and facility practices would enhance their participation in care. The author argues that improvement in the health care provision and community sensitisation of the importance of male partner involvement in the implementation of maternal and child health care programmes needs to be prioritised in order to improve their participation and mitigate the effect of socio-economic and cultural  barriers to access. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Men, masculinity, and engagement with treatment as prevention in KwaZulu-Natal, South Africa","field_subtitle":"Chikovore J; Gillespie N; McGrath N; Orne-Gliemann J; Zuma T; ANRS 12249 TasP Study Group: AIDS Care 28 (Iss Sup3), 2016","URL":"http://www.tandfonline.com/doi/full/10.1080/09540121.2016.1178953","body":"Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. This refers to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a \u201ctreatment as prevention\u201d (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January\u2013November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. The accounts detailed men\u2019s unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Given fears regarding getting an HIV-positive diagnosis, men preferred traditional medicine. Further primary health centres were not seen to be welcoming to men discouraging their readiness to test for HIV. These tensions were amplified by masculinity norms. Men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly. In contrast women were found to access care readily. The authors argue that UTT and TasP promotion should use health service delivery models that address these tensions.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Position Announcement: Executive Director Sam Moyo African Institute For Agrarian Studies (SMAIAS)","field_subtitle":"Deadline: 9 January 2017","URL":"http://www.codesria.org/spip.php?article2666&lang=en","body":"Previously known as the African Institute for Agrarian Studies(AIAS), and renamed to SMAIAS in 2016 in honour of its late Founder and Executive Director, Professor Sam Moyo, the SMAIAS in Harare has been in operation for over thirteen years. The SMAIAS aims to enhance Africa\u2019s agrarian transformation by promoting informed participation towards effective land and agrarian policies and reform, by means of Pan- African and South-South partnerships, interdisciplinary research initiatives, policy dialogues, training, and information dissemination. It interacts with various organisations and countries to assist them in developing capacity for policy formulation and research. It also facilitates policy dialogue among governments, academics, civil society and others on land and agrarian developments, especially on the land rights of marginalised social groups. Under the overall authority of the Board of Trustees and the direct supervision of the Chairperson of the Board of Trustees, the Executive Director will be expected to provide intellectual, administrative and strategic leadership to the secretariat of the SMAIAS. Only African citizens will be considered for this post.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Rising Healthcare Costs in South Africa","field_subtitle":"Chowles T: EHealth News, South Africa, September 2016 ","URL":"http://ehealthnews.co.za/rising-healthcare-costs/","body":"The funding of healthcare in South Africa is a highly contentious issue, involving a variety of stakeholders. Royal Philips released the South Africa results of the first edition of its Future Health Index (FHI) in July 2016. The FHI is an extensive international study which explores how countries around the world are positioned to meet long-term global health challenges through integration of health systems and adoption of connected care technologies. The report revealed that cost is a significant barrier to healthcare in South Africa and that HCPs and patients indicate improving access to healthcare services as a core priority for local government. Health status indicators in South Africa as a whole are reported to be worse than that in other upper middle income countries. Privately insured people though have outcomes comparable to best in world. However, this comes at a high cost. People in South Africa who cannot afford private medical insurance have some of the worst outcomes in terms of healthcare. The report identifies that approximately 40% of total healthcare funds in South Africa flow via public sector financing intermediaries (primarily the national, provincial and local Departments of Health), while 60% flow via private intermediaries.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"South Africa and the DRC: Evaluating a South\u2013South Partnership for Peace, Governance and Development","field_subtitle":"Besharati N; Rawhani C: SAIIA Occasional Paper No 235, 2016","URL":"http://tinyurl.com/jofq4nc","body":"The \u2018Rise of the South\u2019 and the role of \u2018emerging powers\u2019 in global development has animated much of the political and economic discourse of the past decade. There is, however, little empirical evidence on the contribution that emerging Southern partners make to sustainable development, due to the lack of common measurement systems for South\u2013South cooperation (SSC). This case study utilises the analytical framework developed by the Network of Southern Think Tanks (NeST) to assess the range, extent and quality of South Africa\u2019s peace, governance and economic support to the Democratic Republic of the Congo (DRC). The study reveals that South Africa, in absolute financial terms, is a significant development partner in the DRC, and even exceeds the traditional donors when its aid is measured in proportion to gross national income. The qualitative field research highlights that South Africa\u2019s approach to development co-operation to a large extent reflects the core values of SSC, although with a mixed bag of successes and failures in terms of the results of co-operation activities. This pilot study of the South Africa\u2013DRC development partnership is one of the first in which the NeST conceptual and methodological framework has been tested for the purpose of further refining tools and indicators for SSC analysis, so as to assist the future monitoring and evaluation endeavours of South Africa and other emerging development partners.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"South African National Department of Health (NDoH) Finalising Draft of National Health Insurance Financing Models","field_subtitle":"Hlabangane S: EHealth News, South Africa, September 2016 ","URL":"http://ehealthnews.co.za/ndoh-nhi-financing-models/","body":"South African Health Minister, Dr Aaron Motsoaledi, announced that a draft set of the National Health Insurance (NHI) \u2018financing scenarios\u2019 are ready for provincial health Members of Executive Councils (MECs) in October 2016. According to the legal brief Policy Watch, the Minister said that \u2013 in finalising government policy on universal healthcare \u2013 the department will consider each scenario and carefully reflect on the \u201dvery useful suggestions\u201d received from stakeholders following the release of a draft White Paper in December 2015 for comment. Noting that the costs associated with implementing universal healthcare are \u201dinfluenced by many factors, including design elements and the pace of implementation,\u201d Dr Motsoaledi emphasised the importance of focusing on the implications of each funding scenario for incrementally introducing the necessary reforms.  With that in mind, the draft scenarios will be informed by an \u201cestimation framework\u201d based on \u201cconfigurations\u201d of projected service demand, service delivery and associated costs \u2018at each level of care. There are views that there are many uncertainties and unaddressed issues in the White Paper, including in the funding model. Meanwhile, the Treasury has allocated South African Rand 4.5bn to renovate healthcare facilities across 11 NHI pilot projects and allocated SAR300 million on developing a national electronic medicine stock management system, a key element for NHI outlined in the White paper. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The People\u2019s Coalition on Food Sovereignty Statement for World Food Day 2016","field_subtitle":"The People\u2019s Coalition on Food Sovereignty: Pambuzuka News, October 2016","URL":"http://www.pambazuka.org/food-health/fight-food-injustice-and-repression","body":"The People\u2019s Coalition on Food Sovereignty unites with the farmers, agricultural workers, small-scale food producers, indigenous peoples and the peoples of the world in commemorating World Food Day 2016. To call attention to the hunger being experienced by the majority of the world\u2019s population, the coalition has called it World Hunger Day with the theme \u201cFight Food Injustice and Repression!\u201d This calls attention to repression of farmers and activists for food justice. In 2015, the Pesticides Action Network \u2013 Asia-Pacific claimed that almost six farmers, indigenous people and/or land activists were being killed every month in relation to land struggles and conflicts, and many cases remain unreported. In 2016 they argue that there has been intensifying repression of farmers, indigenous peoples, agricultural workers, and other small-scale food producers. People\u2019s Coalition on Food Sovereignty condemn this repression and point to the need to change the structural causes of widespread hunger and intensifying monopoly control over the world\u2019s agriculture and food systems. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The Prevention Gap","field_subtitle":"UNAIDS: Geneva November 2016","URL":"http://www.unaids.org/en/resources/documents/2016/prevention-gap","body":"A new report by UNAIDS released prior to World AIDS Day 2016 reveals concerning trends in new HIV infections among adults. The Prevention gap report shows that while significant progress is being made in stopping new HIV infections among children (new HIV infections have declined by more than 70% among children since 2001 and are continuing to decline), the decline in new HIV infections among adults has stalled. The report shows that HIV prevention urgently needs to be scaled up among this age group. The Prevention gap report shows that an estimated 1.9 million adults have become infected with HIV every year for at least the past five years and that new HIV infections among adults are rising in some regions. New HIV infections among adults declined by only 4% in eastern and southern Africa since 2010. The Prevention gap report gives the clear message that HIV prevention efforts need to be increased in order to stay on the Fast-Track to ending AIDS by 2030. \u201cWe are sounding the alarm,\u201d said Michel Sidib\u00e9, Executive Director of UNAIDS. \u201cThe power of prevention is not being realized. If there is a resurgence in new HIV infections now, the epidemic will become impossible to control. The world needs to take urgent and immediate action to close the prevention gap.\u201d","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review","field_subtitle":"Corley A; Thornton C; Glass N: PLOS Neglected Tropical Diseases 10(9), 2016, ","URL":"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004914","body":"Neglected tropical diseases produce an enormous burden on many of the poorest and most disenfranchised populations in sub-Saharan Africa, where a dearth of skilled health providers limits primary care efforts to address such diseases. Consequently, many countries rely on nurses and community health workers to engage with under-served and hard-to-reach populations. This review of the literature was conducted to assess the role nurses and community health workers play in the primary, secondary, and tertiary prevention of neglected tropical diseases in sub-Saharan Africa. Articles published between January 2005 and December 2015 were reviewed in order to capture the full scope of nurses\u2019 and community health workers\u2019 responsibilities for neglected tropical disease control within their respective countries\u2019 health systems. A total of 59 articles were identified that fit all inclusion criteria. It reports that successful disease control requires deep and meaningful engagement with local communities and that horizontal or multidisease control programs can create complimentary interactions between their different control activities as well as reduce costs through improved program efficiencies.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Trump and Trumpism: Reflections on post US elections geopolitics","field_subtitle":"Tandon Y: Pambuzuka News, November 2016","URL":"http://tinyurl.com/jlnrjec","body":"The author analyses that Trump\u2019s victory in the US elections is partly because the world is changing. He writes that the world is witnessing a civilisational shift \u2013 the slow, painful death of the Western Empire. Even in rich America millions of people go hungry and without shelter. He argues thus that Africa will in this current era use its own resources and ingenuity to prosper. He notes that if Trump rejects the TTIP (Transatlantic Trade and Investment Partnership) and the TPP (Trans Pacific Partnership) then he can count on his support. Tandon welcomes the idea that he might scrap AGOA (which he sees as divisive of Africa) and Obama's \"Power Africa\" $7 billion initiative. These \u201cinitiatives\u201d he argues are to help corporate America, not Africa. He also notes that if Trump talks with Russia, China, Iran and Syria, then he could help forces of peace and reconciliation that the world badly needs. He notes that Trump does not have Africa on his map and has criticised the notion of \"exporting democracy\", which Tandon also welcomes. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"UN Human Rights Council creates position of Special Rapporteur on the Right to Development","field_subtitle":"Timosi A: SOUTHNEWS Issue 127, 2016","URL":"http://www.alainet.org/es/node/180636","body":"The UN General Assembly Human Rights Council on 29 September 2016 adopted a resolution (A/HRC/33/L.29) which established a mandate for a Special Rapporteur on the Right to Development. The draft of the resolution was presented by Venezuela on behalf of the member states of the Non-aligned Movement and China, and was adopted by a vote of 34 in favour, two against and 11 abstentions. The Council decided to appoint, for a period of three years, a Special Rapporteur on the right to development, whose mandate will include: to contribute to the promotion, protection and fulfilment of the right to development in the context of the 2030 Agenda for Sustainable Development and other internationally agreed outcomes of 2015; to engage and support efforts to mainstream the right to development among various United Nations bodies, development agencies, international development, financial and trade institutions, and to submit proposals aimed at strengthening the revitalized global partnership for sustainable development from the perspective of the right to development; to contribute to the work of the Working Group with a view to supporting the accomplishment of its overall mandate, taking into account, inter alia, the deliberations and recommendations of the Working Group while avoiding any duplication;  to submit any specific study by the Human Rights Council in accordance with its mandate;  to submit an annual report to the Human Rights Council and to the General Assembly covering all activities relating to the mandate. In his remarks introducing the draft proposal, Ambassador Mr. Jorge Valero (Bolivarian Republic of Venezuela), on behalf of the Non-Aligned Movement (NAM), recalled that in the Vienna Declaration and Programme of Action on the Right to Development, the Council committed to elevate the right to development to the same level as other human rights and fundamental freedoms. South Africa\u2019s Permanent Representative to the United Nations in Geneva, Ambassador Nozipho Joyce Mxakato-Diseko, speaking on behalf of the African Group expressed the support of the African continent for the draft resolution proposed by NAM and China. Ambassador Mxakato-Diseko underscored that 2016 was a crucial year for the start of the implementation of the 2030 Agenda for Sustainable Development.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Universal Health Coverage in Africa: A framework for action. Joint UHC working paper","field_subtitle":"World Bank: World Bank Group, August 2016","URL":"http://tinyurl.com/jd8p2z6","body":"Africa\u2019s population is estimated to reach 2.5 billion by 2050, raising a challenge for  progress toward Universal Health Coverage (UHC), the principle that everyone receives needed health services without financial hardship. The primary reason for investing in UHC is argued to be a moral one: it is not acceptable that some members of society should face death, disability, ill health or impoverishment for reasons that could be addressed at limited cost. However, UHC is also argued to be a good investment. Prevention of malnutrition and ill health is likely to have enormous benefits in terms of longer and more productive lives, higher earnings, and averted care costs. Effectively meeting demand for family planning will accelerate the fertility transition, which in turn will result in higher rates of economic growth and more rapid poverty reduction. And strong health and disease surveillance systems halt epidemics that take lives and disrupt economies. The authors report for example that In 2015, the forgone economic growth due to Ebola amounted to more than a billion US dollars in the three countries hit by the epidemic. ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Urgent Action Fund-Africa Communications and Knowledge Management Programme Officer","field_subtitle":"Vacancy open until filled","URL":"http://tinyurl.com/jmqc65d","body":"Urgent Action Fund-Africa (UAF-Africa) seeks a Communications and Knowledge Management Programme Officer who will translate UAF-Africa\u2019s strategic plans into effective social justice initiatives and results. Guided by feminist principles and values, the Fund advocates for gender equality, not only as a matter of human rights, but also as a fundamental prerequisite for social change, global security, and sustainable peace. In addition to her core business of Rapid Response Grant making, UAF-Africa also runs alliance building and advocacy initiatives in collaboration with other national, regional and international social justice organisations.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Urgent Action Fund-Africa Partnerships and Development Manager","field_subtitle":"Vacancy open until filled","URL":"http://tinyurl.com/zwebryw","body":"Urgent Action Fund-Africa (UAF-Africa), is a consciously feminist and women\u2019s human rights pan- African Fund, registered in Nairobi, Kenya. UAF-Africa seeks a Partnerships & Development Manager who will translate UAF-Africa\u2019s strategic plans into effective social justice initiatives and results. Guided by feminist principles and values, the Fund advocates for women\u2019s equality, not only as a matter of human rights, but also as a fundamental prerequisite for social change, global security, and sustainable peace. In addition to her core business of Rapid Response Grant making, UAF-Africa also runs alliance building and advocacy initiatives in collaboration with other social justice organisations,","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Vancouver Statement from the Fourth Global Symposium on Health Systems Research","field_subtitle":"Health Systems Global: Vancouver, Canada, 18 November 2016","body":"From 14-18 November 2016, 2,062 delegates from 101 countries assembled in Vancouver, Canada, for the Fourth Global Symposium on Health Systems Research on the theme of \u2018Resilient and responsive health systems for a changing world\u2019. This year\u2019s Symposium consisted of five days of 53 organised sessions, 248 oral presentations, 74 satellite and skills building sessions, 385 posters, and 155 e-posters. Social media played a great part in whipping up the spirit of engagement, before and during the Symposium. Blogs also played a role in generating energy before the Symposium; the most popular of these was a blog from the SHAPES thematic working group challenging the concept of resilience in health systems.\r\n\r\nSince Cape Town, the world has shifted from efforts to achieve the MDGs to the launch of the SDGs, which maintain a focus on UHC, but call more strongly for a systems-orientated approach by embedding health in broader social and environmental perspectives. In support of these goals, there is even greater focus on research to reduce inequities in relation to marginalised and vulnerable groups. On the policy and implementation front, there has been a transition in the funding landscape from donor funding for interventions, towards emphasis on locally generated funds. In this context, the local production of health policy and systems research is also increasingly valued. \r\n\r\nSeveral themes emerged from the discussion and debate during this Symposium. First, it is important to recognise the many meanings of resilience. Health system resilience and responsiveness is anchored in people living and working within their communities. But, we need to be cautious not to romanticise communities as resilient, when what they are doing is coping in difficult situations. Systems need to be resilient precisely so that the burden of such  resilience does not fall on the most vulnerable in our societies. Health systems resilience needs to be qualified by an explicit focus on equity and social justice, and support the empowerment of the most vulnerable. Second, discussions amongst participants highlighted the importance of resilient and responsive health systems as ones which provide integrated, people-centred services, with a focus on primary health care as the frontline of routine services and outbreak response. Subnational actors, including communities, are reservoirs of resilience for health systems. Resilient health systems are those which operate from the \u201cend-user back\u201d, and not from the organisation forward. Nevertheless, governments have the responsibility for steering all actors \u2013 public and private \u2013 in the interests of the broader community.\r\n\r\nThird, while some discourse on resilience emphasises health security, such a perspective can sometimes be counter-productive, and should be balanced with the protection of health rights and health system strengthening. Health security should be an inclusive concern of the entire global community, and never a reason to exclude or marginalize. Fourth, the resilience discourse should be positioned within achieving the SDGs and mobilising collaboration and leadership across sectors. This together with integration and a move away from vertical approaches will help achieve the sustainable management of health systems. Symposium delegates repeatedly stressed the importance of people and relationships, flexibility and the capacity to mobilize new resources. Fifth, the Symposium gave occasion to highlight the struggles of indigenous peoples against historic privileges, including in high income countries. This has received insufficient attention in the Symposia to date. People in high income countries have much to learn from the experiences of low and middle income countries as well as from their own indigenous or marginalized populations.\r\n\r\nThe Symposium identified several areas for action for HSG, for researchers, funders and policy makers. \r\n\r\nThe Fourth Global Symposium has allowed our community to hold a light to the concept of resilient and responsive health systems, recognising their importance for achieving UHC and the SDGs, while acknowledging the potential shortcomings. Resilience adds a useful lens to our existing concepts and approaches, but it does not replace or supersede them. The world is changing, and resilience and responsiveness are needed now more than ever. The accumulated knowledge we have as a community builds on the continuing Symposia agenda of improving the science needed to accelerate Universal Health Coverage; to be more inclusive and innovative towards achieving UHC; and to make health systems more people-centred. For the next two years, Health Systems Global as a community of practitioners and researchers will look to remain at the vanguard of defining the field of health policy and health systems, while impacting our broader communities, and improving our global society.\r\n\r\nThe full statement is found at http://healthsystemsresearch.org/hsr2016/wp-content/uploads/Vancouver-Statement-FINAL.pdf  and further information on Health Systems Global and the conference can be found on the HSG website at http://healthsystemsresearch.org/hsr2016/ ","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"WHO Reform: the need for a global mobilisation directed to the democratisation of global health governance","field_subtitle":"Legge D: People\u2019s Health Movement, 2016","URL":"http://tinyurl.com/hf7wrg9","body":"The author observes that the role and reach of the World Health Organisation has been contested since it was created in 1948. The debate is commonly couched in terms of whether the organisation is \u2018fit for purpose\u2019 although whose purpose is not always made clear. There have been several attempts at WHO reform since its establishment, directed to making it fitter for a still contested purpose. The current round of \u2018WHO reform\u2019 was launched in 2010 following a budget crisis and it continues as the new director\u2010general settles into the job. The current reform program addresses: funds mobilisation, budgeting, evaluation, relationships with non\u2010state actors, relationships within the secretariat (between headquarters, the regions and the country offices), WHO\u2019s role in global health governance, the emergency program and the management of the WHO\u2019s staff. The capacity, effectiveness and accountability of WHO is critical to the project of equitable health development globally. Nevertheless, there have been shortfalls. The root causes of WHO\u2019s disabilities are argued to include the freeze on WHO revenues, the dysfunctions associated with WHO\u2019s highly decentralised organisational structure, and the lack of accountability of member states for their contribution to WHO decision making and their implementation of WHO resolutions. In this paper the author reviews the evolution of the current reform program and some of the major elements of the reform, with the shortfalls, disabilities and reform options within the broader context of global health governance. The author argues that the reform of WHO, to realise the vision of its Constitution, will require a global mobilisation around the democratisation of global health governance.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"World Aids Day: Hands Up Campaign","field_subtitle":"UNAIDS: Geneva, November 2016","URL":"http://www.unaids.org/sites/default/files/media_asset/WAD2016-brochure_en.pdf","body":"The decline in new HIV infections among adults has stalled. The UNAIDS Prevention gap report shows that worldwide an estimated 1.9 million adults have become infected with HIV every year for at least the past five years and that the number of new HIV infections is rising in some regions. The report shows that HIV prevention efforts must be reinvigorated if the world is to stay on the Fast-Track to ending the AIDS epidemic by 2030. In the lead-up to World AIDS Day 2016, the hands up for #HIVprevention campaign will explore different aspects of HIV prevention and how they relate to specific groups of people, such as adolescent girls and young women, key populations and people living with HIV. Starting in September 2016, the campaign will offer people a space to express their views on what they think needs to be done to strengthen HIV prevention efforts. UNAIDS is asking people around the world to submit: A photograph of a word or short phrase written on the palm of their hand summarising what is needed to strengthen HIV prevention efforts, for example more condoms, empowerment, inclusion, pre-exposure prophylaxis (PrEP), rights for women and girls. People may also submit a short video message (maximum 30 seconds) explaining what in their view needs to be done to reduce new HIV infections in their community.","php":"","field_issue_date":"2016-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"'Hiigsiga Nolosha': How Has a Youth Radio Show Given Young Somalis Hope for Their Future?","field_subtitle":"BBC Media Action: Somalia, August 2016","URL":"http://tinyurl.com/jsvlks8","body":" The Media Action radio programme Hiigsiga Nolosha (meaning desire or aspirations for life) is designed for Somali youth as a discussion platform to prompt \"dialogue and interaction across divides, create... understanding and acceptance between youth from different parts of the country, improve... how youth are viewed (by themselves and adults), give... young people hope and motivation for the future and help... them to believe they can positively contribute to their country.\" The project was created to improve capacity of local Somali partner radio stations to deliver audience-driven, and particularly youth-focused, media programming. Hiigsiga Nolosha \"has been broadcast via the BBC Somali Service and three partner community radio stations and included both a drama Maalmo Dhaama Maanta (A Better Life than Today)  and discussion segments produced by each partner radio station.\"  Phase I formative research showed a need for programming in which youth could exchange \"ideas and experiences and come up with solutions to the challenges they face. The impact evaluation at the end of Phase I found that the programme had given Somali youth an opportunity to interact and express their ideas, had helped to highlighted commonalities of young people, had positively shifted how young Somalis viewed themselves and contributed to youth empowerment.\" ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"2nd World Breastfeeding Conference 2016","field_subtitle":"11-14 December 2016, Johannesburg, South Africa","URL":"http://worldbreastfeedingconference.org/doc/Concept-Note_WBC2016.pdf","body":"The International Baby Food Action Network (IBFAN) and the Department of Health - Republic of South Africa are co-hosting the 2nd World Breastfeeding Conference in collaboration with WHO, UNICEF, WABA and gBICS partners in Johannesburg South Africa from 11th to 14th December 2016. The Conference will  provide an opportunity to review the global investment promises for maternal, infant and young child nutrition in light of resolutions from the 65th WHA of 2012, and to generate ideas for further resource mobilisation and/or strengthening of interventions. In addition, the conference will provide an opportunity to broaden understanding barriers to breastfeeding including promotion of artificial feeding by manufacturers, unsupportive health facility practices, more working mothers, inadequate traditional support, among others and address breastfeeding in a human rights framework. Furthermore, the conference will raise awareness on progress so far made in improving breastfeeding rates, which has occurred at different speeds in many countries and raise awareness on a number of challenges to the promotion, protection and support of breastfeeding and other IYCF interventions due to the funding, structural, policy and political environment.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"59th International Conference on Multidisciplinary Research","field_subtitle":"9 - 10 November 2016, Cape Town, South Africa","URL":"http://www.academicsera.com/Conference/SouthAfrica/2/ICMRP/","body":"59th International Conference on Multidisciplinary Research & Practice(ICMRP) is to bring together innovative academics and industrial experts in the field of Science Technology and Management to a common forum. All the registered papers will be published by the World Research Library and will be submitted for review for indexing by Google Scholar etc. All submissions to the conference will be reviewed by at least two independent peers for technical merit and content. It is anticipated that a broad range of research and applied topics will be covered during the conference.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"After Habitat III: a stronger urban future must be based on the right to the city","field_subtitle":"Colau A: The Guardian, October 2016","URL":"http://tinyurl.com/jctjsvh","body":"Innovative and agile cities are better placed to solve major global challenges than national governments \u2013 in thrall to the momentum of the last century \u2013 but the fight must start now, argues Barcelona\u2019s first female mayor. Colau argues that all the major global challenges \u2013 climate change, the economy, inequality, the very future of democracy \u2013 will be solved in cities. If nations want to succeed with their policies, cities must be counted as serious actors on the global stage. She argues that national governments are hostages to the momentum of the previous century \u2013 but that\u2019s not the real world any more. We live in a world that functions by networking, by faster and more agile contact between cities. Colau notes that it is not possible to talk about a just, sustainable, equitable or inclusive city without speaking about the right to the city - a model of urban development that includes all citizens. She argues that the reference to it in the UN\u2019s New Urban Agenda document ratified at Habitat III in Quito this week could be more ambitious. However it is necessary to recognise the problems overcome just to get this far. She comments that some global powers such as the United States and China resisted it completely; they didn\u2019t want the right to the city in the declaration at all. Thanks to popular mobilisation in Latin America and in some European countries, this political movement has won its place on the agenda \u2013 and she notes it as a significant achievement.  For the right to the city to become real, however, needs action to transform it into concrete policies and regulations. Colau notes that the most important tests will come after the summit finishes \u2013 when we find out whether all these statements can translate into commitments that create positive solutions for urban citizens.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Building capacity to use research evidence (BCURE)","field_subtitle":"Department for International Development (DFID): UK, November 2014","URL":"https://bcureglobal.wordpress.com","body":"Building Capacity to Use Research Evidence (BCURE) is a programme of work funded by the UK Department for International Development (DFID) which aims to build the skills, knowledge and systems that will allow policy makers and practitioners in low income countries to access, appraise and use rigorous evidence. BCURE works through a consortium of organisations, focusing on building capacity to make evidence informed decisions. Examples of some of the different interventions are incorporating processes to improve evidence use by Cabinet Ministers, using innovative online training methods to improve the skills of individuals to make evidence informed decisions, establishing open policy dialogues between government officials, civil society and the research sector  to promote the use of evidence in decision making and developing the African Evidence Network \u2013 where policy makers and practitioners can discuss and share lessons on evidence use. Each project has a primary provider, who oversees the management of that work.  BCURE is being delivered with a specific focus on building the capacity of locally based partner organisations in the countries where projects are operating, as essential for the sustainability of the programme.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Call for abstracts and announcement: 21st to 23rd February 2017, Kampala, Uganda Contribution of Community Health Workers in attainment of the Sustainable Development Goals","field_subtitle":"Deadline for abstract submission: 30 November 2016","URL":"http://chwsymposium.musph.ac.ug","body":"Makerere University College of Health Sciences, School of Public Health, Uganda in partnership with Nottingham Trent University, UK and Ministry of Health, Uganda invites submissions of abstracts for the symposium on Community Health Workers (CHWs) and their contribution towards the Sustainable Development Goals (SDGs). Sub themes include CHWs programmes (past, present and future), CHWs and health systems and the role of CHWs in the SDGs era. For further details on the symposium themes, the abstract format, dates for registration and the conference details see the website.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for applicants: WHO Health Systems Cluster Sierra Leone Technical Officer on District Strengthening","field_subtitle":"Deadline 10 November","URL":"https://erecruit.who.int/public/hrd-cl-vac-view.asp?o_c=1000&jobinfo_uid_c=34544&vaclng=en","body":"The Health Systems Cluster in Sierra Leone is recruiting a P3 Technical Officer to work on District Strengthening. This is an extremely exciting position and opportunity to become part of our small, but dynamic health systems strengthening cluster within the WHO Sierra Leone office. The deadline for applications is 10 November, and more information is available in the website. The WHO Country Office is also supporting Sierra Leone\u2019s College of Medicine and Allied Health Sciences (COMAHS) by helping to recruit a number of short-term faculty as found in other folders on the other current vacancies on the website. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Calling for examples of great research on human resources for health","field_subtitle":"University of the Western Cape, Cape Town, South Africa","URL":"http://tinyurl.com/zaxtjon","body":" Do you know of excellent health policy and systems research publications on human resources for health (HRH)? Health Systems Global at the University of Western Cape are looking for submissions for a reader that provides guidance on and examples of excellent HRH research within the broader rubric of people-centred health policy and systems research. Please see the blog post for more detail and submit your suggestions using the google sheet. Submit publication suggestions here: https://docs.google.com/spreadsheets/d/18B7QW5Xv-RLyiz0i-oxLigvtecJObhbyaW3lEffUXvI/edit#gid=0","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Can Habitat III mark a watershed for women informal workers?","field_subtitle":"Chatterjee P: Cityscape, October 2016","URL":"http://tinyurl.com/h3ueyqw","body":"Informal employment makes up more than half of non-agricultural employment in most developing regions, according to Women in Informal Employment Globalising and Organising (WIEGO). In three major regions (South Asia, sub-Saharan Africa, Latin America and the Caribbean) plus urban China, informal employment is a greater source of non-agricultural employment for women than for men. Elsewhere in East and Southeast Asia, these shares are roughly the same. WEIGO advocates made this case at Habitat III, urging national and local governments to support the urban informal economy. The group released a paper listing the sector-specific needs of urban informal workers from local and national governments, noting that despite their contributions, informal workers\u2019 lives and livelihoods continue to be vulnerable in many cities. Many myths persist about the informal economy in the minds of policymakers and the general public, such as the conflation of the informal economy with illegal activities. Sally Roever, urban policies programme director for WIEGO, pointed to \u2018micro-innovations\u2019, which can make a huge difference....Like a municipality issuing identity cards to waste pickers. Residents view a waste picker with an ID card as legitimate entity and are more likely to be cooperative. This enhances the productivity of waste pickers.\u201d  She gave the example of Bogota, where recyclers are formally recognised stakeholders in the city's waste-management system. WIEGOs efforts also have prompted the creation of two labour groups \u2014 the Association of Recyclers of Bogot\u00e1 organisation that represents the city\u2019s 3,000 informal recyclers, while the National Association of Recyclers in Colombia represents 12,000 members. These are argued to serve as precedent and inspiration for other informal workers globally.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Commission hears data on WHO report on high price of hospital care in SA","field_subtitle":"Pitso R: BusinessDay, August 2016","URL":"http://tinyurl.com/jpf24qw","body":"The South African Competition Commission\u2019s healthcare market enquiry on Tuesday convened a special session in Pretoria, at which stakeholders were due to give oral presentations in response to a report by the World Health Organisation (WHO). The report, contested by the private actors, concluded that the cost of hospital care in SA was high when measured against GDP per capita and that the driving forces were in-house hospital and specialist fees. The Organisation for Economic Co-operation and Development (OECD) collected the data and conducted the study, which compared the prices of South African private hospitals to those of 20 OECD countries. The health market inquiry was established to determine why medical inflation has historically risen faster than consumer price inflation, and whether there are barriers to effective competition in the private healthcare sector. The public hearings aim to explore the relationships among different players. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"COSATU Hosts the 3rd Africa Trilateral Summit in Johannesburg ","field_subtitle":"Southern Africa Coordination Council (SATUCC) Blog, September 2016","URL":"http://tinyurl.com/hrstb92","body":"The Congress of South African Trade Unions (COSATU) hosted the 3rd Africa Trilateral Summit in Johannesburg, South Africa in September 2016. Attended by the delegates from the unions affiliated to the three federations; Nigeria Labour Congress (NLC), Congress of South African Trade Unions (COSATU), and Trade Union Congress, Ghana (TUC); the Summit was held under the theme: Building a progressive workers movement for development alternatives for Arica: Decent work, industrialisation and Job Creation NOW. The Summit proposed formulating alternative growth and development path for both Africa\u2019s industrialisation and a re-industrialisation approach to create jobs and fight poverty and to actively campaign against corruption, illicit financial flows and for tax justice, fair trade and inclusive development. The Summit proposed that unions work to build a democratic developmental state that serves the needs of its people and guarantees peace, justice and security, and to fight for a comprehensive social security system for all workers. The Africa Trilateral Cooperation is the historic relationship between COSATU (South Africa), NLC (Nigeria) and TUC (Ghana) on the African continent. \r\n","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Countdown to 2015 country case studies: what can analysis of national health financing contribute to understanding MDG 4 and 5 progress?","field_subtitle":"Mann C; Ng C; Akseer N; Bhutta Z; et al.: BMC Public Health 16(Suppl 2) (792), 2016, doi: 10.1186/s12889-016-3403-4","URL":"http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3403-4","body":"Countdown to 2015 (Countdown) supported countries to produce case studies that examine how and why progress was made toward the Millennium Development Goals (MDGs) 4 and 5. Analysing how health-financing data explains improvements in RMNCH outcomes was one of the components to the case studies. This paper presents a descriptive analysis on health financing from six Countdown case studies (Afghanistan, Ethiopia, Malawi, Pakistan, Peru, and Tanzania), supplemented by additional data from global databases and country reports on macroeconomic, health financing, demographic, and RMNCH outcome data as needed. It also examines the effect of other contextual factors presented in the case studies to help interpret health-financing data. Dramatic increases in health funding occurred since 2000, where the MDG agenda encouraged countries and donors to invest more resources on health. Most low-income countries relied on external support to increase health spending, with an average 20\u201364 % of total health spending from 2000 onwards. Middle-income countries relied more on government and household spending. RMNCH funding also increased since 2000, with an average increase of 119 % (2005\u20132010) for RMNH expenditures (2005\u20132010) and 165 % for CH expenditures (2005\u20132011). Progress was made, especially achieving MDG 4, even with low per capita spending; ranging from US$16 to US$44 per child under 5 years among low-income countries. Improvements in distal factors were noted during the time frame of the analysis, including rapid economic growth in Ethiopia, Peru, and Tanzania and improvements in female literacy as documented in Malawi, which are also likely to have contributed to MDG progress and achievements. Increases in health and RMNCH funding accompanied improvements in outcomes, though low-income countries are still very reliant on external financing, and out-of-pocket comprising a growing share of funds in middle-income settings. Enhancements in tracking RMNCH expenditures across countries are still needed to better understand whether domestic and global health financing initiatives lead to improved outcomes as RMNCH continues to be a priority under the Sustainable Development Goals.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Decolonising the University: The African Politics Reading List","field_subtitle":"Democracy in Africa: 2016","URL":"http://democracyinafrica.org/decolonising-the-university-the-african-politics-reading-list/","body":"Democracy in Africa, a site promoting writing from African authors, have assembled a reading list on African Politics. This reading list is collated in solidarity with those who are currently attempting to decolonise the university across Africa, and beyond. It includes readings on themes such as Citizenship and Statehood, Social Movements and Civil Society, the Politics of Gender and Youth, the Politics of International Development  amongst others. The hosts welcome your recommendations of outstanding scholarship to add to it.   Currently, the list focuses on English translations and texts but the site hosts are in the midst of developing lists in other languages and would welcome suggestions.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Discourse, ideas and power in global health policy networks: political attention for maternal and child health in the millennium development goal era","field_subtitle":"McDougall L: Globalization and Health 12(21), 2016 doi: 10.1186/s12992-016-0157-9","URL":"http://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-016-0157-9","body":"Maternal and child health issues have gained global political attention and resources in the past 10 years, due in part to their prominence on the Millennium Development Goal agenda and the use of evidence-based advocacy by policy networks. This paper identifies key factors for this achievement, and raises questions about prospective challenges for sustaining attention in the transition to the post-2015 Sustainable Development Goals, far broader in scope than the Millennium Development Goals. The paper uses participant observation methods and document analysis to develop a case study of the behaviours of global maternal and child health advocacy networks during 2005\u20132015. The development of coordinated networks of heterogeneous actors facilitated the rise in attention to maternal and child health during the past 10 years. The strategic use of epidemiological and economic evidence by these networks enabled policy attention and promoted network cohesion. The time-bound opportunity of reaching the 2015 Millennium Development Goals created a window of opportunity for joint action. As the new post-2015 goals emerge, networks seek to sustain attention by repositioning their framing of issues, network structures, and external alliances, including with networks that lay both inside and outside of the health domain. Issues rise on global policy agendas because of how ideas are constructed, portrayed and positioned by actors within given contexts. Policy networks play a critical role by uniting stakeholders to promote persuasive ideas about policy problems and solutions. The author argues that the behaviours of networks in issue-framing, member-alignment, and strategic outreach can force open windows of opportunity for political attention -- or prevent them from closing.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 188: Transforming not absorbing: Messages from a dialogue on participatory learning from action","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Policy Brief 41: Giving new momentum to strategies for retaining health workers","field_subtitle":" Dambisya Y:  ECSA HC, TARSC and U Limpopo, Policy brief 41 , EQUINET Harare","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Polbrief%2041%20HR.pdf","body":"This brief discusses the strategies used for attracting and retaining skilled health workers in ESA countries, especially to address under-served rural and remote areas, primary care settings and in the public sector. It reviews practice to date and identifies strategic options, given both regional learning and the opportunity of the 2016 Global Strategy on Human Resources for Health. Whereas ESA countries have implemented various attraction and retention regimes, the results have not been well documented, with still limited evaluation and reporting of impact of these strategies. The evidence suggests a need for a comprehensive, multi-sectoral and co-ordinated approach to planning and implementation, to make the case for improved funding and with greater use of information and monitoring systems. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Factors influencing motivation and job satisfaction among supervisors of community health workers in marginalised communities in South Africa","field_subtitle":"Akintola O; Chikoko G: Human Resources for Health 14(54), 2016 ","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0151-6","body":"Management and supervision of community health workers (CHWs) is important for the success of CHW programmes. This study explored factors influencing motivations of supervisors in CHW programmes. The authors conducted qualitative interviews with 26 programme staff providing supervision to CHWs in eight community-based organisations in marginalised communities in the greater Durban area of South Africa from July 2010 to September 2011. Findings show that all the supervisors had previous experience working in the health or social services sectors and most started out as unpaid CHWs. Most of the participants were poor women from marginalised communities. Supervisors\u2019 activities include the management and supply of material resources, mentoring and training of CHWs, record keeping and report writing. Supervisors were motivated by intrinsic factors like making a difference and community appreciation and non-monetary incentives such as promotion to supervisory positions; acquisition of management skills; participation in capacity building and the development of programmes; and support for educational advancement like salary, bonuses and medical benefits. Hygiene factors that serve to prevent dissatisfaction are salaries and financial, medical and educational benefits attached to the supervisory position. Demotivating factors identified are patients\u2019 non-adherence to health advice and alienation from decision-making. Dis-satisfiers include working in crime-prevalent communities, remuneration for CHWs, problems with material and logistical resources, job insecurity, work-related stressors and navigating the interface between CHWs and management. While participants were dissatisfied with their low remuneration, they were not demotivated but continued to be motivated by intrinsic factors. The authors findings suggest that CHWs\u2019 quest for remuneration and a career path continues even after they assume supervisory positions. Supervisors continue to be motivated to work in mid-level positions within the health and social services sectors. Global efforts to develop and increase the sustainability of CHW programmes will benefit immensely from insights gained from an exploration of supervisors\u2019 perspectives. Further, they suggest that national CHW programmes be conceptualised with the dual purpose of building the capacity of CHWs to strengthen health systems and reducing unemployment especially in marginalised communities.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Habitat 3: Jean Pierre Elong Mbassi on the importance of cities in implementing the SDGs","field_subtitle":"Global Goals UN: Quito  19 October 2016","URL":"https://vimeo.com/187999676","body":"Jean Pierre Elong Mbassi, Secretary-General of United Cities and Local Governments Africa, speaks about how cities help with implementing the Sustainable Development Goals (SDGs), Paris Agreement and more. He noted that it was a positive move to have had the second world assembly of local and regional governments in Quito in the framework of the UN Habitat 3 conference. This was an accomplishment from Habitat 2 when they were not included. This shows that local authorities are not part of the process, and the next step is to bring them around the table with higher level decision making authorities. He argued that without local authorities there is no way to implement global agendas and that if governments and regional bodies listen to cities, the SDGs, climate agendas, and related agreements will stand a significantly better chance of realisation. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Habitat III: How will the New Urban Agenda promote health and wellbeing?","field_subtitle":"Editor, EQUINET Newsletter","body":"In this issue we have a numerous papers and videos reporting the discussions, debates and policy proposals at Habitat III in Quito, Ecuador in October. They provide evidence of the challenges for and visions of life in today's and tommorrow's cities, including in relation to improvements in health for all in the city. We will keep an eye on these debates from Habitat III that affect urban health equity and invite you to send us your views for the next newsletter. What do you see as the major urban health challenges in our region? What success stories do we have? And how has Habitat III has contributed to meeting challenges for and nourishing success towards meeting the right to health in our cities?","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Health Financing Assessment and Policy Analysis toward Universal Health Coverage: A Systematic Review of Qualitative Research","field_subtitle":"Sakha M; Rashidian A; Bazyar M; Sari A; Yazdani S; Moghadam A: Global Journal of Health Science 9(5) 2016, doi: http://dx.doi.org/10.5539/gjhs.v9n5p131 ","URL":"http://www.ccsenet.org/journal/index.php/gjhs/article/view/61901","body":"This research explored health financing policies for universal health coverage to identify issues that need to be addressed and approaches that can fruitfully be pursued in future policy design. The authors systematically searched the following databases: PubMed, SCOPUS, and COCHRANE up to January 2016 and included health financing policy assessment toward universal health coverage followed by a thematic and descriptive synthesis of data. Twenty three papers were included. The authors categorised dimensions that were important in health financing assessment to achieve UHC into nine groups as follows: stewardship, raising revenues and contribution methods, risk pooling and financial protection, resource allocation purchasing, human resources, policy stakeholders, policy content, policy context, and policy process. As countries commit to expand universal health coverage, the authors argue that these dimensions identified from the literature can help policy makers to prioritise competing demands, make rational choices, and adapt their approaches.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Here\u2019s what happened at Habitat III \u2013 the world\u2019s biggest conference on cities","field_subtitle":"Cast\u00e1n Broto V: The Conversation, October 2016","URL":"http://tinyurl.com/zoec5a8","body":"Habitat III \u2013 the United Nation\u2019s global conference on the future of cities \u2013 came to a close in late October. About 30,000 people gathered in Quito, Ecuador, to discuss the key issues facing cities today and sign off on the New Urban Agenda \u2013 the global strategy which will guide urban development over the next 20 years. The author describes the event: Efforts to make the conference inclusive \u2013 it was free and anyone could register \u2013 materialised in a big jamboree of all kinds of people interested in urban affairs (as well as complaints about long queues). The overall message of the conference emphasised the need to address social, economic and material inequalities in cities and urban areas. Yet - he notes- international experts often appeared oblivious to the enormous progress that the poorest urban communities have made to organise themselves and finance their futures. The main outcome of Habitat III was that UN nation states agreed on the New Urban Agenda (NUA): a non-binding document, which will guide policies over the next 20 years with the goal of making cities safer, resilient and sustainable and their amenities more inclusive. The NUA itself emerged from a consultative process, whereby UN-Habitat collected the inputs of a diverse community of urban scholars, leaders, planners and activists. Its key message was \u201cleaving no one behind\u201d. Its vision for the future of cities was one where aspirations of prosperity and sustainable development are linked to a desire for equality. Yet the document did not escape criticism: How far did it grassroots perspectives? How far did the consensual approach and redrafting exclude key issues? How will it be put into practice? Some proposed, for example, that 20% to 25% of global finance for development \u2013 in instruments such as the Green Climate Fund \u2013 should be allocated directly to cities. The author calls the consensus around the \u201cright to the city\u201d \u2013 an idea championed by Ecuador and Brazil \u2013 historical. The \u201cright to the city\u201d generally refers to the capacity of urban citizens to influence processes of urban development, and make a city they want to live in. Social movements promoted this right to denounce urban processes that generate injustices, such as gentrification, privatisation of public spaces, forced evictions and the mistreatment of urban refugees. But as it is not explicitly recognised as a universal human right, the NUA merely encourages governments to enshrine it in their laws. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Implementing Eco-Social Policies: Barriers and Opportunities: A Preliminary Comparative Analysis","field_subtitle":"Carmi D: United Nations Research Institute for Social Development, Geneva, Working Paper 2016-12","URL":"http://tinyurl.com/gnp9zt3","body":"Despite the global consensus on the importance of shifting to a model of sustainable development, identifying pathways that can simultaneously and equally fulfil social, economic and environmental goals remains extremely difficult. After briefly tracing the evolution of the concept of sustainable development to its central place in current international development debates, the paper explains what is understood by eco-social policies. This paper analyses opportunities for and barriers to the effective adoption of eco-social policies in national programmes by undertaking a comparative analysis of three case studies: Payment for Ecosystem Services in Costa Rica, the Ishpingo-Tambococha-Tiputin (ITT) proposal for Yasuni\u0301 National Park in Ecuador and the Virunga Alliance in the Democratic Republic of Congo. The three programmes had varying degrees of success. The Virunga Alliance is a development project that aims to foster peace and prosperity through the responsible economic development of natural resources for 4 million people who live within a day\u2019s walk of the park\u2019s borders. The project identified poverty and the lack of a sustainable business sector as the root causes of Virunga\u2019s problems, forcing the park\u2019s inhabitants to over-exploit natural resources for their daily fuel and food needs. While the Payment for Ecosystem Services was a successful national programme that led to unprecedented forest recovery in Costa Rica, the ITT proposal was a governmental policy initiative that failed due to various national and international issues. The Virunga Alliance operated with an eco-social logic by involving job creation and clean energy provision. While the outputs were successfully achieved, the outcomes were at risk in part due to regional insecurity and a fragile national economy. The author looks at the different approaches taken in each country, analysing the benefits and trade-offs as well as the factors that led to their adoption or defeat.  After briefly tracing the evolution of the concept of sustainable development to its central place in current international development debates, the paper explains what is understood by eco-social policies. \r\n","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"In the Spirit of Marikana: Disruption, Workers and Insourcing","field_subtitle":"Grossman J: Review of African Political Economy, March 2016","URL":"http://roape.net/2016/02/18/in-the-spirit-of-marikana-disruption-workers-and-insourcing/","body":"In a penetrating analysis of events in South Africa, Jonathan Grossman writes a linked analysis of the student mobilisations and of the workers at Marikana. The author that an old legacy of struggle is being rediscovered and rescued,  reflecting a solidarity between workers and students taking action.  Grossman argues that the struggle for free education and against outsourcing in the public sector at the universities now needs to become the struggle for free education at all levels and free basic services, against outsourcing and for a living wage across the whole of the public sector. He argues that this is necessary for the renewal of the workers movement to tap into the vitality of a student-worker alliance that enriches both struggles in South Africa with a more holistic vision. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"International Panel on Social Progress ","field_subtitle":"International Panel on Social Progress: France, September 2016","URL":"https://www.ipsp.org","body":"The International Panel on Social Progress (IPSP) is a global initiative that brings together a large group of scholars brought together to compile evidence across disciplines to rethink ideas of a just society. They recognised the interconnected forces of: weakening traditional nation states; technological change; profound and unequal transformations in health and education outcomes; and contestations between the religious and secular. IPSP have produced this report aimed at social actors, movements, organisations, politicians and decision-makers, to provide them with the best evidence on questions that bear on social change. The report has 22 chapters covering a comprehensive range of areas that have an important bearing on society now and into the future. It is the first comprehensive synthesis of social sciences knowledge about key issues facing humankind today.  This first draft is available for public consultation and comment and IPSP invite comments from all concerned citizens and organisations. There is a web based platform for comments and inputs.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Keynote address by WHO DG Margaret Chan at a TICAD high-level side event on UHC in Africa","field_subtitle":"Chan M: WHO, Tokyo International Conference of Africa's Development (TICAD), Nairobi, Kenya August 2016","URL":"http://www.who.int/dg/speeches/2016/universal-health-africa/en/","body":"Director General of the World Health Organisation, Dr Margaret Chan, addressed the Tokyo International Conference of Africa's Development (TICAD) held in Nairobi, Kenya, in August 2016. She raised the issue of Ebola as an example of the consequences of failing to invest in the community and resilient health systems. Dr Chan noted that well-functioning health systems that cover entire populations are now regarded as the first line of defence against the threat from emerging and re-emerging diseases. Apart from strengthened health security, Africa has much to gain from its commitment to universal health coverage (UHC). For decades, the biggest barriers to better health in Africa have been weak health systems and inadequate human and financial resources. A commitment to UHC means a commitment to address these barriers. UHC also addresses a third barrier to progress of dire poverty, including poverty caused by catastrophic spending on health care. A commitment to UHC, backed by country-specific plans for implementation gives African countries a huge opportunity to leap ahead. Dr Chan offered three pieces of advice. First, to understand that UHC is a direction for a journey, not a destination. Second, use the power of robust data to shape equitable policies in line with national contexts. For example, Kenya used the results from a survey of public expenditure to launch its innovative Health Sector Services Fund that provides direct cash transfers to primary health care facilities. Third, if UHC is to work as both a poverty-reduction strategy and a boost to health security, countries need to ensure that reforms reach health systems at the district level that support impoverished communities, and are best placed to engage them in health promotion, prevention, and the delivery of services that match perceived needs. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Knowledge and Engagement: Building Capacity for the Next Generation of Community Based Researchers","field_subtitle":"Tandon R; Hall B; Lepore W (eds); Singh W: United Nations Educational, Scientific and Cultural Organisation (UNESCO), 2016","URL":"http://tinyurl.com/zpuowh9","body":"This open access book presents findings of and separately authored case study examples of work in a global study titled \u2018Building the Next Generation of Community-Based Researchers\u2019 (a.k.a. the Next Gen project), funded by the Social Science and Human Research Council of Canada. The Next Gen project aimed to increase access to high quality training in Community-Based Research (CBR) within higher education institutions (HEIs) and civil society organisations (CSOs). The book presents a state-of-the art in pedagogies and strategies for building CBR capacities, to strengthen the existing training for fieldwork and theoretical and curricular content on participatory research within and outside academia. It outlines a number of important trends, approaches and challenges in the field of training the next generation of researchers in CBR; through a comparative analysis of 21 institutional case studies of CBR training providers from around the world and includes the results of a global survey of training CBR in HEIs & CSOs. With over 40 contributing authors from all around the world, Knowledge and Engagement is the first book of its kind, which represents a collective effort to bring many note-worthy aspects within one umbrella (i.e., \u2018Community Based Research\u2019), analyse the current scenario and training opportunities, and provide recommendations with regard to what can be done in the best possible manner. It includes two case studies from East and Southern Africa, namely Training And Research Support Centre Zimbabwe and Umphilo waManzi South Africa. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Mainstreaming gender into PMTCT guidelines in Tanzania","field_subtitle":"Nyamhanga T: Resilient and responsive health systems (RESYST) blog, Muhimbili University of Health and Allied Sciences, Tanzania, September 2016","URL":"http://tinyurl.com/zgctdmd","body":" In Tanzania, the prevention of mother to child transmission of HIV (PMTCT) is a health sector priority, but there is very little information on how well gender mainstreamed in relation to national PMTCT guidelines. In this paper the authors research assessed the gender content of key policy documents in order to better understand how this area could be strengthened, using a WHO Gender Responsive Assessment Scale (GRAS). The GRAS divides gender responsiveness into 5 levels. Level 1, gender unequal, contains content which perpetuates gender inequality by reinforcing unbalanced norms, roles and relations. Level 2, gender blind, contains content which ignores gender norms, roles and relations and differences in opportunities and resource allocation for women and men. Level 3, gender sensitive, contains content which indicates awareness of the impact of gender norms, roles, and relations, but no remedial actions are developed. Level 4, gender specific, contains content which goes beyond indicating how gender may hinder PMTCT to highlighting remedial measures, such as the promotion of couple counselling and testing for HIV. Level 5, gender transformative, contains content which includes ways to transform harmful gender norms, roles and relations. The findings showed that gender-related issues are mentioned in all of the guidelines, indicating some degree of gender responsiveness. The level of gender responsiveness of PMTCT policy documents, however, varies, with some graded at GRAS level 3 (gender sensitive), and others at GRAS level 4 (gender specific). None of the reviewed policy documents could be graded as gender transformative. While the policy documents indicate recognition of gender inequality in decision-making and access to resources as a barrier to accessing PMTCT services by women, no attempt is made to transform harmful gender norms, roles, or relations. Overall, gender was not mainstreamed into any of the documents in the sense that gender was not considered in all key sections. Overall, the study revealed limited integration of gender concerns (less or lack of attention on the disadvantageous position of women in terms of  inequality in ownership of resources, power imbalance in decision making, asymmetrical division of roles, and masculine norms that distance men from maternal  and child care) in PMTCT guidelines. The authors suggest that revision of guidelines to mainstream gender is greatly needed if PMTCT services are to effectively contribute towards a reduction of child and maternal morbidity and mortality in Tanzania","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Motivation and incentive preferences of community health officers in Ghana: an economic behavioural experiment approach","field_subtitle":"Shiratori S; Agyekum EO; Shibanuma A; et al., EMBRACE Implementation Research Team: Human Resources for Health 14(54), 2016","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0148-1","body":"The health worker shortage in rural areas is a problems in many African countries, in part due to fewer incentives and support systems available to attract and retain health workers in these areas. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana. A discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences.  Mixed logit analyses of the data found a shorter projected time frame before study leave as the most important motivation for most CHOs, while an education allowance for children, a salary increase and housing provision also played a role. While male CHOs had a high affinity for an early opportunity to go on study leave, CHOs who had worked at the same place for a long time valued more a salary increase. To reduce health worker shortage in rural settings, policymakers could provide \u201cneeds-specific\u201d motivational packages. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Pambazuka Special Issue: Call for Articles","field_subtitle":"Deadline: 30 November 2016","URL":"http://www.pambazuka.org/announcements/pambazuka-special-issue-call-articles","body":"Pambazuka News is preparing a special issue on the labour movement and the struggles for Africa's liberation today. Pambazuka News wishes to dedicate a Special Issue to the labour movement and the struggles for Africa's liberation today. Labour has a mission that goes beyond agitation for worker rights towards the bigger project of concrete self-determination of the African people through ownership of their resources and means of production, etc. Shaun Whittaker of the Marxist Study Group of Namibia and former member of the Workers' Organisation for Socialist Action (South Africa) is guest editor for the special issue.  Authors are urged to write on their own countries and not generalize about the entire continent. They should try to only focus on one of the sub-themes or a related sub-theme. Articles should be up to 3, 000 words. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Position Announcement: Executive Director Sam Moyo African Institute for Agrarian Studies (SMAIAS)","field_subtitle":"Application Deadline: 9 January 2017","URL":"http://www.codesria.org/spip.php?article2666&lang=en","body":"Previously known as the African Institute for Agrarian Studies(AIAS), and renamed to SMAIAS in 2016 in honour of its late Founder and Executive Director, Professor Sam Moyo, the SMAIAS in Harare has been in operation for over thirteen years. The SMAIAS aims to enhance Africa\u2019s agrarian transformation by promoting informed participation towards effective land and agrarian policies and reform, by means of Pan- African and South-South partnerships, interdisciplinary research initiatives, policy dialogues, training, and information dissemination. It interacts with various organisations and countries to assist them in developing capacity for policy formulation and research. It also facilitates policy dialogue among governments, academics, civil society and others on land and agrarian developments, especially on the land rights of marginalised social groups. Under the overall authority of the Board of Trustees and the direct supervision of the Chairperson of the Board of Trustees, the Executive Director will be expected to provide intellectual, administrative and strategic leadership to the secretariat of the SMAIAS. Only African citizens will be considered for this post.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Positioning women's and children's health in African union policy-making: a policy analysis","field_subtitle":"Toure K; Sankore R; Kuruvilla S; Scolaro E; Bustreo F; Osotimehin B: Globalization and Health 8(3), 2012 doi: 10.1186/1744-8603-8-3","URL":"http://globalizationandhealth.biomedcentral.com/articles/10.1186/1744-8603-8-3","body":"In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyse how these policies are prioritised and framed. It used a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings were discussed with key actors to identify policy implications. With over 220 policies in total, peace and security was the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010). This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organisation of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritisation of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more that by frameworks looking at their economic impact. The authors suggest that more effective prioritisation of women's and children's health in African Union policies could be supported by widening the policy framework to integrate their economic benefit  and strengthening the evidence base of policies and strengthening multi-stakeholder advocacy for them. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Problem or Promise? Harnessing Youth Potential in Uganda","field_subtitle":"Banks N; Sulaiman M: Building Resources Across Communities, 2012","URL":"http://www.comminit.com/governance-africa/content/problem-or-promise-harnessing-youth-potential-uganda","body":"This report from Building Resources Across Communities\u2019s (BRAC) Youth Watch team in Uganda. It shares lessons from the Research and Evaluation Unit's mixed-methods research, including a nationally representative survey of youth, focus groups, and in-depth case studies. Chapter 1 introduces the conceptual framework used in this report and describes the research methodology. Chapter 2 presents the asset portfolio of Ugandan youth. Chapter 3 outlines the position of youth in the family, community and political participation. Chapter 4 discusses the perceived opportunities of Ugandan youth, versus their aspirations. Chapters 5 to 7 outline the health outcomes for Ugandan youth, focusing on risky sexual behaviour, examples of success stories among youth and policy recommendations. The report points out the need for a comprehensive approach that emphasises employment and institutional support to avoid conditions that lead to early pregnancy in young women and sexually transmitted infections and HIV. \"Improved support from communities and local governments along with increased access to financial services and vocational training are key to facilitate healthy transition of youth into adulthood.....The combination of the multiple barriers facing youth - including limited assets and support, difficult economic, political and social environments, and limited perceived opportunities for the future - negatively influences the self-esteem, motivations, and aspirations of youth.\" ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Schools of Public Health in Low and Middle-income Countries: An imperative Investment for Improving the Health of Populations?","field_subtitle":"Rabbani F; Shipton L; White F; et al.,: BMC Public Health 16(941) 2016","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3616-6","body":"Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasised the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualising a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005\u20132008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. The challenges faced by LMICs include rapid urbanisation, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs).","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Skills Building on Methods and Tools for Learning From Action in Participatory Action Research","field_subtitle":"Tuesday 15 November 2016 8:30am\u201312pm Room 17 Convention Centre, Health System Global, Vancouver, Canada","body":"This participatory skills session convened under the umbrella of the pra4equity network is being held at the Heath System Global Conference. In the session we will discusses methods and tools to build learning from action as a key element of participatory action research, directly engaging affected communities to build responsive health systems. The session draws on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. From prior global symposia, methods for learning from action were identified as weak in PAR practice. This session seeks to address this gap. It is targeted at researchers and practitioners. It uses methods resources and group discussions of case studies from health managers, policy actors, civil society and researchers in low and middle income countries to discuss the participatory processes and methods for learning from action at different levels, and the issues in applying and institutionalising these methods. We will also review what these participatory efforts to transform and build knowledge on health systems implies for the understanding of \u2018resilience\u2019. As the places are limited if you will be in Vancouver on the 15th November morning and would like to participate in this skills session please can you notify on the email shown with your name, institution and a line or two on any prior PAR experience.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"The Inequality Question Project","field_subtitle":"Rodney N: London School of Hygiene & Tropical Medicine Alumni Blog, October 2016","URL":"http://inequalityquestion.com","body":"The Inequality Question is a unique project to debate global inequality issues. On the last Thursday of each month \u2013 #ThoughtfulThursday \u2013 children formerly or currently living on the streets of Uganda choose one inequality question to discuss and lead a live conversation online, with participants worldwide. These conversations give participants and facilitators the opportunity to discuss their thoughts, experiences and aspirations on how to make the world a more equal place. Individuals, classes, groups and organisations are joining into the conversation, not only to have direct discussions with children experiencing many inequalities, but also to spark ideas that lead them to undertake an \u201cInequality Challenge\u201d, so that they can become a catalyst for change. Samuel Woria undertook one of the Inequality Challenges that focused on gender. For one week, six women dictated all of Samuel\u2019s decisions. Samuel chose to take part in this challenge because he believes that men in Uganda do not treat women fairly and equally. His experiment not only facilitated challenging conversations, but also made an impact in his community. Many men have contacted Samuel to say they are trying to alter their behaviour towards women, and women have expressed their happiness to be shown such public support in their struggle for equality. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The Next WHO Director-General\u2019s Highest Priority: A Global Treaty on the Human Right to Health","field_subtitle":"Gostin L; Friedman E; Buss P; et al.,: Lancet Global Health, October 2016","URL":"http://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(16)30219-4.pdf","body":"Amidst the many challenges facing the next WHO Director-General, the authors argue that the new WHO head should prioritise the right to health. They call for leadership on a Framework Convention on Global Health (FCGH), based in the right to health and aimed at national and global health equity. The treaty would, they argue, enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes, while catalysing governments to institutionalise the right to health at community through to national levels. With the Framework Convention on Tobacco Control having served as a proof of concept, the FCGH would be an innovative treaty finding solutions to overcome global health failings in accountability, equality, financing, and inter-sectoral coherence, with a national and global health financing framework. They raise options for reaching beyond the health sector with right to health assessments, public health participation in developing international agreements, and responsibility for all sectors for improving health outcomes. Finally they propose that the FCGH would reinvigorate WHO\u2019s global health leadership, breathing new life into its founding principles and bringing badly-needed reforms to the institution, such as community participation, new priorities favouring social determinants of health, and a culture of transparency and accountability. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Transforming not absorbing: Messages from a dialogue on participatory learning from action","field_subtitle":"Members of the EQUINET pra4equity network","body":"\r\nWhen the Global Symposium on Health Systems Research (GSHR) gathers health systems researchers in November 2016 to explore \u2018resilience\u2019 in health systems in a context of inequality and economic, social, environmental and health challenges, what learning and insights will we bring to the table?\r\n\r\nBetween August and October this year we carried out two rounds of discussion drawing in diverse voices from amongst the over 300 people globally in our pra4equity list, hosted by the Regional Network for Equity in Health in East and Southern Africa (EQUINET).  The first was to discuss our experiences in learning from action in participatory action research (PAR) and the second on what that implies for how we understand the concept of resilience. \r\n\r\nThe PAR process involves gathering and systematising lived experience to collectively analyse and validate the underlying causes, set, take and reflect on actions on these causes and draw knowledge from it. In earlier meetings we realised that people are less confident of this phase of learning from action. There was a demand to discuss further the processes for building the understanding, power and self-confidence to produce and evaluate change. \r\n\r\nIn the discussions, people drew attention to various  methods they used to facilitate learning from action, including through the \u2018but why\u2019 method, progress markers and wheel charts,  and mapping or taking photographs of change from initial findings as a means to reflect on the change and what has enabled or blocked it.  These processes and tools have not only been used to review how far we have achieved intended actions and outcomes, but also to reflect on the thinking and hypotheses on what produces change.  The collaborative development of hypotheses for change by those involved in the PAR (as a form of critical theory or using PAR forecasts,  like weather forecasts) was seen to be integral to learning from action. So too was helping people to document their ongoing learning. \r\n\r\nIn our learning network we\u2019ve also used the reflections across countries on actions on the same problem area as a form of \u2018meta-analysis\u2019,  to share insights on what facilitates the implementation of change, what blocks it and why, drawing learning also from what is similar and different across countries. \r\n\r\nThe steps of action and learning often take several PAR cycles to address deeper determinants and build meaningful change. This is especially relevant when people are engaging on deeply rooted power relations or determinants that are beyond local control, such as addressing gender in South Sudan or commercial sex work in Malawi. While not always the case, some noted that this can take more than a decade of work in both high and low income settings, calling for sustained processes.  \r\n\r\nThis raises challenges in some settings. Tracking of change may stop too early, those working in communities may lack the time or resources to record and report the change and the resources and attention to do this may not last for the time needed.  Researchers or facilitators may not always be included in or able to stay with change processes that take place over years.  PAR processes may also differ from the institutional cultures or priorities of universities or of the trade unions, social movements and other organisations that represent or work with the social groups involved.  \r\n\r\nThe power imbalances involved are often protected by strong interests. We reflected that before applying any method, including PAR, we need to be clearer on its strategic possibilities, given the contexts and social actors.  While this may lead to choices within range of approaches and forms of activism,  it was asserted that a self-determined understanding of the symbolic and material dimensions of inequalities remains a powerful starting point for any approach.\r\nNotwithstanding the difficulties, numerous examples of positive experience were shared!  In Monrovia, for example, PAR implemented after the Ebola epidemic led to a shared, more comprehensive understanding of maternal health amongst the health workers and community members involved, pointing to actions to strengthen the continuity and interaction of the different services and roles needed to improve maternal health care.  \r\n\r\nIn our discussions it was also suggested that the action and change in PAR should not only be seen in terms of material changes in conditions, although this is important.  It can in addition be seen in the change in the people involved. As one participant noted in the discussion, \u201cwe pay too much attention to the actions and not enough to the actors.\u201d  For those often excluded from formal planning and decision making, it is important to appreciate how far they themselves are transformed in the process, in terms of their consciousness and self- confidence to produce change.  This can start early in the PAR process, even from the first step of recognising and listening to shared experience. \r\n\r\nGiven these reflections, we had a second, equally challenging discussion on the concept of resilience from a PAR lens. In part this was due to its adoption as a theme by the GSHSR and in part its increasing use in global discourse.  Resilience has been used in environmental and physical sciences to describe the stability of a system against interference from external disturbances, but has migrated to the social sciences.  The GSHR website says:  \u201cResilience: absorbing shocks and sustaining gains\u2026. Health systems must be resilient \u2013 able to absorb the shocks and sustain the gains already made\u2026.\u201d\r\n\r\nAs was raised in June by Topp, Flores, Sriram and Scott, our network also challenged use of a term that implies \u2018absorbing shocks\u2019 and \u2018stability\u2019 when the system is an outcome of unjust and structural inequalities that undermine health. PAR has developed in many settings as a direct confrontation with these inequities, seeing their disruption as necessary for health. It would thus not comfortably be applied in the science of \u2018absorbing shocks\u2019, when these derive from such injustice.  \r\n\r\nAt the same time some noted that there appears to be a second set of meanings to the term. Resilience has also been used in some contexts to refer to the capability to sustain a positive change or to resist negative change, to transform and move from a harmful equilibrium to new more positive one and the ability to self-organise into a healthier state.  This appears to have greater resonance with the process in PAR, given that it draws in the learning from action on a system and intends to raise the direct power and capability of those directly affected.\r\n\r\nGiven how different these \u2018meanings\u2019 are, we noted that we need to understand explicitly and not assume how people are using the term resilience, including at GSHSR.  It has often been applied in relation to shocks and emergencies, for example. However participants raised that \u2018emergency\u2019 responses commonly use command and control styles that do not strengthen the capacity of or build co-determination with the affected community.  If resilience refers to the ability to move to a healthier state, then systems need to transform the conditions producing shocks to prevent them, and not merely to absorb them, and to do so in ways that are defined with and build the capabilities, voice and power of those directly affected. \r\n\r\nPlease send feedback or queries on the issues raised in this oped or interest in the pra4equity list to the EQUINET secretariat at  admin@equinetafrica.org.  ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"UN political declaration on antimicrobial resistance signals high level recognition","field_subtitle":"Alas M: TWN Info Service on Health, Sustainable Agriculture and UN Sustainable Development, September 2016","URL":"http://www.twn.my/title2/health.info/2016/hi160904.htm","body":"On 21 September 2016 the United Nations General Assembly (UNGA) adopted the political declaration on antimicrobial resistance. Its adoption provides recognition of the critical nature of antimicrobial resistance (AMR) at the highest political level. It recognises the World Health Organisation (WHO) Global Action Plan on AMR as the blue print of action.  It also acknowledges that the lack of access to health services and antimicrobial medicines continues to affect more people than resistance, as a major challenge for developing countries. The document clearly states that research and development efforts should be guided by need and by the principles of affordability, effectiveness, efficiency and equity as well as be de-linked from the price and volume of sales. There are two calls for action in the text. The first one calls upon the WHO \u201ctogether with Food and Agriculture Organisation (FAO) of the United Nations and the World Organisation for Animal Health (OIE), to finalise a global development and stewardship framework. \u201d Preliminary discussions on this framework have taken place in Geneva at the WHO Headquarters in early 2016 but this call for action gives an explicit mandate to continue the negotiations that will define and structure how this framework would look like. The second call for action requests the Secretary-General to establish an ad hoc interagency coordination group co-chaired by the Executive Office of the Secretary-General and the WHO. During the negotiations for the political declaration civil society groups that were following the process in New York told Third World Network that it was necessary that the UN, with all its agencies, participated in creating actions within their mandates to complement and support the WHO leadership in this issue due to the fact that AMR is interconnected with many other aspects beyond human health. According to several civil society organisations that attended the panel, while the declaration is a good step and recognition at the highest level of this critical issue the declaration had few commitments on the mobilisation of funds to support developing countries. It did not make specific commitments in the animal health sector. The declaration calls for a report back in 2018 at the UNGA and hopefully some of the commitments discussed in this meeting can be truly realised.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Urban Governance in Africa Today: Reframing, Experiences, and Lessons","field_subtitle":"Obeng-Odoom F: Growth and Change, August 2016, doi: 10.1111/grow.12164","URL":"http://onlinelibrary.wiley.com/doi/10.1111/grow.12164/full","body":"Progress in analysing the instrumental view of governance as an engine for growth, poverty reduction, and inclusive development has been held back by the difficulty in framing governance. This essay seeks to address this problem by 1) reframing urban governance 2) evaluating its aims, processes, and outcomes, and 3) explaining those outcomes on the basis of which some lessons are teased out. Using examples from Africa and an institutional political economy approach the author argues that, overall, while urban economies are growing; both urban poverty and inequality levels have risen substantially. Urban governance has paved the way for new forms of urban development that only benefit the few, including in how differences in how urban services and resources are experienced, accessed, and controlled. The author argues that the underlying reasons for this disjuncture between \u201curban governance\u201d in theory and \u201cactually existing urban governance\u201d are 1) difficulties in implementing urban governance theory consistently in practice, 2) problems arising because urban governance theory has been implemented in practice, 3) tensions that would entangle most policies which do not address historical and structural economic issues, 4) restrictive assumptions, and 5) incoherence among the different dimensions of urban governance. To resolve these contradictions, the author puts the case for major structural and institutional change involving: 1) the re-ordering of the roles of the state, market, and society as institutions of change; 2) re-working the relationships that bind together land, labour, capital, and the state, and 3) re-organising the channels for keeping the attainment of the ends of urban governance in check.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"What is Habitat III and why does it matter? A beginner\u2019s guide to the new urban agenda","field_subtitle":"Robin E: The Conversation, October 2016","URL":"http://tinyurl.com/h8y4ts4","body":"The Habitat process was launched by the UN in 1976, when governments began to recognise the risks of rapid urbanisation: in particular, rising inequality, falling quality of life and unsustainable development. More than half of the world\u2019s population now lives in urban areas, and this figure is predicted to rise to almost 70% by 2050. As a result, cities have become focal points for addressing many of humanity\u2019s greatest challenges. Economic inequalities have dramatically increased, and are heavily concentrated in urban areas: almost one third of city-dwellers live in informal settlements, such as slums. Habitat is a state-led process, so many world leaders and UN representatives will be at the conference. The UN also established a General Assembly of Partners to encourage the participation of local authorities, grassroots and indigenous organisations, women\u2019s and youth groups, as well as the private and charitable sectors. The main topic of discussion was the Zero Draft of the New Urban Agenda (NUA): a 24-page document, which outlines the nation states\u2019 shared vision for a sustainable urban future. The NUA has undergone three rounds of revisions between May and September 2016, to iron out conflicts and reach a consensus between the UN nation states. The \u201cright to the city\u201d is also enshrined in the document, calling on governments to create \u201ccities for people, not for profit\u201d, ensuring an inclusive, gender and age sensitive approach to city planning, as well as continuing efforts to reduce urban poverty. Unlike the Paris climate agreement or the SDGs, the NUA is non-binding \u2013 it merely provides guidelines for those involved in urban development. It does not give practical advice about how the NUA should be carried out, and who is in charge of implementing it. It does recognise the need for producing evidence to inform the implementation of the NUA, but does not indicate how progress should be measured and assessed. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Why are maternal health outcomes worse for migrant women in Masindi, Uganda?","field_subtitle":"Ayiasi R; Mangwi A; Kiiza A; Orach C: Resilient and responsive health systems (RESYST) blog, Makerere University, School of Public Health, September 2016 ","URL":"http://tinyurl.com/gnemeao","body":"Globally, 298,000 women die due to pregnancy related causes each year and half of these occur in Africa. In Uganda, maternal mortality has marginally reduced from 526/100,000 to 435/100,000 livebirths between 2001 and 2011. The presence of a skilled attendant during the entire continuum of care for maternal and new born care has great potential to reduce maternal and new born morbidities and mortality. In 2013, an intervention to mobilize communities in Masindi, Uganda for maternal and new born health was introduced and the results showed marked improvement in utilization of maternal health services such as antenatal care and health facility delivery. However, non-indigenous populations were found to use maternal health services less compared to the indigenous populations. The non-indigenous population are mainly from the West Nile region of Arua and Nebbi. These group of people provide a cheap source of labour for the sugar plantation and sugar factory in Kinyala. This study could not adequately explain why migrants were using maternal health services less. The aim of this study was to gain a deeper understanding of internal migrant\u2019s low access and utilisation of maternal and new born care services in Masindi, Uganda. Key barriers to access were identified as lack of financial resources, social beliefs, neglect by health workers, lack of education and lack of male involvement. There are a number of barriers to access to maternity care among migrant women in Masindi, Uganda. These barriers can be addressed at two levels. At the household level, there should be deliberate efforts to engage with men to support their partners during pregnancy and childbirth for example, by saving money and preparing for transport to the health facility in case of antenatal care and delivery. At the district level, there is need for district local managers together with district health managers to create a dialogue platform in which communication barriers and the mistreatment of migrant women can be addressed in the health sector.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Zimbabwe\u2019s child marriages on the rise as food runs short","field_subtitle":"Mutizwa G: CNBC Africa, August 2016","URL":"http://www.cnbcafrica.com/news/southern-africa/2016/08/16/zimbabwes-child-marriages/","body":"The author reports that food is becoming scarce in large parts of rural Zimbabwe with United Nations agencies and government warning more than one in three Zimbabweans may need food assistance by next March. The government has appealed for $1.5 billion in emergence support to cover the food and nutrition, agriculture, water, education, and health sectors. Mbire is a traditionally rain starved area, which lies in the Zambezi escarpment, near the border with Zambia. In Mbire, George Nyarugwe, the Acting District Administrator, said at the local clinics there was growing anecdotal evidence of forced child marriages with many of the young mothers telling nurses they were forced to marry because of the drought. Similar reports have been made in Mt Darwin in the country\u2019s northeast and in Seke, near Harare, according to the Zimbabwe Vulnerability Assessment Committee report released in January. Between last December and April, UNICEF says 3,042 new child protection cases were reported in 65 districts in Zimbabwe, with child neglect showing the highest incidence at 568, followed by sexual abuse at 306 and physical abuse at 218. There are plans to train government, non-government organisation and community social workers to better protect children in drought afflicted areas. ","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"\u201cOne-stop shop\u201d brings life-saving HIV care, reproductive health to Botswana\u2019s women","field_subtitle":"United Nations Population Fund (UNFPA), Geneva, September 2016","URL":"http://tinyurl.com/z5z7rrl","body":"When Rose Matuulane was pregnant five years ago, she had to wait for a nurse to visit her small village, Otse in Botswana,  to provide antenatal check-ups. When the nurse could not make it, Ms. Matuulane had to travel 84 km to the nearest clinic, in Shoghong, arriving the day before so that she could rise early and queue for hours. If she or any other woman additionally needed a family planning consultation, cervical cancer screening, HIV testing and counselling, or HIV treatment, they would have to come back another day, waiting again for hours. Ms. Matuulane, 24, is now a mother of two. The experience she had with her second pregnancy was worlds apart from the first. In 2011, shortly after she had her first baby, UNFPA helped to introduce integrated reproductive health care services at the Otse Health Post. It meant Ms. Matuulane no longer had to travel all the way to Shoshong. The new approach \u2013 called a \u201cone-stop shop model\u201d \u2013 also meant women no longer had to return time and again for different sexual and reproductive health services. The one-stop shop model is helping to increase women\u2019s access to life-saving maternal health care and family planning. It is also a critical tactic in the fight against Botswana\u2019s devastating HIV epidemic. The country has an HIV prevalence of 22 per cent among 15-to-49 year olds, according to 2015 UNAIDS estimates. A staggering 18 per cent of maternal deaths in the country are due to HIV-related causes. By integrating a full suite of reproductive health care together with a full range of HIV services \u2013 including prevention, testing and antiretroviral treatment \u2013 health workers have more opportunities to provide both kinds of care. The project \u2013 a partnership between the Ministry of Health, UNFPA and UNAIDS, with funding from the European Union, and the Swedish and Norwegian development agencies \u2013 is being piloted in seven countries in the East and Southern Africa Region. Botswana is the first of the pilot countries to implement the approach nationwide. Since the programme\u2019s launch, the number of women visiting clinics for post-natal care, who are then able to simultaneously receive HIV and family planning services, has increased by 63 per cent, according to a recent report. The number of women seeking family planning, who are now able to access HIV services at the same time, has increased by 89 per cent.","php":"","field_issue_date":"2016-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":" Skills Building On Methods And Tools For Learning From Action In Participatory Action Research","field_subtitle":"Tuesday 15 November 2016 8:30am\u201312pm Convention Centre, Health System Global, Vancouver, Canada","body":"This participatory skills session convened under the umbrella of the pra4equity network is being held at the Heath System Global Conference. In the session we will discusses methods and tools to build learning from action as a key element of participatory action research, directly engaging affected communities to build responsive health systems. The session draws on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. From prior global symposia, methods for learning from action were identified as weak in PAR practice. This session seeks to address this gap. It is targeted at researchers and practitioners. It uses methods resources and group discussions of case studies from health managers, policy actors, civil society and researchers in low and middle income countries to discuss the participatory processes and methods for learning from action at different levels, and the issues in applying and institutionalising these methods. We will also review what these participatory efforts to transform and build knowledge on health systems implies for the understanding of \u2018resilience\u2019. As the places are limited if you will be in Vancouver on the 15th November morning and would like to participate in this skills session please can you notify on the email shown with your name, institution and a line or two on any prior PAR experience.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"2016: Old Challenges, New Hopes","field_subtitle":"Independent Accountability Panel, September 2016","URL":"http://iapreport.org/","body":"The Independent Accountability Panel (IAP) inaugural report '2016: Old Challenges, New Hopes' was launched September 18, 2016 in conjunction with the Partnership for Maternal Newborn and Child Health and Countdown to 2030 and  formally submitted to the Secretary-General at the Every Woman Every Child high level reception on the 20th September 2016. The report details how inequalities within and between countries are leaving women, children and adolescents at a disadvantage. It argues that more must be done to give every woman, every adolescent, and every child the opportunity to survive and thrive. In a statement at http://tinyurl.com/hadb8np  the O\u2019Neill Institute for National and Global Health Law at Georgetown University Law Center endorsed the report noting \"The IAP\u2019s report encompasses remedies as a necessary part of an accountability framework, building on the earlier work of the Commission on Information and Accountability and its accountability framework of monitor, review, and act. The inclusion of remedies rounds out a cycle of accountability that is necessary to realize the right to health and other health-related rights, which must extend beyond the traditional emphasis on monitoring and evaluation. This report is intended to help catalyze the use of national, regional, and global accountability mechanisms \u2013 and vitally, to ensure that all people, with special attention to the most marginalized, have the resources and respect that empower their ability to access them\". \r\n","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"A focus on parliamentary roles in health in the region","field_subtitle":"Editor, EQUINET newsletter","body":"In 2008 parliamentarians from Parliamentary Committees on Health in East and Southern Africa committed to raising the profile of health in all parliaments in the region, to strengthen their leadership, roles, capacities in and evidence for promoting, monitoring and advancing equity in health and health care. In this issue we have given attention to the role and work of African parliaments in health, both in the editorial and in various recently published items. Parliaments play a critical role in health, promoting public information and dialogue, scrutinising and reviewing laws, reviewing budget proposals and overseeing the implementation of policy and the functioning of the executive.  There are numerous documents on the EQUINET site that report this parliamentary work in health since 2008, including on raising accountability on the Abuja commitment on domestic financing for health. This issue gives a glimpse into the more recent work and debates on health underway in African parliaments.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"A tale of two worlds \u2013 Vedanta AGM 2016","field_subtitle":"Whitmore A: London Mining Network, August 2016","URL":"http://londonminingnetwork.org/2016/08/a-tale-of-two-worlds-vedanta-agm-2016/","body":"Vedanta Ltd is a mining company which various subsidiaries has operations in India, Zambia, Namibia, South Africa, Liberia, Ireland and Australia in copper, zinc, silver, aluminium, oil, gas, iron ore and power segments. This article reports on Vedanta\u2019s annual general meeting in London and some of the debates that took place at the meeting, including in relation to the report back by shareholders who visited mine sites and reported on what they had seen on working and environmental conditions. The author comments that in part a promise of \u201czero harm\u201d by large extractive corporations is illusory and can lead to real problems being hidden. The author argues for reports to rather be clearer about the real conditions and situation on the ground to include and allow debate on the improvements intended to manage them. ","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"African Health Economics and Policy Association 4th Biennal Scientific Conference ","field_subtitle":"26-29 September 2016, Rabat, Morocco.","URL":"http://tinyurl.com/jse64y3","body":"The African Health Economics & Policy Association (AfHEA) was set up in March 2009 as a membership-based non-profit association of Africans and non-Africans including students working on Africa-related issues in the fields of health economics, financing and policy. The theme of the 2016 AfHEA  conference will be: \u201cThe Sustainable Development Goals (SDGs), the Grand Convergence and Health in Africa\". The conference aims to: help define the research agenda and identify research gaps regarding the conference theme; ensure a minimum of 20 African countries and 200 participants from Africa (both Francophone and Anglophone) attend conference; attendance from at least 10 globally recognised experts on African health economics and policy; at least 120 abstracts presented; publish all abstracts and posters of conference both in hard copy and electronically (online); identify currently emerging and priority research areas for African countries and regional bodies; outputs from the AfHEA conference are translated into policy notes and communicated to decision makers. The target audience is researchers, policy makers, health professionals, academics and students, practitioners from Ministries of Health, Finance and related agencies, individuals from the NGO and community-based organisations, and others with a research or policy interest in the subject areas covered by AfHEA.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"African Institute for Development Policy (AFIDEP) conducts training for Parliament Staff from across Africa on evidence use","field_subtitle":"Oronje R: African Institute for Development Policy (AFIDEP), Uganda, July 2016","URL":"https://www.afidep.org/?p=4341","body":"The African Institute for Development Policy AFIDEP conducted a training workshop for more than 15 parliament staff from 10 African countries on evidence-informed decision-making (EIDM) on June 27-28, 2016 in Munyonyo, Uganda. The parliamentary staff included researchers and clerks who support parliamentary health committees. These staff provide committees with briefings on issues to inform their debates and decisions, and therefore play a crucial role in the ecosystem of evidence use in parliament. The workshop equipped the parliamentary researchers and clerks with knowledge and skills in: the critical place of evidence in the legislature; knowledge of where and how to effectively search for evidence, assess its quality, and synthesise and package it appropriately for use by MPs.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"African parliaments networking to ensure delivery of key health goals","field_subtitle":"Hon Blessing Chebundo, Network of African Parliamentary Committees of Health","body":"\r\nOne reason why many of our health policies fail to be fully implemented in our region is that we lack a robust mechanism to make sure of this. Parliaments play a key role in this. They provide a link between government and citizens on laws and treaties, budgets and in overseeing in implementation of national programmes. In the early 1990s, most African countries initiated reforms for their parliaments to play a more effective and visible role in these functions. \r\n\r\nThe idea to bring the Portfolio Committees on health in the region together was first mooted in 2003, in part due to falling budget allocations to health, to the devastating impact of AIDS and to evident inequalities in access to funds and services. We recognized that as members of parliament (MPs) we needed to use our representative mandate to communicate social expectations and strengthen social voice and power in health.  A core group of MP used our own resources to visit other parliaments in the region to share the idea and listen to the feedback. The network was finally launched in 2005 as the Southern and East Africa Parliamentary Committees on Health (SEAPACOH). Today we have widened to all of Africa and are the Network of African Parliamentary Committees on Health (NEAPACOH).  So far we have active participation from Angola, Botswana, Benin, Burkina Faso, Burundi, Ethiopia, Ivory Coast, Gambia, Ghana, Kenya, Kingdom of Lesotho, Malawi, Mali, Morocco, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe and we welcome other parliamentary committees on health in the continent. \r\n\r\nSince 2008 and with technical partners like EQUINET and Partners in Population and Development Africa Regional Office, the network has annually brought together the health committee chair, clerk and several other MPs from committees across the continent. This provides a forum for parliamentary committees on health to share concerns, unify voice on common concerns and calls for action, to advocate for health as a fundamental human right and promote democratic principles in health, including in our engagement with global processes. It also allows us to share promising practice and lessons learned. Strategically, we use the annual conference to identify common challenges and resolve on areas for action and on commitments that national health committees/delegations undertake to implement and report progress on at the next conference. We have found that identifying joint areas of action that brings us on the same \u2018wave length\u2019 strengthens our effectiveness, individually and collectively. The experiences, views and success stories that we share inspire and inform the individual committees. For example from 2005 we took up a common cause on advocating our Ministries of Finance to meet the Abuja commitment of 15% of the government budget going to health, that raised attention to this issue and contributed to improved allocation in a number of countries. We also raised issues that affect other sectors and committees, such as the positions on intellectual property that are needed to support access to medicines. We produced with EQUINET parliamentary briefs on international treaties affecting health and other health issues that are common for all parliaments in the region. We have in the process built solidarity and collaboration with civil society organisations and regional networks, and with health professionals, academics, non-state actors, research institutes and international agencies.  This has enabled us to better understand and synergise our different but complementary roles across all actors to ensure we deliver on social values and policy commitments, such as on health equity.\r\n\r\nIn our recently held 2016 NEAPACOH conference we have identified some key areas of attention and work for the coming year. Some are platforms we are sustaining from prior years, including to: facilitate greater public participation in health; to pursue and monitor achievement of equity in health; to advocate for improved health budgets and financing (in line with the Abuja commitment); and to promote access to key reproductive health, family planning and HIV/AIDS services. We agreed, further, to evaluate how far our governments have ratified and domesticated health related treaties and to engage on how far actions have been institutionalized and implemented to advance Universal Health Coverage and other Sustainable Development Goals (SDGs) that affect health, including within parliament. We see a need to mainstream the SDGs within the diverse areas of work of parliament, including the public information and consultation for them, and would want to spearhead work on this in health. We also plan to develop a handbook for African parliamentary health committee members as a practical resource to support their role. \r\n\r\nThe 2016 conference also raised a proposal for NEAPACOH to work with technical partners to evaluate how effectively parliamentary committees are taking forward resolutions, to understand the barriers and support practice. We will do this by visiting a selection of member committees in their countries before the next meeting.\r\n\r\nThe process of building this network has itself been a learning experience. Indeed we understand that the longevity of this network of parliamentary committees is unique in the continent, outside the formal all parliament unions.  We have grown stronger over the years building on our constitution and founding values, and have a board of serving MPs from all five African regions chosen in our annual conference and an office hosted by the Parliament of Uganda. Over the 13 years since we were formed we have benefited from perseverance of leadership and retention of key founding personnel, from sound founding principles, and from a consistent collaboration with key technical partners in the region. At the same time we still have much to do to deliver on our mandate, to be more robust and effective at national, regional and continental level to protect shared health values and to play our role in ensuring that they are delivered on in practice. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. You can find out more on NEAPACOH at www.seapacoh.org ","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"African Speakers of Parliament commit to support maternal, newborn and child health: Resolution on Declaration of Commitment to Prioritize and Increase Budget Support to Maternal, Newborn and Child Health","field_subtitle":"The Partnership for Maternal, Newborn and Child Health: October 2011","URL":"http://www.who.int/pmnch/media/news/2011/20111024_africanspeakersdeclaration/en/","body":"African Speakers of Parliaments and Presidents of Senate have unanimously adopted a landmark resolution on a Declaration of Commitment to prioritise parliamentary support for increased policy and budget action on Maternal, Newborn and Child Health in African countries. The milestone Declaration of Commitment was adopted at the 3rd Pan African Speakers Conference 17th \u2013 18th October 2011, in Midrand, Johannesburg, South Africa. In the communiqu\u00e9 issued at the end of the conference, the speakers committed to \u201cprioritise policy and budget support for implementation of African Union Summit Decisions, in particular the \u2026 Kampala July 2010 Summit Declaration on the Summit theme of \u201cActions on Maternal, Newborn and Child Health Development in Africa\u201d. The Commitment was the first of its kind by African Speakers of Parliament, and marks a significant milestone in accelerating progress in Africa towards the attainment of the Millennium Development Goals (MDGs) 4 and 5 on Child and Maternal Health, respectively. It also promises high-level parliamentary support to hasten implementation of the Africa Parliamentary Policy and Budget Action Plan on Maternal, Newborn and Child Health, agreed by Chairs of Finance and Budget committees of national parliaments in October 2010.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana","field_subtitle":"Katisi M; Daniel M; Mittelmark M: Globalization and Health 12(42), 2016, doi: 10.1186/s12992-016-0179-3","URL":"http://link.springer.com/article/10.1186/s12992-016-0179-3","body":"Government of Botswana partners with two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. This paper uses a systems model to establish how the functioning of the partnership on Safe Male Circumcision in Botswana contributed to the outcome. Data were collected using observations, focus group discussions and interviews. Thirty participants representing all three partners were observed in a 3-day meeting; followed by three rounds of in-depth interviews with five selected leading officers over 2 years and three focus group discussions. Financial resources, \u201cownership\u201d and the target were found to influence the success or failure of partnerships. A combination of inputs by partners brought progress towards achieving set program goals. Although there were tensions between partners, they worked together in strategising to address some challenges of the partnership and implementation. The authors found that pressure to meet the expectations of the international funders caused tension and challenges between the in-country partners to the extent of Development Partners retreating and not pursuing the mission further. Target achievement, the link between financial contribution and ownership expectations caused antagonistic outcomes. ","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"CODESRIA Vacancy Announcement: Programme Officer (Research)","field_subtitle":"Deadline: 23 October 2016","URL":"http://www.codesria.org/spip.php?article2660&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites applications from African scholars to fill a vacant position of Programme Officer (Research) in its pan-African Secretariat located in Dakar, Senegal. This position is categorized as belonging to the senior staff of the Council and as such is filled on the basis of an international announcement. The successful candidate will work as a member of the Secretariat under the overall supervision of the Executive Secretary of the Council. For further details see the website.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Developing a mHealth intervention to promote uptake of HIV testing among African communities in the conditions: a qualitative study","field_subtitle":"Evans C; Turner K; Suggs L; Occa A; Juma A; Blake H: BMC Public Health 16(656), 2016, doi: 10.1186/s12889-016-3278-4 ","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3278-4","body":"HIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the conditions. A community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined. The focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits. HIV remains a stigmatised and de-prioritised issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. ","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Dirty Diesel","field_subtitle":"Gu\u00e9niat M, Harjono M, Missbach A, Viredaz GV: Public Eye, Lausanne, September 2016 ","URL":"https://www.publiceye.ch/fileadmin/files/documents/Rohstoffe/DirtyDiesel/PublicEye2016_DirtyDiesel_A-Public-Eye-Investigation.pdf","body":"A new report published by Public Eye, 'Dirty Diesel'  reports that Swiss commodity trading firms exploit lax regulatory standards to sell African customers fuel with high sulfur content that have been banned in Europe. Operating behind the Energy brands, trading companies have a dominant position in the import and distribution of petroleum products in many African countries. Public Eye researchers drew fuel at local pumps in eight countries, viz: Angola, Benin, the Republic of the Congo, Ghana, C\u00f4te d'Ivoire, Mali, Senegal and Zambia. The result revealed that the diesel samples contained up to 378 times more sulfur than is permitted in Europe. Furthermore, other toxic substances, such as benzene and polycyclical aromatic hydrocarbons, were also found in concentrations that are also banned in Europe. The 160-page report further indicates that the traders mix up a petrochemical cocktail from refinery products and other components known in the industry as \"African Quality\". These toxic fuels are reported to be mainly mixed in the ARA-Zone (Amsterdam-Rotterdam-Antwerp) where Swiss trading firms have their own refineries and storage facilities. Many West African countries that export high grade crude oil to Europe receive toxic low quality fuel in return. The authors indicate that these fuels investigated contribute to rising air pollution in African cities and jeopardise health, as noted in studies on rapidly increasing levels of air pollution and estimates that by 2030 Africa will have three times as many deaths from traffic-related particle dust than Europe, Japan, and the US combined. Respiratory illnesses are already a major health issue and diesel fumes can cause cancer. The authors argue that African governments need to set and enforce stricter standards. In a petition addressed to Trafigura, Public Eye and its West African partners call on the Geneva-based commodities giant to only sell fuel that meets European standards in all of its global operations, and the UN-Guiding Principles on Business and Human Rights adopted in 2011.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Drama for Conflict Transformation Toolkit: Youth Theatre for Peace","field_subtitle":"International Research & Exchanges (IREX): July 2016","URL":"http://tinyurl.com/jazlzwl","body":"The Drama for Conflict Transformation (DCT) methodology introduced in this toolkit is used to create community conversation about conflict issues, piloted in conflict-prone areas in Kenya, amongst other countries. Since 2010, participants have collaborated with more than 50,000 audience members to talk about solutions to bullying in schools, labour migration, bride kidnapping, resource scarcity, and substance abuse. The idea is that, \"when youth are engaged positively and given a voice, they can play vital roles in building peace. This toolkit is designed to introduce young people to an innovative theatre methodology that creatively examines and transforms conflict. After working through the exercises in this manual, youth will be equipped to lead community dialogue as agents of positive change.\u201d This toolkit guides facilitators in creating a custom workshop to introduce youth to the DCT methodology. The material can be adapted by the facilitator to be culturally or regionally specific and to integrate various themes important to the participant group. Many options for workshop modules - including lead-in activities, warm-up modules, main sessions, energisers, and closing activities - are included to allow the facilitator to craft workshops that best fit their local context and needs. After working through these exercises, participants are expected to be able to analyse conflicts in their communities using theatre exercises, create a Forum Theatre performance based on a community conflict issue, and engage with their local communities through DCT. The toolkit is divided into two sections. Section I: Introduction to DCT Methodology and Facilitation includes hints on organising a DCT workshop, structuring exercises, and establishing group dynamics, as well as an illustration of good facilitation to create a safe, fun, and informative space for participants. Section II: DCT Activities and Theatre Techniques includes a toolbox of DCT activities, arranged by type (warm-up, lead-in, main activity, energiser, or closing activity). Notations on sequencing indicate when certain exercises should be used to build upon earlier trust-building or skill-building work. A glossary of terms, bibliography of relevant works, and selection of handouts are found at the end of the manual.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Economics, financing and HIV: Reflections from the 2016 International AIDS Economics Network Preconference","field_subtitle":"Forsythe S; Barker C; Chaitkin M: Results for Development, August 2016","URL":"http://tinyurl.com/joxdjp7","body":"The International AIDS Economics Network (IAEN) Preconference in Durban in July 2016 demonstrated the strong political will to prioritise financing and harness economics to sustain the global HIV response and end AIDS, with high-level participation by ministers of health from Lesotho, Namibia, Botswana, Uganda, and Zimbabwe, along with the heads of UNAIDS and PEPFAR and experts from the CDC and the World Bank. At the policy level, a high-level panel discussed how evidence generated by economists can help facilitate engagement between the ministries of health and treasury and with civil society to keep health and HIV as a top priority in many countries. They also argued that investment cases should be made alongside human rights cases. These messages were echoed throughout the main conference. The face of HIV economics has changed, with young researchers from low- and middle-income countries making most of the presentations. The community\u2019s focus has also changed in other promising ways. In 2000 health economists were just starting to explain why it makes economic sense to introduce antiretroviral (ARV) medicines into low-resource settings, and responsibility for financing HIV programs was seen to lie squarely in the hands of rich countries. In contrast, today energy is channeled towards sustaining the response and striving toward the 90-90-90 targets as efficiently as possible. Critically, the International AIDS Economics Network are supporting countries to mobilize ever more domestic resources and take ownership of their national programs.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Educate public on GMOs ","field_subtitle":"Parliamentarians: Parliament of Uganda: Kampala, August 2016","URL":"http://tinyurl.com/hv468tc","body":"Members of the Ugandan Parliament (MPs) under the Parliamentary Committee on Science and Technology have tasked scientists at Kawanda Agricultural Research Institute(KARI) to educate the public more on Genetically Modified crops. The MPs raised concern over the unawareness of the public about genetically modified crops, the misconceptions people have concerning genetically modified organisms (GMOs) and problems in some of the genetically modified crops that have been introduced locally. This was during a meeting at  the Agricultural Research Institute.  Hon. Rose Mutonyi (Bubulo West) said the public is not convinced about genetically modified crops.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 187: African parliaments networking to ensure delivery of key health goals ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Policy Brief 41: Giving new momentum to strategies for retaining health workers","field_subtitle":"Dambisya Y: EQUINET with ECSA HC, TARSC and U Limpopo, September 2016","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Polbrief%2041%20HR.pdf","body":"This brief discusses the strategies used for attracting and retaining skilled health workers in ESA countries, especially to address underserved rural and remote areas, primary care settings and in the public sector. It reviews practice to date and identifies strategic options, given both regional learning and the opportunity of the 2016 Global Strategy on Human Resources for Health. Whereas ESA countries have implemented various attraction and retention regimes, the results have not been well documented, with still limited evaluation and reporting of impact of these strategies. The evidence suggests a need for a comprehensive, multi-sectoral and co-ordinated approach to planning and implementation, to make the case for improved funding and with greater use of information and monitoring systems.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Global Forum 2015 dialogue on \"From evidence to policy - thinking outside the box\": perspectives to improve evidence uptake and good practices in the African Region","field_subtitle":"Kirigia J; Pannenborg C; Amore L; Ghannem H; IJsselmuiden C; Nabyonga-Orem J: BMC Health Services Research 16(Suppl 4), 18 July 2016, doi: 10.1186/s12913-016-1453-z","URL":"https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1453-z","body":"The Global Forum 2015 panel session dialogue entitled \u201cFrom evidence to policy \u2013 thinking outside the box\u201d was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region. The Global Forum 2015 debate attributed African Region\u2019s low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organisations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region. The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening national health research governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of action plans for implementing research recommendations, preferably in the context of the Sustainable Development Goals; and encouragement of competition on health research strengthening and research output and uptake among the countries using a barometer or scorecard to review their performance at various regional ministerial forums and taking into account the lessons learned from the MDG period.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Indian Private Sector Investments in African Healthcare","field_subtitle":"Ngangom T; Aneja U: ORF Issue Brief 145, 2016 ","URL":"http://tinyurl.com/gu6aw49","body":"This paper examines India's partnership with Africa in four sectors \u2013 medical tourism, tele-health, frugal innovations, and the pharmaceutical industry. It examines the nature of Indian private sector investments in African healthcare. It analyses their effectiveness in dealing with the issues around equity of access, the establishment of comprehensive 'prevention- based' health systems, and the creation of mutual benefit. The author reports that there is significant Indian commercial presence in Africa's health systems but the engagement needs a broader conception of the 'private sector' to include traditional healers and social entrepreneurs engaged in innovation for healthcare. Given their common health challenges, the authors argue that India and African countries must work towards crafting innovative low-cost healthcare models, and invest in the production and research of pharmaceutical products, especially for neglected diseases.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Intellectual Property and Access to Science","field_subtitle":"South Centre: Research Paper 69, 2016","URL":"https://www.southcentre.int/research-paper-69-july-2016/","body":"The boundaries between scientific and technological knowledge are nebulous in some technical fields, such as the biological sciences and their applications. This has led to the appropriation under patents of knowledge (such as on specific genes) of scientific nature, which may not only have negative effects for the further development of science and new technological contributions, but also encroach on the fundamental right of access to science. The South Centre argues in this paper that the patenting policies adopted by some universities and other research institutions may aggravate this problem. Court decisions in the USA and Australia and some national laws (e.g. Brazil) have limited the possibility of that appropriation, but this is still feasible in many jurisdictions. The authors argues that other measures \u2013 such as a well formulated research exception, the limitation of the patent claims\u2019 scope, and legislation mandating open access to research results achieved with public funding \u2013 may mitigate the effects of the exclusivity granted by patent rights, but more fundamental policy changes may be necessary in order to preserve scientific outcomes in the public domain for free use and follow-on research.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Kenya women Parliamentarians speak out on the need for evidence to improve legislation and governance","field_subtitle":"Warira D: African Institute for Development Policy (AFIDEP), July 2016","URL":"https://www.afidep.org/?p=4557","body":"Members of the Kenya Parliament, specifically women, have expressed the need to close the evidence gap currently curtailing effective legislation and policy formulation. Speaking at a workshop organised by African Institute for Development Policy (AFIDEP) and the Parliamentary Caucus on Evidence-Informed Decision-Making (PC-EIDM), the Members of Parliament (MPs) acknowledged the critical role evidence plays towards enhancing their effectiveness in legislation, representation and policy-making. The workshop, which specifically targeted members of the Kenya Women Parliamentary Association (KEWOPA), provided an excellent opportunity for the women Parliamentarians to speak out on the challenges they are grappling with as legislators. Hon Naisula Lesuuda, a nominated Senator, Samburu County and the Deputy Chairperson of KEWOPA in the Senate, said that through the Association, women in Parliament play a critical role since KEWOPA\u2019s mandate is to ensure that policies are gender-responsive, and that programmes related to women\u2019s affairs get adequate resource allocation. Evidence is therefore of essence as the Association needs to ensure that its recommendations are evidence-informed. The MPs expressed their desire to use evidence to debate policy issues but the evidence is not readily available. There were also calls to digitise all data in the custody of various government ministries and to have it uploaded to an online portal to enhance its accessibility by Parliamentarians when need arises. In addition, the MPs noted that they would have achieved more during their current tenure had relevant evidence on pressing socio-economic challenges in their areas of jurisdiction been presented immediately they took over office. In a bid to identify strategies to enhance evidence use in Parliament, the members called attention to the need for the training of research and personal assistants.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Leaving no one behind: a critical path for the first 1,000 days of the Sustainable Development Goals","field_subtitle":"Stuart E; Bird K; Bhatkal T; Greenville R; Rabinowitz S; Samman E; Sarwar M; Lynch A: Overseas Development Institute, 2016","URL":"http://www.developmentprogress.org/leave-no-one-behind","body":"The authors argue that leaving no one behind is the moral issue of our age, and is at the heart the Sustainable Development Goals (SDGs). One specific goal is \u2018ending poverty, in all its forms, everywhere\u2019, but the SDGs also aim to tackle marginalisation. The SDG outcome document specifies that the goals should be met for all segments of society, with an endeavour to reach those furthest behind first. Now the focus is on implementation, particularly at the national level. This report makes the case for early action, and quantifies its benefits. The report outlines the actions that governments can take in the first 1,000 days of the SDGs to respond to what poor people want and to deliver for the most marginalised people and groups. The evidence shows that achieving the SDGs and the ambition to leave no one behind will become far more difficult the longer governments delay. The report concludes that early action is critical for the achievement of the SDGs.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Linkages between researchers and legislators in developing countries: A scoping study","field_subtitle":"Datta A; Jones N: Overseas Development Institute, Working paper 332, 2011","URL":"http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/2989.pdf","body":"The need for legislative information and research, especially in developing and transition countries, is growing as policy-making processes become more complex, particularly in the context of globalisation, regional integration and decentralisation. Since the executive branch of governments generally has access to a larger pool of knowledge and expertise than the national legislature, there is a need to address the imbalance in access to knowledge between the executive, legislature and judiciary in order to promote better quality policy-making. Better access to information and research can help empower legislatures to formulate and pass effective legislation and perform effective scrutiny of government. Using the Research and Policy in Development (RAPID) framework, this study maps the links between researchers and legislators in a number of transition and developing countries; explores the role of politics in influencing researcher\u2013legislator linkages; and comments on the type of research produced as well as the credibility of the research/researchers. Civil society organisations (CSO) particularly in Sub-Saharan Africa, perhaps because of weak political parties, play a key role in representing grassroots constituencies in legislative processes. Legislative committee hearings across all legislatures tend to be a key mechanism through which researchers\u2019 voices can be heard in the processes of law-making and oversight. Some legislatures, particularly those in East Asia, have substantial in-house technocratic capacity, including library and research services and the capacity to commission research. In Sub-Saharan Africa, a number of (donor-funded) organisations have been set up to provide the legislature with input and capacity, particularly on management of public finances. Researcher\u2013legislator linkages, particularly in Sub-Saharan Africa, tend to be stronger or more visible in areas that are perceived to require hard data, such as quantitative analyses. These include public financial management, particularly budgeting and budget control. In Sub-Saharan Africa, these formal mechanisms were found in the study to be externally funded and/or -inspired. Where hard data is concerned, research tends to be demand-oriented; in the softer sectors, CSOs have tended to take the initiative to engage legislators. The relationship between political context factors and researcher\u2013legislator links was found to be  complex. Legislators\u2019 personal motivations, such as the desire for political advancement, to influence policy, for power in a legislative body and for private gain, can affect the way they view or use evidence in the policy process. The capacity provided by a legislature\u2019s procedures, structures and support mechanisms also influences the role of research in law-making and oversight processes. They propose that researchers work harder to ensure evidence is accessible by legislators and related to legislative decisions, that fits tightly with legislative processes. Legislators emphasised the need for researchers to go beyond stating research findings to actually narrate a compelling story with practical policy recommendations. Moreover, evidence is more likely to be taken up if messages resonate with broader national policy agendas, such as economic growth. Given the pressures on their time and relatively low research literacy levels, research intended for legislators needs to be presented in short summaries, where possible illustrated by pictures and/or charts. Nevertheless, Legislators\u2019 staff prefer formats that present more detail.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Mega-philanthropy: Charitable deeds or monopoly tyranny?","field_subtitle":"Pheko L: Pambazuka News, 28 July 2016","URL":"http://tinyurl.com/zbo6mfb","body":"The author of this article suggests that the individual multi-billionaire philanthropists who control and define the work of their foundations are able to exert massive influence in public policy and political agendas far beyond the average citizen. He questions this significant entitlement that money gives to a few people to influence global health, environment, education, food, medical, housing policies, whilst benefiting from global and economic inequality, including from the tax exemption they obtain. He cautions on the regression of the power of the state that this may imply, and calls for the legacy of the liberation struggle to be redeemed by building countervailing options and influence that increase citizen voice and engagement.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"METHOD(E)S: Call for Papers","field_subtitle":"Deadline: 30 October 2016","URL":"http://www.codesria.org/spip.php?article2652&lang=en","body":"The recurrent allusion to the \u201cglobalisation of the social sciences\u201d validates the idea of the dominance of Western scientific norms and practices over those of \u201cthe rest of the world\u201d. In preparation for the next issue of M\u00e9thod(e)s, CODESRIA invites colleagues to critically engage with the production of methods and knowledge in the social sciences: that explore modes of domination and resistance in the social sciences. The editors are particularly interested in seeing contributions based on experiences in the field, using empirical materials. Various formats are invited. For  further information visit the website.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Pan African Parliament Endorses Ban on Female Genital Mutilation","field_subtitle":"Latham D: Inter Press Service, August 2016","URL":"http://www.ipsnews.net/2016/08/pan-african-parliament-endorses-ban-on-fgm/","body":"After years of wrangling and debates among African leaders, the movement to end female genital mutilation (FGM) is gaining real momentum, with a new action plan signed in August by the Pan African Parliament (PAP) representatives and the U.N. Population Fund (UNFPA) to end FGM as well as underage marriage. The UNFPA has already trained over 100,000 health workers to deal specifically with aiding victims of FGM, while tens of thousands of traditional leaders have also signed pledges against the practice. In some African countries, girls as young as eleven and twelve are forced to marry much older men, leading to an increase in serious health problems, including cervical cancer and a host of social problems. UNFPA East and Southern Africa Deputy Regional Director Justine Coulson said if the current trend continues, the number of girls under 15 who had babies would rise by a million \u2013 from two to three million. There are believed to be at least seven million child brides in Southern Africa alone. While underage marriage and childbirth is a major health risk, the Pan African Parliament UNFPA workshop also heard how FGM had led to an increased likelihood girls and women would be exposed to sexually transmitted diseases such as HIV/AIDS. Globally, an estimated 200 million girls and women alive today have undergone some form of FGM. In Africa, FGM is practiced in at least 26 of 43 African countries, with prevalence rates ranging from 98 percent in Somalia to 5 percent in Zaire. The buy-in of African political leadership is argued to be crucial if this latest move is to succeed, with up to 140 million women and girls in sub-Saharan Africa who\u2019ve been forced to submit to FGM. The aim is to influence people on the ground as well as effect legislation banning the practice. There are no health benefits in the process and it can cause severe bleeding, problems urinating, cysts, infections and a host of childbirth complications. The PAP also agreed to work with the UNFPA in seeking to overturn the practice of marrying off children under the age of sixteen. In June 2016, the UNFPA worked with Southern African Development Community Parliamentary Forum representatives at a meeting in Swaziland which voted through a Model Law on eradicating child marriage.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Pan-African Parliament Committee members emphasise women\u2019s rights and access to land","field_subtitle":"Pan-African Parliament (PAP): South Africa, March 2016","URL":"http://tinyurl.com/jer24ub","body":"The Rural Economy, Agriculture, Natural Resources and Environment Committee of the Pan-African Parliament (PAP) organized a joint workshop with the committees on gender, agriculture, justice and bureau of women on the 1st of March 2016 during the Committee Sittings in Midrand, South Africa. The Maputo Protocol ON \u201cProtocol to the African Charter on Human and People\u2019s Rights on the Rights of Women in Africa.\u201d was originally adopted by the \u201cAssembly of the African Union\u201d in Maputo, Mozambique July 2003. It provides that women have access to opportunities as well as resources that are available in the country. The PAP aims to ensure that the policies and objectives of the AU are implemented.  The members agreed that as a team they need to adopt laws to secure women\u2019s access to land and ensure that they be given a chance to play productive roles with regards to economic development in the agriculture sector. Article 15 of the Maputo protocol raises women\u2019s rights to food and security as well as land access. Granting women access to land was seen to not only improve their lives but to enable food security and sustainable development.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Parliament committee welcomes probe into deaths of psychiatric patients","field_subtitle":"Gqirana T: News 24, 16 September 2016","URL":"http://tinyurl.com/hbugdh3","body":"The South African parliament\u2019s social services select committee has welcomed the investigation into the death of 36 psychiatric patients in Gauteng. This comes after Gauteng Health MEC Qedani Mahlangu revealed during an oral reply to questions in the legislature that 36 psychiatric patients, who had been transferred from Life Healthcare Esidimeni, had died while in the care of NGOs. The psychiatric patients were relocated to 122 NGOs after the department cancelled its contract with Life Healthcare, which looked after almost 2 000 patients. Health Minister Aaron Motsoaledi has called for the Office of the Health Ombudsman to investigate the allegations. The committee conveyed its condolences to the families of the patients. \"While the Committee is cognisant of the need to find alternative measures to care for patients, these measures should have been made with the clear understanding and guarantees that the care of patients will not deteriorate. Every decision that is made must have as its central pillar the delivery of quality care for our people,\" committee chairperson Cathy Dlamini said in a statement. The committee called for the investigation to be sped up, in order to avoid further loss of life. They would engage with the health department at national and provincial levels to ensure quality care of all patients, the committee said.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Perception and attitude of healthcare workers towards the use of a female condom in Gaborone, Botswana","field_subtitle":"Mashanda-Tafaune B; Monareng L: Health SA Gesondheid 21, 163-170, 2015","URL":"http://www.sciencedirect.com/science/article/pii/S102598481500037X","body":"Although the female condom (FC) is viewed as an effective female controlled barrier contraceptive device that can be used by women to prevent them from contracting the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), other sexually transmitted infections (STIs) and unwanted or unintended pregnancy, the perception and attitude of healthcare workers (HCW) plays a key role in its effective use and distribution amongst women. This study aimed to identify and examine factors that influences the perception and attitude of HCWs towards the use and distribution FCs. A quantitative, explorative and descriptive design was used to conduct the study based on the Health Belief Model as a conceptual framework in June 2013 with a convenience sample of 164 HCWs. The results showed that 64% of the respondents perceived unavailability of FCs as contributing to lack of adequate use. Only 32% of them reported using the FC. There was an association with increasing use of a FC with age, marital status and training. The results revealed that lack of knowledge and training on the use of a FC might prevent its effective use and distribution. The results showed evidence that the FC was a safe method of contraception and protection against STIs and that it empowers women to make decisions related to sexuality. However, awareness campaigns, increased availability of FCs and training of HCWs are essential to enhance positive perception and attitudinal change to reduce sexual risks related infections and poor quality of life for women.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Reforming essential health competencies and training in Africa in light of the Sustainable Development Goals","field_subtitle":"Houeto D; Bambini N: Global Health Promotion 23(1), 2016, doi: 10.1177/1757975916629737 ","URL":"http://ped.sagepub.com/content/23/1/3.full.pdf+html?rss=1","body":"Many African countries were not able to meet their Millennium Development Goals (MDGs) by the 2015 deadline. While this poor performance can be attributed to several factors, many analyses have revealed the main cause to be the absence of systematic and coordinated action on the social determinants of health, which are in large part outside of the health sector. Today, in light of the Sustainable Development Goals (SDGs), it is absolutely necessary to address this shortcoming. The authors indicate that reaching the SDGs calls for action on the social determinants of health and reduction of social inequalities. However, the current way health systems in the region operate emphasise treatment of disease, as if health systems are waiting for people to fall ill before taking care of them. In light of the SDGs, they argue that it has grown urgent for the African region to accelerate training of professionals who are skilled in acting on the social determinants of health to help reorient health services and place health in all policies.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Report of the Reflection Group on the 2030 Agenda for Sustainable Development","field_subtitle":"Social Watch; Global Policy Forum; Development Alternatives with Women for a New Era; Third World Network; Arab NGO Network for Development; Friedrich-Ebert-Stiftung, 2016","URL":"https://www.2030spotlight.org","body":"Independent monitoring and review of the implementation of the 2030 Agenda and its structural obstacles and challenges are key factors for the success of the SDGs. For this reason, the Reflection Group on the 2030 Agenda for Sustainable Development together with other civil society organisations and networks has produced the first annual Spotlight Report assessing the implementation of the 2030 Agenda and the structural obstacles in its realisation. The report puts a spotlight on the fulfilment of the 17 goals, with a particular focus on inequalities, responsibility of the rich and powerful, means of implementation and systemic issues. It raises the main obstacles to achieving the SDGs and explores transnational spill over effects that influence or even undermine the implementation of the goals. It comments on whether the current policy approaches, as reflected in the 2030 Agenda, are an adequate response to the challenges and obstacles or are part of the problem and discusses necessary policy changes.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Report on the Proceedings of the Network of African Parliamentary Committees of Health Meeting: From Millennium Development Goals to Sustainable Development Goals","field_subtitle":"NEAPACOH and PPD Aro: June 2016, Kampala, Uganda","URL":"http://tinyurl.com/h7beo2x","body":"This meeting, organized under the auspices of the Network of Africa Parliamentary Committees on Health (NEAPACOH), and organised by PPD Aro, focused on implementation of regional and international commitments including the International Congress on Population and Development, Program of Action, the Maputo Plan of Action, the Millennium Development Goals (MDGs), and the FP2020 commitments, among others. The meeting provided a platform for building capacity and raising awareness of members of parliament on sustainable development. At the meeting parliamentarians from across the continent assessed progress made, challenges and lessons learned on achieving the country commitments made at its previous 2014 NEAPACOH meeting, built a common understanding of the challenges and opportunities for sexual and reproductive health in the post-2015 development agenda, shared experiences and innovative practices on the implementation of the 2030 Agenda for Sustainable Development, to enhance accountability, political leadership and stewardship for implementation over the coming 12 months. By the end of the meeting, a resolution (The Kampala Call for Action) was adopted by participants, on their commitments to address these issues. ","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Second Annual Paula Kantor Award for Excellence in Field Research","field_subtitle":"Deadline for nominations: 14 October 2016","URL":"http://www.icrw.org/media/icrw-now-soliciting-nominations-second-annual-paula-kantor-award","body":"The International Center for Research on Women (ICRW) is soliciting nominations for the second annual Paula Kantor Award for Excellence in Field Research. The 2016 award will be given to a young female researcher who is a citizen of a sub-Saharan African country in order to recognise and honour outstanding achievement in the fields of gender and empowerment of women and girls. The 2016 Paula Kantor Award for Excellence in Field Research will be conferred to the winner at the launch of ICRW\u2019s Africa Regional Office in December in Kampala, Uganda. Nominations must be made by a third-party. The 2016 award will again be given as part of ICRW\u2019s annual Champions for Change awards, which honours the work of thought-leaders and visionaries. The award will provide the recipient recognition and bring greater visibility to the researcher\u2019s work and to the populations on which they focus. At the awards ceremony, the recipient of the award will have the opportunity to present in front of an esteemed global audience, comprising those in the development, business, NGO, and government sectors, and will receive opportunities to promote their research.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Seven Traditional African Sports that Should Be in the Olympics","field_subtitle":"Robertson E: Okay Africa, August 2016","URL":"http://www.okayafrica.com/news/7-traditional-african-sports-olympics/","body":"The Olympic Games may go back 3,000 years to Ancient Greece, but the international sporting event that takes place every four years didn\u2019t take on its modern form until 1896. And while the games claim to represent global sporting culture, as suggested by the Olympics\u2019 logo, the author argues that many of the sports seem to have uniquely European aristocratic origins. He asks, what would the Olympics in Rio look like if traditional African sports were included? This article discusses seven traditional African sports that would be welcomed additions to the games: including Ngolo and capoeira, Afro-Brazilian and West African martial arts, Senegalese wrestling, donkey racing and Dambe boxing.  ","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The Commonwealth Women Parliamentarians holds a Sub-regional sensitization Workshop in Kigali","field_subtitle":": Parliament of the Republic of Rwanda: Kigali, July 2016","URL":"http://tinyurl.com/j8b6yn7","body":"The Commonwealth Women Parliamentarians (CWP) which is an organ of the Commonwealth Parliamentary Association (Africa Region) held a two day East Africa Sub-Regional sensitization workshop in July 2016. Themed \u201cEstablishing CWP Chapters to Leverage Women Representation and Advocacy,\u201d the CWP sensitization workshop is to encourage all branches to set up CWP Chapters and functional structures and adoption of the guidelines fully and to advocate for policies legislation and programmes that eradicate social, cultural and religious practices that are harmful to the women. Rt. Hon. Mukabalisa said that Rwanda\u2019s achievements in gender  equality and women empowerment have been made possible by the strong political will and the commitment from the highest  level, accompanied by innovative, home-grown  and people centered development approaches. Hon. Angela Thoko Didiza Vice Chairperson of CWP Africa Region and its current Acting Chairperson stated that despite the recognition of women\u2019s rights and need for deliberate action towards the empowerment of women; there remains a marked difference in the status and access of men and women in political, social, economic domains. She confirmed that even where has been progress, there are still challenges in ensuring the full participation of women, \u201censuring gender equality and participation of women in decision-making position is imperative to human development. There is a need to change the traditional roles that limit women\u2019s potential, as well as acknowledge women\u2019s full contribution to social and economic development.\u201d","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The race to UHC \u2013 How Malawi has outperformed most in Africa but risks going off course","field_subtitle":"Yates R: Global Health Check, August 2016","URL":"http://tinyurl.com/zqz95la","body":"Malawi has been the only country in Sub-Saharan Africa to provide universal free health services throughout its public health system and never charge user fees \u2013 with the exception of some recent worrying user fee experiments. Conversely in Nigeria, which only spends 0.9% of its GDP in the form of public health financing and where user fees are charged at all levels, private out-of-pocket health financing accounts for 72% of total health expenditure \u2013 one of the highest rates in the world. Perhaps the most stark illustration of the difference in performance between these two countries at the opposite ends of this curve, is that whereas Nigeria is 8 times richer than Malawi, Nigeria\u2019s child mortality rate (109 deaths per 1000 live births) is 70% higher than Malawi \u2019s (64 deaths). In reviewing these records, the obvious policy recommendation for Nigeria is that it too should increase its public health spending and abolish user fees in its public health system. And for Malawi, the authors argue that the lesson should be to build on this success and use further increases in public financing to improve the availability and quality of free services.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The Use Of Information And Communication Technology, And Social Networking Sites In Political Governance Of East African Legislative Assembly Parliament","field_subtitle":"Robert A; Namusonge G: International Journal of Scientific and Technology Research 4(6), June 2016","URL":"http://tinyurl.com/ha5v327","body":"This research project was carried out to ascertain the use of Information and Communication Technologies (ICT) and Social Networking Sites (SNSs) in political governance of East African Legislative Assembly (EALA) Parliament. It was based on the conviction that in this era of globalisation use of ICTs and SNS\u2018s are fundamentally important and will have tremendous impact on governance, leadership and legislation. The findings showed that that all the parliamentarian respondents were subscribed to social networking sites and used them from time to time. The EALA parliamentarians had a disparity when it came to use of SNSs to interact with constituents, 73% indicated that they have used SNSs to interact with constituents on matters affecting the community from time to time however 27% did not. The use of ICTs and SNSs by EALA was argued by the authors to enable citizens to view Assembly proceedings in real time. The recommend that Parliamentarians in Africa embrace SNS\u2018s as major tools in interacting with and being accountable to their constituents.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Think Again - A film on Women in Energy","field_subtitle":"ECOWAS Centre for Renewable Energy and Energy Efficiency, 4 March 2016","URL":"https://www.youtube.com/watch?v=oo2cRJO3CDY","body":"ECOWAS Centre for Renewable Energy and Energy Efficiency ( ECREEE) presents \u201cThink Again\u201d, a film on women who have made it as leaders in the energy sector in West Africa. The video documentary goes beyond the common understanding of gender and energy issues by replacing the traditional story of women as victims in energy development with stories of women as influential contributors to improving energy access. If you thought women were only end-users of energy, Think Again.\r\n","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Understanding Ebola: the 2014 epidemic","field_subtitle":"Kaner J; Schaak S: Globalization and Health 12(53), 2016, doi: 10.1186/s12992-016-0194-4 ","URL":"http://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-016-0194-4","body":"Near the end of 2013, an outbreak of Zaire ebolavirus (EBOV) began in Guinea, subsequently spreading to neighbouring Liberia and Sierra Leone. As this epidemic grew, important public health questions emerged about how and why this outbreak was so different from previous episodes. This review provides a synthetic synopsis of the 2014\u201315 outbreak, with the aim of understanding its unprecedented spread. The authors present a summary of the history of previous epidemics, describe the structure and genetics of the ebolavirus, and review our current understanding of viral vectors and the latest treatment practices. They conclude with an analysis of the public health challenges epidemic responders faced and some of the lessons that could be applied to future outbreaks of Ebola or other viruses.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"What are the benefits and risks of using return on investment to defend public health programs?","field_subtitle":"Broussellea A; Benmarhniab T; Benhadjc L: Preventive Medicine Reports 3, 135-135, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S2211335516000036","body":"Return on investment (ROI) is an economic measure used to indicate how much economic benefit is derived from a program in relation to its costs. Interest in the use of ROI in public health has grown substantially over recent years. Given its potential influence on resource allocation, it is crucial to understand the benefits and the risks of using ROI to defend public health programs. In this paper, the authors explore those benefits and risks. They present two recent examples of ROI use in public health and conclude with a series of proposals to minimise the risks associated with using ROI to defend public health interventions. ROIs are increasingly being calculated to demonstrate the value of investments and ultimately to reinforce funding. Consequently, they argue that careful reflection is needed on how their use influences allocation decisions, especially given their role as an advocacy tool in the political arena. It is therefore crucial to understand the basics of how ROIs are calculated and to know their limitations and risks, rather than blindly accepting black-box numbers.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Women rise","field_subtitle":"Tay K: Accra dot Alt, Live from the Ghana Space Station, August 2016","URL":"http://tinyurl.com/zzg9psp","body":"A new project \u2018woman, rise\u2019 is a special collaboration project with Ghanaian muralist, Ayambire Faustina Nsoh, who descends from a tradition of women-led painting that carries lessons and messages around ethics and social relations, as well as a practice in space and design making daily life more beautiful. Visually, \u2018woman, rise\u2019, draws on how Nsoh learned how to paint from her grandmother in Sirigu, northern Ghana, and the global activist tradition of political murals, graffiti and stenciling. Horn\u2019s project asks some critical probing by asking these questions: When we dream of African freedom, do we dream in the colours of our grandmothers\u2019 cloths? Do we dream in the voice of young women rallying in a public square for an end to tyranny? And as we dream, do we hear the sound of women spirit mediums fortifying our souls by humming the ancestors into our midst? These women crafters of our liberation- do we know their names? These women who have offered heartbeat and intellect and magic to clear space in the world so all of us can breathe, do we know their faces? \u2018Woman, rise\u2019 explores the spirit of African women\u2019s dynamic contributions to shaping selves, communities and a world that is equal. It invokes the history of African women who have worked against the grain of social expectations and offered their spiritual, intellectual and emotional power to the work of social change.","php":"","field_issue_date":"2016-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A Decade of Biomedical Research in West Africa (2005\u201314): A Bibliometric Analysis of the Ten Most Productive Countries in Medline","field_subtitle":"Nwagwu W: Council for the Development of Social Science Research in Africa, July 2016","URL":"http://codesria.org/spip.php?article2637","body":"This research determined the quantity and quality of publications in biomedical research in top-producing countries in West Africa during 2005\u201314 as well as characteristics of journals and collaborative evidence in the area. Data was drawn from MEDLINE/PubMed and Google Scholar while the impact factors of the journals were retrieved from the SCImago Journal and Country Rank portal. Quantity of publications was measured by counting the number of publications attributable to a country while h-index was extracted to measure quality. Productivity was analysed by sorting the data according to their first named authors, journals and publication dates, and analysed using MS Excel and LOTKA\u00ae. Nigeria, Ghana, Senegal, Burkina Faso and Mali had the highest number of publications. In respect of productivity, apart from C\u00f4te d\u2019Ivoire that had an \u03b1 value less than 2 indicating a higher level of productivity, all other countries had an \u03b1 value greater than 2. West African Journal of Medicine is the only journal of West African origin in the list of top ten journals where the authors from the sub-region published their papers, and it ranked tenth. Nigeria and Ghana published more of their research in local journals in comparison with other countries, but these journals have very low mean impact factors. This study reinforces the need for improved research production and collaboration between the big and small countries.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"A Story in Words and Images from Cassa Banana Informal Settlement, Zimbabwe","field_subtitle":"Kaim B: Training and Research Support Centre (TARSC) Cassa Banana Community Health Committee and Community (CBCHC), August 2016","URL":"http://tinyurl.com/jsxa98y","body":"The Training and Research Support Centre  and Zimbabwe Association of Doctors for Human Rights reported on how Participatory Action Research (PAR) was used in the Cassa Banana community to explore, analyse and take action on priority health problems faced by the community. PAR activities led to the formation of a Community Health Committee (CHC) and the development of a community action plan that prioritised lack of clean water and poor sanitation as the key health problem in the area. The work in Cassa Banana is building a body of knowledge on strategies to support community efforts to take action and on how to hold duty bearers accountable. As part of this process, in October 2015, nine community members were trained as community photographers using a PAR tool called Photovoice. The photographers took hundreds of photographs reflecting the lives and struggles in their community. They then self-edited the photographs to be included it in a 12-page advocacy booklet that described their community. It showcases challenges in the community and the community\u2019s response to it. Some of the questions included are: Has the process of taking and using the photos deepened understanding of underlying conditions at community level? Has it changed relations and/or levels of organizing between community members (both photographers and non-photographers)? And what impact has use of the booklet had in facilitating changes in interactions with duty bearers? Cassa Banana and partners will be reflecting on these questions in the coming months. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Africa\u2019s demographic future: why Africa should take the lead","field_subtitle":"Sankoh O: The Lancet Global Health 4(8), pp.e522-e522, 2016","URL":"http://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(16)30103-6.pdf","body":"In 2010, the UN\u2019s Population Division predicted that the African continent, the population of which is now 1\u00b72 billion, will have 3\u00b75 billion people by the year 2100. By 2015, the projection for the year 2100 had risen to 4\u00b74 billion. In many ways this is good news for Africa\u2014the population increase reflects impressive progress in reducing mortality, especially child mortality, and improving life expectancy. But the response to the news in developed countries has been of concern, often turning into panic. John Bongaarts, vice president of the Population Council, warned that \u201cMost of these people are going to end up in slums. That\u2019s not good news.\u201d Mertule Mariam said: \u201cAlarmingly, population growth in Africa is not slowing as quickly as demographers had expected...the number of Africans seeking a better life in Europe and other richer places is likely to increase several times over\u201d. These reactions have revived discussions in developed countries on what should be done to alleviate the apparent crisis. Policy prescriptions in developed countries focus on family planning services and education of girls. The author argues that these recommendations might be sensible, but if Africans do not take the lead in framing the population discourse, their motivations and needs could be overlooked. New policies must consider African development. An African-led response to population change might begin with efforts to establish the size of the population Africa wants, in the context of broader developmental ambitions. Rather than being dictated by fears in developed countries of mass emigration, conflict, and environmental destruction, such a strategy would be based on the needs of African people. As well as national objectives, a continent-wide perspective on population goals led by the African Union, might be useful. Just as many of the drivers of population change are pan-national (eg, armed conflict, environmental damage, or economic pressures), so are some of its results. In consultation with their people, African Governments will no doubt propose further population policies that are closely tailored to the needs of their societies. What is important, the author poses, is that these objectives and policies are established by Africans.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"China loans Africa much less than you think (and four other lessons from a new database)","field_subtitle":"Benabdallah L; Robertson W; Wang Y: African Arguments, June 2016","URL":"http://tinyurl.com/jjjahql","body":"A detailed new database provides information on Chinese loans to African governments and state-owned enterprises (SOEs). Started in 2007 the database details a total of $86.9 billion of Chinese loans from 2000 to 2014, with the loans verified on the ground or with relevant stakeholders and cross-checked the data in multiple languages. This paper reports five initial lessons that emerge from the endeavour. Media perceptions of Africa-China relations tend to emphasise high sums of money going from China to Africa \u2013 such as reports that $1 trillion in Chinese financing destined for Africa by 2025 \u2013 but the reality appears far more modest. According to the database, China loaned $86.9 billion to African governments and SOEs from 2000 to 2014.  Although the average value of Chinese loans to Africa from 2000-14 may be just $6.2 billion/year, this number has been growing in recent years. While China is sometimes portrayed as only being interested in Africa\u2019s natural riches, the data paints a more complex picture. 28% of Chinese financing goes to transport; 20% to energy; and 8% communication. When China\u2019s engagement in Africa is talked about in the international media, \u201caid\u201d, \u201cloans\u201d, \u201cinvestment\u201d, and \u201cdevelopment finance\u201d are often mixed up or used interchangeably. That means that whenever China offers any money to an African country, it is typically interpreted as a combination of aid and development assistance. The database avoids these conceptual confusions by focusing on loans without trying to define these as either aid or not. It tracks both concessional and commercial lines of credit extended by government, policy, and commercial banks and their corresponding suppliers/contractors. The project shows that using clearly defined categories such as loans can be a much more meaningful and unambiguous approach to understanding the impacts of Chinese money in African countries than many previous methods.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Civil society: the catalyst for ensuring health in the age of sustainable development","field_subtitle":"Smith J; Buse K; Gordon C: Globalization and Health 12(40), 16 July 2016, doi: 10.1186/s12992-016-0178-4","URL":"http://tinyurl.com/j3qcxsj","body":"Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, the authors argue that progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. The authors argue, using illustrative examples, that a robust civil society can fulfil eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalysed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised. Given that civil society activism has catalysed tremendous progress in global health, the authors consider civic engagement as vital to the transformation promised by the SDGs. The authors recognise the need for further research on role of CSOs in health governance at national and global levels. Many of the leading civil society organisations in global health, as well as those providing direct services, are struggling for survival, due to decreased resources. The authors suggest that this trend will have to be reversed if SDG3 is to be achieved. The historic commitment to finance civil society, made in the 2016 UN Political Declaration on Ending AIDS, recognises both the essential functions CSOs fulfil and the need to support them in doing so. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Community health worker programmes after the 2013\u20132016 Ebola outbreak","field_subtitle":"Perry H; Dhillon R; Liu A; Chitnis K; Panjabi R; Palazuelos D; Koffi A; Kandeh J; Camara M; Camara R; Nyenswah T: Bulletin of the World Health Organization 94(7) 551-553, 2016","URL":"http://www.who.int/bulletin/volumes/94/7/15-164020/en/","body":"The 2013\u20132016 Ebola virus disease outbreak in West Africa exposed an urgent need to strengthen health surveillance and health systems in low-income countries, not only to improve the health of populations served by these health systems but also to promote global health security. Chronically fragile and under-resourced health systems enabled the initial outbreak in Guinea to spiral into an epidemic of over 28 616 cases and 11 310 deaths (as of 5 May 2016) in Guinea, Liberia and Sierra Leone, requiring an unprecedented global response that is still ongoing. Control efforts were hindered by gaps in the formal health system and by resistance from the community, fuelled by fear and poor communication. Lessons learnt from this Ebola outbreak have raised the question of how the affected countries, and other low-income countries with similarly weak health systems, can build stronger health systems and surveillance mechanisms to prevent future outbreaks from escalating. Factors that were important in the growth and persistence of the Ebola virus outbreak were lack of trust in the health system at the community level, the spread of misinformation, deeply embedded cultural practices conducive to transmission (e.g. burial customs), inadequate reporting of health events and the public\u2019s lack of access to health services. Community health workers are in a unique position to mitigate these factors through surveillance for danger signs and mobilisation of communities when an outbreak has been identified. In this paper the authors make the case for investing in robust national community health worker programmes as one of the strategies for improving global health security, for preventing future catastrophic infectious disease outbreaks and for strengthening health systems.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Corporations and Human Rights Database ","field_subtitle":"Corporations and Human Rights Global, 2016","URL":"http://www.chrdproject.com","body":"Businesses are often implicated in human rights violations. Yet the patterns behind claims of corporate human rights abuses and the pursuit of justice and remedy associated with those claims remain unstudied and thus unknown. Who makes claims about corporate human rights abuse? How do companies respond? And, what explains why some claims are addressed and others are not? To address some of these gaps, the CHRD team is currently creating a database of claims of corporate human rights abuses from 2000 through today. The database intends to inform practitioners, policymakers, and academics alike and the data will be made readily available. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Council for the Development of Social Science Research in Africa (CODESRIA) Vacancy Announcement: Executive Secretary","field_subtitle":"Deadline: 15th September 2016","URL":"http://www.codesria.org/spip.php?article2629&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites applications from suitably qualified senior African scholars for the position of Executive Secretary in its pan-African Secretariat located in Dakar, Senegal. This position, which will fall vacant in 2017, is the most senior management post in the Executive Secretariat and the successful candidate will be expected to function as the leader of the institution and a diverse team of staff under the overall supervision of the Executive Committee of the Council. Established in 1973 as a pioneering, independent, pan-African and not-for-profit organisation for the development of social research in Africa, CODESRIA is today widely recognised as the premier institution on the continent for the generation and dissemination of multidisciplinary research knowledge in the social sciences and humanities. The position of Executive Secretary is a key one both in the development of the programme mandate of the Council and the realisation of the strategic institutional objectives set by the triennial General Assembly of its members. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Developing the African national health research systems barometer","field_subtitle":"Kirigia J; Ota M; Senkubuge F; Wiysonge C; Mayosi B: Health Research Policy and Systems, 14(53), July 2016, doi: 10.1186/s12961-016-0121-4","URL":"http://tinyurl.com/j9nxps3","body":"A functional national health research system (NHRS) is crucial in strengthening a country\u2019s health system to promote, restore and maintain the health status of its population. Progress towards the goal of universal health coverage in the post-2015 sustainable development agenda will be difficult for African countries without strengthening of their NHRS to yield the required evidence for decision-making. This study developed a barometer to facilitate monitoring of the development and performance of NHRSs in WHOs African Region. The African national health research systems barometer algorithm was developed in response to a recommendation of the African Advisory Committee for Health Research and Development of WHO. Survey data collected from all the 47 Member States in the WHO African Region using a questionnaire were entered into an Excel spreadsheet and analysed. The barometer scores for each country were calculated and the performance interpreted according to a set of values ranging from 0% to 100%. The overall NHRS barometer score for the African Region was 42%, which is below the average of 50%. Among the 47 countries, the average NHRS performance was less than 20% in 10 countries, 20\u201340% in 11 countries, 41\u201360% in 16 countries, 61\u201380% in nine countries, and over 80% in one country. The performance of NHRSs in 30 (64%) countries was below 50%. An African NHRS barometer with four functions and 17 sub-functions was developed to identify the gaps in and facilitate monitoring of NHRS development and performance. The NHRS scores for the individual sub-functions can guide policymakers to locate sources of poor performance and to design interventions to address them.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"e-Learning Course on Health Financing Policy for universal health coverage (UHC)","field_subtitle":"Closing date: 30th September 2016","URL":"http://tinyurl.com/jzcudon","body":"WHO's new e-learning course on health financing policy for UHC has now been launched. This e-learning course comprises six modules which cover the core functions of health financial policy as conceptualised by WHO. Each module is divided into a number of sub-topics. This is a foundational course which targets participants of various levels of experience and expertise. The course is designed to be used in a variety of ways: as preparation for those who will attend a WHO face-to-face course, for those who are for various reasons unable to attend a face-to-face course, and for those who have already attended courses and wish to refresh their knowledge. Individual modules can also be used as part of a programme of blended capacity building. The course is also designed to work seamlessly on a range of devices, operating systems, and browser in a responsive fashion, in order to maximise ease of use. Module 1 provides an overview of the goals of universal health coverage, health financing and what UHC brings to health financing policy. The following modules cover revenue raising, pooling revenues, purchasing and benefit package design. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 186: Will the new global health emergency funds secure or securitise health?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Facing up to the world\u2019s critical health crises","field_subtitle":"Khor M: Third World Network Info Service on UN Sustainable Development, 2016","URL":"http://www.twn.my/title2/unsd/2016/unsd160601.htm","body":"The global health situation is facing many critical challenges, and multiple actions must be taken urgently to prevent crises from boiling over. This paper reflects on the 2016 World Health Assembly (WHA) as the world\u2019s prime public health event, attended by 3,500 delegates, including Health Ministers from most of the 194 countries.World Health Organisation director-general Dr Margaret Chan gave an overview of what went right and what is missing in global health. 19,000 fewer children dying every day, a 44% drop in maternal mortality, the 85% cure rate for tuberculosis, and 15 million people living with HIV now receiving therapy, up from just 690,000 in 2000. Chan also described how health has become a globalised problem, with air pollution becoming a transboundary health hazard, and drug-resistant pathogens being spread through travel and food trade. The recent Ebola and Zika outbreaks showed how global health emergencies can quickly develop. The world is not prepared to cope with the dramatic resurgence of emerging and re-emerging infectious diseases. Chan said the global health landscape is being shaped by three slow-motion disasters: climate change, antimicrobial resistance and the rise of chronic non-communicable diseases. The assembly agreed that the WHO set up a new Health Emergencies Programme to enable it to give rapid support to countries and communities to prepare for, face or recover from emergencies caused by health hazards including disease outbreaks, disasters and conflicts. On anti-microbial resistance, many developing countries stressed the importance of funds and technology to help them develop national action plans by 2017. The WHA called on the WHO to develop an implementation plan and urged governments to develop national policies on marketing unhealthy foods to children. Two environment-related health issues were discussed. Air pollution accounts for eight million deaths worldwide annually \u2013 4.3 million due to indoor and 3.7 million to outdoor air pollution. The assembly welcomed a new WHO road map for actions in 2016-19 to tackle the health effects of air pollution. A controversial issue is how the WHO should relate to \u201cnon-state actors\u201d. After two years of negotiations, the WHA adopted the Framework of Engagement with Non-State Actors (FENSA), which provides the WHO with policies and procedures on engaging with non-governmental organisations, private sector entities, philanthropic foundations and academic institutions.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"For sexual minorities, \u201cclosing space\u201d for civil society means losing access to critical services","field_subtitle":"Mbote D: Pambazuka News, July 2016","URL":"http://tinyurl.com/jge8z7y","body":"Closing space for African sexual and gender minority groups is argued by this author to affect access to critical services that no one else provides. In Kenya, for example, the Muslims of Human Rights (MUHURI) provide safe injection sites to prevent the sharing of needles among drug users, as studies show that needle sharing facilitates the spread of HIV. As a result, when the state froze the group's bank accounts, the crackdown also threatened the safety and wellbeing of people who need HIV treatment and care. To fight on their own, many GSM groups have been using the courts to help win victories. Whether it has been appealing the repressive Ugandan anti-gay law, or ordering the un-freezing of bank accounts in Kenya, or ruling against the denial of registration of LEGABIBO (an LGBT rights group in Botswana), most of these court victories are based on constitutionally guaranteed rights and freedoms of most open and democratic countries, and held under the International Declaration of Human Rights.  Fostering partnerships with international organizations such as UNAIDS and the UN Human Rights Council has been very helpful for GSM organizations to facilitate their role in service access. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Fourth Global Symposium on Health Systems Research","field_subtitle":"14-18 November 2016, Vancouver, Canada","URL":"http://tinyurl.com/qfof3jo","body":"The Fourth Global Symposium on Health Systems Research will be held in Vancouver at the Vancouver Convention Centre. The theme for 2016 is \u201cResilient and responsive health systems for a changing world\u201d. The Global Symposium on Health Systems Research is hosted every two years by HSG to bring together its members with the full range of players involved in health systems and policy research. There is currently no other international gathering that serves the needs of this community. The Symposium aims to share new state-of-the-art evidence; review the progress and challenges towards implementation of the global agenda of priority research; identify and discuss the approaches to strengthen the scientific rigour of health systems research including concepts, frameworks, measures and methods; and facilitate greater research collaboration and learning communities across disciplines, sectors, initiatives and countries. Participants will include researchers, policy-makers, funders, implementers, civil society and other stakeholders from relevant national and regional associations and professional organisations. The program will include plenary addresses from world experts, as many as 12-15 concurrent sessions made up from abstracts and other proposals, an estimated 600 poster presentations, a vibrant marketplace and many other networking opportunities. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Gendered Navigations: Women in Mining","field_subtitle":"Benya A: Review of African Political Economy, August 2016","URL":"http://roape.net/2016/08/09/gendered-navigations-women-mining/","body":"In reflections on her fieldwork in South Africa, Asanda Benya writes about the difficulties and insights she gained while researching underground female mine-workers. Through immersive anthropological research she examined how women make sense of themselves against the masculine underground and mining culture. Some women often remarked that they were \u201cmen at work, and women at home\u201d. They admitted to changing how they behaved in the multiple spaces they navigated. It is these shifts in women\u2019s gender performances and identities that the study explored. To get at these gender performances and gendered identities she spent almost a year working underground as a winch operator, and a general labourer, pulling blasted rock from the stope face to the tip. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Helpdesk report: Comparative advantage of the private sector in delivery of health services","field_subtitle":"Browne E: Health and Education Advice and Resource Team, June 2016","URL":"http://tinyurl.com/juvljz9","body":"This report explores evidence on the private sector in delivery of health care services for public health goals particularly in the areas of MNCH and SRH. It finds that there is a considerable body of evidence on the private provision of healthcare in low- and middle-income countries, often focusing on SSA, but that the evidence base is not robust. The arguments in favour of private healthcare suggest it is more responsive and efficient, while arguments in favour of public services suggest they are more equitable and better equipped than the market to respond to health needs. Some studies find that the private sector is unregulated, has financial incentives for inappropriate healthcare, and is expensive. There is very little evidence on the comparative cost-effectiveness of the private sector. This varies considerably across country contexts and types of services. There is no conclusive evidence that the private sector is more cost-effective or more efficient than the public sector. The literature warns that increased use of private services may crowd out or decrease the funding available to the public sector. The major criticism of private sector services is that their higher user fees create inequality of access, limiting their use by the poor. The literature is quite clear that private for-profit health services create inequality. Private non-profit, or services run by NGOs, appear to mitigate some of the inequality effects. In practice, boundaries can be blurred between public and private; both formal and informal cost recovery schemes operate at public facilities. NGOs providing healthcare are generally seen as private, although they may not charge for their services. The difference between free-at-the-point-of-use NGOs and out-of-pocket-expenditure on private doctors can be enormous, and it is important to differentiate between the types of providers when reviewing the evidence on private services. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda","field_subtitle":"Ware N; Wyatt M; Asiimwe S; Turyamureeba B; Tumwesigye E; van Rooyen H; Barnabas R; Celum C: Journal of the International AIDS Society 19(20929), 2016","URL":"http://www.jiasociety.org/index.php/jias/article/view/20929/html","body":"The successes of HIV treatment scale-up and the availability of new prevention tools have raised hopes that the epidemic can finally be controlled and ended. Reduction in HIV incidence and control of the epidemic requires high testing rates at population levels, followed by linkage to treatment or prevention. As effective linkage strategies are identified, it becomes important to understand how these strategies work. The authors use qualitative data from The Linkages Study, a recent community intervention trial of community-based testing with linkage interventions in sub-Saharan Africa, to show how lay counselor home HIV testing and counselling (home HTC) with follow-up support leads to linkage to clinic-based HIV treatment and medical male circumcision services. They conducted 99 semi-structured individual interviews with study participants and three focus groups with 16 lay counselors in Kabwohe, Sheema District, Uganda. The participant sample included both HIV+ men and women (N=47) and HIV-uncircumcised men (N=52). Interview and focus group audio-recordings were translated and transcribed. The transcripts were  analysed to identify emergent themes. Trial participants expressed interest in linking to clinic-based services at testing, but faced obstacles that eroded their initial enthusiasm. Follow-up support by lay counselors intervened to restore interest and inspire action. Together, home HTC and follow-up support improved morale, created a desire to reciprocate, and provided reassurance that services were trustworthy. In different ways, these functions built links to the health service system. They worked to strengthen individuals\u2019 general sense of capability, while making the idea of accessing services more manageable and familiar, thus reducing linkage barriers. Home HTC with follow-up support leads to linkage by building \u201csocial bridges,\u201d,  viz: interpersonal connections established and developed through repeated face-to-face contact between counselors and prospective users of HIV treatment and male circumcision services. Social bridges are found to link communities to the service system, inspiring individuals to overcome obstacles and access care.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Knowledge, opinions and practices of healthcare workers related to infant feeding in the context of HIV","field_subtitle":"Janse van Rensburg L; Nel R;  Walsh C: Health SA Gesondheid 21, 129-136, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S1025984815000368","body":"This study aimed to determine the knowledge, opinions and practices of healthcare workers in maternity wards in a regional hospital in Bloemfontein, Free State Province, South Africa, regarding infant feeding in the context of HIV. For this descriptive cross-sectional study, all the healthcare workers in the maternity wards of Pelonomi Regional Hospital who voluntarily gave their consent during the scheduled meetings (n = 64), were enrolled and given self-administered questionnaires. Only 14% of the respondents considered themselves to be experts in HIV and infant feeding. Approximately 97% felt that breastfeeding was an excellent feeding choice provided proper guidelines were followed. However, 10% indicated that formula feeding is the safest feeding option. 45% stated that heat-treated breast milk is a good infant feeding option; however, 29% considered it a good infant feeding option but it requires too much work. Only 6% could comprehensively explain the term \u201cexclusive breastfeeding\u201d as per World Health Organisation (WHO) definition. Confusion existed regarding the period for which an infant could be breastfed according to the newest WHO guidelines, with only 26% providing the correct answer. Twenty per cent reported that no risk exists for HIV transmission via breastfeeding if all the necessary guidelines are followed. Healthcare workers' knowledge did not conform favourably with the current WHO guidelines, even though these healthcare workers were actively involved in the care of patients in the maternity wards where HIV-infected mothers regularly seek counselling on infant feeding matters.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Making aid and domestic public finance work for Africa and its people","field_subtitle":"Chagutah T: Pambazuka News, June 2016","URL":"http://tinyurl.com/grl5ema","body":"The author argues that the key to sustainable, adequate and predictable financing of Africa\u2019s development no longer lies in the delivery of aid from traditional donors but largely in unlocking the domestic resource potential, so that the continent can harness more of its own revenue for development. Africa\u2019s much celebrated growth over the last two decades has benefited in large part from public revenues derived from the sale of natural resources. While the tax base remains narrow, and tax compliance levels low on the continent, revenues from tax collection continue to increase, rising from USD 259.3 billion in 2005 to USD 527.3 billion in 2012. A 2013 study by NEPAD and UNECA shows that the fundamentals and resource potential exist for the continent to raise more financial resources domestically to implement its development programmes and finance its own institutions. At the same time, South-South Cooperation in Africa is increasing, with more public finances being channelled from emerging economies to Africa via various bilateral and multi-lateral arrangements. In contrast, there is clear evidence that Official Development Assistance (ODA) from traditional donors is dwindling \u2013 falling from 38% as a proportion of all external financial flows to Africa in 2000 to 27% in 2014. Africa\u2019s reliance on aid and the sale of natural resources, as opposed to broad-based tax collection, for example, is argued to have distorted accountability over public expenditure, with governments incentivised to meet the needs of the extractive and commodity private sector corporations and the priorities of external funders, as opposed to those of their citizens. The author suggests that aid will achieve its best outcomes when it is used in ways that complement and bolster domestic financing, support other financing mechanisms and help African countries to better manage revenues for their citizens\u2019 development.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Managing the public-private mix to achieve universal health coverage","field_subtitle":"Hanson K; McPake B: The Lancet, June 2016, doi: http://dx.doi.org/10.1016/S0140-6736(16)00344-5","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)00344-5.pdf","body":"The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. This paper draws and extrapolates main messages from the papers in the Lancet series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, the authors explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Medicine and the Arts: Humanising Healthcare","field_subtitle":"Free online course, University of Cape Town, starting 29 August 2016","URL":"http://tinyurl.com/zoxu3hf","body":"This free online course will explore the intersection of medicine, medical anthropology and the creative arts. Through each of its six weeks, participants visit a new aspect of human life and consider it from the perspectives of people working in health sciences, social sciences and the arts. The course will introduce participants to the emerging field of medical humanities and the concept of whole person care, via these six themes: The Heart of the Matter: A Matter of the Heart, Children\u2019s Voices and Healing, Mind, Art and Play, Reproduction and Innovation, Tracing Origins, Death and the Corpse. Participants will question the propensity to separate the body from the mind in healthcare, consider what defines humanity, and share points of connection and difference between art and medicine. Contributors to the course will include a psychologist, heart surgeon, pathologist, oncologist, geneticist, sociologist, poet and visual artist. They will pose critical questions about how we deal with health, healing and being human. Each has been filmed on location in Cape Town, including at the Red Cross War Memorial Children\u2019s Hospital, the Heart of Cape Town Museum, and the Pathology Learning Centre.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"New report exposes impact of Uganda\u2019s abortion law through personal stories","field_subtitle":"Centre for Health, Human Rights and Development: Blog, July 2016","URL":"http://tinyurl.com/zhkqqww","body":"This new report by the Center for Health, Human Rights and Development (CEHURD). \u201cFacing Uganda\u2019s Law on Abortion: Experiences from Women and Service Providers\u201d raises that an unclear abortion law in Uganda means that women and adolescents seek unsafe abortions and are vilified by their families and communities, with doctors and health workers who provide legal post-abortion care being arrested. This report highlights experiences and perspectives of individuals who have been affected by or have dealt with abortion. It includes interviews with women and girls who ended pregnancies, as well as doctors, nurses, health worker, lawyers, police and community members. Abortion in Uganda is legal in limited circumstances, yet approximately 85,000 women each year receive treatment for complications from unsafe abortion and an additional 65,000 women experience complications but do not seek medical treatment.  The CEHURD report also draws on a research report by the Center for Reproductive Rights in 2012 on Uganda\u2019s laws and policies on termination of pregnancy that found that the laws and policies are more expansive than most believe, and that Uganda has ample opportunity to increase access to safe abortion services.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Outcomes and costs of implementing a community-based intervention for hypertension in an urban slum in Kenya","field_subtitle":"Oji Oti S; van de Vijver S; Gomez G; Agyemang C; Egondi T; Kyobutungi C; Stronks K: Bulletin of the World Health Organization 94(7) 501-509, 2016","URL":"http://www.who.int/bulletin/volumes/94/7/15-156513/en/","body":"Cardiovascular diseases are the leading cause of death globally, killing 17.5 million people per year and 80% of deaths from these diseases occur in low- and middle-income countries. Evidence suggests that the main drivers of the global cardiovascular disease epidemic are urbanisation and industrialisation, which lead to an increase in sedentary lifestyles, unhealthy dietary patterns, tobacco consumption and increased alcohol consumption. Hypertension is a leading risk factor for cardiovascular diseases, and its prevalence is increasing worldwide \u2013 from 25% in 2000 to a projected 40% in 2025. The rising burden of hypertension in low- and middle-income countries is amplified by the public\u2019s low levels of awareness, treatment and control of this condition, particularly among slum residents, who typically constitute a large portion of neglected urban populations in such settings. Studies in slum populations suggest that when people are made aware of having hypertension they do tend to seek care. However, the level of adherence to treatment for hypertension remains low for several reasons, including, but not limited to, the high costs of treatment and to patients\u2019 perceptions of a low risk of cardiovascular diseases and belief in a one-time cure for disease rather than to lifelong preventive treatment and monitoring. In response to the rising burden of cardiovascular disease risk factors in slum populations in Kenya, a community-based intervention was developed and implemented in the capital city, Nairobi. This intervention, known as SCALE UP (the sustainable model for cardiovascular health by adjusting lifestyle and treatment with economic perspective in settings of urban poverty), has been described in detail elsewhere. The intervention had multiple components with the overall aim of reducing cardiovascular diseases risk through awareness campaigns, improvements in access to screening and standardised clinical management of hypertension. This paper shares experiences of implementing a comprehensive intervention for primary prevention of hypertension in a slum setting and to examine the processes, outcomes and costs of the intervention. It raises lessons for policy-makers and other stakeholders looking to implement similar interventions in highly resource-constrained settings.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Performance of private sector health care: implications for universal health coverage","field_subtitle":"Morgan R; Ensor T; Waters H: The Lancet, June 2016, doi: http://dx.doi.org/10.1016/S0140-6736(16)00343-3","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30242-2.pdf","body":"Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers\u2014including their size, objectives, and technical competence\u2014the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"PhD-fellowships within the research program \u201cWest and Central African partnership for Health Policy and Systems strengthening to support Maternal, New born, Child and Adolescent Health\u201d","field_subtitle":"Closing date: 30th September 2016","URL":"http://www.hst.org.za/jobs/phd-research-fellowship","body":"High rates of maternal death and teen pregnancy persist in West and Central Africa.  Research and programming efforts are not sustainably reducing these rates. The challenge is how to link the evidence on useful health interventions with evidence on how to effectively deliver the interventions within the health systems of West and Central Africa.   This project aims to build the foundation for delivering better maternal, new born, child and adolescent health care by addressing this gap and enhancing the capacity of researchers and leaders. As part of the South-South collaborative approach the program is partnering with consortiums led from the University of Cape Town and the University of the Western Cape in South Africa and is offering PhD fellowships within the programme, including using mixed qualitative and quantitative methods for building explanations for what mechanisms underpinned the outcomes observed as a result of the program through the doctoral level training of young researchers from Anglophone and Francophone countries and institutions in the sub-region. The PhD fellows /researchers in Maternal, New born, Child and Adolescent health and Health Policy and Systems research will develop their thesis projects as sub-projects of the larger monitoring and evaluation.  Participation in the project is a full time commitment for four years.   The successful fellow will be based in the project office, which is currently located in the Dodowa Health Research Centre of the Ghana Health Service. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Podcast: Sustainable funding for Africa\u2019s cities","field_subtitle":"African Research Institute, July 2016","URL":"http://www.urbanafrica.net/urban-voices/sustainable-funding-for-africas-cities/","body":"Governments are being overwhelmed by the rapid growth of Africa\u2019s cities. Strategic planning has been insufficient and the provision of basic services is worsening. Since the 1990s, widespread devolution has substantially shifted responsibility for coping with urbanisation to local authorities, yet municipal governments across Africa receive a paltry share of national income with which to discharge their responsibilities. Responsible city authorities are examining how to improve revenue generation and diversify their sources of finance. Following the creation of a sustainable development goal for cities (SDG 11), and ahead of the Habitat III summit in October 2016, this Africa Research Institute event examined some of the financing options and the urgent need for a proactive approach on the part of national and municipal governments. The speakers in the podcast include, Professor Susan Parnell Department of Environmental and Geographical Sciences, Jeremy Gorelick, Lead technical adviser, Dakar Municipal Finance Program and Dr Beacon Mbiba, Senior Lecturer, Urban Policy and International Development.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Post Graduate Diploma in Public Health","field_subtitle":"Applications close: 30th September 2016","URL":"http://tinyurl.com/z3aechy","body":"This post graduate diploma in Public Health aims to strengthen the ability of middle managers to manage various programs and strengthen the health system as a whole as a bridge into the Master of Public Health. It aims to equip graduates with the critical knowledge skills to be able to engage in reflection on public health practices for eg. Health system, health service management, service delivery and critically analyse existing data sources to be able to engage in operational research, plan, implement, monitor and evaluate programs. Graduates will be provided with the skill and expertise to manage the health system and health programmes at district, provincial and national levels. The following learning outcomes are expected of the student: to have gained an understanding of the key components of public health and its application to the relevant context and apply the necessary principles within the local context; to be able to measure at a descriptive level health and management indicators such that they may be analyse the relevant program outputs; to have an insight on the organisation of services and programs to be able to optimise and better manage the relevant programs; to be able to identify challenges within the health system and programs so that they may be able to generate workable solutions to local; to be able to plan, implement, monitor and evaluate public service interventions that results in action planning and optimal use of resources. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children","field_subtitle":"Kraak V; Vandevijvere S; Sacks G;Brinsden H; Hawkes C; Barquera S; Lobsteind T; Swinburn B: Bulletin of the World Health Organization 94(7), 540-548, 2016 ","URL":"http://www.who.int/bulletin/volumes/94/7/15-158667.pdf","body":"In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. The authors examined the actions taken between 2010 and early 2016 \u2013 by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organisations, philanthropic institutions and transnational industries \u2013 to help decrease the prevalence of obesity and diet-related non-communicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organisations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors the authors investigated appears variable and generally less robust. The authors suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from non-communicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Realising the Right to Health in the WHO African Region: Issues, Challenges and the Way Forward","field_subtitle":"Motari M; Kirigia JM: Health Systems and Policy Research 3(2), 2016","URL":"http://tinyurl.com/hzcstte","body":"The right to health has been enshrined in a number of core international and regional human rights treaties, to which WHO African Region Member States are signatories. This therefore imposes an obligation on them to make every possible effort using available resources to respect, protect, fulfil and promote the right to health of their citizens. This study analysed key issues and challenges affecting the realisation of the right to health in African countries. A survey questionnaire was sent by email to the then 46 Member States in the African Region through the WHO Country Representatives, and explored legal, policy and institutional aspects that affect the realisation of the right to health and the main health related human rights issues, and challenges in implementing the right to health. Twenty-five (54%) countries responded. The main findings were that all countries were signatories to at least one human rights treaty that recognises the right to health; all countries had national legislation touching on aspects of the right to health but only 12 countries (48%) had policies or strategies for mainstreaming human rights in healthcare. On issues affecting the realisation of the right to health: 88% identified access to health care services, medical products, and technologies; 52% identified inadequate financing for health; 28% cited marginalisation, stigma and discrimination of some groups and communities; and 24% cited gender-related inequities and violations. Lack of awareness of the right by the general population and health workers was cited by 52% of the respondents. A lot remains to be done towards the realisation of the right to health in the African Region. Member States are encouraged to review their legislation and policies to assess their consistency with human rights standards, and put in place institutional mechanisms and adequate resources that will ensure their implementation, enforcement and monitoring. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Sad passing of Dr TJ Ngulube, Zambia","field_subtitle":"","body":"EQUINET is saddened by the news of the passing of Doctor TJ Ngulube, a long-time colleague in EQUINET, director of the Center For Health Science and Social Science Research in Zambia and significant contributor to  EQUINETs early work on social participation in health, on parliamentary roles and equitable health systems. Colleagues in EQUINET have noted memories of TJ\u2019s warmth, wisdom and friendship; his leadership and his consistent contribution to work in the region. We send sympathies to his family and colleagues and are the poorer for his passing. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Skills building on methods and tools for learning from action in participatory action research: Building action learning within affected actors and communities for resilient and responsive health systems","field_subtitle":"Tuesday 15 November 2016 8:30am\u201312pm Convention Centre, Health System Global, Vancouver, Canada","body":"This participatory skills session convened under the umbrella of the pra4equity network is being held at the Heath System Global Conference. In the session we will discusses methods and tools to build learning from action  as a key element of participatory action research, directly engaging affected communities to build responsive health systems.  The session draws on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. From prior global symposia, methods for learning from action were identified as weak in PAR practice. This session seeks to address this gap. It is targeted at researchers and practitioners. It uses methods resources and group discussions of case studies from health managers, policy actors, civil society and researchers in low and middle income countries to discuss the participatory processes and methods for learning from action at different levels, and the issues in applying and institutionalising these methods. We will also review what these participatory efforts to transform and build knowledge on health systems implies for the understanding of \u2018resilience\u2019.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Southern Africa: Food Insecurity - 2015-2016","field_subtitle":"ReliefWeb, June 2016","URL":"http://reliefweb.int/disaster/dr-2015-000137-mwi","body":"Indications of significant food supply shortages are likely to impact on the next marketing season. The rains experienced in late March and early April provided some relief to livestock farmers, but arrived too late for both staple foods and cash crops. These adverse weather conditions are likely to reduce crop production in southern Angola, Namibia, Botswana, Zimbabwe, Lesotho, Malawi, Madagascar and South Africa. The negative impact of flooding will also affect food security in Malawi, Madagascar and Mozambique. Nearly 29 million people are currently food insecure in southern Africa region mainly due to the carry-over effects of the past poor harvest season combined with other structural factors. Unless a two-track approach is quickly taken to address the current food insecurity and to establish measures to mitigate against the El Ni\u00f1o effects, the existing food insecurity will deepen and increase in scope with its effects will last till 2017. In July, Southern African Development Community (SADC) launched the Regional Appeal seeking US$2.7 billion. ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The HIV and AIDS Tribunal of Kenya: An Effective Mechanism for the Enforcement of HIV-related Human Rights?","field_subtitle":"Eba P: Health and Human Rights Journal 18(1), 2016","URL":"http://tinyurl.com/hjefgzg","body":"Established under Section 25 of the HIV Prevention and Control Act of 2006, the HIV and AIDS Tribunal of Kenya is the only HIV-specific statutory body in the world with the mandate to adjudicate cases relating to violations of HIV-related human rights. Yet, very limited research has been done on this tribunal. Based on findings from a desk research and semi-structured interviews of key informants conducted in Kenya, this article analyses the composition, mandate, procedures, practice, and cases of the tribunal with the aim to appreciate its contribution to the advancement of human rights in the context of HIV. It concludes that, after a sluggish start, the HIV and AIDS Tribunal of Kenya is now keeping its promise to advance the human rights of people living with and affected by HIV in Kenya, notably through addressing barriers to access to justice, swift ruling, and purposeful application of the law. The article, however, highlights various challenges still affecting the tribunal and its effectiveness, and cautions about the replication of this model in other jurisdictions without a full appraisal.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Need for Global Application of the Accountability for Reasonableness Approach to Support Sustainable Outcomes; Comment on \u201cExpanded HTA: Enhancing Fairness and Legitimacy","field_subtitle":"Byskov J; Maluka S; Marchal B; et al.: International Journal of Health and Policy Management, 5(x), 1-4, 2016","URL":"http://www.ijhpm.com/article_3252_f14a5cd0ccc3301ad179acbcc7635c45.pdf","body":"The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. Its potential use in health technology assessments (HTAs) has recently been identified another justification for AFR-based process guidance, but it has also raised concerns from those who primarily support the consistency and objectivity of more quantitative and reproducible evidence. With reference to studies of AFR-based interventions, the authors argue that increasing evidence and technical expertise are necessary but at times contradictory and do not in isolation lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. They suggest that legitimacy, accountability and fairness do not come about without an inclusive and agreed process guidance that can reconcile differences of opinion and differences in evidence to arrive at a decision.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The prevalence of self-reported vision difficulty in economically disadvantaged regions of South Africa","field_subtitle":"Naidoo K; Jaggernath J; Ramson P; Chinanayi F; Zhuwau T; \u00d8verland L: African Journal of Disability 4(1) 2015","URL":"http://www.ajod.org/index.php/ajod/article/view/136/346","body":"Vision impairment is a leading cause of disability, and a barriers to access education and employment, which may force people into poverty. This study determined the prevalence of self-reported vision difficulties as an indicator of vision impairment in economically disadvantaged regions in South Africa, and to examine the relationship between self-reported vision difficulties and socio-economic markers of poverty, namely, income, education and health service needs. A cross-sectional study was conducted in 27 economically disadvantaged districts (74901 respondents) to collect data from households on poverty and health, including vision difficulty. As visual acuity measurements were not conducted, the researchers used the term vision difficulty as an indicator of vision impairment. The prevalence of self-reported vision difficulty was 11.2%. More women (12.7%) compared to men (9.5%) self-reported vision difficulty (p < 0.01). Self-reported vision difficulty was higher (14.2%) for respondents that do not spend any money. A statistically significant relationship was found between the highest level of education and self-reporting of vision difficulty; as completed highest level of education increased, self-reporting of vision difficulty became lower (p < 0.01). A significantly higher prevalence of self-reported vision difficulty was found in respondents who are employed (p < 0.01). The evidence from this study suggests associations between socio-economic factors and vision difficulties that have a two-fold relationship (some factors such as education, and access to eye health services are associated with vision difficulty whilst vision difficulty may trap people in their current poverty or deepen their poverty status). ","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The retreat of neoliberalism","field_subtitle":"Gumede W: Pambazuka News, 21 July 2016","URL":"http://www.pambazuka.org/economics/retreat-neoliberalism","body":"An internal IMF report admitting the destructive nature of neoliberalism may have come too late for many African countries. The neoliberal structural adjustment programs have led to economic hardships, political instability and conflicts in most African countries where they have been implemented. The report makes three devastating conclusions: One, that the neoliberal reform program has not delivered increased economic growth. Secondly, neoliberal reforms have increased inequality. And thirdly, the increased inequality caused by neoliberal reforms has in turn undermined the level and sustainability of economic growth. The report states that the removal of barriers to capital flows, or financial openness, has often resulted in short-term speculative, so-called \u201chot\u201d inflows, in developing countries. However, such speculative capital inflows to African countries are often quickly withdrawn by industrial country investors as they seek better returns elsewhere, destabilising African economies which were initial recipients of such \u201chot\u201d inflows. Such speculative inflows neither boost growth nor allow the African country to share the costs of such destabilisation with the industrial countries from which speculators originate. The authors conclude that there was an increased \u201cacceptance of controls to limit short-term debt flows that are viewed as likely to lead to \u2013 or compound \u2013 a financial crisis\u201d. They argue that while exchange rates and financial policies could help to alleviate risks of increased financial instability, \u201ccapital controls are a viable, and sometimes the only, option when the source of an unsustainable credit boom is direct borrowing from abroad\u201d. The report says that although high public debt is detrimental to growth and welfare, it would be better for African and developing countries to pay off their public debt over a longer time, rather than cut current productive spending needs. To lower public debt, proponents of neoliberal reforms have proposed that taxes should be raised or public spending cut, or both. If African countries do not come up with quality policies, or if they have them, but the policies are captured by corrupt elements, or half-heartedly implemented, or not implemented at all, they won\u2019t be able to take advantage of the seeming retreat of the four-decade long globally dominant \u201cneoliberalism\u201d.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Trends and challenges toward integration of traditional medicine in formal health-care system: Historical perspectives and appraisal of education curricula in Sub-Sahara Africa","field_subtitle":"Innocent E: Journal of Intercultural Ethnopharmacology, 2016, doi: 10.5455/jice.20160421125217","URL":"http://www.scopemed.org/fulltextpdf.php?mno=220532","body":"Sub-Saharan Africa (SSA) communities suffer a disease burden that is aggravated by shortage of medical personnel and medical supplies such as medical devices. This paper outlines how for a long time, observation and practical experiences meant that people learned to use different plant species that led to the emergence of traditional medicine (TM) systems. The ancient Pharaonic Egyptian TM system is for example, said to be one of the oldest documented forms of TM practice in Africa and a pioneer of world\u2019s medical science. These medical practices diffused to other continents and were accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health-care system. The author raises issues that drag back integration, such as the lack of development of education curricula for training TM experts as the way of disseminating the traditional medical knowledge and practices. A few African countries such as Ghana have managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone, and Tanzania have TM products being sold over the counters due to the availability of education training programs. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should take in the integration process to safeguard the SSA population from disease burdens.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Will the new global health emergency funds secure or securitise health?","field_subtitle":"Garrett Wallace Brown, Olivia Wills, University of Sheffield, Rene Loewenson, TARSC","body":"\r\nWhen leaders at the 2015 G7 summit called the 2014 Ebola epidemic  \u2018a wake-up call for all of us\u2019 they acknowledged that the global response had been too slow, with inadequate health leadership, coordination and emergency funding.   At the same time, as argued in the May 2016 editorial in the newsletter, emergency responses cannot be delinked from the strength and authority of health systems to prevent, detect and respond to emerging public health threats, nor to their power to engage sectors on their role in the economic, social, environmental, trade and other determinants of these threats. Shortfalls in public health capacities, including those set in the 2005 International Health Regulations (IHRs) are a warning sign of future outbreaks, often due to neglected diseases or public health risks that get inadequate attention or resources until they trigger large-scale and highly expensive outbreaks. \r\n\r\nThe two new global financing mechanisms introduced in 2015 to support health emergency responses are thus important additional resources.  These are the World Health Organisation (WHO)\u2019s Contingency Fund for Emergencies (CFE) and the World Bank\u2019s Pandemic Emergency Facility (PEF). \r\n\r\nThe CFE emerged from discussions on the IHRs and was adopted at the 2015 World Health Assembly. It aims to fill the gap from the first 72 hours of a declared health emergency until resources from other financing mechanisms begin to flow. It covers all countries regardless of income to prevent events that have substantial public health consequences. As defined in the IHR, these may be due to infectious agents, chemicals, radiation, food safety or other hazards that can escalate into a public health emergency of international concern. The fund is triggered by national request and the level of funding is decided on a case-by-case basis from a $100m fund. It can support personnel; information technology and information systems; medical supplies; and field and local government support. To date, the CFE has disbursed $8.5 million for interventions related to the Zika virus in South America, on yellow fever in central Africa, and drought related food insecurity in Asia.  \r\n\r\nThe 2015 G7, indicating reasons of accountability and effectiveness, located the PEF at the World Bank. It is currently being finalized for launch at the end of 2016, uniquely as an insurance mechanism rather than a grant fund,  to support follow up measures in emergencies after initial funding, such as from CFE.  It is only focused on infectious disease outbreaks that could become cross border epidemics. Unlike the CFE, only low income countries are eligible for PEF financing.   Funds are provided through two delivery windows: an insurance mechanism for up to $500 million per outbreak, and a cash injection between $50 and $100 million. The disbursement criteria are yet to be clarified. The World Bank expresses its anticipation that an insurance model will bring \u2018greater discipline and rigor to pandemic preparedness and incentivize better pandemic response planning\u2019, including by building \u2018better core public health capabilities for disease surveillance and health systems strengthening, toward universal health coverage\u2019. However it is both ambiguous and problematic that the PEF is yet to state the specific measures for supporting and measuring these aims. \r\n\r\nAlthough born from different governance processes, the two funds do have some links. For example, the CFE intends to be a first response and the PEF a subsequent deeper resource package. They make reference to one another, recognizing the need to interact for coherence of emergency responses.\r\n\r\nHowever, only the CFE has a formal relationship with the IHRs and its core capacities, only the CFE is universal in coverage of all countries, comprehensive in addressing the full spectrum of cross border public health risks enumerated in the IHRs, including radiation, chemical and other risks, and only the CFE is managed under intergovernmental funding rules and institutional frameworks, with explicit support for system functions such as health information, planning and health worker mobilization.\r\n\r\nIt is not clear why the PEF seemingly circumnavigates the institutional and intergovernmental mechanisms of the IHRs. Two explanations stand out: Firstly, the PEF is a product of G7 processes, which similar to the establishment of the Global Fund in 2000, have supported funds that are independent of WHO governance processes. Secondly the PEF seeks to create an insurance market that will incentivize certain health system conditions to access the funds. The funding mechanism involves reinsurance and proceeds of \u2018catastrophe bonds\u2019 (capital-at-risk notes) issued by the International Bank for Reconstruction and Development purchased by insurance-linked securities and catastrophe bond investors, with development partners and international agencies covering the cost of the premiums and bond coupons.  As a new financing mechanism drawing in development funds the trigger criteria for funding and reforms to be incentivized, as yet unstated, need to be carefully reviewed. \r\n\r\nG7 countries are presently encouraging G20 countries to financially back the PEF and its insurance agenda this September in Hangzhou.  But what of the CFE?  It covers a wider spectrum of public health risks, fits most comfortably within the IHR framework and aligns more clearly with efforts to strengthen core IHR capacities and national response plans.  How far will the PEF, despite its role to fund the \u2018deeper\u2019 response, strengthen the health systems to be more effective in detecting and responding to emergencies, and even more importantly in preventing them.  How will the PEF explicitly strengthen capacities for the IHR, provide direct funding support for system capacities and align with existing national plans and intergovernmental frameworks?  How far will both funds strengthen the community literacy, networks and capacities and the primary health care systems that are needed for effective prevention, preparedness and containment, or link with the rising mobilization of resources and personnel from within Africa, noting the significant role these played in the last major Ebola epidemic.  \r\n\r\nThe addition of new global resources for managing public health are welcome. However, global measures need to reach beyond measures for surveillance and containment if they are to stretch beyond a remedial securitization of global health. Securing health calls for local, national and regional capacities for and global investment in systems that can identify, prepare for, prevent and manage significant public health risks, and for a re-invigorated public health authority and capability to mobilise attention to those communities and action on those key determinants of health that are often ignored, until the onset of such mass scale events. \r\n\r\nPlease see the full brief at http://tinyurl.com/jsgsgnh and send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"\u2018Neoliberal Epidemics\u2019 in Global Context","field_subtitle":"Schrecker T; Bambra C: Policies for Equitable Access to Health, 2016","URL":"http://www.peah.it/2016/02/neoliberal-epidemics-in-global-context/","body":"Conditionalities attached to loans from the World Bank and IMF were among the key negative influences  on health and its social determinants between 1980 and 2000 in many of the more than 75 low- and middle-income countries in which they were applied. Best available evidence suggests that this 'neoliberal epidemics' era is not over. In the future, neoliberalism is likely to reflect the erosion of territorial divisions between core and periphery, or the global North and the global South, in the world economy. The authors write that the success of efforts to fight neoliberal epidemics and reduce health inequalities will depend on blurring boundaries: between the global and local frames of reference, and between public health practice and the politics of health.  This last blurring means a return to the wisdom of Rudolf Virchow, to the effect that \u2018medicine is a social science, and politics is nothing else but medicine on a large scale\u2019.  As Martin McKee and colleagues wrote in a 2012 commentary on the failure of austerity policies, \u2018Virchow\u2019s words are as relevant today as they ever were\u2019.  Understanding how to translate that insight into political action will require the development of a comparative political science of health inequalities \u2013 a critically important project that remains in its infancy.","php":"","field_issue_date":"2016-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A political economy analysis of human resources for health (HRH) in Africa","field_subtitle":"Fieno JV; Dambisya YM; George G; Benson K: Human Resources for Health 14:44 2016 ","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0137-4","body":"Despite a global recognition from all stakeholders of the gravity and urgency of health worker shortage in Africa, little progress has been achieved to improve health worker coverage in many of the African human resources for health (HRH) crisis countries. The problem consists in how policy is made, how leaders are accountable, how the World Health Organization (WHO) and foreign funders encourage (or distort) health policy, and how development objectives are prioritized in these countries. The paper uses political economy analysis, which stems from a recognition that the solution to the shortage of health workers across Africa involves more than a technical response. A number of institutional arrangements dampen investments in HRH, including a mismatch between officials\u2019 tenure in office and program results, the vertical nature of health programming, the modalities of Overseas Development Assistance in health, the structures of the global health community, and the weak capacity in HRH units within Ministries of Health. A major change in policy-making would only occur with a disruption to the political or institutional order. The case study of Ethiopia, who has increased its health workforce dramatically over the last 20 years, disrupted previous institutional arrangements through the power of ideas\u2014HRH as a key intermediate development objective. The framing of HRH created the rationale for the political commitment to investment in health workers. The authors argue that Ethiopia demonstrates that political will coupled with strong state capacity and adequate resource mobilization can overcome the institutional hurdles above. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"African Economic Outlook 2016","field_subtitle":"African Development Bank (AfDB); Organisation for Economic Co-operation and Development; UN Development Programme (UNDP): 2016","URL":"http://www.africaneconomicoutlook.org/en/outlook","body":"How Africa urbanises will be critical to the continent\u2019s future growth and development, according to the African Economic Outlook 2016. Africa\u2019s economic performance held firm in 2015 amid global headwinds and regional shocks. The continent remained the second fastest growing economic region after East Asia. In 2015, net financial flows to Africa were estimated at USD 208 billion, 1.8% lower than in 2014 due to a contraction in investment, while official development assistance increased by 4%; and remittances remain the most stable and important single source of external finance at USD 64 billion in 2015. According to the authors, if harnessed by adequate policies, urbanisation can help advance economic development through higher agricultural productivity, industrialisation, services stimulated by the growth of the middle class, and foreign direct investment in urban corridors. It also can promote social development through safer and inclusive urban housing and robust social safety nets. Finally, it can further sound environmental management by addressing the effects of climate change as well as the scarcity of water and other natural resources, controlling air pollution, developing clean cost-efficient public transportation systems, improving waste collection, and increasing access to energy. Seizing this urbanisation dividend requires bold policy reforms and planning efforts, however, such as by strengthening local governance, tailoring national urban strategies to specific contexts and diverse urban realities and harnessing innovative financing instruments. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"An Independent Review and Accountability Mechanism for the Sustainable Development Goals: The Possibilities of a Framework Convention on Global Health","field_subtitle":"Friedman E: Health and Human Rights Journal 18(1), 2016","URL":"http://tinyurl.com/hlgx3tt","body":"The author argues that the proposed Framework Convention on Global Health (FCGH) could establish a nuanced, layered, and multi-faceted regime of compliance and accountability to the right to health and strengthen accountability for the health-related Sustainable Development Goals (SDGs). If legally binding, he argues that the FCGH could facilitate accountability through the courts and catalyze comprehensive domestic accountability regimes, requiring national strategies that include transparency, community and national accountability and participatory mechanisms, and an enabling environment for social empowerment. A \u201cRight to Health Capacity Fund\u201d could ensure resources for these strategies. Inclusive national processes could establish targets, benchmarks, and indicators consistent with FCGH guidance, with regular reporting to a treaty body, which could also hear individual cases. State reports could be required to include plans to overcome implementation gaps, subjecting the poorest performers to penalties and targeted capacity building measures. Regional special rapporteurs could facilitate compliance through regular country visits and respond to serious violations. And reaching beyond government compliance, from capacity building to the courts and contractual obligations, the author proposes that the FCGH could establish nationally enforceable right to health obligations on the private sector.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Associations in the continuum of care for maternal, newborn and child health: a population-based study of 12 sub-Saharan Africa countries","field_subtitle":"Owili P; Muga M; Chou YJ; Elsa Hau YH; Huang N; Chien LY: BMC Public Health 16(414), 2016","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869316/","body":"Despite the progress in the Millennium Development Goals (MDGs) 4 and 5, inequity in the utilization of maternal, newborn and child health (MNCH) care services still remain high in sub-Saharan Africa (SSA). In this study, the authors explored the distributions in the utilisation MNCH services in 12 SSA countries and further investigated the associations in the continuum of care for MNCH as key for health equity, using Demographic and Health Surveys data of 12 countries in SSA.  Some countries have a consistently low (Mali, Nigeria, DR Congo and Rwanda) or high (Namibia, Senegal, Gambia and Liberia) utilisation in at least two levels of MNCH care. The path relationships in the continuum of care for MNCH from \u2018adequate antenatal care\u2019 to \u2018adequate delivery care\u2019 (0.32) and to \u2018adequate child\u2019s immunisation\u2019 (0.36); from \u2018adequate delivery care\u2019 to \u2018adequate postnatal care\u2019 (0.78) and to \u2018adequate child\u2019s immunisation\u2019 (0.15) were positively associated and statistically significant. Only the path relationship from \u2018adequate postnatal care\u2019 to \u2018adequate child\u2019s immunisation\u2019 (\u22120.02) was negatively associated and significant. In conclusion, utilisation of each level of MNCH care is related to the next level of care, that is \u2013 antenatal care is associated with delivery care which is then associated with postnatal and subsequently with child\u2019s immunisation. At the national level, identification of communities which are greatly contributing to overall disparity in health and a well laid out follow-up mechanism from pregnancy through to child\u2019s immunisation program could serve towards improving maternal and infant health outcomes and equity.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for applicants: CODESRIA Executive Secretary","field_subtitle":"Deadline : 15th September 2016","URL":"http://www.codesria.org/spip.php?article2629&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites applications from suitably qualified senior African scholars for the position of Executive Secretary in its pan-African Secretariat located in Dakar, Senegal. This position, which will fall vacant in 2017, is the most senior management post in the Executive Secretariat and the successful candidate will be expected to function as the leader of the institution and a diverse team of staff under the overall supervision of the Executive Committee of the Council. Established in 1973 as a pioneering, independent, pan-African and not-for-profit organisation for the development of social research in Africa, CODESRIA is today widely recognised as the premier institution on the continent for the generation and dissemination of multidisciplinary research knowledge in the social sciences and humanities. The position of Executive Secretary is a key one both in the development of the programme mandate of the Council and the realisation of the strategic institutional objectives set by the triennial General Assembly of its members.  More information can be obtained from the website. CODESRIA policy is to reflect the disciplinary, gender, generational and linguistic diversity of the African social science community in its structures. In this connection, female candidates meeting the required qualifications are especially encouraged to send in their dossiers for consideration for this position.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Proposal-Research on Sexual and Reproductive Health and Rights (SRHR) in Migration Affected Communities of East and Southern Africa","field_subtitle":"Deadline: 5 August 2016","URL":"http://tinyurl.com/gl66a4k","body":"IOM, through the PHAMESA programme seeks to carry out a study that examines SRH challenges faced by migrants and barriers to access to SRH care services in migration affected communities and migration corridors. In addition, the study should identify gaps in existing SRHR programmes and policies in the selected migration affected communities and migration corridors. The research institution/consortium will lead the research in all selected migration corridors and migration affected communities, and is expected to carry out the following activities: Produce inception report and detailed plan to carry out the study; develop study protocol and data collection tools and translate into local languages as appropriate; conduct detailed desk review including sexual and reproductive health policy analysis at national and regional levels; conduct semi-structured interviews with policy makers, key stakeholders and actors (state and non-state) and migrants at community, national and regional levels; develop a field manual to guide on the data collection process; develop and administer appropriate data collection instruments/tools in line with the study purpose, objectives, study population and the outlined SRHR focus areas and submit a narrative report of findings and recommendations using a format that shall be agreed upon.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for submissions Cities & Health","field_subtitle":"Now accepting submissions for the first issue ","URL":"http://explore.tandfonline.com/cfp/pgas/cities-and_health_cfp","body":"Cities & Health aims to provide an innovative new international platform for consolidating research and know-how for city development to support human health. The journal will publish papers and commentary from researchers and practitioners working to build stronger relationships and a better understanding for supporting healthier cities. Unique to the journal, authors are asked to provide a one page lay summary of their papers specifically to illustrate its relevance for the practitioner community and to inform city authorities. A forum of city leaders and practitioners who are already fostering change will be asked to review and comment on these summaries. The journal invites contributions from a broad range of disciplines, including, but not limited to: built environment, including: urban design, planning, architecture, transport, landscape and city governance; public health, including: epidemiology, health economy, public health advocacy and community health; experts in many other relevant fields, such as psychology, human behaviour, geography, environmental resources, cultural studies, communications and the arts. The paper is to be published bi-annually, starting from 2017. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call to Sign: The Second Durban Declaration: Access Equity Rights - Now!","field_subtitle":" International AIDS Society: Geneva, July 2016","URL":"http://www.iasociety.org/Second-Durban-Declaration","body":"There has been remarkable progress in the response to AIDS since the global HIV community last convened in Durban in 2000. Curbing the spread of HIV was the first step . Accelerating investment and action on a robust human rights and social justice agenda is the next. Despite significant scientific advancements, the authors argue that we continue to encounter structural barriers that impede real world progress. Realising the promise of scientific achievement requires a greater commitment to removing barriers between discovery and implementation. The 21st International AIDS Conference (AIDS 2016) must bring these pieces together \u2013 the key scientific advances needed to end the epidemic and the key structural barriers impeding progress \u2013 and secure greater political commitment including financial resources to get the job done. They argue that it is key to focus on five key scientific advances; ensuring access to antiretroviral therapy for all people living with HIV, scaling up modern combination HIV prevention packages, treating and managing co-infections and co-morbidities, amplifying research efforts for a vaccine and a cure, optimising implementation research. They argue that there is a need to address five key structural barriers; focusing on key populations within and across various HIV epidemic scenarios, addressing gender inequality and empowering young women and girls, challenging laws, policies and practices that stigmatise and discriminate against people living with HIV and key populations, increasing investment in civil society and community lead responses, and enhancing the capacity of front-line healthcare workers. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Caring for a child with Cerebral Palsy: The experience of Zimbabwean mothers","field_subtitle":"Dambi J; Jelsma J; Mlambo T: African Journal of Disability 4(1) 2015 doi: 10.4102/ajod.v4i1.168","URL":"http://www.ajod.org/index.php/ajod/article/view/168/352","body":"The needs of caregivers of children with disability may not be recognized despite evidence to suggest that they experience increased strain because of their care-giving role. This strain may be exacerbated if they live in under-resourced areas. The authors set out to establish the well-being of caregivers of children with Cerebral Palsy (CP) living in high-density areas of Harare, Zimbabwe. In addition, the authors wished to identify factors that might be predictive of caregivers\u2019 well-being. Finally, they examined the psychometric properties of the Caregiver Strain Index (CSI) within the context of the study. Caregivers of 46 children with CP were assessed twice, at baseline, and after three months, for perceived burden of care and health-related quality of life. The psychometric properties of the CSI were assessed post hoc. The caregivers reported considerable caregiver burden with half of the caregivers reporting CSI scores in the \u2018clinical distress\u2019 range. Many of the caregivers experienced some form of pain, depression and expressed that they were overwhelmed by the care-giving role. No variable was found to be associated with clinical distress. The authors propose that caregivers be monitored routinely for their level of distress and that there is an urgent need to provide them with support. The CSI is likely to be a valid measure of distress in this population.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Case studies on improving tax collection: How can progressive financing systems be developed in different contexts, particularly through increasing domestic public funding?","field_subtitle":"Resilient and Responsive Health Systems (RESYST): London School of Hygiene and Tropical Medicine, 2016","URL":"http://resyst.lshtm.ac.uk/research-projects/case-studies-improving-tax-collection","body":"This research project investigates how governments can generate more of their own national resources for health and reduce their dependence on donor funding, which can be both unstable and unsustainable. Case studies in Nigeria, South Africa and Kenya, document country experiences of increasing the effectiveness of their tax collection services and investigate how this has contributed to increased health sector spending. Governments in Kenya, Lagos State (Nigeria) and South Africa have increased domestic tax revenue by expanding the tax base and improving the efficiency of tax collection systems. Specific efforts have been made to reach the informal sector by taxing businesses (in Kenya) and reaching informal trade associations (in Nigeria). Political support to tax policy reforms and the tax collection agencies led to additional funding for their operations and strengthened human resource capacity. Despite achievements in raising tax revenue, the share of government spending allocated to the health sector has not increased. A critical challenge for Ministries of Health is to make a better case for health during budget negotiations, and to demonstrate the social and economic benefits of health investments.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Charting a path to end the AIDS epidemic","field_subtitle":"Sidib\u00e9 M: Bulletin of the World Health Organisation 94(6) 408, 2016, doi: http://dx.doi.org/10.2471/BLT.16.176875","URL":"http://www.who.int/bulletin/volumes/94/6/16-176875/en/","body":"From 8 to 10 June 2016, heads and representatives of states and governments, along with other key stakeholders, assembled at the United Nations (UN) in New York, for the High-Level Meeting on Ending AIDS. There are three reasons why this meeting is an important milestone for the global response against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). First, the meeting provides an opportunity to reflect on the extent of progress and unprecedented achievements that have been made in responding to the AIDS epidemic, as described in the UN Secretary-General\u2019s report. Second, the meeting served as an occasion to galvanise support from the global community to scale up the AIDS response. The 90\u201390\u201390 treatment target calls for 90% of people living with HIV to know their status, 90% of people who know their HIV status to have access to treatment and 90% of people on treatment to achieve suppressed viral loads by 2020. Third, the meeting was an opportunity to reflect on specific challenges that need to be addressed going forward. Among them is a treatment gap and inadequate global investments in prevention. The UNAIDS 2016\u20132021 Strategy integrated efforts towards ending the AIDS epidemic fully into Transforming our world: the 2030 agenda for sustainable development. The strategy sets out the links between the HIV response and several sustainable development goals (SDGs), from SDG 1 on ending poverty to SDG 16 on promoting inclusive societies.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Creating a supportive legal environment for universal health coverage","field_subtitle":"Clarke D; Rajana D; Schmets G: Bulletin of the World Health Organization 94(7), 481-556, 2016 ","URL":"http://www.who.int/bulletin/volumes/94/7/16-173591/en/","body":"The authors note a proposal for the World Health Organization (WHO) to provide capacity-building for drafting health laws in Member States. They highlight that WHO has the authority and credibility to work with countries to make their national laws easier to access and understand, and to monitor and evaluate their implementation. WHO\u2019s new technical support work related to universal health coverage (UHC) laws is observed as one example of its support for Member States in this important area. Strengthening countries\u2019 legal and regulatory frameworks and engaging in universal health coverage-compliant law reforms has been missing from the universal health coverage agenda. WHO calls on Member States to align their health system policies with universal health coverage goals such as equity, efficiency, health service quality and financial risk protection. Strengthening health systems using health laws and legal frameworks is a pivotal means for attaining these goals and achieving sustainable results in health security and resilience.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya","field_subtitle":"Jessani N; Boulay M; Bennett S: Health Policy and Planning 31(5), 600-611, 2016 ","URL":"http://heapol.oxfordjournals.org/content/31/5/600.full","body":"The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role\u2014serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, the authors administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks and identified academic KBs using social network analysis (SNA). Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, they identified 7 KBs in 4 of the 6 SPHs. KBs were also situated in a wide range along a 'connector/betweenness\u2019 measure. The authors propose that  SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"East Central and South Africa Health Community Global Health Diplomacy Course, Arusha, 22-26 August 2016","field_subtitle":"Deadline for applications: 15th August 2016","URL":"http://www.ecsahc.org/wp-content/uploads/2016/06/GHD-Bronchure.pdf","body":"Globalisation has been portrayed to developing countries as a panacea for under development, poverty, inequality and ill health. After two decades, (since the structural adjustment programmes) of operating in a globalised world the Health Sector has increasingly borne the brunt of failed globalisation, increased poverty and inequality through higher investments in health and mitigating against an ever increasing burden of disease. What has become apparent to developing countries is that they need to be very prepared for international meetings and to improve diplomacy and negotiations skills as they participate in these meetings so that they can accrue the most benefits for their citizens and countries. This five day course is offered by the ECSA Health Community and presented by experts on issues especially for the World Health Assembly and trade and Health agenda. For further information and an application form please visit the website. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"El Nin\u0303o: Undermining Resilience - Implications of El Nin\u0303o in Southern Africa from a Food and Nutrition Security Perspective","field_subtitle":"World Food Programme, February 2016","URL":"http://documents.wfp.org/stellent/groups/public/documents/ena/wfp282004.pdf","body":"Southern Africa\u2019s unprecedented El Nin\u0303o-related drought and weather-related stress has triggered a second shock-year of hunger and hardship for poor and vulnerable people with serious consequences that World Food Programme (WFP) say will persist until at least to the next harvest in 2017, with the 2015-16 maize harvest insufficient to cover full cereal needs for the region without significant importation. El Nin\u0303o conditions have caused the lowest recorded rainfall between October 2015 and January 2016 across many regions of Southern Africa in at least 35-years. The period also recorded the hottest temperatures in the past 10 years. Short-term forecasts, based on more recent data, (February to May) indicate the high probability of continuing below-normal rainfall across the region, signalling this may become one of the worst droughts in recent history. El Nin\u0303o\u2019s impact on rain-fed agriculture is severe. Poor-rainfall, combined with excessive temperatures, has created conditions that are unfavourable for crop growth in many areas. In Lesotho, South Africa, Swaziland, Zambia and Zimbabwe, planting was delayed by up to two months or more and is expected to severely impact maize yields. Already by early 2016 an estimated 15.9 million people in southern Africa were highly food insecure, not including a growing number in South Africa. Zimbabwe, Malawi, Lesotho, Madagascar were the hardest hit from the 2015 poor harvest and early impacts from El Nin\u0303o, with Swaziland, Angola and Mozambique show increasing signs of concern. WFP note that El Nin\u0303o is usually accompanied by economic slowdown in Southern Africa, associated with reduced agricultural output and contraction in industrial activities. Current macro-economic conditions, including falling international commodity prices and currency depreciations, may inhibit countries\u2019 capacity to secure sufficient food supply. Crop failure and economic contraction threaten both rural and urban livelihoods as it undermines people\u2019s capacity to meet their basic social and economic needs, coupled with increasing levels of livelihood stress and unemployment, El Nin\u0303o incurs social, economic and political consequences. The WFP note that regional coordination and government leadership of critical contingency, preparedness and response planning is crucial to guarantee sufficient food supply and access for the most vulnerable people.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"EQUINET Information brief: Global emergency financing and health system strengthening","field_subtitle":"Brown G; Wills O; Loewenson R","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Emergency%20Funds%20brief%202016.pdf","body":"The 2005 International Health Regulations (IHR) adopted by member states in the World Health Organization (WHO) require that all countries have the ability to detect, assess, report and respond to potential public health emergencies of international concern at all levels of government, and to report such events rapidly to the WHO to determine whether a coordinated, global response is required. Recent epidemics have strengthened the demand to improve the capacities to implement the IHR and the effectiveness of health system prevention and detection of and responses to epidemics. Evidence from ESA countries suggests that this demands effective communication between local levels of health systems and national responses, and capacities for prevention, detection and response at community, primary care and district level. In 2016 two new global financing mechanisms were introduced to support emergency responses, the WHO Contingency Fund for Emergencies (CFE), that aims to fill the gap from the beginning of a declared emergency and a World Bank Pandemic Emergency Facility (PEF), to support follow up measures after initial CFE funding. This report provides information on the new CFE and PEF financing mechanisms, to explore any stated or implied links with the IHR goals and health system strengthening in the response to emergencies. It is based on a desk review of available literature by the University of Sheffield and the Training and Research Support Centre, under the umbrella of EQUINET. The report aims to inform African policy-makers and stakeholders about the CFE and PEF financial mechanisms and their relationship to the IHR to locate areas where links could be more explicitly made between the new financial mechanisms, the IHR and the health system strengthening needed for longer-term preparedness for and prevention of emergencies.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 185:We need to understand beyond what the numbers show to improve health systems","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Header"}},{"node":{"title":"Essential Medicines in National Constitutions: Progress Since 2008","field_subtitle":"Perehudoff S; Toebes B; Hogerzeil H: Health and Human Rights Journal 18(1), June 2016","URL":"http://www.hhrjournal.org/2016/05/essential-medicines-in-national-constitutions-progress-since-2008/","body":"A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realisation of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008. Relevant articles were selected from an inventory of constitutional texts from WHO member states. References to states\u2019 legal obligations under international human rights law were evaluated. Twenty-two constitutions worldwide now oblige governments to protect and/or to fulfil accessibility of, availability of, and/or quality of medicines. Since 2008, state responsibilities to fulfil access to essential medicines have expanded in five constitutions, been maintained in four constitutions, and have regressed in one constitution. Government commitments to essential medicines are an important foundation of health system equity and are included increasingly in state constitutions.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Fair publication of qualitative research in health systems: a call by health policy and systems researchers","field_subtitle":"SHaPeS TWG of Health Systems Global; EQUINET; Emerging Voices for Global Health; Daniels K; Loewenson R; et al.: International Journal for Equity in Health 15(98) June 2016, doi: 10.1186/s12939-016-0368-y","URL":"http://tinyurl.com/ztaglj2","body":"An open letter from Trisha Greenhalgh et al. to the editors of the British Medical Journal (BMJ) triggered wide debate by health policy and systems researchers (HPSRs) globally on the inadequate recognition of the value of qualitative research and the resulting deficit in publishing papers reporting on qualitative research. One key dimension of equity in health is that researchers are able to disseminate their findings and that they are taken into account in a fair and just manner, so that they can inform health policy and programmes. The Greenhalgh et al. letter and editorial responses were actively discussed within \u201cSHAPES\u201d, a thematic group within Health Systems Global, focused on Social Science approaches for research and engagement in health policy & systems (http://healthsystemsglobal.org/twg-group/6/Social-science-approaches-for-research-and-engagement-in-health-policy-amp-systems/) and within EQUINET (www.equinetafrica.org). The discussion precipitated this follow up open letter/commentary, which has 170 co-signatories. Collectively, the signatories feel that barriers to publication of qualitative research limit publication of many exemplary studies, and their contribution to understanding important dimensions of health care, services, policies and systems.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Fellowships for threatened scholars around the world: Scholar\u2019s Rescue Fund (SRF)","field_subtitle":"Institute of International Education (IIE)","URL":"http://www.scholarrescuefund.org","body":"The IIE-SRF selects outstanding professors, researchers, and public intellectuals for fellowship support and arranges visiting academic positions with partnering institutions of higher learning and research. Their fellowships enable scholars to pursue their academic work in safety and to continue to share their knowledge with students, colleagues, and the community. If conditions in the scholars\u2019 home countries improve, scholars may return after their fellowships to make meaningful contributions to their national academies and civil society. If safe return is not possible, scholars may use the fellowship period to identify longer-term opportunities.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Focus on young women\u2019s sexual health on World Population Day","field_subtitle":"Davids N: Times Live, 11 July 2016","URL":"http://tinyurl.com/zu6lowg","body":"World Population Day in July 2016 was held with the theme \u201cInvesting in teenage girls\u201d. \u201cThe teenage years are for some girls a time of exploration\u201a learning and increasing autonomy. But for many others\u201a it is a time of increasing vulnerability and exclusion from rights and opportunities\u201a or just plain discrimination\u201a'\u201d said Babatunde Osotimehin\u201a UN under-secretary-general and executive director of the UN Population Fund (UNFPA). \u201cWhen a teenage girl has the power\u201a the means and the information to make her own decisions in life\u201a she is more likely to overcome obstacles that stand between her and a healthy\u201a productive future. This will benefit her\u201a her family and her community.\u201d According to the UN\u201a 20 000 girls under the age of 18 give birth every day in developing countries. Siyabulela Mamkeli\u201a Cape Town mayoral committee member for health\u201a said good health and access to services were \u201ccrucial to help young women on the road to success\u201d. In conjunction with other organisations\u201a the city has been involved in pilot projects to provide girls who have started with their menstrual cycle with reusable sanitary towels. Meanwhile\u201a the UNFPA's initiative - to end child marriages\u201a curb adolescent pregnancy and encourage girls to make informed decisions about their futures - helped more than 11-million girls between the ages of 10 and 19 gain access to sexual and reproductive health services and information in 2015.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"From publish or perish to publish and perish: What \u2018Africa\u2019s 100 Best Books\u2019 tell us about publishing Africa","field_subtitle":"Nyamnjoh F: Journal of Asian and African Studies 39(4), 2004","URL":"http://www.nyamnjoh.com/files/publish_or_perish.pdf","body":"This paper draws on the African publishing industry initiative to determine \u2018Africa\u2019s 100 Best Books of the 20th Century\u2019, to discuss writing, scholarship and publishing in and on Africa. It argues that it is not enough to publish or read about Africa, just as it is not enough to pass for an African writer or scholar. There is need to problematise what is published and read on Africa, and how sympathetic to Africa culturally, morally and scientifically authors and publications are. The author argues that it is not enough to simply assume Africanness from the fact that a publication is produced by an African, or that 'non-Africans\u2019 cannot competently and positively articulate African causes in ways relevant to ordinary Africans, and poses challenge as one of how to promote commitment to African humanity and creativity without producing a simplistic reductionism or the inflation of belonging in Africa. The paper pursues these considerations, by focusing on how \u2018Africans\u2019 and \u2018non-Africans\u2019 alike have tended to represent Africa in publications. The author states \"Often missing have been perspectives of the silent majorities deprived of the opportunity to tell their own stories their own ways or even to enrich defective accounts by\r\nothers of their own life experiences. Correcting this entails paying more attention to the popular epistemologies from which ordinary people draw on a daily basis\".... \"It also means encouraging \u2018a meaningful dialogue\u2019 between these epistemologies and \u2018modern science\u2019, both in its old and new forms, as a way of enhancing rather than simply trampling and crushing the past with modern creativity. For publishers to play a part in this rehabilitation, a deliberate effort must be made to privilege people over profit, and to do more than reproduce the rhetoric of equality of humanity and the celebration of creative diversity. So far, publishing Africa for most is much less an\r\nideological commitment than a commercial option...\".","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Global health diplomacy in east and southern Africa, Report of a Regional Meeting, 8-9 April 2016, Nairobi Kenya","field_subtitle":"ECSA HC; EQUINET","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Regional%20GHD%20meeting%20report2016.pdf","body":"This 2016 regional meeting was convened by ECSA HC with EQUINET in line with HMC Resolution \u2013 ECSAHMC50/R2 to prepare and discuss issues on the 69th World Health Assembly (WHA) Agenda and Regional GHD work. The objectives of the meeting were to 1. Update participants from ECSA-HC member states on Global Health Diplomacy (GHD) and its health impact. 2. Share information and discuss, from a GHD perspective, selected WHA agenda items and related issues from other key global health platforms. 3. Present and discuss research findings, recommendations on effective engagement on GHD and proposals for future work. 4. Discuss proposals for strengthened regional co-ordination and communication on GHD and a framework for monitoring progress. The meeting included senior officials delegated or responsible for health diplomacy from ECSA HC member states and South Africa, diplomats from the Africa group from ECSA HC member states, technical personnel from EQUINET and other institutions, including regional organisations and partners.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Grants to research the \u201cEnergy - Health - Natural Disasters\u201d nexus in African cities","field_subtitle":"Deadline: 15 August 2016","URL":"http://tinyurl.com/j2cwqz6","body":"International Council for Science, together with Network of African Science Academies and the International Social Science Council, will support 10 research projects across Africa. These projects are expected to generate new solutions-oriented knowledge that will help develop new urban paradigms in Africa and make African cities more resilient, adaptable and healthier. This is the first call in a five-year, 5 million EUR project that seeks to increase the production of high quality, integrated (inter- and transdisciplinary), solutions-oriented research on global sustainability by early career scientists in Africa. With the impending adoption of the New Urban Agenda at the Habitat III conference in Quito, Ecuador, later this year, it is imperative to ensure that science can effectively contribute to the implementation of this Agenda. The International Council for Science (ICSU), in partnership with the Network of African Science Academies (NASAC) and the International Social Science Council (ISSC) will support research projects across Africa to the value of up to 90,000 Euro each over two years. The call is part of the 5-year \u201cLeading Integrated Research for Agenda 2030 in Africa\u201d programme funded by the Swedish International Development Cooperation Agency. The goal of the call is to better understand inter-relationships between energy systems, air pollution, health impacts and provision of health services, climate adaptation opportunities, land use and urban planning, and disaster risk reduction in the urban environment in Africa. The call for pre-proposals aims to identify collaborative research projects in Africa interested to explore inter-relationships across at least two domains of the nexus and that clearly indicate the inter- and trans-disciplinary nature of the research project. Successful applicants will be invited to join a training workshop on integrated research in Nairobi, Kenya, on 3-7 October 2016. Applicants should have no more than 10 years work experience following their PhDs or equivalent research experience.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health financing lessons from Thailand for South Africa on the path towards universal health coverage ","field_subtitle":"Blecher M; Pillay A; Patcharanarumol W; Tangcharoensathien V; Teerawattananon Y; Pannarunothai S; Daven J: South African Medical Journal 106(6) 533-534, 2016 ","URL":"http://www.samj.org.za/index.php/samj/article/view/10953/7375","body":"This paper argues that there are useful lessons for South Africa (and other countries in putting into place the legal and institutional frameworks system and systems for implementation of universal health coverage (UHC). Thailand has received widespread international recognition as one of several middle-income countries that have made enormous progress in building a UHC system and in achieving \u2018good health at low cost. Thailand has a strong national fund called the Universal Coverage (UC) Fund,  which covers 75% of its population, the rest being covered by social health insurance and the Civil Servant Medical Benefit Scheme. Thailand has a well-developed purchaser-provider split, with the independent UC Fund established by legislation, with a multi-stakeholder governing body including private and civil society representatives. Its internal structure, operating systems, procedures and information technology are firmly established, accessible and affordable in the middle-income country context. It uses capitation purchasing, with a focus on primary care systems. The National Health Security Office (NHSO), which manages the UC Fund, concentrates on pooling and strategic purchasing; it has no revenue collection function, as the scheme is financed through an annual budget. The NHSO manages the disease prevention and health promotion budget for all Thai citizens, thus assisting the other schemes and providing a strong focus on prevention and promotion. The article discusses these and other positive features and the challenges as learning for South Africa and other countries financing UHC.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"How equitable are community health worker programmes and which programme features influence equity of community health worker services? A systematic review","field_subtitle":"McCollum R; Gomez W; Theobald S; Taegtmeyer M: BMC Public Health 16(419) 2016 doi: 10.1186/s12889-016-3043-8","URL":"https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3043-8","body":"Community health workers (CHWs) are uniquely placed to link communities with the health system, playing a role in improving the reach of health systems and bringing health services closer to hard-to-reach and marginalised groups. A systematic review was conducted to determine the extent of equity of CHW programmes and to identify intervention design factors which influence equity of health outcomes. In accordance with published protocol, the authors systematically searched eight databases from 2004 to 2014 for quantitative and qualitative studies which assessed access, utilisation, quality or community empowerment following introduction of a CHW programme according to equity stratifiers (place of residence, gender, socio-economic position and disability). Thirty four papers met inclusion criteria. A thematic framework was applied and data extracted and managed, prior to charting and thematic analysis. The authors believe this to be the first systematic review that describes the extent of equity within CHW programmes and identifies CHW intervention design features which influence equity. CHW programmes were found to promote equity of access and utilisation for community health by reducing inequities relating to place of residence, gender, education and socio-economic position. CHWs can also contribute towards more equitable uptake of referrals at health facility level. There was no clear evidence for equitable quality of services provided by CHWs and limited information regarding the role of the CHW in generating community empowerment to respond to social determinants of health. Factors promoting greater equity of CHW services include recruitment of most poor community members as CHWs, close proximity of services to households, pre-existing social relationship with CHW, provision of home-based services, free service delivery, targeting of poor households, strengthened referral to facility, sensitisation and mobilisation of community. However, if CHW programmes are not well planned some of the barriers faced by clients at health facility level can replicate at community level. CHWs promote equitable access to health promotion, disease prevention and use of curative services at household level. However, care must be taken by policymakers and implementers to take into account factors which can influence the equity of services during planning and implementation of CHW programmes.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"International Call for Admission BRAC James P Grant School of Public Health, BRAC University: Master of Public Health 2017-18, Scholarship Available","field_subtitle":"Deadline: 15 September 2016 ","URL":"http://www.bracu.ac.bd/academics/institutes-and-schools/jpgsph/master-public-health","body":"In January 2005, James P Grant School of Public Health initiated its flagship Master of Public Health (MPH) programme with the aim of developing public health leaders. As of now 395 students from 26 countries including South Asia, Southeast Asia, Africa, Australia, North and South Americas, and Europe have graduated from this programme. The MPH curriculum is designed on experiential learning around the health problems faced by communities in rural and urban areas. This includes extensive field-based instructions complemented by innovative pedagogic approaches such as case study and collaborative project based learning. In 2015 JPGSPH has been selected as one of the global seven educational institutes to implement WHO TDR Postgraduate International Training on Implementation Research through MPH Programme. The next MPH batch will start in the last week of January, 2017.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Leaving no child in Africa behind: Financing public investments in children in the post-MDGs era","field_subtitle":"Muchabaiwa B: Pambazuka News, June 2016","URL":"http://tinyurl.com/jksdhqo","body":"The author observes that insufficient, ineffective and inequitable public spending on child-focused sectors and programmes stands as the biggest barrier to enjoyment of rights by all children. To date, only 7 countries in Africa have at some point in time met the Abuja target for African governments to allocate at least 15% of their budgets to health. Furthermore, no African country has so far met the Dakar Commitment on Education for All to allocate at least 7% of its GDP to education, which should have increased to 9% in 2010. In 2014, with the exception of Malawi, Niger and South Africa, who have come close by spending between 5.5-7%, the rest of African states are spending below 5% of their GDP on education, well below the Dakar Commitment. The author asks: What then are some of the concrete actions that African states should undertake to ensure sufficient, equitable, sustainable and effective public investments in children? Domestic revenue from effective and progressive taxation will continue to be the most significant and sustainable source of revenue for states to finance investments in children. He argues that, in line with the overarching SDG focus on \u2018leaving no one behind\u2019, African governments should develop and implement fiscal policies and budgets that promote equity. In line with the spirit of SDGs and of the African Charter on the Rights and Welfare of the Child, African states should create formal platforms and opportunities for children and their representatives to meaningfully participate in planning and public budgeting, including to hold duty bearers to account for their commitments to children.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Namibia: Drought funds to last until month end","field_subtitle":"The Namibian, 5 July 2016","URL":"http://www.namibian.com.na/Drought-funds-to-last-until-month-end/42557/read","body":"The N$90 million for drought relief set aside by the government from April 2016 to feed the 595 000 needy people in Namibia will last only until the end of July said Prime Minister Saara Kuugongelwa- Amadhila. In the  light of this, she said that the government needs to raise N$659 million for the drought relief programme from 1 August 2016 until March 2017. President Hage Geingob declared a state of emergency in 2016 due to the ongoing drought in the country. This is the second time in three years that the Namibian government has declared a state of emergency. The 2016/17 Rural Food Security and Livelihood Vulnerability Forecast report presented yesterday by Obert Mutabani from the Prime Minister's Office shows that the price of maize meal increased from N$8 per kilogramme in 2012 to N$18 now. Millet now costs about N$14 from N$7 in 2012, while sorghum is at N$29, up from N$7. The report also revealed that about 595 839 people have been affected by the drought, and will need assistance. It gave recommendations that government should set up programmes to help communities become self-reliant.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Physical, emotional and sexual adolescent abuse victimisation in South Africa: prevalence, incidence, perpetrators and locations","field_subtitle":"Meinck F; Clever L; Boyes M; Loening-Voysey H: Journal of Epidemiology and Community Health, 2016, doi:10.1136/jech-2015-205860 ","URL":"http://jech.bmj.com/content/early/2016/03/09/jech-2015-205860.full","body":"Physical, emotional and sexual abuse of children is a major problem in South Africa, with severe negative outcomes for survivors. This study investigated the prevalence and incidence, perpetrators, and locations of child abuse in South Africa using a multicommunity sample. 3515 children aged 10\u201317 years (56.6% female) were interviewed from all households in randomly selected census enumeration areas in two South African provinces. Child self-report questionnaires were completed at baseline and at 1-year follow-up (97% retention). Prevalence was 56% for lifetime physical abuse (18% past-year incidence), 36% for lifetime emotional abuse (12% incidence) and 9% for lifetime sexual abuse (5% incidence). 69% of children reported any type of lifetime victimisation and 27% reported lifetime multiple abuse victimisation. Main perpetrators of abuse were reported: for physical abuse, primary caregivers and teachers; for emotional abuse, primary caregivers and relatives; and for sexual abuse, girlfriend/boyfriends or other peers. This is the first study assessing current self-reported child abuse through a large, community-based sample in South Africa. Findings of high rates of physical, emotional and sexual abuse demonstrate the need for targeted and effective interventions to prevent incidence and re-abuse.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Pooling of resources for NHI could lower cost of universal access.","field_subtitle":"Nkosi S: Health E-news, June 2016","URL":"http://www.health-e.org.za/2016/06/30/pooling-resources-nhi-lower-cost-universal-access/","body":"In June 2016, South African Minister of Health Dr Aaron Motsoaledi addressed the media to respond to criticism over the high cost associated with rolling out universal health care in South Africa. \u201cThe National Health Insurance (NHI) scheme is the only way to ensure that everyone is not excluded to quality health because of their socio-economic status, \u201d said Motsoaledi. The NHI White Paper was released last year and plans to reform both public and private health sectors by combining all South Africans into one purchasing pool. The cost of NHI has been estimated to be R256-billion by 2025, which is higher than the current national budget allocation toward healthcare. But according to Motsoaledi, the figure is a projection and could change with the process. Arguing the benefit of pooling resources, he stated that in 2002, the department of health combined all South Africans into one purchasing pool and were able to lower the costs of antiretroviral treatment.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Poverty amidst plenty: How Africans are robbed of benefits of mineral wealth","field_subtitle":"Obeng K: Pambuzuka News, June 2016","URL":"http://tinyurl.com/z5uobfc","body":"The author argues that Africa has not benefited substantially from its mineral wealth and that it is essential for resource-rich African countries to tailor their economic policies to harness and utilise mineral revenues to improve the productivity of non-mineral sectors to break out of the extractive enclave. The article observes that the remarkable extractives-driven economic growth of the last decade across Africa failed to trickle down. It was jobless, benefited foreign corporates and the local elite, and it widened the gap between the rich and the poor. If Africa is to avoid the failures of the previous decades and successfully transition from its present state to that foreseen by Agenda 2030 then the author proposes that it must better harness the potential benefits of its vast mineral wealth. African countries must institute fiscal reforms that will ensure that they are better positioned to derive maximum benefit from the next commodity price super cycle; they must plug loopholes that continue to facilitate the bleeding of much needed development revenues via illicit flows; countries must align all relevant local frameworks to the African Mining Vision, thereby putting the needs of citizens at the centre of their natural resource management agenda; and Africa must unite in a broad and strong push for long overdue global tax reforms.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Pressure to publish is choking the academic profession","field_subtitle":"Vale P; Karataglidis S: The Conversation, 6 July 2016","URL":"http://tinyurl.com/hduyqsx","body":"The regime of publication pervades contemporary academic life across countries. The obligation that academic staff must publish is invariably presented as a virtuous thing. It is right and proper for academics to expand and extend the boundaries of their respective disciplines by publishing in outlets, as approved by their peers. Moreover, a public that is often sceptical of the usefulness of universities is often told that academics publish in \u201cthe public good\u201d. But, the authors ask, if academic publishing is so significant in the profession, why is it that the young and talented in the academy increasingly resist it, calling it formulaic, at best, and, at worst, a sweatshop? And they ask, why is it that old academic hands are simply no longer interested in contributing to the peer-review system that is at the heart of the system and without which the standing of the entire industry will falter? For one thing, the authors argue, there is a dark side in the ceaseless pressure to publish. Funding agencies use publication records to distribute money or rank scholars and academic managers use the publication record as a means to manage people. For another, the current system privileges the journal over the book, which is argued to be damaging to the humanities. They argue for the need to recognise that \u201cslow scholarship\u201d is as important as it is necessary, and that deep research \u2013 especially, but not exclusively in the humanities \u2013 requires what strategic theorist Albert Wohlstetter once called a high thought to publication ratio. Research and publishing is the oxygen of academic life, but the authors suggest that the regimes of control that surround contemporary approaches to publishing are choking creativity and, with it, the profession itself.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Priority-setting for achieving universal health coverage","field_subtitle":"Chalkidou K; Glassman A; Marten R; Vega J; Teerawattananon Y; Tritasavit N; Gyansa-Lutterodt M; Seiter A; Kieny M; Hofman K; Culyer A: B: Bulletin of the World Health Organization, 94(6), 405-480, 2016","URL":"http://www.who.int/bulletin/volumes/94/6/15-155721/en/","body":"Governments in low- and middle-income countries are legitimising the implementation of universal health coverage (UHC), following a United Nation\u2019s resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost\u2013effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities \u2013 implicitly or explicitly \u2013 it has not been made clear how priority-setting for UHC should be conducted. The authors provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Private sector, for-profit health providers in low and middle income countries: can they reach the poor at scale?","field_subtitle":"E Tung; S Bennett: Globalization and Health 10(52), 2014","URL":"http://globalizationandhealth.biomedcentral.com/articles/10.1186/1744-8603-10-52","body":"This paper analyses private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health. The authors searched published and grey literature and databases to identify PFP companies that provided more than 40,000 outpatient visits per year, or who covered 15% or more of a particular type of service in their country. For each included provider, the authors searched for additional information on location, target market, business model and performance, including quality of care. Only 10 large scale PFP providers were identified. The majority of these were in South Asia and most provided specialised services such as eye care. The characteristics of the business models of these firms were found to be similar to non-profit providers studied by other analysts. They pursued social rather than traditional marketing, partnerships with government, low cost/high volume services and cross-subsidization between different market segments. There was a lack of reliable data concerning these providers. The authors observe that there is very limited evidence to support the notion that large scale bottom of the pyramid PFP models in health offer good prospects for extending services to the poor in the future,  while successful PFP providers often require partnerships with government or support from public funding. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?","field_subtitle":"Montagu D; Goodman C: The Lancet, June 2016, doi: http://dx.doi.org/10.1016/S0140-6736(16)30242-2","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30242-2.pdf","body":"The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. The authors review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are argued to be possible. Prohibiting the private sector is said by the authors to be unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope. This  indicates the limitations of such interventions as a basis for universal health coverage, though they can address focused problems on a restricted scale. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Regulating the for-profit private health sector: lessons from East and Southern Africa","field_subtitle":"Doherty J: Health Policy and Planning 30(suppl 1), i93-i102, 2014","URL":"http://heapol.oxfordjournals.org/content/30/suppl_1/i93.full","body":"This article explores the areas of likely comparative advantage of the private sector in delivery of health care services for public health goals. It finds that there is a considerable body of evidence on the private provision of healthcare in low- and middle-income countries, often focusing on SSA. However, the evidence base is not robust. Evidence is often mixed and sometimes conflicting and policy implications are unclear. The arguments in favour of private healthcare suggest it is more responsive and efficient, while arguments in favour of public services suggest they are more equitable and better equipped than the market to respond to health needs. Some studies find that the private sector is unregulated, has financial incentives for inappropriate healthcare, and is expensive. There is very little evidence on the comparative cost-effectiveness of the private sector. This varies considerably across country contexts and types of services. There is no conclusive evidence that the private sector is more cost-effective or more efficient than the public sector. The literature warns that increased use of private services may crowd out or decrease the funding available to the public sector. The major criticism of private sector services is that their higher user fees create inequality of access, limiting their use by the poor. The author suggests that the literature is quite clear that private for-profit health services create inequality. Private non-profit, or services run by NGOs, appear to mitigate some of the inequality effects. In practice, boundaries can be blurred between public and private; both formal and informal cost recovery schemes operate at public facilities. NGOs providing healthcare are generally seen as private, although they may not charge for their services. It is observed that the difference between free-at-the-point-of-use NGOs and out-of-pocket-expenditure on private doctors can be enormous, and that it is important to differentiate between the types of providers when reviewing the evidence on private health care.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Research Fairness Initiative Website","field_subtitle":"Council on Health Research for Development (COHRED): Geneva, 2016.","URL":"http://rfi.cohred.org","body":"Hosted by COHRED, the Research Fairness Initiative aims to create a reporting system that encourages governments, business, organisations and funders to describe how they take measures to create trusting, lasting, transparent and effective partnerships in research and innovation. The RFI prioritises its application in global health because there are so many urgent health-related issues, but it can be applied to other settings as well. By providing a guide to high quality reporting on measures and conditions that promote fair research partnerships, the RFI encourages all stakeholders in research and innovation for health to describe what is done within their organisation to promote fair partnerships. Through an extensive global consultative process, the RFI have identified 17 key areas of relevance to effective and lasting partnerships. The RFI acknowledges that successful partnerships often start at personal level but are then continued at institutional or national levels. While mutual admiration, respect and friendship are essential to create the foundation of effective partnerships \u2013 it is the institutional and national dimensions of research collaboration that define how, ultimately, benefits are shared. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Scholars at Risk Network","field_subtitle":"Applications accepted at any time","URL":"https://www.scholarsatrisk.org/secure-submission/","body":"Scholars at Risk protects scholars suffering grave threats to their lives, liberty and well-being by arranging temporary research and teaching positions at institutions in our network as well as by providing advisory and referral services. In most cases this is a one-semester or one-year position as a visiting scholar, researcher or professor at a higher education institution in a safe location anywhere in the world. SAR provides advisory services for displaced scholars who are struggling to restart their lives and their careers in their new location. Since the Network\u2019s founding in 2000, more than 700 scholars have found sanctuary and hundreds more have benefited from SAR\u2019s advisory and referral services.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Southern Africa Network for Biosciences ","field_subtitle":"African Union: New Partnership for Africa's Development, 2016","URL":"http://www.nepad.org/resource/southern-africa-network-biosciences-sanbio","body":"The Southern Africa Network for Biosciences (SANBio) is a platform to address and find means to resolve key bioscience concerns in health, nutrition, agriculture and environment in the Southern Africa.  SANBio, was established alongside four other networks under the African Biosciences Initiative (ABI), for the SADC region. Thirteen countries of the SADC region are part of the SANBio network, supporting each other to be acknowledged as the biosciences network improves livelihoods in Southern Africa through research and innovation. The platform provides access to world-class laboratories for African and international scientists conducting research on Africa\u2019s biosciences challenges. SANBio\u2019s Mission is pursued through functions for : Research, development and innovation; and increasing capacity (human resources and infrastructure) to strengthen the network. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Tackling Zika: What health communicators can learn from Ebola","field_subtitle":"Wilkinson S: BBC Media Action, July 2016","URL":"http://tinyurl.com/h9o7bd2","body":"Since the World Health Organisation declared Zika a global public health emergency in February of this year, much attention has been brought to bear on applying lessons learned during the Ebola crisis of 2014-15. This blog draws on the lessons for the health communication sector explored through a new practice briefing from BBC Media Action, Using media and communication to respond to public health emergencies - lessons learned from Ebola, and the unique role media and communications can play in effectively tackling Zika. BBC Media Action has responded to 28 humanitarian emergencies since 1994 \u2013 including Ebola. One recurring lesson has been that interventions are most effective if the formats and technologies used to communicate give affected communities a chance to participate and have a voice. This ensures that content reflects local realities, needs and concerns. People need to be told more than just what they should or should not do. They need to be engaged in a discussion around the \u2018how\u2019 and the \u2018why\u2019.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The burden of road traffic crashes, injuries and deaths in Africa: a systematic review and meta-analysis","field_subtitle":"Adeloye D; Thompson J; Akanbi M; Azuh D; Samuel V; Omoregbe N; Ayo C: Bulletin of the World Health Organization 94(7), 510-521A, 2016 ","URL":"http://www.who.int/bulletin/volumes/94/7/15-163121/en/","body":"Road traffic injuries are among the leading causes of death and life-long disability globally. The World Health Organization (WHO) reports road traffic injuries as the leading cause of death among young people aged 15\u201329 years globally and are among the top three causes of mortality among people aged 15\u201344 years.  In Africa, the number of road traffic injuries and deaths have been increasing over the last three decades. According to the 2015 Global status report on road safety, the WHO African Region had the highest rate of fatalities from road traffic injuries worldwide at 26.6 per 100 000 population for the year 2013. In 2013, over 85% of all deaths and 90% of disability adjusted life years (DALYs) lost from road traffic injuries occurred in low- and middle-income countries, which have only 47% of the world\u2019s registered vehicles. The increased burden from road traffic injuries and deaths is partly due to economic development, which has led to an increased number of vehicles on the road. Given that air and rail transport are either expensive or unavailable in many African countries, the only widely available and affordable means of mobility in the region is road transport. However, the road infrastructure has not improved to the same level to accommodate the increased number of commuters and ensure their safety and as such many people are exposed daily to an unsafe road environment. The 2009 Global status report on road safety presented the first regional estimate of a road traffic death rate, which was used to statistically address the under-reporting of road traffic deaths by countries with an unreliable death registration system. In the 2009 report, Africa had the highest estimated fatality rate at 32.2 per 100 000 population, in contrast to the reported fatality rate of 7.2 per 100 000 population. The low reported death rate is said to reflect missing data due to non-availability of road traffic data systems. This has a direct impact on health planning including emergency care and other responses by government agencies. ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"THE CAADP Results Framework (2015 - 2025)","field_subtitle":"African Union: New Partnership for Africa's Development, Adis Ababa, 2016","URL":"http://www.nepad.org/resource/caadp-results-framework-2015-2025","body":"The Comprehensive Africa Agricultural Development Programme (CAADP) Results Framework is an essential component in facilitating CAADP implementation. The AU Malabo Declaration in June 2014 sent the goals for African countries, including a 10% public spending target for agriculture, a commitment to zero hunger  by 2025, reducing stunting to 10%, halving poverty, by 2025, and providing preferential and participation for women and youth in gainful and attractive agribusiness This document  presents the critical actions required to achieve agricultural development agenda targets. The indicators are accompanied by baseline data and targets that can be achieved within the next 10 years. The framework provides standardised tools which can be used by CAADP stakeholders at country, REC (Regional Economic Community) and continental level to measure agricultural performance and progress. It intends to be used in improving planning processes and strengthening existing monitoring and evaluation systems to achieve CAADP targets within the next 10 years.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane","field_subtitle":"Mataboge M; Beukes S; Nolte A: Health S A 21(1) 67-76, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S1025984815000150","body":"Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV) and to acquired immunodeficiency syndrome (AIDS) than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. This study explored and described the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs, as were providers. The authors argue that inputs from people at grass roots level be integrated during policy development to ensure that informal settlement residents are provided with accessible reproductive health services. It was further found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The political and economic challenges facing provision of municipal infrastructure in Durban","field_subtitle":"Zikode S: Pambazuka News, 14 July 2016","URL":"http://tinyurl.com/zkrmbls","body":"Started 10 years ago, South Africa\u2019s shack dwellers movement Abahlali baseMjondolo has mounted a remarkable struggle \u2013 often at a terrible cost - to protect and promote the rights of impoverished people in the towns. This inspirational story shows what poor people can achieve when they organise themselves. The Abahlali baseMjondolo movement was formed in the Kennedy Road shack settlement in Clare Estate in Durban in 2005. It was formed to fight for, protect, promote and advance the interests and dignity of shack dwellers and other impoverished people in South Africa. At the time of the movement\u2019s formation Kennedy Road was facing eviction. The conditions were very bad in the settlement due to the lack of infrastructure. At the time the government had a policy of \u2018eradicating slums\u2019 and promised that there would be no more \u2018slums\u2019 by 2014. However the process left some people homeless and others would be taken to tiny and badly made \u2018houses\u2019 far outside of the cities. So the Abahlali baseMjondolo movement successfully organised to stop the evictions and the \u2018slum eradication\u2019 program. They organised clean ups and brought \u2019Operation Khanyisa\u201d (self-connection to electricity) which started in Soweto to Durban. Abahlali aims to build the power of the impoverished from below.  However they write that they have faced serious repression in their struggle and that basic rights, like the right to protest, have been denied to them. They reject that others should speak for them and that municipalities should work with people in shack settlements to plan participatory upgrades so that the impoverished can live a dignified life.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Video on Health Committees","field_subtitle":"Learning Network for Health and Human Rights: University of Cape Town, South Africa, July 2016","URL":"http://salearningnetwork.weebly.com","body":"The Learning Network for Health and Human Rights is a network is a collection of 5 civil society organisations (The Women's Circle, Ikamva Labantu, Epilepsy South Africa, The Women on Farms Project and the Cape Metro Health Forum) as well as 4 higher education institutions (UCT, UWC, Maastricht University, in the Netherlands, and Warwick University in the UK). The network collaborates to explore how collective action and reflection can identify best practice with regard to using human rights to advance health issues. The work of the Learning Network seeks to operationalise the right to health as stated in South Africa\u2019s Constitution and other international treaties and agreements. This is accomplished through a programme in which research, training and advocacy are linked to empower organisations and their members to assert rights for health. One of their latest training materials, this video explores the role of Health Committees from different perspectives \u2013 from that of a facility manager, a health care provider, health committee members and patients. It aims to enhance understanding of what Health Committees can do, what the challenges are in building effective health committees and how they can strengthen the health system.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"We need to understand beyond what the numbers show to improve health systems","field_subtitle":"Editor, EQUINET newsletter","body":"The barriers researchers face in having qualitative research published in many mainstream health and medical journals is limiting our understanding of important dimensions of health care. At a time when health systems are increasingly involving a range of disciplines in health teams and using more holistic models to respond to the mix of physical, psycho-social and  environmental factors that lead to ill health, excluding qualitative work deprives decision makers of a significant body of knowledge that could inform decision making on health systems. \u201cFurthermore, this effectively silences the voices of community members, particularly those who are marginalised across all countries\u201d.\r\n\r\nSo argued 170 co-signatories from all regionals globally of a letter from the Social science approaches for research and engagement in health policy & systems (SHaPeS) thematic working group of Health Systems Global, the Regional Network for Equity in Health in East and Southern Africa (EQUINET), and the Emerging Voices for Global Health.  The full letter was published in June in the International Journal for Equity in Health and can be read at http://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0368-y \r\n\r\nThe signatories raised that many issues that affect both the effectiveness and equity of health systems cannot simply be \u2018measured\u2019 by numbers alone. Issues such as the subjective relationships and communication between health workers, clients and communities, the perceptions of and trust in services, the role of social literacy, or the values and preferences that managers, health workers and communities bring to systems affect health outcomes and therapeutic relationships.  One young researcher argues in the letter that qualitative work \u201cfacilitates my understanding beyond what the numbers show\u201d.\r\n\r\nResearchers in east and southern Africa have in past EQUINET forums voiced similar views. They have raised the difficulties they face in publishing generally, not only in meeting the format, style and other demands of a journal paper, but also in finding the time for the process, given competing time pressures.  Those working with qualitative research appear to face even higher barriers. The signatories to the letter stated \u201cWe are particularly disenchanted by our general experience of the limited and often inadequate publication of qualitative research in the major health and medical journals, and the resultant loss of important insights for those working in, or concerned with, health services and systems, including around clinical decision-making\u201d.\r\n\r\n For those working with participatory approaches the barriers can seem even more insurmountable. At a 2014 regional workshop on participatory action research, researchers raised that most traditional journals - and many funders - do not understand or appreciate these approaches. One researcher, from Malawi, described that despite his research leading to real changes, publishing it was an uphill task, calling for constant efforts to make to justify the approach, the role of community members as partners in the research and the use of subjective or qualitative evidence. Indeed in another article in this issue of the newsletter the authors comment: \"research and publishing is the oxygen of academic life. But the regimes of control that surround contemporary approaches to publishing are choking creativity...\" \r\n\r\nThe letter published by the health system researchers argues for methodological diversity in mainstream publication on health systems research, to build a more holistic and richer understanding of complex systems. Given the multiple factors, including subjective, dynamic and social factors, that influence health and the way services are delivered and experienced, it would indeed seem to oversimplify reality to give singular dominance to the old maxim that \u201cwhat is measured counts\u201d at the cost of the wider range of methods and lenses that we have to explore, analyse, and understand what counts.  \r\n\r\nThe full letter referred to in this editorial was published as SHaPES, EQUINET, Emerging voices for global Health, Daniels, Loewenson et al., 2016, International Journal for Equity in Health 15:98 DOI: 10.1186/s12939-016-0368-y.  Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org or to the SHaPES working group in Health Systems Global  http://www.healthsystemsglobal.org/  ","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries","field_subtitle":"Mackintosh M; Channon A; Karan A; Selvaraj S; Cavagnero E; Zhao H: The Lancet, June 2016, doi: http://dx.doi.org/10.1016/S0140-6736(16)00342-1","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)00342-1.pdf","body":"Private health care in low-income and middle-income countries is noted to be extensive and heterogeneous, ranging from medicine sellers, through millions of independent practitioners\u2014both unlicensed and licensed\u2014to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this paper, the authors propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. The authors develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"ZimVAC Rapid Assessment Report","field_subtitle":"Government of Zimbabwe Food and Nutrition Council, Zimbabwe Vulnerability Assessment Committee: Food Security Cluster, April 2016","URL":"http://fscluster.org/sites/default/files/documents/zimvac_rapid_assessment_final.pdf","body":"In response to the advent of the El Nino phenomena which has resulted in the country experiencing long dry spells, the ZimVAC undertook a rapid assessment focussing on updating the ZimVAC May 2015 results. The process followed a 3 pronged approach which were, a review of existing food and nutrition secondary data, qualitative district Focus Group Discussions (FGDs) and for other variables a quantitative household survey which in most cases are representative at provincial and national level. This report provides a summation of the results for the 3 processes undertaken. The report concludes that there is an urgent need to strengthen and expand current livestock support programmes to prevent further deterioration of livestock condition and deaths; to implement a Drought Relief Policy and Food Deficit Mitigation Strategy through multi-sectoral participation of all relevant Government structures, and to adopt registration, distribution and monitoring strategies that are inclusive. Gender based violence cases were found to be on the increase in most districts, while noting that this may be attributable to an increase in awareness and reporting and not necessarily to an increase in incidents.","php":"","field_issue_date":"2016-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"5th Annual Outbreak Control and Prevention Africa Conference","field_subtitle":"23 - 24 August 2016, Johannesburg, South Africa","URL":"http://tinyurl.com/j5jse59","body":"The Intelligence Transfer Centre is hosting the 5th Annual Outbreak Control and Prevention Africa Conference. The two day conference will enable participants to network with key role players in the industry, and to analyse disaster risk management and preparedness plans, and look surveillance and clinical treatment of infectious diseases in hospitals and confined spaces. Speakers will also examine the role of medical and health innovation to prevent and treat deadly infectious diseases.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A Free Course on Medicines in Health Systems working towards UHC","field_subtitle":"World Bank Open Learning Campus, 2016","URL":"http://tinyurl.com/jcpur99","body":"Many countries are reforming their health systems working toward universal health coverage (UHC). These reforms can be harnessed to increase equity in medicines access, affordability, and appropriate use of medicines. However, they also have the potential to decrease the effectiveness of prescribing and dispensing, increase unnecessary use of medicines, and derail systems from a path toward sustainable universal coverage. The goal of the Medicines in Health Systems course is to strengthen the capacity of practitioners working toward universal health coverage in low- and middle-income country health systems to design, implement, and monitor evidence-informed pharmaceutical policy and management strategies. Specifically, after completing the course, participants will be able to explain the different roles medicines play in health systems, and the roles and responsibilities of different system actors with respect to medicines in systems. They will be able to illustrate the competing objectives that system stakeholders face when striving toward greater availability of and more equitable access to high quality medicines, at affordable costs for households and the system, and with appropriate use to achieve target health outcomes. Participants will learn to assess the potential of different medicines policy and management approaches to balance these competing objectives, and identify the facilitators of and barriers to success of specific strategies, in a given context. Lastly, participants will learn to lay out strategies for monitoring desired and potential unintended outcomes of specific medicines policy and management strategies in a given setting. It provides step-by-step guidelines for clinicians, ranging from diagnoses to correct medicine dosages, and how to administer the medicine. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia","field_subtitle":"Letebo M; Shiferaw F: Globalization and Health 12(26), June 2016","URL":"http://link.springer.com/article/10.1186/s12992-016-0163-y?view=classic","body":"Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organised and comprehensive response to NCDs. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardisation of patient and program monitoring tools. In this cross-sectional qualitative study the authors assessed existing monitoring and evaluation tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, they explored the tools being used in the program and analysed how they might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. The authors findings indicate the apparent lack of information systems for NCD services, including the absence of standardised patient and program monitoring tools to support the services. They identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardised tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardising patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Africa Health Budget Network & International Budget Partnership - Transparency and Participation Scorecard","field_subtitle":"Africa Health Budget Network & International Budget Partnership, 2016","URL":"http://www.mamaye.org/en/evidence/africa-health-budget-network-international-budget-partnership-transparency-and","body":"This scorecard can help one see at a glance how a country is doing on the areas of budget transparency and participation most relevant for the health sector. All the information in the scorecard comes from the Open Budget Survey 2015. The information collected by the Open Budget Survey is not health specific, but the authors have selected the indicators most relevant to the health sector. Budget documents in different countries display how much will be spent on what priorities in different ways, with more or less detail. For citizens and civil society to understand what is being spent on their health, a high level of detail is required: one doesn\u2019t just need to see the amount as classified by Ministry (e.g. what is allocated to the Ministry of Health) but also by function (e.g. primary healthcare), by economic classification (e.g. how much is spent on health workers\u2019 salaries) or by programme (e.g. how much is spent on free healthcare for pregnant women). There is also an indicator which measures whether budget documents explicitly make the link between money spent, intended health outcomes, and actual results. Information is not enough for accountability. Civil society and citizens also need entry points to influence decisions during the budget process: this is what participation in budgeting provides. There are many ways to facilitate this, from releasing the budget timetable so that Civil Society organisations can get ready for important meetings or information release, to holding formal hearings at different stages in the budget process for the public to feed in their priorities. The scorecard is available in English and French.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Africa's Blue Economy: A policy handbook","field_subtitle":"United Nations Economic Commission for Africa, March 2016","URL":"http://www.uneca.org/publications/africas-blue-economy-policy-handbook","body":"Africa\u2019s 'Blue world' is made of vast lakes and rivers and an extensive ocean resource base. The Blue Economy can play a major role in Africa\u2019s structural transformation, sustainable economic progress, and social development. The largest sectors of the current African aquatic and ocean based economy are fisheries, aquaculture, tourism, transport, ports, coastal mining, and energy. This Policy Handbook, offers a step by step guide to help African member States to better mainstream the Blue Economy into their national development plans, strategies, policies and laws. The Blue Economy approach is premised in the sustainable use, management and conservation of aquatic and marine ecosystems and associated resources.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Almost Two Years Passed, No Member State Has Ratified SADC Employment and Labour Protocol","field_subtitle":"Southern Africa Coordination Council (SATUCC), 8 June 2016","URL":"http://tinyurl.com/ht4b48q","body":"Two years after it was signed in August 2014, SATUCC reports that no Member State has ratified the SADC Employment and Labour Protocol as of June 2016. The SADC Employment & Labour Protocol was developed to serve as legal framework for the cooperation of SADC Member States on matters concerning employment and labour in line with Article 22 of the SADC Treaty which provides as follows: \u201cMember States shall conclude protocols as may be necessary in each area of cooperation, which shall spell out the objectives and scope of, and institutional mechanisms for cooperation and integration\u201d. This Protocol was then finally endorsed by nine Member States during the SADC Heads of States Summit held in Victoria Falls, Zimbabwe in August of 2014. These are: DRC, Lesotho, Malawi, Mozambique, Namibia, Seychelles, South Africa, Zambia and Zimbabwe. However, for this Protocol to enter into force, it is required that at least 10 Member States representing two-thirds ratify it. Since then, no single Member State has ratified the Protocol. It is against this that the SADC Ministers of Labour and Social Partners during their meeting on 12th May 2016, directed the SADC Secretariat with support of the ILO to conduct a study to establish the problems and challenges underlying the non-ratification of the Protocol and further explore ways how to promote its ratification by Member States. SATUCC is conducting a regional campaign on the ratification and implementation of the SADC Employment and Labour Protocol.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Amitav Ghosh - The Great Derangement: Climate Change and the Unthinkable","field_subtitle":"Schmidt J: The Anthropo.scene, June 2016","URL":"http://tinyurl.com/gl9m9bb","body":"Are we deranged? The acclaimed Indian novelist Amitav Ghosh argues that future generations may well think so. How else to explain our imaginative failure in the face of global warming? Ghosh examines in a series of video lectures our inability\u2014at the level of literature, history, and politics\u2014to grasp the scale and violence of climate change. The extreme nature of today\u2019s climate events, Ghosh asserts, make them peculiarly resistant to contemporary modes of thinking and imagining. This is particularly true of serious literary fiction: hundred-year storms and freakish tornadoes simply feel too improbable for the novel; they are automatically consigned to other genres. In the writing of history, too, the climate crisis has sometimes led to gross simplifications; Ghosh shows that the history of the carbon economy is a tangled global story with many contradictory and counterintuitive elements, and suggests that global crises like the climate crisis challenge our thinking and ask us to imagine other forms of human existence\u2014a task that fiction can support.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Amnesty International Refugee and Migrant Rights MOOC 2016","field_subtitle":"Course launches: November 2016 ","URL":"http://www.pambazuka.org/sites/default/files/Refugee_and_Migrants_Rights_MOOC_Briefing.pdf","body":"In November 2016 Amnesty International will launch a Massive Open Online Course (MOOC) on the subject of refugee and migrant rights to educate and empower audiences in the 25 to 35 age range to take action on the human rights issues associated with Amnesty\u2019s Global Campaign on People on the Move. The 3-4 week course requiring 2-3 hours of participants\u2019 time per week, will be launched in November in Spanish, French and English. The introductory course will remain open for people to complete the course anytime over a six month period. The three overall objectives of the MOOC are to provide knowledge and empower people to take action for refugee and migrant rights and to do so on a large scale, contributing to the campaign and growth.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries","field_subtitle":"Goeppel C; Frenz P; Grdabenhenrich L; Keil T; Tinnemann P: Bulletin of the World Health Organization, 94(4), 276-285C, 2016","URL":"http://www.who.int/bulletin/volumes/94/4/15-163832/en/","body":"This study assesses universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. The authors obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. The weighted proportion of participants with access to basic chronic care ranged from 21% in Mexico to 48% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 15% in China to 55% in Ghana. Financial hardship was more common among poor people in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. No country provided access to basic chronic care for more than half of the participants with chronic illness. Poor people were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. The authors argue that future health reforms should aim to improve service quality and increase democratic oversight of health care.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Black Girl","field_subtitle":"Mohdin A: Quartz, June 2016","URL":"https://www.youtube.com/watch?v=4ElkpBCDFhU","body":"The writer and director, Ousmane Semb\u00e8ne, uses a then newly independent Senegal, hungry for political and social alternatives, as the backdrop for this widely acclaimed film. Through the film\u2019s main character, Diouana Semb\u00e8ne makes a powerful argument about Senegal\u2019s independence and the impact of colonialism in Africa. It was one of the first African films to receive international acclaim. The short one-hour film, released in 1966, is a simple yet powerful story of a Senegalese nanny, who hopes and dreams of a better future, but is tied down by the French couple who hire her. Sembene presents a powerful critique of black aspiration to be in a France, or more broadly, in a colonizer\u2019s country. Though people are now free in Senegal, they will in many ways still be seen as colonial objects. At a time where issues of race and class are resonating more than ever, and countries are struggling to come to terms with their colonial legacies, Black Girl remains a powerful story about personal and political freedom\u2014one that stills hits just as hard.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Close-to-community providers of health care: increasing evidence of how to bridge community and health systems","field_subtitle":"Theobald S; Hawkins K; Kok M; Rashid S; Datiko D; Taegtmeyer M:Human Resources for Health 14(32), June 2016","URL":"https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0132-9","body":"The recent thematic series on close-to-community providers published in this journal brings together 14 papers from a variety of contexts and that use a range of research methods. The series clearly illustrates the renewed emphasis and excitement about the potential of close-to-community (CTC) providers in realising universal health coverage and supporting the sustainable development goals. This editorial discusses key themes that have emerged from this rich and varied set of papers and reflect on the implications for evidence-based programming. The authors argue that it is a critical stage in the development of CTC programming and policy which requires the creation and communication of new knowledge to ensure the safety, sustainability, quality and accessibility of services, and their links with both the broader health system and the communities that CTCs serve.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Critiquing the response to the Ebola epidemic through a Primary Health Care Approach","field_subtitle":"Scott V; Crawford-Browne S; Sanders D: BMC Public Health16(410), 2016, ","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869325/","body":"The 2014/2015 West Africa Ebola epidemic has caused the global public health community to engage in difficult self-reflection. First, it must consider the part it played in relation to an important public health question: why did this epidemic take hold and spread in this unprecedented manner? Second, it must use the lessons learnt to answer the subsequent question: what can be done now to prevent further such outbreaks in the future?  The authors contribute to the current self-reflection by presenting an analysis using a Primary Health Care (PHC) approach. This approach is appropriate as African countries in the region affected by EVD have recommitted themselves to PHC as a framework for organising health systems and the delivery of health services. The approach suggests that, in an epidemic made complex by weak pre-existing health systems, lack of trust in authorities and mobile populations, a broader approach is required to engage affected communities. In the medium-term health system development with attention to primary level services and community-based programmes to address the major disease burden of malaria, diarrhoeal disease, meningitis, tuberculosis and malnutrition is needed. This requires the development of local management and an investment in human resources for health. Crucially this has to be developed ahead of, and not in parallel with, future outbreaks. In the longer-term a commitment is required to address the underlying social determinants which make these countries so vulnerable, and limit their capacity to respond effectively to, epidemics such as EVD. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET Brief","field_subtitle":"EQUINET, June 2016","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQUINET%20brief%202016.pdf","body":"This brief introduces EQUINET, our organisation, work and the lessons we have learned in the struggle for equity and social justice in health. EQUINET is a consortium network of institutions registered in different countries in the region, with its secretariat at TARSC, a non-profit organization registered in Zimbabwe. The network constitution sets out its vision, principles, composition, structures, governance and procedures. The network is governed by a steering committee of institutions leading key areas of work from within and beyond east and southern Africa. The steering committee includes academic, government, civil society, parliament and non-profit institutions that co-ordinate different theme, process and country activities in the network and the secretariat. The five clusters of EQUINET work are: 1. Cross cutting equity analysis, integrating work in other clusters and the pra4equity network on PAR and the newsletter, together with theme work on the equity watch and district health systems. 2. Health rights and the law, integrating work of the learning network on heath rights, theme work on law and constitutional rights in health, and work in national networks. 3. Fairly resourcing health systems, integrating theme work on health financing and health workers. 4. Social empowerment for health, integrating theme work on health centre committees, and with parliamentarians and civil society. 5. Global engagement, including work on trade and health and health diplomacy.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Discussion paper 107: Literature Review: Essential health benefits in east and southern Africa","field_subtitle":"Todd G; Mamdani M; Loewenson R: IHI, Tanzania, TARSC, EQUINET, Harare, June 2016","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss%20107%20EHB%20litrev%20May2016.pdf","body":"An Essential Health Benefit (EHB) is a policy intervention designed to direct resources to priority areas of health service delivery to reduce disease burdens and ensure equity in health. Many east and southern Africa (ESA) countries have introduced or updated EHBs in the 2000s. Recognising this, EQUINET, through Ifakara Health Institute and Training and Research Support Centre is implementing research to understand the role of facilitators and the barriers to nationwide application of the EHB in resourcing, organising and in accountability on integrated health services. This literature review provides background evidence to inform the case study work and regional dialogue. It compiles evidence from published and public domain literature on EHBs in sixteen ESA countries, including information on the motivations for developing the EHBs; the methods used to develop, define and cost them; how they are being disseminated and communicated within countries; how they are being used in budgeting, resourcing and purchasing health services and in monitoring health system performance for accountability; and the facilitators and barriers to their development, uptake or use.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 184: Learning from regional work on health centre committees","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Header"}},{"node":{"title":"Gender Equality and Equity in Health Will Anchor Drive Towards a Sustainable National Development","field_subtitle":"Chatterjee S; Kariuki S: Inter Press Service, April 2016","URL":"http://kenya.unfpa.org/video/launch-assessment-report-unfpa-advocacy-campaign","body":"The Government of Kenya (GoK) in partnership with United Nations Population Fund (UNFPA) at the sidelines of the 60th Session of the UN Commission of Women in New York launched the report on the \u2018Assessment of the UNFPA Campaign to End Preventable Maternal and New-born Mortality in support of the Campaign for Accelerated Reduction of Maternal Mortality in Africa\u2019  The report captures the important strides the country has made to significantly address disparities in advancing maternal and new-born health at all levels, as part GoK's commitment to address inequalities, as a key principle of Agenda 2030, to ensure that no one is left behind. This video records the event.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Global Report on Diabetes","field_subtitle":"World Health Organization, Geneva, 2016","URL":"http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua=1","body":"Diabetes prevalence is steadily increasing everywhere, most markedly in the world's middle-income countries. In many settings the environments and services do not enable the prevention and management of diabetes. As part of the 2030 Agenda for Sustainable Development, Member States have set an ambitious target to reduce premature mortality from non communicable diseases - including diabetes \u2013 by one third. This report presents trends in diabetes prevalence, in the contribution of high blood glucose (including diabetes) to premature mortality, and outlines actions governments are taking to prevent and control diabetes. From the analysis it is clear that stronger responses are needed not only from different sectors of government, but also from civil society and people with diabetes themselves, and also producers of food and manufacturers of medicines and medical technologies. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Health Systems Global seeks views on its next five years","field_subtitle":"Health Systems Global: June 2016","URL":"http://tinyurl.com/zgb3c43","body":"HSG is asking its members and other interested parties to share their views to inform HSG\u2019s priorities over the next five years. HSG\u2019s 2016-2020 Draft Strategic Plan sets out the membership network\u2019s strategic objectives and what actions should be taken in pursuit of these. Please also see the slideshow outlining the 2016-2020 Draft Strategic Plan. The HSG Strategic Plan 2016-2020 consultation process will run from 17 June until the end of 22 July 2016. HSG particularly welcomes ideas and suggestions in response to the following questions: How can HSG be an attractive home and effective voice for a diverse membership of policy-makers, researchers, NGOs, media and funders? And what can HSG do to bring these different groups together? What are the key Health Policy and Systems Research (HPSR) issues that HSG should be actively advocating on and should HSG be a more conspicuous campaigner for its members and the wider health systems community? If so, how? How can HSG grow its membership in geographic regions and stakeholder communities (policy-makers, researchers, NGOs, media and funders) where its membership base is currently smaller? HSG members and other stakeholders can participate in this consultation process in a number of different ways, including two face-to-face consultation meetings, an online consultation and feedback submission via email.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"How can health ministries present persuasive investment plans for women\u2019s, children\u2019s and adolescents\u2019 health?","field_subtitle":"Anderson I; Maliqi B; Axelson H; Ostergren M: Bulletin of the World Health Organisation 94(6) 468-474, 2016","URL":"http://www.who.int/bulletin/volumes/94/6/15-168419/en/","body":"Most low- and middle-income countries face financing pressures if they are to adequately address the recommendations of the Global Strategy for Women\u2019s, Children\u2019s and Adolescent\u2019s Health. Negotiations between government ministries of health and finance are a key determinant of the level and effectiveness of public expenditure in the health sector. Yet ministries of health in low- and middle-income countries do not always have a good record in obtaining additional resources from key decision-making institutions. This is despite the strong evidence about the affordability and cost\u2013effectiveness of many public health interventions and of the economic returns of investing in health. This article sets out 10 attributes of effective budget requests that can address the analytical needs and perspectives of ministries of finance and other financial decision-makers. The authors developed the list based on accepted economic principles, a literature review and a workshop in June 2015 involving government officials and other key stakeholders from low- and middle-income countries. The aim is to support ministries of health to present a more strategic and compelling plan for investments in the health of women, children and adolescents.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"International AIDS Conference","field_subtitle":"17th-22nd July 2016, Durban, South Africa","URL":"http://www.aids2016.org/","body":"The International AIDS Conference is a gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess state of affairs, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.  The AIDS 2016 programme will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. A variety of session types \u2013 from abstract-driven presentations to symposia, bridging and plenary sessions \u2013 will meet the needs of various participants. Other related activities, including the Global Village, satellite meetings, exhibitions and affiliated independent events, will contribute to an exceptional opportunity for professional development and networking. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Joint Statement - First Plenary Meeting of the Africa Global Partnership Platform","field_subtitle":"African Union: New Partnership for Africa's Development, Dakar, October 2015","URL":"http://www.nepad.org/resource/joint-statement-first-plenary-meeting-africa-global-partnership-platform","body":"The first plenary meeting of the Africa Global Partnership Platform (AGPP/the Platform) was held in Dakar, Senegal on 22 October 2015. The meeting re-affirmed the strong commitment of African countries and partners to achieving food security for the continent, through agricultural growth and transformation to create agricultural commodity value chains for smallholder farmers, create job opportunities for the youth in food and agricultural value chains, and support entry and participation of women and youth in agricultural and agri-food SMEs, in line with SDG 8. This was also seen as the most viable entry point for sustainable industrialization on the continent. The meeting also underlined the need to promote further regional integration, particularly through the development of intra-African trade of food and agricultural commodities. The signing of the COMESA-EAC-SADC Tripartite Free Trade Agreement and the fast-tracking of negotiations for the Continental Free Trade Area was seen as important to contribute to more stable food and agricultural markets at regional and country levels in Africa. The meeting highlighted the gaps in implementation of the  CAADP goal of allocating at least 10% of public expenditure to the agricultural sector. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Learning from regional work on health centre committees","field_subtitle":"I Rusike, T Nkrumah, C Chimhete, F Kowo and E Mutasa, Community Working Group on Health","body":"\r\nHealth Centre Committees (HCCs) are a mechanism through which community participation can be integrated into the health system to achieve a sustainable people-centered health system. \r\n\r\nThese community-based committees are increasingly becoming an established voice of the communities providing input into the health service delivery processes in the 16 East and Southern Africa (ESA) countries covered by EQUINET. In the Ngombe area of Lusaka, Zambia, for example, the Neighborhood Health Councils with local government have successfully addressed water and sanitation, garbage and housing concerns. In Kenya, Health Facility Committees manage funds from the Health Sector Services Fund for primary care, outreach and community based services. They link the facility with the community, to plan and oversee the performance of the services. \r\n\r\nIn a regional dialogue, delegates from ESA countries urged national authorities to better recognize and work with HCCs. Their recommendations, captured in EQUINET Policy Brief 37, included reforming public health laws to include provisions for participation and public information and to set laws that provide for the roles and duties of HCCs, backed by adequate information, training and resources for them to play these roles. \r\n\r\nTo advance these recommendations a consortium of organizations have come together in EQUINET to build and strengthen the capacity and effectiveness of HCCs, led by the Community Working Group on Health (CWGH) in partnership with the Training and Research Support Centre (TARSC) on photovoice and information sharing; University of Cape Town (UCT) School of Public Health on training programmes; and the Lusaka District Health Management Team (LDHMT) on legal provisions.  With work in Kenya, Zambia, Malawi, South Africa, Uganda, and Zimbabwe and at ESA regional level, we are advocating for policy and legal recognition of HCCs, giving visibility to their roles as well as identifying and strengthening the different capacities that committees, communities and the health systems need for HCCs to implement these roles. This includes areas such as tracking and monitoring health system budgets and resources and their use and health system performance as well as the building social dialogue and accountability. \r\n\r\nAs part of the work, UCT in South Africa is building a database of information on the current training materials and training programmes for HCCs to enable us to share materials, skills and experiences on capacity building in the region, and to advocate for HCC training that addresses their roles comprehensively. and their coverage of the key areas of functioning.  LDHMT in Zambia has initiated an in-country process to review the laws and regulations that provide for the establishment and functioning of HCCs, and to document the Zambia experience for wider regional exchange. In Zimbabwe, the CWGH has supported the HCCs to engage with government, so that HCC members can speak out about their concerns on the health system and on the support they need to successfully implement their roles. Training on community photography by TARSC means that the members have visual tools as well as words to raise evidence on their problems and progress. \r\n\r\nMost ESA countries still do not have laws that explicitly or adequately recognise the functioning of the HCCs. We are thus advocating for their legal status and for them to have constitutions. This is important for their accountability to communities. It is also necessary if they are to directly receive, manage and account for public funds as was the case with Neighbourhood Health Committees in Zambia in the 1990s. The HCCs\u2019 current vague mandates weaken their effectiveness, role and legitimacy, for communities and local actors and at national-level.  We are thus sharing information on HCC constitutions, and on laws, statutes or guidelines on HCCs in the region and promoting their inclusion in law, including by showing their important positive role in the health system.\r\n\r\nAs a consortium, we are building a regional database of institutions and organizations working with HCCs in ESA countries so that we can better exchange and share information on the training materials, programmes underway with HCCs and the learning from them. We invite colleagues to send information to EQUINET if they are working in this area.  We are building innovative ways of sharing and learning from our work, that build more direct voice, such as through photovoice where cameras are being put into the hands of communities and HCC members to identify and document community perspectives, experiences and actions related to their health conditions to be used in local HCC dialogue and wider reflection and learning. \r\n\r\nMembers of HCCs are carrying out exchange visits to allow for more direct learning and collective understanding of problems and achievements, creating inspiration to keep working and resulting in the launch of new initiatives. \r\n\r\nWe have seen evidence of the positive impact of HCCs in improved health outcomes. In Zimbabwe for example, since 2009, HCCs have played a role in in decision-making on the use of performance based funds at clinics, promoting improvements in facility-based deliveries, improving uptake of antenatal care and postnatal care visits and supporting demand by communities for these resources to be used to ensure delivery on patients\u2019 rights at clinics. They have also mobilized resources to develop clinics such as by building waiting mothers\u2019 homes, fencing clinics, supporting community health workers and raising advocacy on the needs of local services at higher levels. \r\n\r\nWe are seeing an increasing appreciation of the role of HCCs in community and primary care health interventions, with increasing attention and support from government, international and national partners. Our HCC in-country exchange visits are proving to be an effective way of sharing knowledge  and good practice, inspiring others to see their own potential and act when they see the practical successes of other HCCs.  \u201cHCC exchange visits are rich in knowledge and should always be a key part of HCC activities carried out at local, district, provincial and national levels,\u201d  said Brighton Ngoteni, the HCC chairperson of Mudanda Clinic in Manicaland, Zimbabwe.\r\n\r\nOur regional exchanges have also shown us that HCCs can only be as strong as the communities that support them. For this, we need to have recognition of the right to health, including on constitutions in the region, and comprehensive primary health care approaches that support health literacy and that inform communities, include communities and the views they bring in plans and services and give feedback to the communities for a people centred approach to universal health systems. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org and find further publications on the issue on the EQUINET website at www.equinetafrica.org","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"MamaYe Factsheet on Malawi\u2019s Blood Services","field_subtitle":"MamaYe \u2013 Evidence for Action, Dar es Salaam, 2016","URL":"http://www.mamaye.org/en/evidence/mamaye-factsheet-malawi%E2%80%99s-blood-services-2016","body":"MamaYe is a campaign initiated by Evidence for Action, a multi-year programme which aims to improve maternal and newborn survival in sub-Saharan Africa. It is led by African experts in the six countries, Nigeria, Ghana, Sierra Leone, Ethiopia, Malawi and Tanzania and supported by experts in academic and other institutions specialising in maternal and newborn health. MamaYe has produced a factsheet to summarise the evidence on Malawi\u2019s blood services, including how much blood is collected and how much is needed. Just over one third of blood needed in Malawi is being collected. The factsheet covers the importance of blood for preventing maternal deaths, the 4 key components of World Health Organization\u2019s strategy for safe and effective use of blood and achievements in Malawi in blood donation and availability. The factsheet also reviews continued challenges for availability of blood in Malawi and an overview of Malawi\u2019s blood transfusion services, including: the organisation of the blood transfusion services; blood supply; donor population; blood use towards maternal, newborn and child health; and blood safety and screening.  ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Medical savings accounts: assessing their impact on efficiency, equity and financial protection in health care","field_subtitle":"Wouters O; Cylus J;  Yang W; Thomson S; McKee M: Health Economics, Policy and Law, 1(3)321-35, 2016 ","URL":"http://eprints.lse.ac.uk/65448/1/Medical%20savings%20accounts.pdf","body":"Medical savings accounts (MSAs) allow enrolees to withdraw money from earmarked funds to pay for health care. The accounts are usually accompanied by out-of-pocket payments and a high-deductible insurance plan. This article reviews the association of MSAs with efficiency, equity, and financial protection. The authors draw on evidence from four countries where MSAs play a significant role in the financing of health care: China, Singapore, South Africa, and the United States of America. The available evidence suggests that MSA schemes have generally been inefficient and inequitable and have not provided adequate financial protection. The impact of these schemes on long-term health-care costs is unclear. Policymakers and others proposing the expansion of MSAs should make explicit what they seek to achieve given the shortcomings of the accounts.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Meet BRCK, Internet access built for Africa","field_subtitle":"Juliana Rotich: TED Talk, June 2013","URL":"http://www.ted.com/talks/juliana_rotich_meet_brck_internet_access_built_for_africa","body":"Tech communities are booming all over Africa, says Nairobi-based Juliana Rotich, cofounder of the open-source software Ushahidi. But it remains challenging to get and stay connected in a region with frequent blackouts and spotty Internet hookups. So Rotich and friends developed BRCK, offering resilient connectivity for the developing world. Juliana Rotich is co-founder and executive director of Ushahidi, a nonprofit tech company, born in Africa, that develops free and open-source software for information collection, interactive mapping and data curation. Ushahidi builds tools for democratizing information, increasing transparency and lowering the barriers for individuals to share their stories. Through Crowdmap.com, Swiftly.org and accompanying mobile applications, Ushahidi is making crowdsourcing tools available and useful. Their latest product is BRCK, a tool for resilient connectivity -- anywhere.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Metrics in Urban Health: Current Developments and Future Prospects","field_subtitle":"Prasad A; Gray C; Ross A; Kano M: Annual Review of Public Health 37, 113-133, 2016","URL":"http://qhr.sagepub.com/content/26/8/1019.full.pdf+html","body":"The research community has shown increasing interest in developing and using metrics to determine the relationships between urban living and health. In particular, the authors have seen a recent exponential increase in efforts aiming to investigate and apply metrics for urban health, especially the health impacts of the social and built environments as well as air pollution. A greater recognition of the need to investigate the impacts and trends of health inequities is also evident through more recent literature. Data availability and accuracy have improved through new affordable technologies for mapping, geographic information systems and remote sensing. However, less research has been conducted in low- and middle-income countries where quality data are not always available, and capacity for analysing available data may be limited. For this increased interest in research and development of metrics to be meaningful, the best available evidence must be accessible to decision makers to improve health impacts through urban policies.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Millions of Malawians hungry as food crisis deepens","field_subtitle":"Henderson P: Pambuzuka News, 16 June 2016","URL":"http://tinyurl.com/z8b35pt","body":"The author reports that Almost four million Malawians are battling severe famine due to poor or no harvests because of the effect of El Nino, which last year affected most of the country\u2019s southern and northern regions, and that this could double by the end of the year. The number of hungry people is expected to rise to eight million by December 2016 and this is exactly half of the population. Torrential rains in the north aggravated the already dramatic situations, and in February a state of emergency was declared. In the meantime food prices continue to rise as Malawi\u2019s Kwacha continues to lose value, forcing the poorest families to further reduce their already precarious daily meals, or to sell goods in order to make ends meet. According to a report by World Food Program (WFP) of May, 2016, in most parts in Southern Africa harvesting was underway, temporarily alleviating some market pressure and allowing for food price improvements in pockets of the region as people consume their own production. The report, however, states that, crop expectations remain poor following one of the driest seasons in 35 years with seasonal rainfall deficits experienced throughout the region, particularly in central and southern Malawi.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"New health sector strategies on HIV, viral hepatitis and sexually transmitted infections","field_subtitle":"World Health Organisation: Geneva, June 2016","URL":"http://www.who.int/hiv/strategy2016-2021/en/","body":"Three global health sector strategies on HIV, viral hepatitis and sexually transmitted infections (STIs) for 2016-2021 were adopted by the 2016 World Health Assembly, outlining key actions to be undertaken by countries and WHO, along five strategic directions, over the course of the next six years. The HIV strategy aims to achieve \"fast-track\" targets by 2020 towards ending AIDS by 2030. The hepatitis strategy \u2013 the first of its kind - introduces the first-ever global targets, including the target to eliminate viral hepatitis as a public health threat by 2030.  For the HIV strategy, a central element for success will be country efforts to implement \"Treat All\" recommendations. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"No health security without health systems","field_subtitle":"Kamal-Yanni M: Global Health Check, May 2016","URL":"http://www.globalhealthcheck.org/?p=1865","body":"The Ebola outbreak shocked the world of global health. Even while Ebola lingers in West Africa the future of health security and the organisation of health systems are being debated. There have been many conferences held and reports published to provide \u201clessons learned from the Ebola crisis. A thread running through all of these events has been an agreement on the need to build resilient health systems. Yet building such a system requires planning, investment and serious long term commitment. Short term investment does not produce the necessary workforce needed for a functioning health system. Dhillon and Yates identified 5 key areas that require immediate attention in order to rebuild health systems: community based systems; access to generic medicines; restoring preventive measures; integrating surveillance into health systems and strengthening management. The author identifies 6 critical foundations for resilient health systems: An adequate number of trained health workers, including non-clinical staff and Community Health Workers (CHWs), available medical supplies, including medicines, diagnostics and vaccines, robust health information systems, including surveillance, an adequate number of well-equipped health facilities including access to clean water and sanitation, adequate financing and a strong public sector to deliver equitable, quality services. The author argues that building resilient systems that protect people\u2019s health and deal with outbreaks has to address all the six elements of the system simultaneously and systematically and that a long term global commitment for building health systems must start now.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Pain in amaXhosa Women Living With HIV/AIDS: Translation and Validation of the Brief Pain Inventory\u2013Xhosa","field_subtitle":"Parker R; Jelsma J; Stein D: Journal of Pain and Symptom Management 51(1)126-132, 2016","URL":"http://www.jpsmjournal.com/article/S0885-3924(15)00449-2/fulltext","body":"Pain has been reported as the second most commonly reported symptom in people living with HIV. In South Africa, there are more than five million people living with HIV. Approximately, two million belong to the Xhosa cultural group. A culturally appropriate, valid, and reliable instrument is required to measure pain and its impact in this population. This article documents the process of translation of the Brief Pain Inventory (BPI) into the BPI-Xhosa and presents the results of the validity and reliability testing of the instrument. The translated BPI-Xhosa, a demographic questionnaire and the European Quality of Life-5 Dimensions Xhosa version (EQ-5D-Xhosa) health-related quality of life instrument were administered to 229 amaXhosa women living with HIV in a resource-poor urban settlement in South Africa. A 74% prevalence of pain was recorded. The BPI-Xhosa had good concurrent validity when compared with the previously validated EQ-5D-Xhosa. The BPI-Xhosa was found to be a valid instrument to measure pain prevalence, severity, and interference in amaXhosa women living with HIV.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Questioning Photovoice Research: Whose Voice?","field_subtitle":"Evans-Agnew R; Rosemberg MA: Qualitative Health Research 26(8) 1019-1030, 2016","URL":"http://qhr.sagepub.com/content/26/8/1019.full.pdf+html","body":"Photovoice is an important participatory research tool for advancing health equity. This paper critically reviews how participant voice is promoted through the photovoice process of taking and discussing photos and adding text/captions. PubMed, Scopus, PsycINFO, and Web of Science databases were searched from the years 2008 to 2014  and reviewed for how participant voice was (a) analysed, (b) exhibited in community forums, and (c) disseminated through published manuscripts. Of 21 studies, 13 described participant voice in the data analysis, 14 described participants\u2019 control over exhibiting photo-texts, seven manuscripts included a comprehensive set of photo-texts, and none described participant input on choice of manuscript photo-texts. The findings indicate that photovoice designs vary in the advancement of participant voice, with the least advancement occurring in manuscript publication. The authors indicate that future photovoice researchers should expand approaches to advancing participant voice.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"SADC Ministers of Labour & Social Partners Approve Policy Frameworks on Youth Employment and Portability of Social Security Benefits","field_subtitle":"Southern Africa Coordination Council (SATUCC), 8 June 2016","URL":"http://tinyurl.com/htjc57a","body":"In May 2016, the Southern African Development Community (SADC) Ministers of Labour and Social Partners at their meeting in Gaborone, Botswana, considered and approved two regional policy frameworks pertaining to employment and labour as part of the milestones for the SADC Regional Decent Work Programme (2013-2019). These are: SADC Youth Employment Promotion Policy Framework and the Cross boarder Portability of Accrued Social Security Benefits Policy Framework. The SADC Youth Employment Promotion Policy Framework guides SADC Member States on a harmonised, integrated and coherent approach to realising decent, secure and sustainable employment and entrepreneurship for the youth in the SADC region. The SADC Cross boarder Portability of Accrued Social Security Benefits Policy Framework responds to the fact that non-citizens are quite often discriminated against when it comes to access to social security. Portability of social security benefits is limited because SADC countries do not have a common regional policy framework on the matter despite that a few countries had already concluded bilateral labour and social security agreements. The main aim of the SADC Cross boarder Portability of Accrued Social Security Benefits Policy Framework is thus to provide mechanisms to enable workers moving within the SADC region to keep the social security benefits which they might have acquired under the legislation of one Member State or to enjoy corresponding rights under the legislation of the other Member State.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Setting targets for human resources for eye health in sub-Saharan Africa: what evidence should be used?","field_subtitle":"Courtright P; Mathenge W; Kello A; Cook C; Kalua K; Lewallen S: Human Resources for Health14(1)11, 2016","URL":"http://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0107-x","body":"With a global target set at reducing vision loss by 25% by the year 2019, sub-Saharan Africa with an estimated 4.8 million blind persons will require human resources for eye health (HReH) that need to be available, appropriately skilled, supported, and productive. Targets for HReH are useful for planning, monitoring, and resource mobilization, but they need to be updated and informed by evidence of effectiveness and efficiency. Supporting evidence should take into consideration (1) ever-changing disease-specific issues including the epidemiology, the complexity of diagnosis and treatment, and the technology needed for diagnosis and treatment of each condition; (2) the changing demands for vision-related services of an increasingly urbanized population; and (3) interconnected health system issues that affect productivity and quality. The existing targets for HReH and some of the existing strategies such as task shifting of cataract surgery and trichiasis surgery, as well as the scope of eye care interventions for primary eye care workers, will need to be re-evaluated and re-defined against such evidence or supported by new evidence.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Simon Njami on the restitution of African art and artists\u2019 huge potential for subversion","field_subtitle":"Cessou S: _TRUEAfrica, April 2016","URL":"http://tinyurl.com/zqsdmpv","body":"This is an interview with Simon Njami, a curator responsible for many exhibitions of contemporary African art gathering artists from 20 different African countries. On African photography he notes \u2018Photography is necessarily contextual. First, it\u2019s about the gaze and who is taking the picture. In Africa, it\u2019s also a matter of re-appropriating one\u2019s own image. The South African photographer Santu Mofokeng questions the role of humanity in his work. Africa is only 50 years old. It has done a lot to rebuild the past, live the present and look towards the future.\u2019 On art and politics on the continent he argues \u2018Egyptian artists were at the forefront of the protest before the Revolution. Senegalese young rappers launched the movement Y\u2019en a Marre (\u2018Enough is enough\u2019) in 2011...Art has a dual function....It\u2019s a space of relative freedom\u2019 . He raises the huge social potential of art, but also says 'Having said that, one has to tickle an elephant for a while before it starts laughing. In practice, change takes a while, even if it seems inevitable'.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"South African Health Review 2016","field_subtitle":"Padarath A; King J; Mackie E; Casciola J: Health Systems Trust, 2016","URL":"http://www.hst.org.za/publications/south-african-health-review-2016","body":"The 2016 South African Health Review presents evidence on the current legislative and policy framework guiding healthcare delivery, the challenges that underpin the performance of the health system, on water and food; and on personnel and programmes in the public health system. The report indicates that although tackling HIV targets will be daunting, they are likely to be affordable and cost-effective if implemented in a phased way and if annual increments to Government AIDS budgets are sustained. The report also discusses South Africa\u2019s pharmaceutical pricing and transparency and the concept of and benefit from health research observatories. Finally the report provides a wide range of information on health trends, with a specific focus on the data needed to monitor non-communicable diseases.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Spatial modelling of perinatal mortality in Mchinji, Malawi","field_subtitle":"Banda M; Kazembe L; Lewycka S; King C; Phiri T; Masache G; Kazembe P; Mwasambo C: Spatial and spatio-temporal epidemiology16, 50-58, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S1877584515000490","body":"Annual global estimates of perinatal mortality show Malawi among sub-Saharan Africa with the highest rates. Targeted interventions are required to reduce this mortality. This study aimed to quantify small-scale geographical variations in perinatal mortality, and estimate risk factors associated with perinatal mortality in Mchinji district. Factors associated with reduced perinatal mortality were: previous pregnancy; early and consistent use of antenatal care; syphilis test; abdominal examination; pregnancy danger signs advice; skilled birth attendant; normal labour duration; gestation period of at least 9 months; and normal delivery. Perinatal babies whose mothers had a blood test were associated with high probability of dying. Perinatal babies from mothers between 16 and 40 years had reduced prevalence of dying while those aged less than 16 years and greater than 40 years were associated with higher prevalence of dying. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The History of the HIV/AIDS Epidemic in Africa","field_subtitle":"Kagaayi J; Serwadda D:  Current HIV/AIDS Reports, doi 10.1007/s11904-016-0318-8 May 2016","URL":"http://link.springer.com/article/10.1007%2Fs11904-016-0318-8","body":"HIV testing of African immigrants in Belgium showed that HIV existed among Africans by 1983. However, the epidemic was recognized much later in most parts of sub-Saharan Africa due to stigma and perceived fear of possible negative consequences to the countries\u2019 economies. This delay had devastating mortality, morbidity, and social consequences. In countries where earlier recognition occurred, political leadership was vital in mounting a response. The response involved establishment of AIDS control programs and research on the HIV epidemiology and candidate preventive interventions. Over time, the number of effective interventions has grown. Triple antiretroviral therapy (ART) has led to a rapid decline in HIV-related morbidity and mortality in addition to prevention of onward HIV transmission. Other effective interventions include safe male circumcision, and pre- and post-exposure prophylaxis. However, since none of these is sufficient by itself, the authors argue for a combination package of these interventions in the public health response.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The People Versus The Rainbow Nation","field_subtitle":"Alyssa Klein: OkayAfrica, 19 May 2016","URL":"http://www.okayafrica.com/film/the-people-versus-the-rainbow-nation-documentary-south-africa/","body":"\u201cIs South Africa\u2019s rainbow nation a myth? What is race in 2016?\u201d These are the questions explored in a powerful new documentary film from South Africa. The People versus the Rainbow Nation investigates what drove the country\u2019s students towards mass action in 2015, between the successful #RhodesMustFall campaign to the nationwide #FeesMustFall protests. Filmmaker Lebogang Rasethaba (Future Sound of Mzansi) and producer Allison Swank follow the lives of students across four South African universities as they explore the notion that more than two decades since South Africa\u2019s first democratic elections, the struggle is far from over. \u201cI think it\u2019s about to get really intense in South Africa,\u201d says one student. \u201cI don\u2019t believe in the Rainbow Nation. The Rainbow Nation is a fallacy,\u201d says another.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The role of the law in reducing tuberculosis transmission in Botswana, South Africa and Zambia","field_subtitle":"Verani A; Emerson C; Lederer P; Like G; Kapata N; Lanje S; Peters A; Zulu I; Marston B; Miller B: Bulletin of the World Health Organization, 94(6), 405-480, 2016","URL":"http://www.who.int/bulletin/volumes/94/6/15-156927/en/","body":"This study determined whether laws and regulations in Botswana, South Africa and Zambia \u2013 three countries with a high tuberculosis and HIV infection burden \u2013 address elements of the World Health Organisation (WHO) policy on tuberculosis infection control. An online desk review of laws and regulations that address six selected elements of the WHO policy on tuberculosis infection control in the three countries was conducted in November 2015 using publicly available domestic legal databases. The six elements covered: (i) national policy and legal framework; (ii) health facility design, construction and use; (iii) tuberculosis disease surveillance among health workers; (iv) patients\u2019 and health workers\u2019 rights; (v) monitoring of infection control measures; and (vi) relevant research. The six elements were found to be adequately addressed in the three countries\u2019 laws and regulations. In all three, tuberculosis case-reporting is required, as is tuberculosis surveillance among health workers. Each country\u2019s legal and regulatory framework also addresses the need to respect individuals\u2019 rights and privacy while safeguarding public health. These laws and regulations create a strong foundation for tuberculosis infection control. Although the legal and regulatory frameworks thoroughly address tuberculosis infection control, their dissemination, implementation and enforcement were not assessed, nor was their impact on public health. The authors argue that future research should assess the implementation and public health impact of these laws and regulations.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The world's health sector is expanding. Can it heal our economies?","field_subtitle":"Tulenko K: World Economic Forum, May 2016","URL":"http://tinyurl.com/jm8scvb","body":"The author writes that the health sector is predicted to be the largest source of job creation for the next decade globally. Its growth is being driven by increasing numbers of older people and by the expansion of the global middle class. As these two groups grow, the higher levels of healthcare they demand will cause seismic shifts in the amount of money being spent in the health sector, driving employment. Even without these trends, the world would need millions more health workers. Despite increased training, it is not meeting population demand. The world no longer dominated by infectious diseases requiring episodic treatment, and is instead becoming dominated by non-communicable, chronic diseases such as heart disease, diabetes, cancer, and mental-health conditions, which require continuous treatment. Unlike traditional employment sectors such as agriculture and manufacturing, which shed jobs as technology advances, healthcare tends to add jobs with increasing technology. The author argues that the health sector will be an economic engine that not only creates new jobs and business but, by making workers in other sectors healthier and more productive, will enable those sectors to grow faster creating tens of millions of new jobs. \r\n","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Trends and risk factors for childhood diarrhoea in Sub-Saharan countries (1990 - 2013): Assessing the neighbourhood inequalities.","field_subtitle":"Bado A; Susuman A; Nebie E: Global Health Action 9(30166), May 2016, ","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/30166","body":"This paper assesses the risk factors of and neighborhood inequalities in diarrhoeal morbidity among under-5 year old children in selected countries in sub-Saharan Africa over the period 1990\u20132013, using DHS data from selected countries. The findings showed that the proportion of diarrhoeal morbidity among under-5 children varied considerably across the cohorts of birth from 10% to 35%, with increasing inequalities across DHS rounds. The main risk factors were the child\u2019s age, size of the child at birth, the quality of the main floor material, mother\u2019s education and her occupation, type of toilet, and place of residence. ","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Universal Health Coverage\u2019s evolving location in the post-2015 development agenda: Key informant perspectives within multilateral and related agencies during the first phase of post-2015 negotiations","field_subtitle":"Brolan C; Hill P: Health Policy and Planning 31(4) 514-526, 2015","URL":"http://heapol.oxfordjournals.org/content/31/4/514.full","body":"This study examines health\u2019s evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related agencies. Using discourse analysis, this article reports the results and analysis of a Universal Health Coverage (UHC) theme: contextualizing UHC\u2019s positioning within the post-2015 agenda-setting process immediately after the Global Thematic Consultation on Health and High-Level Panel of Eminent Persons on the Post-2015 Development Agenda (High-Level Panel) released their post-2015 health and development goal aspirations in April and May 2013, respectively. Although more participants support the High-Level Panel\u2019s May 2013 report\u2019s proposal\u2014\u2018Ensure Healthy Lives\u2019\u2014as the next umbrella health goal, they nevertheless still emphasize the need for UHC to achieve this and thus be incorporated as part of its trajectory. The final post-2015 SDG framework for UN General Assembly endorsement in September 2015 confirmed UHC\u2019s continued distillation in negotiations, as UHC ultimately became one of a litany of targets within the proposed global health goal.","php":"","field_issue_date":"2016-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"\"I don't have options but to persevere.\" Experiences and practices of care for HIV and diabetes in rural Tanzania: a qualitative study of patients and family caregivers.","field_subtitle":"Mwangome M; Geubbels E; Klatser P; Dieleman M: Int Jo for Equity in Health 15(1)56, 2016, doi:10.1186/s12939-016-0345-5","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818906/","body":"The high prevalence of chronic diseases in Tanzania is putting a strain on the already stretched health care services, patients and their families. This study sought to find out how health care for diabetes and HIV is perceived, practiced and experienced by patients and family caregivers, to inform strategies to improve continuity of care. Thirty two in-depth interviews were conducted among 19 patients (10 HIV, 9 diabetes) and 13 family caregivers (6 HIV, 7 diabetes).  The innovative care for chronic conditions framework informed the study design. Three major themes emerged; preparedness and practices in care, health care at health facilities and community support in care for HIV and diabetes. In preparedness and practices, HIV patients and caregivers knew more about aspects of HIV than did diabetes patients and caregivers on diabetes aspects. Continued education on care for the conditions was better structured for HIV than diabetes. On care at facilities, HIV and diabetes patients reported that they appreciated familiarity with providers, warm reception, gentle correction of mistakes and privacy during care. HIV services were free of charge at all levels. Costs involved in seeking services resulted in some diabetes patients to not keep appointments. There was limited community support for care of diabetes patients. Community support for HIV care was through community health workers, patient groups, and village leaders. Diabetes and HIV have socio-cultural and economic implications for patients and their families. The HIV programme is successfully using decentralization of health services, task shifting and CHWs to address these implications. For diabetes and NCDs, decentralization and task shifting are also important and, strengthening of community involvement is warranted for continuity of care and patient centeredness in care. While considering differences between HIV and diabetes, the authors show that Tanzania's rich experiences in community involvement in health can be leveraged for care and treatment of diabetes and other NCDs.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"5th Annual East African Health and Scientific Conference and Exhibition Concludes in Kampala, Uganda","field_subtitle":"East African Community Headquarters, Kampala, Uganda, March 2015","URL":"http://tinyurl.com/glt3t8p","body":"The EAC Sectoral Council of Health Ministers Regional Health Sector Strategic Plan (2015-2020) is a roadmap for improving and strengthening of the regional health sector through implementation of the various approaches, interventions and innovation in the region.  The 5th EAC Health and Scientific Conference  contributes to and is a catalyst for strengthening regional cooperation in the health sector especially with regard to the improvement of health care service delivery and patient care outcomes. It is a platform for synthesizing, sharing and dissemination of research findings to inform policy makers, scientists and programmers on evidence-based decision-making and mobilization of political will and resources for the Health Sector.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"African Newsletter on Occupational Health and Safety Issue of Infectious Diseases","field_subtitle":"African Newsletter on Occupational Health and Safety 25 (1), 2015","URL":"http://www.ttl.fi/en/publications/electronic_journals/african_newsletter/Documents","body":"This issue of the African Newsletter on Occupational Health and Safety examines infectious disease and occupational health. Marie-Paul Kelly explores governance and leadership, both at regional and global levels in preventing health emergencies.  The issue explores guidance to workplaces and occupational health professionals in prevention of occupational infections and examines the workplace as an arena for raising awareness on infectious diseases. Further papers look at protecting front-line health care workers and enterprise workers from Ebola. Jeanneth Manganyi and Kerry Wilson author a paper on the importance of respirator fit testing and proper use of respirators. Further articles in the issue explore food-borne illnesses at workplaces, the effectiveness of personal protective equipment to prevent Ebola transmission and the use of blunt suture needles to halve the risk of needle stick injuries among surgeons.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Assessing equitable health financing for universal health coverage: a case study of South Africa","field_subtitle":"Ataguba J: Applied Economics, 3 February 2016, doi: 10.1080/00036846.2015.1137549","URL":"http://www.tandfonline.com/doi/full/10.1080/00036846.2015.1137549","body":" This article argues that an assessment of progressivity over time can provide an indication of progress towards a \u2018more\u2019 progressive or a \u2018less\u2019 regressive health financing system and can be useful to policymakers. It introduces a framework to characterize \u2018shifts\u2019 in progressivity in health financing between two time periods using the popularly known Kakwani index of progressivity and other associated indices. It also decomposes the \u2018shifts\u2019 in progressivity into the relative contributions of the changes in income distribution and the changes in the distribution of health payments. Further, it proposes graphics that statistically analyses how the \u2018shifts\u2019 in progressivity vary along the distribution of income. A pro-poor (pro-rich) shift implies that the health financing mechanism is becoming more (less) progressive or less (more) regressive between two time periods. A proportional shift means that progressivity is constant between the two periods. This framework is applied to nationally representative household data from South Africa. It emerged that such characterization is a very useful tool for policy in assessing progress towards equitable health financing.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Banting Postdoctoral Fellowships","field_subtitle":"Deadline: 21 September 2016","URL":"http://banting.fellowships-bourses.gc.ca/en/home-accueil.html","body":"The Banting Postdoctoral Fellowships program provides funding to the very best postdoctoral applicants, both within Canada and internationally, who will positively contribute to the country's economic, social and research-based growth. The fellowship covers health research, natural sciences and/or engineering and social sciences and/or humanities. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Blueprint for an Integrated Approach to Implement Agenda 2063","field_subtitle":"African Union: New Partnership for Africa's Development, 2014","URL":"http://www.nepad.org/resource/blueprint-integrated-approach-implement-agenda-2063-0","body":"This synthesis paper offers a broad framing of the issues to consider in implementing the proposed African Agenda 2063. In doing so, it re-interprets the African historical experience  to underscore the point that the core pillar and contribution of Agenda 2063 must be to help translate centuries of efforts to regain freedom, and to rebuild the self-reliance and dignity of Africans. The paper also identifies some of the possible challenges to which the Agenda must respond if it is to be effective and relevant, the existing policy and institutional pillars into which it fits and on which it must build, and a broad menu of issues which would need to be further reflected upon towards its full-fledged articulation. A set of background papers annexed to the synthesis offer a more in-depth assessment of some of these issues, as a foretaste of the kind of additional technical work required in the course of articulating a robust 2063 Agenda for the continent.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Challenges of partnerships: Some lessons from Africa","field_subtitle":"Kakonge J: Pambuzuka News, 5 May 2016","URL":"http://www.pambazuka.org/global-south/challenges-partnerships-some-lessons-africa","body":"Sustainable, effective and successful partnerships need to be built on mutual trust, on an explicit programme, clearly defined responsibilities, champion figures and financial resources. In this article, Dr. Kakonge outlines positive and negative factors that influence development assistance partnerships in Africa. The article notes that partnership demands creativity, compromise, commitment, consistency, flexibility and fairness. Some scholars argue that partnerships do not work when there is poor coordination relating to external assistance. . The author reviews factors that are critical in making development assistance partnerships successful in Africa.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Challenges to antiretroviral adherence among MSM and LGBTI living with HIV in Kampala, Uganda","field_subtitle":"Therkelsen D: HEARD, Durban, December 2015 ","URL":"http://www.heard.org.za/wp-content/uploads/2016/02/CHALLENGES-TO-ANTIRETROVIRAL.pdf","body":"\u2018Treatment as prevention\u2019 has become the cornerstone of UNAIDS\u2019s post-2015 global strategy to end AIDS by 2030. As the expansion of treatment provision continues, and access improves, adherence becomes a determining factor in the impact of ART for both treatment and prevention. HEARD are conducting a number of small scoping studies on challenges to ART adherence in men who have sex with men (MSM) and lesbian, gay, bisexual, transgender, and intersex (LGBTI) communities living with HIV in East and Southern Africa (ESA), as key populations in the AIDS response. This report presents findings from a scoping study carried out in Kampala, Uganda, in December 2015. The findings suggest that (double) stigma and criminalisation of behaviour of people living with HIV (PLHIV) in MSM and LGBTI communities cut across almost every perceived challenge to ART adherence as a driving or contributory factor. As a result, indications suggest MSM and LGBTI experience challenges that are similar in type to the general population, but that these population groups experience the challenges more often, more acutely, and with less opportunity to overcome the challenges.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Choosing the next UN boss: A political quagmire","field_subtitle":" Bochaberi D: Pambuzuka News, 12 May 2016","URL":"http://www.pambazuka.org/global-south/choosing-next-un-boss-political-quagmire","body":"Ban Ki-Moon\u2019s term as UN Secretary General ends this year and already political jostling is underway ahead of the selection of the new head of the world body. There are strong indications that favour a woman candidate. And how has Africa positioned itself for the unfolding contest? A number of African female candidates with the right credentials fit to lead the UN exist. The author discusses which African candidates could be in the running and whether a candidate from Kenya might have the diplomatic weight to lobby and get elected. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Community Health Worker Data for Decision-Making","field_subtitle":"One Million Community Health Workers (1mCHW) Campaign; mPowering Frontline Health Workers (mPowering): 2016","URL":"http://1millionhealthworkers.org/files/2016/03/HIFA-Report.pdf","body":"In 2015, the One Million Community Health Workers (1mCHW) Campaign and mPowering Frontline Health Workers (mPowering) conducted a series of interviews and held an online discussion, hosted on the Healthcare Information for All forum, on the need for improved data on community health workers (CHWs) to help achieve the Sustainable Development Goals. The key findings showed that CHWs deliver life-saving health care services than can address health issues in poor rural communities. They help keep track of disease outbreaks and overall public health, and offer a vital link between underserved populations and the primary health care system. CHWs have been recognised for their success in reducing morbidity and averting mortality in mothers, newborns and children. While they have proven crucial in settings where the primary health care system is weak, or where there are health workforce shortages, they are most effective when properly supported and deployed within the context of an appropriately financed health system. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Community participation for transformative action on women\u2019s, children\u2019s and adolescents\u2019 health","field_subtitle":"Marston C; Hinton R; Kean S; Baral S; Ahuja A; Costello A; Portela A: Bulletin of the World Health Organization 94(5) May 2016","URL":"http://www.who.int/bulletin/volumes/94/5/15-168492/en/","body":"The Global strategy for women\u2019s, children\u2019s and adolescents\u2019 health (2016\u20132030) recognizes that people have a central role in improving their own health. The authors propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the demand to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. This paper examines what this implies in practice. The authors discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. They  outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Critiquing the Concept of Resilience in Health Systems","field_subtitle":"Stephanie Topp, Walter Flores, Veena Sriram and Kerry Scott","body":"\r\nIn social theory, the dominant state is known as the hegemon. In the 19th century, hegemony came to denote the \u2018Social or cultural predominance or ascendancy; predominance by one group within a society or milieu\u2019. However, commentators on power have also used the term to describe the power of discourse - particularly in the field of governance. In this note we wish to draw attention to, and challenge, what we fear is an emerging hegemonic discourse in the field of health policy and systems work - the discourse of resilience.\r\n\r\nIn the past five years \u2018resilience\u2019 has been increasingly applied in health policy and systems research (HPSR) to refer to the need for distressed health systems (micro or macro) to \u2018bounce back\u2019 from shocks. Often implicit in this discourse, is the assumption that such systems were \u2018there\u2019 in the first place, or at the very least, that with a concerted effort they can get there. What a resilient health system means in this context is not clear - but we contend that, in a form of technocratic reductionism, resilience strategies and solutions are often divorced from meaningful assessment of the political economy and power dynamics that produced the health system crises in the first place. \r\n\r\nHealth systems in crises suffer from chronic deficiencies in many things - material and human resources central-level planning and coordination capacity and domestic financing to name but a few. The populations and communities seeking services from these deficient systems are more likely to have low levels of education, weak citizen engagement and to experience deep class inequity. Much of the technocratic discussion around \u2018building resilience\u2019 appears to bypass these issues, however, often focusing on tweaking inputs or health system components, and frequently emphasising self-reliance and behaviour change. This technocratic and formulaic approach to building resilience is at odds with the complex reality of health systems in each country. \r\n\r\n\u2018Building resilience\u2019 rarely seems to involve a direct examination of, or challenge to, the structural conditions that contribute to overarching health system dysfunction, including historical colonial legacies, current trade and aid structures, tax and health insurance structures. We are concerned that the discourse of resilience will follow the trend of global health policy reforms being fuelled by the perceived immediacy of a problem instead of careful analysis of root causes and strategies likely to prevent recurrence in the long-term. Recent examples include the Ebola epidemic and now Zika, in which resilience discourse is getting close to that of the global health security agenda in which the main concern is transnational epidemics from the south to the north. The rise of hegemonic resilience discourse has effectively enabled global health stakeholders to replace the conversation about systemic failures at multiple levels which supports a far more long term vision, with an action-oriented discourse that implies much shorter time-frames. \r\n\r\nA conscious discussion is needed to reframe what the health system community means when we use the term \u2018resilience\u2019. Resilience and the linked concept of sustainability of health programming have value, as long as they are not divorced from the material changes that need to occur to support them and the requirement for a more balanced relationship among national states (trade, flow of resources, and others). Use of these terms should build on previous work and consensus around social determinants of health, right to health and people-centered health systems. This means resilience should be situated on a continuum rather than replacing important advances around health systems and its relation with equity, fairness and human rights. \r\n\r\nUltimately, we contend that a more ambitious and nuanced application of the term \u2018resilience\u2019 is required if the term is to contribute to improving LMIC health systems\u2019 capacity to withstand political, financial, epidemiological and environmental shocks. We must also do everything possible to prevent such shocks in the first place. But at the very least, we in the health policy and systems community need to start acknowledging the dangers of using \u2018resilience\u2019 as part of a de-politicised and technocratic discourse. \r\n\r\nThis piece was first posted as a blog for Health Systems Global (HSG) http://tinyurl.com/j968dqc. The authors are thematic leads of the cluster on Power in Health Systems in the SHaPeS Technical working group of HSG. Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 183: Critiquing the Concept of Resilience in Health Systems","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Policy brief 40: Implementing the International Health Regulations in east and southern Africa: Progress, opportunities and challenges","field_subtitle":"SEATINI, TARSC","URL":"http://www.equinetafrica.org/sites/default/files/uploads/documents/Pol%20Brief%2060%20IHR%20April2016%20.pdf","body":"When the International Health Regulations (IHR) were adopted in 2005 by member states of the World Health Organisation (WHO), State Parties were given up to June 2012 to have developed minimum core public health capacities to implement them. This included having surveillance, reporting and response systems for public health risks and emergencies and measures for disease control at designated airports, ports and ground crossings. In East and Southern Africa (ESA), the IHR are being implemented within an Integrated Disease Surveillance and Response (IDRS), which is a comprehensive, evidence-based strategy for strengthening national public health surveillance and response systems in African countries. This policy brief outlines the progress made and deficits in ESA countries in achieving the core capacities to implement the IHR. It proposes national measures to strengthen public health systems to both meet gaps in the implementation of the IHR and to link responses to health emergencies and outbreaks to health systems strengthening in ESA countries.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Equity in Extractives: Stewarding Africa\u2019s natural resources for all","field_subtitle":"Africa Progress Panel: Africa Progress Report, 2013","URL":"http://www.africaprogresspanel.org/publications/policy-papers/africa-progress-report-2013/","body":"This Africa Progress panel Report argues that African policy makers have critical choices to make. They can either invest their natural resource revenue in people to generate jobs and opportunities for millions in present and future generations, or they can squander this opportunity, allowing jobless growth and inequality to take root. In many African countries, natural resource revenues are widening the gap between rich and poor. Although much has been achieved, a decade of highly impressive growth has not brought comparable improvements in health, education and nutrition. The Africa Progress Panel is convinced that Africa can better manage its vast natural resource wealth to improve the lives of the region\u2019s people by setting out bold national agendas for strengthening transparency and accountability. The Panel consists of ten distinguished individuals from the private and public sector who advocate for equitable and sustainable development for Africa. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Equity in Health Care Financing in Low- and Middle-Income Countries: A Systematic Review of Evidence from Studies Using Benefit and Financing Incidence Analyses","field_subtitle":"Asante A; Price J; Hayen A; Jan S; Wiseman V: PLoS One11(4) e0152866, 2016","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827871/","body":"Health financing reforms in low- and middle- income countries (LMICs) over the past decades have focused on achieving equity in financing of health care delivery through universal health coverage. This systematic review assesses progress towards equity in health care financing in LMICs through the use of benefit incidence analysis (BIA) and financing incidence analysis (FIA). A total of 512 records were obtained and 24 were judged appropriate for inclusion. Twelve of the 24 studies originated from sub-Saharan Africa. The evidence points to a pro-rich distribution of total health care benefits and progressive financing in sub-Saharan Africa. In the majority of cases, the distribution of benefits at the primary health care level favoured the poor while hospital level services benefit the better-off.  Studies evaluated in this systematic review indicate that health care financing in LMICs benefits the rich more than the poor but the burden of financing also falls more on the rich. There is some evidence that primary health care is pro-poor suggesting a greater investment in such services and removal of barriers to care can enhance equity. The results overall suggest that there are impediments to making health care more accessible to the poor and this must be addressed if universal health coverage is to be a reality.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Financial accessibility and user fee reforms for maternal- health care in five sub-Saharan countries: a quasi-experimental analysis","field_subtitle":"Leone T; Cetorelli V; Neal S; Matthews Z: BMJ Open 6(1), e009692, 2016","URL":"http://bmjopen.bmj.com/content/6/1/e009692.full","body":"This paper aimed to measure the impact of user fee reforms on the probability of giving birth in an institution or receiving a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population.  The authors analysed data from consecutive surveys in five countries: two case countries that experienced reforms (Ghana and Burkina Faso) in contrast to three that did not experience reforms (Zambia, Cameroon, Nigeria). User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest) and non-educated women and those in rural areas benefited the most from the reforms. Findings show a clear positive impact on access when user fees are removed but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"For Poor Children, Two Healthy Meals a Day Can Keep Obesity Away","field_subtitle":"Graham L: NGO Pulse, April 2016 ","URL":"http://www.ngopulse.org/article/2016/04/14/poor-children-two-healthy-meals-day-can-keep-obesity-away","body":"Access to poor quality and inexpensive food that are high in fats and refined carbohydrates have the potential to expose children to obesity. Fighting obesity could translate into a decrease in the number of adults who suffer from non-communicable diseases such as diabetes, hypertension and heart disease. In this edition of NGO Pulse, Lauren Graham, a senior researcher at the University of Johannesburg\u2019s Centre for Social Development for Africa, writes that with the current drought and increased food prices, it is becoming more expensive and difficult for families, especially those in poor communities, to afford and opt for healthier food baskets. Graham, who argues that it is easy and cost effective to prevent obesity and overweight, adds that: \u201cObesity is not necessarily driven by overeating, as is commonly thought.\u201d She notes that children who grow up in poor communities are at high risk for obesity and \u2018hidden hunger\u2019 since they have no option but to consume food that lacks the right balance of nutritious meals.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"From Resilience to Resourcefulness: A Critique of Resilience Policy and Activism","field_subtitle":"MacKinnon D; Driscoll Derickson K: Progress in Human Geography 37(2) 253\u2013270, 2013","URL":"http://tinyurl.com/z5cbrsu","body":"This paper provides a theoretical and political critique of how the concept of resilience has been applied to places. It is based upon three main points. First, the ecological concept of resilience is conservative when applied to social relations. Second, resilience is externally defined by state agencies and expert knowledge. Third, a concern with the resilience of places is misplaced in terms of spatial scale, since the processes which shape resilience operate primarily at the scale of capitalist social relations. The authors argue that resilience is fundamentally about how best to maintain the functioning of an existing system in the face of externally derived disturbance. Both the ontological nature of \u2018the system\u2019 and its normative desirability escape critical scrutiny. As a result, the existence of social divisions and inequalities tends to be glossed over when\r\nresilience thinking is extended to society. Ecological models of resilience are thus argued to be fundamentally\r\nanti-political, viewing adaptation to change in terms of decentralized actors, systems and relationships and failing to accommodate the critical role of the state and politics. In place of resilience, the authors offer the concept of resourcefulness as an alternative approach for community groups to foster. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Gender and health inequalities: Intersections with other relevant axes of oppression","field_subtitle":"Deadline: end of August 2016","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/30292","body":"This call for papers entitled \u2018Gender and health inequalities: intersections with other relevant axes of oppression\u2019 aims to generate knowledge about how gender inequalities in health/disease/mortality/and access to health care systems interact with other important axes of oppression (race/ethnicity, social class, religion, and/or migratory status, among others) through different levels of power (from the global to the local) at different lifetime stages for a population. It aims to contribute to a better understanding of the relationship between gender (in)equalities and health (inequalities). The editors welcome different types of contributions: empirical research, theoretical papers, methodological papers, and reviews. The editors also welcome papers that address not only issues of dominance and/or suffering but also those about resistance, agency, resilience, and/or empowerment. Submissions are encouraged from researchers working in low-, middle-, and high-income countries. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health Systems Trust Conference Presentations","field_subtitle":"Health Systems Trust (HST), May 2016","URL":"http://www.hst.org.za/publications/hst-conference-presentations","body":"The HST Conference 2016 programme included 90 oral and poster presentations from a wide range of presenters in the South African public health policy, research and implementation field. Presentations range from health governance and health financing to  health counselling and electronic medical records. The presentations are available at this site..","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Historic silicosis and TB judgment","field_subtitle":"Treatment Action Campaign (TAC); SECTION27: Section 27, 13 May 2016 ","URL":"http://tinyurl.com/jopf628","body":"A judgment handed down in May 2016 in the South Gauteng High Court in the case of Bongani Nkala and 68 Others v Harmony Gold Mining Company Ltd and 31 Others is reported an important step toward providing just compensation for the many thousands of miners who contracted silicosis or tuberculosis on South Africa\u2019s gold mines. The court certified two classes. The first and larger is gold miners and former gold miners who have contracted silicosis and the second is those who have contracted TB. The class requires that a person has worked underground in the mines for at least two years since 1965 and contracted either disease. The lawsuit, unless settled, will now proceed into trials in which common issues relevant to all class members will be determined. The court confirmed that for mineworkers, \u201cit is class action or no action at all. Class action is the only realistic option open to mineworkers and their dependents. It is the only way they would be able to realise their constitutional right of access to court bearing in mind that they are poor, lack the sophistication to litigate individually, have no access to legal representatives and are continually battling the effects of two extremely debilitating diseases.\u201d [para 100] The judgment is also important for all vulnerable people in South Africa. A class action is a powerful mechanism by which poor or vulnerable people can access justice. It is however not commonly used in South Africa. This judgment is argued to help those who do not have resources on their own to pool efforts in order to access justice. The authors argue that it recalibrates the balance of power to give the poor a better chance of holding the powerful to account. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"In Tanzania, 22.8% of Teen Girls Are Mothers","field_subtitle":"Mwijarubi M: VITAL, 16 May 2016","URL":"http://tinyurl.com/zjkjh8u","body":"In this blog, the author reports that in Tanzania, less than one in 10 (9%) of sexually active youth who want to avoid pregnancy use modern contraceptives and that 22.8% of young women between the ages of 15 and 19 are mothers, according to the Tanzania Demographic and Health Survey 2010. Tanzanian women, the survey shows, have an average of 5.4 children each. Early childbearing and high rates of fertility put stress on the health and education systems, on the availability of food and clean water, and on natural resources, according to the country's National Family Planning Costed Implementation Plan. Tanzania has committed to Family Planning 2020 (FP2020), to ensure that, in line with the United Nations secretary general's global strategy for women, children, and adolescent health, all women have access to contraceptives by 2020. The aut5hor indicates that its needed: 47% of Tanzania's population is 15 years or younger. In Tanzania, family planning has been synonymous with child spacing for married men and women, as typified by posters and brochures featuring monogamous couples with their three distinctly spaced children. But the term \"family planning\" doesn't resonate with young people because they are not yet ready to start families. He notes therefore that as a result, the global health workers' advocacy and support group, IntraHealth International, has started referring to it as \"future planning.\"","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Inequality in disability-free life expectancies among older men and women in six countries with developing economies","field_subtitle":"Santosa A; Schr\u00f6ders J; Vaezghasemi M; Ng N: Journal of Epidemiology and Community Health, March 2016, doi:10.1136/jech-2015-206640","URL":"http://jech.bmj.com/content/early/2016/03/18/jech-2015-206640.full","body":" Evidence on trends and determinants of disability-free life expectancies (DFLEs) are available in high-income countries but less in low and middle-income countries (LMICs). This study examines the levels of and inequalities in life expectancy(LE), disability and DFLE between men and women across different age groups aged 50 years and over in six countries with developing economies. This study utilised the cross-sectional data (n=32 724) from the WHO Study on global AGEing and adult health in China, Ghana, India, Mexico, the Russian Federation and South Africa in 2007\u20132010. Disability was measured with the activity of daily living  instrument.. The disability prevalence ranged from 13% in China to 54% in India. Women were more disadvantaged with higher prevalence of disability across all age groups. Though women had higher LE, their proportion of remaining LE free from disability was lower than men. There are inequalities in the levels of disability and DFLE among men and women in different age groups among people aged over 50 years in these six countries. Countermeasures to decrease intercountry and gender gaps in DFLE, including improvements in health promotion and healthcare distribution, with a gender equity focus, are needed.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"International AIDS Conference","field_subtitle":"17th-22nd July 2016, Durban, South Africa","URL":"http://www.aids2016.org/","body":"The International AIDS Conference is a gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess state of affairs, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.  The AIDS 2016 programme will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. A variety of session types \u2013 from abstract-driven presentations to symposia, bridging and plenary sessions \u2013 will meet the needs of various participants. Other related activities, including the Global Village, satellite meetings, exhibitions and affiliated independent events, will contribute to an exceptional opportunity for professional development and networking. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Is any wheelchair better than no wheelchair? A Zimbabwean perspective","field_subtitle":"Visagie S; Mlambo T; van der Veen J; Nhunzvi C; Tigere D; Scheffler E: African Journal of Disability 4(1) doi: 10.4102/ajod.v4i1.168, November 2015","URL":"http://www.ajod.org/index.php/ajod/article/view/201/387","body":"Within a rights-based paradigm, wheelchairs are essential in the promotion of user autonomy, dignity, freedom, inclusion and participation. This paper described a group of 94 Zimbabwean wheelchair users\u2019 satisfaction with wheelchairs, wheelchair services and wheelchair function in a mixed method, descriptive study using the Quebec User Evaluation of Satisfaction with Assistive Technology for adults and children and Functioning Every day with a Wheelchair questionnaire. Qualitative data were collected through two focus group discussions (22 participants) and two case studies with participants purposively sampled from those who participated in the quantitative phase. More than 60% of participants were dissatisfied with the following wheelchair features: durability (79%), weight (76%), ease of adjustment (69%), effectiveness (69%), safety (67%), reliability (67%), and meeting user needs (61%). Similarly, more than 66% of participants were dissatisfied with various services aspects: professional services (69%), follow-up (67%), and service delivery (68%). Although 60% of participants agreed that the wheelchair contributed to specific functions, more than 50% of participants indicated that the features of the wheelchair did not allow in- (53%) and outdoor (53%) mobility. Findings indicate high levels of dissatisfaction with wheelchair features and services, as well as mobility. It is recommended that minimum service standards are set incorporating evidence and good practice guidelines for wheelchair services and management of wheelchair donations in Zimbabwe.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Is There Evidence for a Subnational Resource Curse?","field_subtitle":"Cust J; Viale C: Natural Resource Governance Institute, April 2016","URL":"http://tinyurl.com/haugr8n","body":"This paper examines the evidence for a 'resource curse' at subnational level. Natural resource extraction can have positive effects, generating profits, tax revenue for government, and economic linkages to other sectors. It can also have negative economic, environmental and social consequences, including changes in local relative prices that might crowd out other productive activities; deforestation; pollution and degradation; and the potential for social dislocation and displacement. This paper evaluates the evidence for how these effects accrue specifically to the subnational economy and whether government policy can lead to positive development impacts, while avoiding the challenge of unbalanced costs borne locally.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Launch of the first Call for Proposals of the new \"Intra-Africa Academic Mobility Scheme\"","field_subtitle":"Deadline: 15 June 2016","URL":"http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX%3AC2016/092/05&from=EN","body":"This programme\u2019s objective is to improve the skills and competences of students and staff through enhanced intra-African mobility and cooperation between Higher Education Institutions (HEIs) in Africa to encourage and enable African students to undertake postgraduate studies in the African continent. The call is for partnerships between a minimum four and maximum six African HEIs including the applicant) and one technical partner from the EU. Eligible applicants and partners are HEIs registered in Africa that provide courses at postgraduate level (master\u2019s and/or doctorate degree) of higher education leading to a qualification recognised by the competent authorities in their own country. Only HEIs accredited by relevant national authorities in Africa are eligible. Branches of HEIs from outside Africa are not eligible.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Malawi and Millennium Development Goal 4: a Countdown to 2015 country case study","field_subtitle":"Kanyuka M; Ndawala J; Mleme T; Chisesa L; et al.: The Lancet Global Health  4(3) e201-e214, 2016","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00294-6/fulltext?rss=yes","body":"This in-depth country case study aimed to explain Malawi's success in improving child survival. The authors estimated child and neonatal mortality for the years 2000-14 using five district-representative household surveys. The study included recalculation of coverage indicators for that period, and used the Lives Saved Tool (LiST) to attribute the child lives saved in the years from 2000 to 2013 to various interventions. They documented the adoption and implementation of policies and programmes affecting the health of women and children, and developed estimates of financing. The estimated mortality rate in children younger than 5 years declined substantially in the study period, from 247 deaths per 1000 livebirths in 1990 to 71 deaths in 2013, with an annual rate of decline of 5\u00b74%. The most rapid mortality decline occurred in the 1-59 months age group; neonatal mortality declined more slowly, representing an annual rate of decline of 3\u00b73%. Nearly half of the coverage indicators increased by more than 20 percentage points between 2000 and 2014. Results from the LiST analysis show that about 280\u2008000 children's lives were saved between 2000 and 2013, attributable to interventions including treatment for diarrhoea, pneumonia, and malaria (23%), insecticide-treated bednets (20%), vaccines (17%), reductions in wasting (11%) and stunting (9%), facility birth care (7%), and prevention and treatment of HIV (7%). The funding allocated to the health sector increased substantially, particularly to child health and HIV and from external sources, albeit below internationally agreed targets. This case study confirmed that Malawi had achieved MDG 4 for child survival by 2013. The authors\u2019 findings suggest that this was achieved mainly through the scale-up of interventions that are effective against the major causes of child deaths (malaria, pneumonia, and diarrhoea), programmes to reduce child undernutrition and mother-to-child transmission of HIV, and some improvements in the quality of care provided around birth. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"One year into the Zika outbreak: how an obscure disease became a global health emergency","field_subtitle":"World Health Organisation: Geneva, May 2016","URL":"http://www.who.int/emergencies/zika-virus/articles/one-year-outbreak/en/","body":"By May 2016, tests conducted at Brazil\u2019s national reference laboratory conclusively identified that a new mosquito-borne disease - Zika- had indeed arrived in the Americas, though no one knew what that might mean. Although the re-profiling of Zika from a benign disease to a global health emergency stimulated a flurry of research, the disease remains poorly understood at levels ranging from its virology and epidemiology to the clinical spectrum of complications it can cause. No one can answer questions about further international spread with certainty, though theories abound. As the virus has been detected in parts of Asia and Africa for several decades, some level of endemicity is assumed, though no one knows whether presence of the virus over time has resulted in widespread or low-level immune protection or possibly no protection at all. In April 2016, researchers in Ecuador and the northeastern part of Brazil reported the detection of Zika in monkeys, suggesting a new transmission cycle that could allow the virus to persist. In Brazil, the virus detected in monkeys was identical to the one circulating in humans. Researchers at a government laboratory in Mexico reported detection of the Zika virus in female Aedes albopictus mosquitoes collected in the wild, as opposed to experimentally infected \u2013 a first for the western hemisphere. As the mosquito can survive the winter in temperate climates, its ability to carry the Zika virus could expand the map of areas at risk of Zika virus transmission.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Open Access Teaching & Learning Resources on Health Policy & Systems Research","field_subtitle":"KEYSTONE India Initiative, 2016","URL":"http://www.phfi.org/index.phpoption=com_content&view=article&id=1593&Itemid=619","body":"The KEYSTONE open access teaching and learning materials on Health Policy and Systems Research (38 videos and 43 slide presentations across 13 modules) are now live online. These teaching and learning resources were developed for the inaugural KEYSTONE India short course on Health Policy and Systems Research. They include 38 videos and 43 slide presentations organized across 13 modules and cover a range of foundational concepts and common approaches used in HPSR. This suite of teaching and learning materials was developed in the process of delivering the inaugural KEYSTONE course, and is being made available as an open access resource under the Creative Commons license.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Our future: a Lancet commission on adolescent health and wellbeing","field_subtitle":"The Lancet Commission:  11 May 2016","URL":"http://www.thelancet.com/commissions/adolescent-health-and-wellbeing","body":"Decades of neglect and chronic underinvestment have had serious detrimental effects on the health and wellbeing of adolescents aged 10\u201324 years, according to a major new Lancet Commission on adolescent health and wellbeing. Two-thirds of young people are growing up in countries where preventable and treatable health problems like HIV, early pregnancy, unsafe sex, depression, injury, and violence remain a daily threat to their health, wellbeing, and life chances. Evidence shows that behaviours that start in adolescence can determine health and wellbeing for a lifetime. Adolescents today also face new challenges, including rising levels of obesity and mental health disorders, high unemployment, and the risk of radicalisation. Adolescent health and wellbeing is also a key driver of a wide range of the Sustainable Development Goals on health, nutrition, education, gender, equality and food security, and the costs of inaction are enormous, warn the authors. While efforts to improve the health of children under 5 have led to major improvements in younger ages, the leading causes of death for young people aged 10-24 years have changed remarkably little from 1990 to 2013, with road injuries, self-harm, violence, and tuberculosis remaining in the top five.  Maternal disorders were the leading cause of death in young women in 2013, responsible for 17% of deaths in women aged 20\u201324 years and 11.5% in girls aged 15\u201319 years. The leading risk factors for death in young people aged 10\u201314 years have not changed in the past 23 years, with unsafe water, unsafe sanitation, and handwashing remaining in the top three. Diarrheal and intestinal diseases are still responsible for 12% of deaths in 10\u201314 year old girls.  Injuries, mental health conditions, common infectious diseases, and sexual and reproductive health problems are the dominant health problems in young people. The two main contributors to health loss worldwide for both sexes are mental health disorders and road injuries.  ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Pharmaceutical Public Health Short Courses and Online Modules","field_subtitle":"University of the Western Cape, South Africa, 2016","URL":"http://tinyurl.com/z47swes","body":"The University of the Western Cape (UWC) School of Public Health presents the 38th Short Course School in a series of Winter and Summer Schools held at UWC since 1992. These courses expose health and health-related workers to the latest thinking in Public Health and enable them to discuss and exchange ideas on improved planning and implementation of Primary Health Care in the changing environment of the developing world. To date, some 12,000 participants, mainly nurses and middle level managers have attended these courses, from all over South Africa and many other African countries. As many of these courses are also used as the teaching blocks of the UWC Master of Public Health degree, the highest academic and practical standards are maintained. Most courses are one week long to allow busy health workers to receive continuing education with minimal disruption of their services. Selection of subjects reflects the main public health priorities. This year UWC are offering courses covering a wide range of management, programme development and policy and planning issues. The cost of courses is kept to an absolute minimum, to allow for the fullest participation.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Poverty Remains World\u2019s Biggest Challenge","field_subtitle":"Commission for Social Development, Forty-fourth Session: United Nations, February 2016","URL":"http://www.un.org/press/en/2016/soc4837.doc.htm","body":"The Commission for Social Development concluded its fifty-fourth session approving three draft resolutions for adoption by the Economic and Social Council. One on Africa\u2019s development, while traditionally endorsed by consensus, required a rare vote to address the United States\u2019 concerns over language around trade issues, and more generally, \u201cthe right to development\u201d. The Commission approved a draft on \u201cSocial dimensions of the New Partnership for Africa\u2019s Development\u201d by 29 in favour, to 12 against, with no abstentions (document E/CN.5/2016/L.5).  This emphasizes that \u201cincreasingly unacceptable\u201d poverty, inequality and social exclusion in most African countries requires social and economic policies to be devised through a comprehensive approach.  African countries are encouraged to prioritize structural transformation, modernize smallholder agriculture, add value to primary commodities and improve public and private governance institutions.While the United States\u2019 delegate, whose delegation had requested the vote, said her Government would vote against the text, as it viewed the World Trade Organization (WTO) as the main venue for trade negotiation, and could not support a text calling on WTO members to conclude the Doha Round of trade negotiations and improve market and duty-free access, South Africa\u2019s representative, associating with the Group of 77, said South Africa would continue to advocate for social development as part of the global agenda.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Reports from WHO Watch","field_subtitle":"People\u2019s Health Movement (PHM) and Medicus Mundi International: May 2016","URL":"http://www.ghwatch.org/who-watch/events","body":"WHO Watch is a civil society project, coordinated by People\u2019s Health Movement (PHM) and Medicus Mundi International, directed both to supporting WHO and holding it accountable. WHO Watch involves a team of \u2018watchers\u2019 attending WHO governing body meetings, lobbying delegates, speaking from the floor, documenting and reporting on the debate and the decisions, and preparing commentaries on each of the agenda items.  These commentaries are designed to support progressive delegations (in particular from smaller countries who have only limited human resources to devote to these issues) as well as arguing for progressive outcomes.  The Sixty Ninth World Health Assembly (WHA69) convened in Geneva from 23 \u2013 28 May 2016. The Watch reports on the debates on various items, including: managing conflicts of interest in global health; maternal, infant and young child nutrition; ending childhood obesity; ageing; air pollution; the \u2018sound\u2019 management of chemicals; antimicrobial resistance; polio; managing global health emergencies; the health of migrants; lessons from Ebola in West Africa; HIV, viral hepatitis, STIs; vaccination; global health workforce issues; medicines and intellectual property.  ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Resilience in the SDGs: Developing an indicator for Target 1.5 that is fit for purpose","field_subtitle":"Bahadur A; Lovell E; Wilkinson E; Tanner T: Overseas Development Institute, 2015","URL":"http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/9780.pdf","body":"The authors outline a comprehensive approach for developing a cross-sectoral, multi-dimensional and dynamic understanding of resilience. This underpins the message of the Sustainable Development Goals (SDGs) that development is multi-faceted and the achievement of many of the individual development goals is dependent on the accomplishment of other goals. It also acknowledges that shocks and stresses can reverse years of development gains and efforts to eradicate poverty by 2030. The authors argue that this approach to understanding resilience draws on data that countries will collect for the SDGs anyway and entails only a small additional burden.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Risk factors affecting child cognitive development: a summary of nutrition, environment, and maternal\u2013child interaction indicators for sub-Saharan Africa","field_subtitle":"Ford N; Stein A: Journal of Developmental Origins of Health and Disease 7(2) pp 197-217","URL":"http://tinyurl.com/h3mkrax","body":"An estimated 200 million children worldwide fail to meet their development potential due to poverty, poor health and unstimulating environments. Missing developmental milestones has lasting effects on adult human capital. Africa has a large burden of risk factors for poor child development. This paper identifies the scope for improvement at the country level in three domains \u2013 nutrition, environment, and mother\u2013child interactions. It uses nationally representative data from large-scale surveys, data repositories and country reports from 2000 to 2014. Overall, there was heterogeneity in performance across domains, suggesting that each country faces distinct challenges in addressing risk factors for poor child development. Data were lacking for many indicators, especially in the mother\u2013child interaction domain. The authors argue that there is a need to improve routine collection of high-quality, country-level indicators relevant to child development to assess risk and track progress.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Stand Up for African Mothers Campaign","field_subtitle":"AMREF: Amref Health Africa in the USA, 2016","URL":"http://www.amrefusa.org/usa/en/what-we-do/maternal-health-/","body":"Every year, nearly 200,000 women die during childbirth in sub-Saharan Africa in part due to poor access to basic reproductive and maternal health services. The author argues that Over 80 percent of these deaths could have been prevented with the assistance of a midwife. This campaign, Stand Up for African Mothers. aims to ensure that more African women can count on the assistance of a trained midwife during pregnancy and childbirth, and promotes reproductive rights and education to help women and their partners make informed choices about family planning. Through campaign, Amref is training 15,000 midwives to reduce the high rate of maternal mortality in sub-Saharan Africa through both traditional classroom-based teaching, and innovative methods such as distance learning and mLearning, which allows midwives to study using basic mobile phone technology. With a skilled midwife providing care to 500 mothers annually, over seven million African women each year could benefit from this campaign in 13 African countries. By 2016, almost 7,000 midwives had been trained since the campaign began in 2010.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The complexity of rural contexts experienced by community disability workers in three southern African countries","field_subtitle":"Booyens M; van Pletzen E; Lorenzo T: African Journal of Disability 4(1) doi: 10.4102/ajod.v4i1.167, 2015","URL":"http://www.ajod.org/index.php/ajod/article/view/167/318","body":"An understanding of rural communities is fundamental to effective community-based rehabilitation work with persons with disabilities. The authors argue that insufficient attention has been paid to the challenges that rural community disability workers face. This qualitative interpretive study, involving in-depth interviews with 16 community disability workers in Botswana, Malawi and South Africa, revealed the complex ways in which poverty, inappropriately used power and negative attitudes of service providers and communities combine to create formidable barriers to the inclusion of persons with disabilities in families and rural communities. The paper highlights the importance of understanding and working with the concept of \u2018disability\u2019 from a social justice and development perspective. It stresses that by targeting attitudes, actions and relationships, community disability workers can bring about social change in the lives of persons with disabilities and the communities in which they live.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The slow shipwreck of the World Health Organization?","field_subtitle":"Velasquez G; Alas M: Third World Network Info Service, May 2016","URL":"http://www.twn.my/title2/health.info/2016/hi160503.htm","body":"In this article the authors argue that the World Health Organisation (WHO) Secretariat, Member States and observers should honestly admit that they have so far fallen very short of the WHO Mission. The authors argue that the organization has become a huge bureaucratic structure while at the same time under-resourcing its needs has made it incapable of providing a timely response to the urgent health needs happening in the world.  The organization is argued to be being privatized with influence from small group of private funders.  This authors observe that the limited participation sometimes turns into an uncomfortable position for many, when faced with the lack of progress in the debates or with the endless diplomatic language that is used without reaching any concrete agreements and with resolutions and decisions where that make it almost impossible to identify the substance and therefore difficult to see their real value. In the meantime millions of diseases and preventable deaths are happening far away from what is being discussed at \u201cthe highest levels\u201d of international public health policy arena. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Towards environmental justice success in mining resistances: An empirical investigation","field_subtitle":"\u00d6zkaynak B; Rodr\u00edguez-Labajos B; Ayd\u0131n C: Environmental Justice Organisations, Liabilities and Trade (EJOLT) Report No. 14, 2015","URL":"http://tinyurl.com/h9d76no","body":"This report explores evidence of success in environmental justice (EJ) activism on socio-environmental mining conflicts by applying a collaborative statistical approach, combining qualitative and quantitative methods. The empirical evidence covers 346 mining cases from around the world in the EJOLT Atlas of Environmental Justice, and is enriched by an interactive discussion of results with activists and experts. The authors used a social network analysis to study the nature of the relationships both among corporations involved in the mining activity, on the one hand, and among EJ organisations, on the other. Multivariate analysis methods were used to examine the defining factors in achieving EJ success and qualitative analysis, based on descriptive statistics, was conducted to investigate factors that configure the perception of success for EJ and incorporate activist knowledge into the theory of EJ. The authors argue that overall, such analytical exercises, coproduced with activists, should be seen as a source of engaged knowledge creation, which is increasingly being recognised as a pertinent method to inform scientific debate with policy implications, and that it can also be insightful and relevant for activism. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya.","field_subtitle":"Waweru E; Goodman C; Kedenge S;  Tsofa B; Molyneux S: Health Policy and Planning 31(2) 137-47, 2015","URL":"http://heapol.oxfordjournals.org/content/31/2/137.long","body":"The authors describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. The authors conducted a process evaluation of HSSF implementation. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. They found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in contexts of enormous need. ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"UnderMining Life: Activists threatened in South Africa","field_subtitle":"Mazibuko S: Earthlore, April 2016","URL":"https://vimeo.com/161007908","body":"Sphiwe Mazibuko's 9 minute documentary exposes the intimidation and violence facing anti-mining activists on the Wild Coast and Zululand, in South Africa. Xolobeni residents have fought for 10 years to prevent an Australian company from mining their titanium rich dunes.  The film documents how an unwavering response of the Pondo people to protect their traditional Wild Coast lands, where they have lived for over 1500 years, has been met by increasing intimidation and violence with activist lives threatened and attacked.  ","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"WHO: Health Assembly adopts framework for non-State actor engagement","field_subtitle":"TWN Info Service: Geneva, 31 May 2016","URL":"http://www.twn.my/title2/unsd/2016/unsd160514.htm","body":"The 69th World Health Assembly (WHA) adopted the Framework of Engagement with Non-State Actors (FENSA) on the concluding day of Assembly. The adoption of FENSA is the conclusion of a process initiated as part of the WHO reform in 2011. FENSA consists of an overarching framework of engagement with Non-State Actors (NSAs) and four separate policies for governing the engagements with four categories, i.e. Non-Governmental Organisations (NGOs), private sector, philanthropic foundations and academic institutions. The overarching principles set out the common rules for all NSAs and treat all NSAs on an equal footing. The separate policies provide certain customised aspects of the overarching principles to the respective categories of NSAs. The framework regulates five types of engagements: participation, resources, advocacy, evidence, and technical collaboration. The WHA resolution that adopts the FENSA decides to replace the two existing policies governing WHO engagements with NGOs and the private sector. Further, the resolution requests the Director-General to start the implementation immediately and take all necessary measures to fully implement FENSA.  Further, it requests the Director-General to expedite the full establishment of WHO\u2019s NSA register.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"\u2018The mercurial piece of the puzzle\u2019: Understanding stigma and HIV/AIDS in South Africa","field_subtitle":"Gilbert L: Journal of Social Aspects of HIV/AIDS Research Alliance (SAHARA-J)13(1) 8-16","URL":"http://www.tandfonline.com/doi/full/10.1080/17290376.2015.1130644","body":"Although stigma and its relationship to health and disease is not a new phenomenon, it has not been a major feature in the public discourse until the emergence of HIV. The range of negative responses associated with the epidemic placed stigma on the public agenda and drew attention to its complexity as a phenomenon and concept worthy of further investigation. Despite the consensus that stigma is one of the major contributors to the rapid spread of HIV and the frequent use of the term in the media and among people in the street, the exact meaning of \u2018stigma\u2019 remains ambiguous. This paper re-visits some of the scholarly deliberations and further interrogates their relevance in explaining HIV-related stigma evidenced in South Africa. In conclusion a model is presented. Its usefulness \u2013 or explanatory potential \u2013 is that it attempts to provide a comprehensive framework that offers insights into the individual as well as the social/structural components of HIV-related stigma in a particular context. As such, it is argued by the authors to have the potential to provide more nuanced understandings as well as to alert us to knowledge-gaps in the process.","php":"","field_issue_date":"2016-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":" Rural Health Care Access and Policy in Developing Countries","field_subtitle":"Strasser R; Kam S; Regalado S: Annual Review of Public Health 37, 395-412, 2016 ","URL":"http://tinyurl.com/gndp4ok","body":"Compared to their urban counterparts, rural and remote inhabitants experience lower life expectancy and poorer health status, and a shortage of health professionals. This article explores rural areas of Sub-Saharan Africa (SSA). Using the conceptual framework of access to primary health care, sustainable rural health service models, rural health workforce supply, and policy implications, this article presents a review of the academic and gray literature as the basis for recommendations designed to achieve greater health equity. An alternative international standard for health professional education is recommended. Decision makers should draw upon the expertise of communities to identify community-specific health priorities and should build capacity to enable the recruitment and training of local students from under-serviced areas to deliver quality health care in rural community settings. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Activists lead fight for the right to cheaper drugs","field_subtitle":"Health Systems Trust, 12 April 2016","URL":"http://www.hst.org.za/news/activists-lead-fight-right-cheaper-drugs","body":"Southern African states are being alerted to the concessions on intellectual property rights that they can take advantage of within the agreement on Trade-Related Aspects on Intellectual Property Rights (TRIPS)  by the Southern African Regional Programme of Access to Medicines and Diagnostics (SARPAM). SARPAM is communicating the flexibilities within the TRIPS to protect public health, including compulsory licensing and parallel importation, as they note that many of these  concessions are not yet being used by African countries to access essential medicines. They article reports ways that states and activists have advanced use of these flexibilities. For example in 2002, Zimbabwe used of one of them after declaring a period of emergency to override anti-retroviral medicine patents to import generic medicines for HIV. The article notes that the issue still demands activism. In March 2016, for example, activists marched to the Johannesburg offices of the multinational pharmaceutical company Roche to put pressure on the company to lower the extremely high cost of a life-saving cancer drug.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"African Union model law on medical products regulation","field_subtitle":"African Union Heads of State: African Union, Addis Ababa, 2015","URL":"http://tinyurl.com/zam6lyf","body":"Member States of the African Union endorsed in 2015 the milestones for the establishment of a single medicines regulatory agency in Africa within the context of the African Medicines Regulatory Harmonization programme. Concerned that the proliferation of Substandard/Spurious/Falsified/Falsely- labelled/Counterfeit medical products on the continent poses a major public health threat and noting that regulatory systems of many African countries remain inadequate the states called for legislation relating to medical products through Regional Economic Communities and the African Union to ensure access to medical products that are safe, efficacious, and of assured quality to the African population. They called for the adoption and domestication of a model law on medical products regulation in Africa for the creation of a harmonized regulatory environment on the continent; and adopted the African Union Model Law on Medical Products Regulation. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Agenda for zero discrimination in health care","field_subtitle":"UNAIDS, Geneva, 2016","URL":"http://www.hst.org.za/sites/default/files/Agenda-zero-discrimination-healthcare_en.pdf","body":"People around the world face barriers to accessing quality health care and enjoying the highest attainable standard of health. Why this occurs varies between countries and communities, but some barriers are present everywhere. These include the various forms of discrimination faced by people who are marginalized, stigmatized, criminalized and otherwise mistreated because of their gender, nationality, age, disability, ethnic origin, sexual orientation, religion, language, socio-economic status, or HIV or other health status, or because of selling sex, using drugs and/or living in prison. One in eight people living with HIV report having been denied health care. Examples of HIV-related stigma and discrimination go beyond denial of care or lower quality care, and include forced sterilization, stigmatizing treatment, negative attitudes and discriminatory behaviour from providers, lack of privacy and/or confidentiality and mandatory testing or treatment without informed consent. UNAIDS argue that such discriminatory practices undermine people\u2019s access to HIV prevention, treatment and care services and the quality of health-care delivery, as well as adherence to HIV treatment.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"AU Policy Framework and Plan of Action on Ageing","field_subtitle":"African Union, HelpAge International Africa Regional Development Centre; Addis Ababa, 2002","URL":"http://sa.au.int/en/sites/default/files/AU%20Policy%20Framework%20on%20ageing.pdf","body":"The population of older people throughout the world is increasing rapidly, with Africa projected to have about 210 million older people by 2050. In addition to the usual physical, mental and physiological changes associated with ageing, old people in Africa are argued to be particularly disadvantaged due to lack of social security for everyday social and economic needs. This policy framework binds all AU member countries to develop policies on ageing and is being used as a guide in the formulation of national policies to improve the lives of the continent\u2019s older people. The authors argue that advocacy efforts need improve the adaptation and domestication of the policy and encourage appropriate consultations with older people in these processes, including to ensure the allocation of resources for the implementation of commitments. Notably, the International Plan of Action on Ageing agreed upon in Madrid during the Second World Assembly on Ageing in April 2002, borrowed significantly from the AU Policy Framework.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Bhekisisa Centre for Health Journalism Website","field_subtitle":"Bhekisisa, Mail and Guardian, 2016.","URL":"http://bhekisisa.org/","body":"The South African-based Mail & Guardian newspaper has launched an Africa wide  health journalism centre, Bhekisisa.  Bhekisisa means \"to scrutinise\" in Zulu. It has its own website.  is mentoring reporters in African countries to file solutions-based health features for the website and is working with health policymakers, activists and researchers to write opinion pieces for the website. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Call for Applicants: South African Field Epidemiology Training Programme","field_subtitle":"Closing date: 30 June 2016","URL":"http://www.nicd.ac.za/?page=call_for_applications_-_2015&id=188","body":"The South African Field Epidemiology Training Programme (SAFETP) is requesting applications for the incoming 2017 class from qualified health professionals with an interest in public health and commitment to public service.  The programme is a combination of didactic and practical training in which the resident is grounded in the academic basics of public health and is assigned to field sites where s/he learns by doing while being mentored by supervisors in projects that address key public health priorities. This residency programme is a two year, full time training, from which residents graduate with a Masters in Public Health (MPH) from the University of Pretoria. The 2017 cohort will begin in January 2017 and end in December 2018. The training focuses on investigations of public health outbreaks (an acute health event or other epidemiological activity) and using epidemiology and biostatistics to conduct descriptive and analytical studies. Bursaries/stipends may be available for select South African applicants fulfilling predefined criteria. For applicants applying from other African countries - the eligibility requirements still apply and the international applicant must have the required visa and permissions to study in South Africa.  The applicants must ensure that all the costs related to participation in SAFETP are fully covered for the 2 years of training \u2013 salaries/stipends, university registration and tuition fees, accommodation, travel and accommodation to investigate outbreaks. Further information available on the website.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Cardiovascular disease and impoverishment averted due to a salt reduction policy in South Africa: an extended cost-effectiveness analysis","field_subtitle":"Watkins D; Olson Z;  Verguet S; Nugent R; Jamison D: Health policy and planning 31(1) 75-82, 2015","URL":"http://heapol.oxfordjournals.org/content/31/1/75.long","body":"The South African Government recently set targets to reduce cardiovascular disease (CVD) by lowering salt consumption. The authors conducted an extended cost-effectiveness analysis to model the potential health and economic impacts of this salt policy. They used surveys and epidemiologic studies to estimate reductions in CVD resulting from lower salt intake; the reduction in out-of-pocket (OOP) expenditures and government subsidies due to the policy and the financial risk protection (FRP) from the policy. The authors found that the salt policy could reduce CVD deaths by 11%, with similar health gains across income quintiles. It could save households US$ 4.06 million (2012) in OOP expenditures (US$ 0.29 per capita) and save the government US$ 51.25 million in healthcare subsidies (US$ 2.52 per capita) each year. The cost to the government would be only US$ 0.01 per capita, so the policy would be cost saving. If the private sector food reformulation costs were passed on to consumers, food expenditures would increase by ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Collected readings on post extractivism","field_subtitle":"Various authors: Yes to Life, No to Mining, 2016","URL":"http://www.yestolifenotomining.org/collected-readings-on-post-extractivism/","body":"This collection of writings draws together the thoughts of scholars, activists, historians and social commentators on post-extractivism in different contexts. As a system of thought and action, post-extractivism offers a new and radical approach to the problems caused by mining and extractivism in general. Founded in philosophies of Buen Vivir (Good Living) it proposes radical alternatives to current models of \u2018development\u2019 thinking that support an oppressively extractive, non-reciprocal relationship with Earth and each other, and suggests fields of action and transition to change the current status-quo. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Developed countries turning against non-State actor WHO engagement framework","field_subtitle":"Gopakumar K: Third World Network (TWN) Info Service on Health Issues 5, 21 April16","URL":"http://www.twn.my/title2/health.info/2016/hi160405.htm","body":"Developed countries are reported to be  turning against the World Health Organization\u2019s framework of engagement with non-State actors (FENSA), by putting conditions for its adoption as negotiations on it enter into the last stage. Member States from Europe are reported to be raising three issues to block the adoption of FENSA. First, that the adoption of FENSA is possible only when there is a clear understanding on the implications of its implementation, especially financial and human resource implications. Secondly, that the Secretariat be given flexibility to suspend FENSA norms while engaging with non-State actors to respond to emergencies, and thirdly that the implementation of FENSA be at all three levels of WHO viz. headquarters, regional and national. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Effects of Response to 2014\u20132015 Ebola Outbreak on Deaths from Malaria, HIV/AIDS, and Tuberculosis, West Africa","field_subtitle":"Parpia A; Ndeffo-Mbah M; Wenzel N; Galvani A: Emerging infectious diseases 22(3) 433-41, 2016","URL":"http://wwwnc.cdc.gov/eid/article/22/3/15-0977_article","body":"Response to the 2014\u20132015 Ebola outbreak in West Africa overwhelmed the healthcare systems of Guinea, Liberia, and Sierra Leone, reducing access to health services for diagnosis and treatment for the major diseases that are endemic to the region: malaria, HIV/AIDS, and tuberculosis. To estimate the repercussions of the Ebola outbreak on the populations at risk for these diseases, the authors developed computational models for disease transmission and infection progression. They estimated that a 50% reduction in access to healthcare services during the Ebola outbreak exacerbated malaria, HIV/AIDS, and tuberculosis mortality rates by additional death counts of 6,269 (2,564\u201312,407) in Guinea; 1,535 (522\u20132,8780) in Liberia; and 2,819 (844\u20134,844) in Sierra Leone. The authors report that the 2014\u20132015 Ebola outbreak was catastrophic in these countries, and its indirect impact of increasing the mortality rates of other diseases was also substantial.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 182: Implementing the International Health Regulations cannot just be about epidemic emergencies","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET PRA paper: Reflections on actions and learning from participatory work on health in Cassa Banana, Zimbabwe.","field_subtitle":"Kaim B: TARSC, ZADHR, Cassa Banana Community Health Committee, EQUINET, Harare, 2016","URL":"http://tinyurl.com/z2svfhe","body":"Over the last two years (2014-2015), the Training and Research Support Centre in cooperation with the Zimbabwe Association of Doctors for Human Rights has been building a programme that aims to foster local and national dialogue to build active citizenship and public and private accountability on water and sanitation, as a key element of primary health care. The work draws on experiences and learning arising from the Health Literacy programme and pra4equity network within EQUINET. This paper explores the Cassa Banana residents\u2019 response to their health situation over the last two years, with a particular focus on the role of the Community Health Committee (CHC) in meeting community health needs and in trying to strengthen relations with the Harare City Council and other key stakeholders. In doing so, the paper reflects on the successes and challenges faced by the CHC, and looks at issues of leadership, social cohesion and power within the community as key components to the successful mobilisation of a diverse and fractured community in trying to get its needs met. It ends by recommending possible actions to deal with the problems identified and comments on the extent to which the challenges faced in Cassa Banana can be generalised to other communities in Zimbabwe.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Equity and achievement in access to contraceptives in East Africa between 2000 and 2010","field_subtitle":"Shah C; Griffith A; Ciera J; Zulu E; Palermo T: International Journal of Gynaecology and Obstetrics 133(1), 53-58, 2016","URL":"http://www.sciencedirect.com/science/article/pii/S0020729215007298","body":"This paper presents trends in equity in contraceptive use and contraceptive-prevalence rates in six East African countries. In this repeated cross-sectional study, Demographic and Health Survey data from women aged 15\u201349 years in Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda between 2000 and 2010 were analysed. Individuals were ranked according to wealth quintile, urban/rural populations stratified, and a concentration index calculated. Equity and contraceptive-prevalence rates increased in most country regions over the study period. In rural Rwanda, contraceptive-prevalence rates increased from 3.9 to 44.0. Urban Kenya showed highest equity with a concentration index of 0.02. The Pearson correlation coefficient between improvements in concentration index and contraceptive-prevalence rates was significant. The results indicate that countries seeking to increase contraceptive use should also prioritize equity in access.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Expensive private healthcare highlighted at inquiry","field_subtitle":"Mashego P: BDLive, February 2016","URL":"http://tinyurl.com/zytdy5q","body":"The high cost of private health care in South Africa was profiled in a February 2016 health market inquiry amid revelations that South Africans pay six times the international average for hospital stays. A World Health Organisation study on price levels for private hospitals found that 42% of the funds spent on private voluntary health insurance in South Africa were equivalent to 4% of the country\u2019s gross domestic product. This is six times the average in the Organisation for Economic Cooperation and Development (OECD) countries, despite the expenditure in SA only covering 17% of the population. The report found that South Africans stayed in hospitals for an average of 3.9 days compared to 5.1 days in OECD countries and paid an estimated R20bn in out-of-pocket payments for healthcare. Speaking on the sidelines of the inquiry, Health Minister Aaron Motsoaledi said that healthcare prices were \"exorbitant\" and that needed to change. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Explaining retention of healthcare workers in Tanzania: moving on, coming to \u2018look, see and go\u2019, or stay?","field_subtitle":"Shemdoe A; Mbaruku G; Dillip A; Bradley S; William J; Wason D; Hildon Z: Human Resources for Health14(1)2, 2016","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717661/","body":"In Tanzania staff shortages in the healthcare system are a persistent problem, particularly in rural areas. To explore this the authors explored which cadres are most problematic to recruit and keep in post, for what reasons and why do some stay and cope? Qualitative data were generated through semi-structured interviews with Council Health Management Teams, and Critical Incident Technique interviews with mid-level cadres. Complementary quantitative survey data were collected from district health officials. Mid-level cadres were problematic to retain and caused significant disruptions to continuity of care when they left. Reasons for wanting to leave included perceptions of personal safety, feeling patient outcomes were compromised by poor care or as a result of perceived failed promises. Staying and coping with unsatisfactory conditions was often about being settled into a community, rather than into the post. The Human Resources for Health system in Tanzania was reported to lack transparency. The authors suggest that centralised monitoring could help to avoid early departures, misallocation of training, and to enable other incentives. It should match workers' profiles to the most suitable post for them and track their progress and rewards; training managers and holding them accountable. In addition, they argue that priority should be given to workplace safety, late night staff transport, modernised and secure compound housing, and in measures to involve the community in reforming the culture and practices in services.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Exploring perceptions of community health policy in Kenya and identifying implications for policy change","field_subtitle":"Mccollum R; Otiso L; Mireku M; Theobald S; de Koning K; Hussein S; Taegtmeyer M: Health Policy and Planning 31(1),10, 2016","URL":"http://heapol.oxfordjournals.org/content/early/2015/03/26/heapol.czv007.full","body":"Kenya is currently revising its community health strategy (CHS) alongside political devolution, revisioning responsibility for local services. This explores drivers of policy change from key informant perspectives and perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. The authors conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives from policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members in two purposively selected counties: Nairobi and Kitui.  There was widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas that informants felt should change included: lack of clear supervisory structure and adequate travel resources, uneven coverage and inequity in community health services, limited community knowledge about the strategy and home-based HIV testing and counselling. The recommendations point towards a more people-centred health system for improved equity and effectiveness, if the policy is to be effectively implemented.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Fourth Global Symposium on Health Systems Research","field_subtitle":"14-18 November 2016, Vancouver, Canada","URL":"http://www.csih.org/en/events/fourth-global-symposium-on-health-systems-research/","body":"The Canadian Society for International Health (CSIH) is organizing the Fourth Global Symposium on Health Systems Research in Vancouver at the Vancouver Convention Centre on behalf of Health Systems Global (HSG). The theme for 2016 is \u201cResilient and responsive health systems for a changing world\u201d. The Global Symposium on Health Systems Research is hosted every two years by HSG to bring together its members with the full range of players involved in health systems and policy research. The Symposium aims to share new state-of-the-art evidence; review the progress and challenges towards implementation of the global agenda of priority research; identify and discuss the approaches to strengthen the scientific rigour of health systems research including concepts, frameworks, measures and methods; and facilitate greater research collaboration and learning communities across disciplines, sectors, initiatives and countries. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global Health Action (GHA) Call for Papers: \u2018Gender and health inequalities: intersections with other relevant axes of oppression\u2019","field_subtitle":"Deadline: End of August 2016 ","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/30292","body":"This call for papers entitled \u2018Gender and health inequalities: intersections with other relevant axes of oppression\u2019 aims to generate knowledge about how gender inequalities in health/disease/mortality/and access to health care systems interact with other important axes of oppression (race/ethnicity, social class, religion, and/or migratory status, among others) through different levels of power (from the global to the local) at different lifetime stages for a population. It also aims to contribute to a better understanding of the relationship between gender (in)equalities and health (inequalities). The editors welcome different types of contributions: empirical research, theoretical papers, methodological papers, and reviews. Studies aiming to contribute to developing gender and social theories building on intersectional, ecosocial, relational, or biosocial approaches are welcome. Also of interest are methodological papers using qualitative, quantitative, or mixed methods, and are particularly studies that explore means of better addressing the complexity of analysing health inequalities according to this multidimensional or multiple approach. The editors also welcome papers that address not only issues of dominance and/or suffering but also those about resistance, agency, resilience, and/or empowerment. They encourage submissions from researchers working in low-, middle-, and high-income countries.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Implementing the International Health Regulations cannot just be about epidemic emergencies","field_subtitle":"Rangarirai Machemedze, SEATINI, Rene Loewenson, TARSC ","body":"\r\nSuccessive epidemics of international concern such as SARS, Ebola, Zika have raised the focus on responses to health emergencies, as \u2018global health security\u2019. It has also given new attention to the implementation of the International Health Regulations (IHR), including as an agenda item in the World Health Organisation\u2019s 2016 World Health Assembly. \r\n\r\nThe IHR were adopted globally by member states in the WHO in 2005, including by all 46 countries in its Africa region. They seek to prevent, protect against, control and provide a public health response to the international spread of diseases \u201c\u2026in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.\u201d  Countries were required by June 2012 to have developed core public health capacities for surveillance, reporting on and response to public health risks and emergencies, including at ports of entry.  This includes capacities to provide specialized staff, multi-sectoral teams and laboratories and local investigations to prepare for, prevent and rapidly contain and control cross border public health risks that may be due to infectious diseases, food safety, and to chemical, radiation and zoonotic hazards. Countries unable to meet these core capacities by June 2012 could request for an extension to 2014 and in exceptional circumstances to June 2016. So we are now a month away from the time all countries were expected to have achieved these core capacities. \r\n\r\nThese capacities are not delinked from the core capacities needed to protect public health within countries, nor from comprehensive primary health care approaches that seek to engage all sectors to promote health and prevent ill health. Within countries, these capacities are not just a matter for the health sector. They call for society, state, private sector and non-state organizations to promote public health. For example, preventing communities living near mines from being poisoned by arsenic or mercury contamination of water, soil, and food calls for intervention from local authorities, planners, mine managers, state sectors responsible for infrastructure, mining, environment, health and labour, workers and communities. This includes workers and families who migrate from other countries to work on mines and who may otherwise return with long term lung, gastrointestinal, neurological or renal problems. While focusing on cross border risks, the presence of uncontrolled environmental risks, or of cholera, typhoid and other epidemics within African countries is not unimportant for the IHR, and certainly not for people in that country. These problems signal weaknesses in public health that may lead to risks spilling across borders. They may also arise from trade or economic determinants that are international in scope. \r\n\r\nHence, as we approach June 2016, while there has been progress in implementing the IHR, it is a matter of concern that there are still deficits in the core capacities. An October 2015 WHO report compiled feedback from 118 of 196 States Parties to the IHR on a self-assessment questionnaire on progress made in developing these core capacities. It showed that progress had been made globally in legislation and policy; coordination and collaboration with other sectors; improved detection, early warning, preparedness and emergency response capacities and in communication with the public and to stakeholders. \r\n\r\nFor the African region, reporting by March 2015 showed that African countries were also making progress on a number of core capacities. Not surprisingly given the responses and investments after the Ebola epidemic, the most notable improvements were in surveillance and laboratory capacities. Improvements in these areas are seen to be essential for early warning system for detection of any public health events for rapid response and control, to prevent them spilling over borders. There has been investment in surveillance and laboratory capacities in Africa through an Integrated Disease Surveillance Response, and international support for African and sub-regional communicable disease control centers for detection and early warning of infectious disease risks. There has, however, been less progress in preparedness, in capacities at ports of entry, and in capacities to deal with chemical and food safety risks. It suggests that while the region may be better prepared to deal with infectious disease epidemics, this may not be the case for other public health risks.\r\n\r\nThe progress suggests that the global health security agenda has given great focus to control of infectious diseases and \u2018biosecurity\u2019, not least as a response to the international spread of recent epidemics of Ebola virus and Zika virus. Significant new global resources are being mobilised for emergency responses. Assessment tools and reporting systems are being discussed in the WHO, with some proposals for new global mechanisms, global financing facilities and independent assessment by global actors.\r\n\r\nHowever global health security cannot be reduced to emergency responses and infectious disease control, nor can the prevention of cross border disease be delinked from the measures taken from local to national level within countries and between countries in their regions to strengthen the primary health care and public health functioning of health systems.  Uganda was able to respond to its 2000 Ebola epidemic within two weeks from first case to confirmation and controls being implemented. This speed of response was as much to do with the strength of systems within districts and the strength of communication between local and national levels of the health systems as the sophistication of its laboratory capacities. The spread of cholera and typhoid epidemics in Africa draws more from inadequate investment in safe water, sanitation and waste management systems and weak public health inspection than from gaps in emergency preparedness. New viral epidemics are emerging as poor communities and animal vectors are being squeezed into closer proximity by mono-cropping and mining activities; and new emergencies such as rising antimicrobial resistance are deeply embedded in how health systems function and interact with the public and with the pharmaceutical industry. Rising levels of chronic conditions in many African countries that foretell a future crisis of escalating unaffordable costs for countries and households are contributed to by cross border trade in harmful processes and products. \r\n\r\nThe global health security agenda cannot thus be narrowed to one of emergency responses to infectious disease. Instead, global health security also needs to identify and act on the determinants to prevent such emergencies. The IHR as an overarching umbrella for international public health obligations recognises this. So too, in their intent, do the Sustainable Development Goals. While many determinants of global health security lie outside the health sector, and while resources are indeed needed to deal with emergencies and their economic and social impacts, a health sector response to preventing and controlling emergencies needs to link with and support longer term health systems strengthening. This starts locally, within countries and particularly with the comprehensive primary health care and public health approaches that are needed to identify, prevent and manage risk before it grows into an emergency. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Increasing Access to High-Quality, Safe Health Technologies Across Africa: African Union Model Law on Medical Products Regulation","field_subtitle":"PATH, NEPAD, March 2016","URL":"http://www.path.org/publications/files/APP_au_model_law_br.pdf","body":"The regulation of health technologies is a critical component of every country\u2019s public health system and ensures that high-quality, safe health technologies reach the people who need them most. To harness momentum for regulatory harmonization, the Pan-African Parliament, New Partnership for African Development, and African Union Commission spearheaded the development of the African Union Model Law on Medical Products Regulation, which guides member states and regional economic communities in harmonizing regulatory systems and providing an enabling environment for the development and scale-up of health technologies. This paper outlines the measures for implementation of the law. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"International AIDS Conference","field_subtitle":"17th-22nd July 2016, Durban, South Africa","URL":"http://www.aids2016.org/","body":"The International AIDS Conference is a gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess state of affairs, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.  The AIDS 2016 programme will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Making the SDGs Transformational: UNRISD and the 2030 Agenda for Sustainable Development","field_subtitle":"Ladd P: United Nations Research Institute for Social Development (UNRISD), 2015","URL":"http://tinyurl.com/gkwkjr7","body":"UNRISD director Paul Ladd shares his reflections on the Sustainable Development Goals (SDGs). He argues that social development means keeping people at the centre, and recognising the contributions that can be made by all people, regardless of gender, age, race, ethnicity, physical ability, sexuality or any other characteristic. Enhancing well-being means that processes, relationships and institutions need to be transformed into ones that are based on equity and justice. This is critically shaped by how governments are run, how technology is used, how people adapt to demographic change, and how economies are structured, all of which depends on the political agenda. He argues that the 17 SDGs have many welcome innovations, including the aspiration to not tackle issues in silos, to leave no one behind and the recognition that all countries have problems. This presents a more political agenda than the Millennium Development Goals (MDGs) that preceded them, with solutions largely found in policy change and doing things differently, rather than solely spending more money on technocratic 'solutions' that, while well-meaning, ignored the power dynamics that determine who benefits from them and who is left by the wayside. Finally he observes that UNRISD\u2019s three research programmes\u2014social policy, gender and development, and the social dimensions of sustainable development\u2014intend to make a critical contribution to debates on which policies and institutions, in which contexts, will make the most progress towards achieving the SDGs. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Modelling the impact of raising tobacco taxes on public health and finance","field_subtitle":"Goodchild M; Perucic AM; Nargis N: Bulletin of the World Health Organisation 94(4), 233-308","URL":"http://www.who.int/bulletin/volumes/94/4/15-164707-ab/en/","body":"This study investigated the potential for tobacco taxes to contribute to the 2030 agenda for sustainable development by reducing tobacco use, saving lives and generating tax revenues. A model of the global cigarette market in 2014 \u2013 developed using data for 181 countries \u2013 was used to quantify the impact of raising cigarette excise in each country by one international dollar (I$) per 20-cigarette pack. All currencies were converted into I$ using purchasing power parity exchange rates. The results were summarized by income group and region. According to the study model, the tax increase would lead the mean retail price of cigarettes to increase by 42% \u2013 from 3.20 to 4.55 I$ per 20-cigarette pack. The prevalence of daily smoking would fall by 9% \u2013 from 14.1% to 12.9% of adults \u2013 resulting in 66 million fewer smokers and 15 million fewer smoking-attributable deaths among the adults who were alive in 2014. Cigarette excise revenue would increase by 47% \u2013 from 402 billion to 593 billion I$ \u2013 giving an extra 190 billion I$s in revenue. This, in turn, could help create the fiscal space required to finance development priorities. For example, if the extra revenue was allocated to health budgets, public expenditure on health could increase by 4% globally. The authors argue that tobacco taxation can prevent millions of smoking-attributable deaths and create the fiscal space needed to finance development, particularly in low- and middle-income countries.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Out-of-pocket expenditure and its determinants in the context of private healthcare sector expansion in sub-Saharan Africa urban cities: evidence from household survey in Ouagadougou, Burkina Faso","field_subtitle":"Beogo I; Huang N; Gagnon MP; Amendah D: BMC Research Notes 9(1)34, 2016","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721044/","body":"This study investigated the level and determinants of  out-of-pocket (OOP) spending among individuals reporting illness or injury in Ouagadougou, Burkina Faso and who either self-treated or received healthcare in either a private or public facility. A cross-sectional study was conducted with a representative sample of 1017 households in 2011. Among the surveyed sample, 29.6% persons reported a sickness or injury. Public providers were the single most important providers of care, whereas private and informal providers accounted for 29.8 and 34.0%, respectively. Almost universally (96%), households paid directly for care, with an average expenditure per episode of illness of 17.4USD. The total expenditure was higher for those receiving care in private facilities compared to public ones and the insured patients\u2019 bill almost tripled uninsured. Medication was the most expensive component of expenditure in both public and private facilities. OOP was the principal payment mechanism of households. Considering the importance of private healthcare in Burkina Faso, the authors argue that regulatory oversight is necessary and an extensive protection policy to shield households from catastrophic health expenditure is required.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Participatory Governance Toolkit","field_subtitle":"Christian C: All Africa, 2016","URL":"http://tinyurl.com/hvwezq3","body":"This toolkit contains tools and resources relating to different categories of participatory governance practices, including for (1) public information, for citizens to access relevant information about government policies, decisions and actions; (2) education and deliberation; (3) public dialogue for communication between citizens and state; (4) design and implementation of public policies and plans that respond effectively to citizens\u2019 priorities and needs; (5) public budgets and expenditures to help citizens understand and influence decisions about the allocation of public resources, monitor public spending and hold government actors accountable for their management of public financial resources (6) monitoring and evaluating the accessibility, quality and efficiency of public services  and (7) monitoring and overseeing public action and seeking retribution for injustices or misdeeds.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Partnerships, Power and the SDGs","field_subtitle":"Faul M: UNRISD seminar, Geneva, March 2016","URL":"http://www.youtube.com/watch?v=kROW3cXOxvk","body":"Partnerships, and their accompanying networks, are now presented as an essential ingredient for fair SDG implementation. But what happens in practice? Network analysis reveals how development \u2018partners\u2019 may in fact informally depart from established rules and relationships, with the end result that networks may amplify the very disparities of power they were intended to reduce. In this seminar, Moira Faul argues that with a better understanding of how partnership works, network members could rewire relationships for more inclusion, and ultimately better policy and practice solutions.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Public Health Association of South Africa 2016 Conference","field_subtitle":"19th - 22th September 2016, East London Convention Centre, South Africa","URL":"http://www.phasa.org.za/conference/","body":"The Public Health Association of South Africa 2016 Conference builds on the 2015 Conference theme of \u201cHealth and Sustainable Development: The Future\u201d. The 2016 Conference will focus on how public health education as well as practice will need to transform to achieve the Sustainable Development Goals (SDGs). The 2016 Conference will feature workshops, satellite sessions, panel discussions, oral and poster presentations and site visits. The panel debate format of 2015 will be retained with National Health Insurance a potential topic. The 2016 Conference forms part of the University of Fort Hare\u2019s centenary and this very special occasion will be marked during the opening of the conference.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"SDGs indicators: more about politics than statistics","field_subtitle":"Vandemoortele J: Deliver 2030, February 2016","URL":"http://deliver2030.org/?p=6738","body":"In his book Damned Lies and Statistics (2001), Best points out that \u2018people who bring statistics to our attention have reasons for doing so\u2019. Some statistics are manufactured and manipulated as ammunition for political struggles, although their purpose is hidden behind assertions of objectivity and accuracy. The author argues that numbers often get amplified in the echo chamber of mainstream media and that one should never accept on face value that statistics always reveal truths. He argues that they are often used to manage perceptions more than to help analysis and  understanding of complex realities.  He thus urges people to be involved in reviewing and commenting on the work of and proposals from the UN Statistical Commission as they develop indicators for the SDGs.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The China Africa Project","field_subtitle":"Olander E; vanStaden C: China Africa Project, 2016","URL":"http://www.chinaafricaproject.com","body":"The China Africa Project is a multimedia resource dedicated to exploring various aspects of China\u2019s growing engagement with Africa.  Through a combination of original content and curation of third-party material from across the Internet, the CAP\u2019s objective is purely informational. The site states that none of the blog\u2019s authors or producers have any vested interest in any Chinese or African position.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The West African Health Organization\u2019s experience in improving the health research environment in the ECOWAS region","field_subtitle":"Aidam J; Sombi\u00e9 I: Health Research Policy and Systems14(30), 20 April 2016","URL":"http://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-016-0102-7","body":"The West African Health Organization (WAHO) implemented a research development program in West Africa during 2009\u20132013  with components of  stewardship, financing, sustainable resourcing and research utilization. This paper describes how programme and lessons learnt, triangulating activity reports, an independent evaluation and the authors\u2019 experiences with stakeholders. WAHO and major stakeholders validated these findings during a regional meeting. All 15 ECOWAS countries benefited from this regional research development programme. WAHO provided technical and financial support to eight countries to develop their policies, priorities and plans for research development to improve their research governance and organised capacity-strengthening training in health systems research methodology, resource mobilization, ethical oversight and on HRWeb, a research information management platform. WAHO helped launch a regional network of health research institutions to improve collaboration between regional participating institutions and mobilised funding for the programme. It supported 24 health research projects. High staff turnover, weak institutional capacities and ineffective collaboration were some of the challenges encountered during implementation. The regional collaborative approach to health research was found to be effective given the challenges in the region, and with research partnerships and funding helped strengthen local health research environments. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Trends in socioeconomic disparities in a rapid under-five mortality transition: a longitudinal study in the United Republic of Tanzania","field_subtitle":"Kant\u00e9 A; Nathan R; Jackson E; Levira F; Helleringer S; Masanja H; Phillips J: Bulletin of the World Health Organisation 94(4), 233-308","URL":"http://www.who.int/bulletin/volumes/94/4/15-154658.pdf","body":"This study explored trends in socioeconomic disparities and under-five mortality rates in rural parts of the United Republic of Tanzania between 2000 and 2011. The authors used longitudinal data on births, deaths, migrations, maternal educational attainment and household characteristics from the Ifakara and Rufiji health and demographic surveillance systems. They estimated hazard ratios (HR) for associations between mortality and maternal educational attainment or relative household wealth, using Cox hazard regression models. The under-five mortality rate declined in Ifakara from 132.7 deaths per 1000 live births in 2000 to 66.2 in 2011 and in Rufiji from 118.4 deaths per 1000 live births in 2000 to 76.2 in 2011. Combining both sites, in 2000\u20132001, the risk of dying for children of uneducated mothers was 1.44 times higher than for children of mothers who had received education beyond primary school and in 2010\u20132011, the HR was 1.18. In contrast, mortality disparities between richest and poorest quintiles worsened in Rufiji, from 1.20 in 2000\u20132001 to 1.48 in 2010\u20132011, while in Ifakara, disparities narrowed from 1.30 to 1.15 in the same period. While childhood survival has improved, mortality disparities still persist. The authors thus argue for  policies and programmes that both reduce child mortality and address socioeconomic disparities.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"UNU-WIDER PhD Internships","field_subtitle":"Applications open 1 March and 1 September of each year","URL":"https://www.wider.unu.edu/opportunity/unu-wider-phd-internships","body":"The UNU-WIDER PhD Internship Programme gives registered doctoral students an opportunity to utilize the resources and facilities at UNU-WIDER for their PhD dissertation or thesis research, and to work with UNU-WIDER researchers in areas of mutual interest. PhD interns typically spend 3 consecutive months at UNU-WIDER and return to their home institution afterwards. They prepare one or more research papers and present a seminar on their research findings. PhD interns may also have the opportunity to publish their research in UNU-WIDER\u2019s working paper series. Applicants must be enrolled in a PhD programme and have shown ability to conduct research on developing economies. Candidates working in other social sciences may apply but should keep in mind that UNU-WIDER is an economics-focused institute. Candidates should be fluent in oral and written English and possess good quantitative and/or qualitative analytical skills. Preference is given to applicants who are living or working in developing countries and who are at later stages of the PhD. For further information see the website.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Video: Health care in Cuba and the Philippines: what are the differences?","field_subtitle":"Third World Health Aid, April 2016","URL":"https://vimeo.com/160877078","body":"April 7 was World Health Day and the European Day of Action against commercialisation of Health Care. For this occasion, Third World Health Aid launched its new video that compares the health system of Cuba with the privatized system in the Philippines and its impact on the population. It spreads a strong message of the necessity of free and accessible health care, and community involvement. In this video, Third World Health Aid compare the situation in two developing countries. Cuba is famous for its excellent health care, which is free of charge for its citizens. In the Philippines, access to health care is not so evident. Third World Health Aid see a big inequality. What explains this big difference.? The video shows a walk together with local health workers in the neighbourhoods of Havana and Manilla, the capitals of these two countries. It shows the different experiences of the broad range of factors affecting health, including health care. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Wellbeing Economics and Buen Vivir: Development Alternatives for Inclusive Human Security","field_subtitle":"Ruttenberg T: Wellbeing Economics and Buen Vivir, XXVIII, 2013","URL":"http://tinyurl.com/glgj8wd","body":"As international development strategies struggle to address issues of human insecurity and socioeconomic inequality, inspiring alternatives are taking shape outside the traditional development discourse. The author argues that locating development strategies within the current neoliberal capitalist framework limits the possibility of success of development goals and strategies, largely designed by 'the North' and argued to be rarely successful in 'the South'. The author argues that these have potential to transform development policy in the South. This article discusses well-being economics, questioning the notion that high income and consumption constitutes genuine wealth, noting that income contributes up to the point of satisfying basic needs, after which human well-being is argued to rest on supporting the development of human potentialities through meaningful livelihoods, strengthening social relations and promoting ways of life in harmony with nature. She argues that this is being applied in the political philosophy of \u201cbuen vivir\u201d (living well) in selected Latin American social movements and states to guide  a development policy that is more inclusive of human security and their environments. The paper explores the manner in which the concept puts  improvement of the quality of life, capacities and potential of the population and its harmonious coexistence with nature at the centre of the economic system, within constitutions, policies  in selected countries and in relation to their impact.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"White Paper: National Sanitation Policy","field_subtitle":"South African National Department of Health: Pretoria,  2016","URL":"http://www.hst.org.za/sites/default/files/160212draftnationalsanitationpolicy.pdf","body":"The sanitation sector in South Africa is currently regulated by three policy documents, namely the White Paper on Water Supply and Sanitation (1994); the White Paper on a National Water Policy of South Africa (1997) and the White Paper on Basic Household Sanitation (2001). These documents provide procedures, rules and allocation mechanisms for sanitation, implemented through laws, regulations; economic measures; information and education programmes; and assignment of rights and responsibilities for providing services. After several years of implementation, a number of challenges and unintended consequences were identified. The regulatory responsibilities were unclear, shifting between departments. Devolving responsibility for implementation to local government resulted in significant changes in the sector. Increased urbanisation is noted to increase stress on urban sanitation systems, but so too is changing human settlement in rural areas placing increased strain on small and limited sanitation systems. The department thus argues for policy review to address these challenges to deliver sanitation.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"World Nutrition Congress 2016","field_subtitle":"30th Aug - 2nd Sept 2016, Cape Town, South Africa","URL":"http://www.wncapetown2016.com","body":"This congress is taking place at a time of unprecedented challenges in population nutrition. Global and national food systems are increasingly concentrated and globalised, with small scale food production being rapidly marginalised in countries where such activity previously predominated. In many countries people are mobilising to defend their rights and taking action to recover and preserve indigenous and environmentally sustainable food systems. Several African countries are experiencing a \u2018nutrition transition\u2019 but are not yet as advanced along this trajectory as is South Africa, your host country. Together with \u2018Big Food\u2019 \u2013 large corporations in the food system \u2013 South African food companies (manufacturers and retailers) are expanding into Sub-Saharan Africa, influencing many countries\u2019 food environments and nutritional indicators. Hence, South Africa\u2019s experience and policies can inform improved understanding and policy making on the continent and can also provide a platform for all concerned with the impact of the food system on the health of humanity and our planet. The holding of the WPHNA Congress in South Africa has the potential to inform key policy makers and researchers and significantly shape the food and nutrition policy landscape in South Africa, Africa and beyond.","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Yellow fever vaccine supply: a possible solution","field_subtitle":"Monath T; Woodall J; Gubler D;  Yuill T; Mackenzie J;Martins R; Reiter P; Heymann D: The Lancet 387;10028; 1599\u20131600, 2016 ","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30195-7/fulltext","body":"The authors note the emerging epidemic of yellow fever in Angola and spread of similar Aedes aegypti mosquito-borne viruses including dengue, chikungunya, and now Zika, albeit with differences noted. Yellow fever was first identified as a viral infection in 1900, has been reported from more than 57 countries and yellow fever outbreaks have case fatality rates as high as 75% in hospitalised cases. There has been an effective yellow fever vaccine since the late 1930s, but with outbreaks in unvaccinated populations in 1987 in urban Nigeria,  despite a mass vaccination campaign. According to WHO, the current yellow fever outbreak is in more than six of Angola's 18 provinces, and there has been movement of unvaccinated travellers from Angola to neighbouring Democratic Republic of the Congo, but also to further states, including Mauritania, and China. Southeast Asian countries are now considered at risk because the Aedes vector is present and the population is unvaccinated.  However should yellow fever outbreaks occur elsewhere in Africa, in Latin America, or in Asia, the authors note that the current global supplies of yellow fever vaccine may be inadequate. ","php":"","field_issue_date":"2016-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for Applications: 2016 Small Grants Programme for Thesis Writing","field_subtitle":"Deadline for Applications: 30 April 2016","URL":"http://www.codesria.org/spip.php?article2524&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) has announced the twenty-seventh session of its Small Grants Programme for Thesis Writing. The grants serve as part of the Council\u2019s contribution to the development of the social sciences in Africa, and the continuous renewal and strengthening of research capacities in African universities, through the funding of primary research conducted by postgraduate students. Hence, candidates whose applications are successful are encouraged to use the resources provided under the grants to cover the cost of their fieldwork, the acquisition of books and documents, the processing of data which they have collected and the printing of their dissertations. The CODESRIA Small Grants Programme is opened to students currently registered in PhD in African universities, and preparing their research in all social science fields and other disciplines involving social or economic analysis. The research proposal should be based on an innovative problematic which sets out the originality of the theme in relation to on-going research in the same area. Candidates\u2019 research proposals should each contain a clear statement of the research hypotheses, a critical review of the existing literature, the methodology to be used, the expected results of the work, and a detailed work plan and timetable. Grants are awarded solely on merit. All applicants are required to use the application forms designed by CODESRIA, accessible via their website.  ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers: Writing South Africa Now: a Colloquium, 16-17 June 2016, ","field_subtitle":"Deadline: 4 March 2016","URL":"https://writingsouthafricanow.wordpress.com","body":"In 2013, it was reported that more than two-thirds of South Africa\u2019s citizens now live in the country\u2019s sprawling urban areas. The Gauteng region alone saw its population swell to some 12 million, an increase of more than 30% in 10 years and more than double the national average. Such statistics, while significant, are not in themselves very instructive. The everyday impact of South Africa\u2019s urbanisation in the years since apartheid, the daily struggles the the poor urban infrastructure imposes, the expanding social and spatial inequalities that fragment the city, and the architecture of anxiety that determines so many ordinary urban habits, are better understood through the narratives crafted by the city\u2019s writers, filmmakers, performers and visual artists, In the imaginative writing of the city, established authors such as Ivan Vladislavic, William Kentridge, and Willie Bester contribute as much to our understanding of the South African city as the emerging voices of photographers and filmmakers such as Mikhael Subotzky, Ramadan Suleman, and Oliver Hermanus. Moreover, like the graffiti commonly daubed on the M1 underpass in Newtown, Johannesburg and the fiction titles that line the shelves of Cape Town\u2019s Book Lounge, the form these stories adopt and the networks through which they find expression are as diverse and uneven as the cityscapes themselves.  Now in it\u2019s fourth year, Writing South Africa Now calls for academic papers that contribute to the ongoing writing of the South African city. For academic papers, send an abstract of 300 words and brief biography to the organisers by 4th March. For artistic contributions, send an outline of the proposed contribution of examples of work, along with a brief biography to organisers as soon as possible. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Coursera: Systems Thinking in Public Health","field_subtitle":"Johns Hopkins University: Next course enrolment ends May 2 ","URL":"http://www.coursera.org/learn/systems-thinking/","body":"This course provides an introduction to systems thinking and systems models in public health. It requires 4 weeks of study, 4-5 hours/week, as an online course. Problems in public health and health policy tend to be complex with many actors, institutions and risk factors involved. If an outcome depends on many interacting and adaptive parts and actors the outcome cannot be analyzed or predicted with traditional statistical methods. Systems thinking is a core skill in public health and helps health policymakers build programs and policies that are aware of and prepared for unintended consequences. An important part of systems thinking is the practice to integrate multiple perspectives and synthesize them into a framework or model that can describe and predict the various ways in which a system might react to policy change. Systems thinking and systems models devise strategies to account for real world complexities.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Delivering Social Protection Systems for All: Why Taxes Matter","field_subtitle":"Bastagli F: United Nations Research Institute for Social Development (UNRISD), 5 October 2015","URL":"http://tinyurl.com/zgcyjdu","body":"Social protection and taxation feature prominently as key policy instruments available to governments in the pursuit of development goals in both the Financing for Development (FFD) Addis Ababa Action Agenda and the Sustainable Development Goals (SDGs). This reflects a growing recognition among policy makers in the international development context of the powerful role fiscal policy plays in shaping development outcomes. It also represents an important opportunity for closer consideration of the ways in which taxation and social protection operate jointly in practice. Taxes and transfers commonly continue to be discussed separately, yet in practice they interact to shape the distribution and redistribution of income and wealth both directly \u2013 through the distribution of transfers and the tax burden \u2013 and by influencing processes of government accountability and legitimacy, the quality of service provision and people\u2019s willingness to pay taxes. If appropriately designed and implemented, taxes and transfers can make a significant dent in poverty and inequality. In high-income OECD countries, direct taxes and transfers alone contribute to an average 30% reduction in income inequality, reducing the average Gini coefficient from 0.41 to 0.29. In comparison, in developing countries, their impact is more muted. There is thus scope to strengthen these systems, particularly as in July 2015, world leaders in Addis Ababa agreed on a commitment to delivering social protection and essential public services for all through a new social compact to \u2018end poverty in all its forms everywhere\u2019. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"ECSA Health Community and EQUINET Regional workshop on global health diplomacy","field_subtitle":"ECSA HC and EQUINET: April 7-8 2016, Nairobi, Kenya","body":"In 2012 EQUINET initiated a three year policy research programme working with government officials, researchers, diplomats and others in the ESA region on the role of  health diplomacy and international co-operation in health, including south \u2013south diplomacy, in addressing selected key challenges to health and strengthening health systems. We aimed to use the evidence and learning to inform African policy actors and stakeholders within processes of health diplomacy. The work was done in association with the Strategic Initiative of Global Health Diplomacy co-ordinated by the East Central and Southern Africa Health Community (ECSA-HC). The research reports and policy briefs have been produced and are included in the EQUINET publications on this website. A March 2015 workshop included senior officials from national and regional organisations, health diplomats, researchers from the EQUINET work and others working on health diplomacy and on south-south co-operation in the region and internationally. The workshop discussed the evidence from the EQUINET research and from research on GHD from other institutions with a particular focus on east and southern Africa and proposed areas for follow up policy, action and research, within ESA and through south-south collaboration. The meeting report is on this website. EQUINET is now taking forward the proposals from this meeting in association with a consortium of institutions in the region, and is working with the ECSA Health Community in its Strategic initiative on global health diplomacy to share evidence and analysis for key global processes, including in the forthcoming regional workshop on GHD hosted by the ECSA HC with EQUINET. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.\r\n","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 181: Human rights approaches can advance maternal health: Lessons from Uganda","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Header"}},{"node":{"title":"Fighting the scourge of female genital mutilation in Kenya","field_subtitle":"Mmaka V: Pambuzuka News 762, 18 February 2016","URL":"http://www.pambazuka.net/en/category.php/features/96643","body":"Female Genital Mutilation (FGM) is outlawed in Kenya. In this interview, Kenyan activist John Wafula holds the view that: \u201cFGM is not a culturally enriching choice but rather a tool to isolate women and girls for disempowerment, domination and stagnation. If FGM negates girls\u2019 right to education and healthy bodies then it ceases to be tenable as a cultural identity\u201d. Prior to interventions to address FGM, he reports undertaking a baseline study to establish the prevalence of FGM in refugee camps, survivors, practitioners. The reasons why FGM was practiced, mostly among refugees of Somali descent, included perceptions that uncircumcised women would otherwise be unfaithful and ineligible for marriage. Their efforts to prevent FGM entailed creating awareness about its health, social and psychological consequences at the community level. They also invited religious scholars to engage the community on religion-based myths that were peddled to justify FGM. They sensitized school children on human rights, which also encompassed protection against any form of violence, FGM included. They targeted refugee community leaders for sensitization because of their visible position as community gatekeepers. The 2014 Kenya Demographic Health Survey indicated a nation-wide prevalence of 23%, down from 27% in 2008-09 and 32% in 2003. After enactment of the Prohibition of Female Genital Mutilation Act in 2011, an Anti-FGM Board was established that is reviewing a FGM policy with vigorous media campaigns to sensitize the public on the Act, supported by insights from research. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Fourth AfHEA Scientific Conference","field_subtitle":"Rabat, Morocco, 26-29 September 2016","URL":"http://afhea.org/en/conferences/conference-2016-rabat/call-for-abstracts","body":"The overall theme of this conference is \u201cThe Sustainable Development Goals (SDGs), the Grand Convergence and Health in Africa\u201d. This theme recognizes the new international health economics and policy landscape with the end of the MDGs and the adoption in September 2015 of the successor SDG global initiative. It seeks to provide an African perspective and analysis of this emerging landscape and agenda. AfHEA will publish a policy paper on this new agenda and the perspectives after the conference. Visit the website for more details.\r\n","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Gender, Diseases and Public Health Governance in Africa, 4th -15th July 2016, Dakar, Senegal","field_subtitle":"Deadline for Applications: 15 April 2016","URL":"http://www.codesria.org/spip.php?article2528","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites researchers to submit their applications for participation in the 2016 Gender Institute to be held from 4th to 15th of July, 2016 in Dakar, Senegal. The re-emergence of a more virulent strain of the Ebola Haemorrhagic Fever (EHF) in West Africa in 2014 has brought to light some key issues of public health governance in Africa. One such issue is the gendered nature of epidemic-prone infectious diseases in Africa. Current epidemiological statistics on Ebola indicate that though the initial cases were predominantly male, the disease is slowly becoming a female epidemic in the affected countries in Africa. This gendered pattern of female vulnerability to disease in its progression and as it progresses in the population, mirrors that of HIV/AIDS. Understanding gender and disease has serious implications for governance of public health in Africa. Governance of public health in Africa relates to more than just the role of government. The relationship between gender, disease and governance of public health raises some key questions which this Institute will explore. Applicants should be PhD candidates or scholars in their early career with a proven capacity to conduct research on the theme of the Institute. Intellectuals active in the policy process and/or social movements and civil society organisations are also encouraged to apply. The number of places offered by CODESRIA for this session is limited to ten (10). Non-African scholars who are able to raise funds for their participation may also apply for a limited number of places. Applicants\u2019 proposals must bring together the three components of the topic: gender, diseases and governance of public health In Africa. The proposed work can be based on empirical studies including field work using quantitative or qualitative methodologies; analytical work involving analysis of existing data or case studies. All work must have some theoretical grounding. Papers can be from any social science discipline including gender studies, sociology, anthropology, demography, economics; or health sciences like epidemiology or biostatistics. Scholars are encouraged to show through their work the way in which gender, diseases and public health governance are linked.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global Wealth Inequality - What you never knew you never knew","field_subtitle":"TheRulesOrg: You tube, April 2013","URL":"https://www.youtube.com/watch?v=uWSxzjyMNpU","body":"While global inequality has become even more intense since this it was made, this short 4 minute video has some quick visuals on global inequalities in wealth. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health care is a social investment: An interview with South Africa's Minister of Health","field_subtitle":"Smith J: Mercury, 22 January 2016","URL":"http://www.iol.co.za/mercury/health-care-is-a-social-investment-1.1974711","body":"This paper presents an interview with South Africa's Health Minister, Aaron Motsoaledi. in which he answers six big questions about the National Health Insurance White Paper: Are you intending to stop medical schemes providing the same services as NHI? Are you intending to curb, if not entirely limit, private health care? Was a battle with the Treasury over the enormous amounts of public money it\u2019s going to take to fund NHI a main reason behind the delay in releasing the White Paper? What\u2019s the point in the Healthcare Market Inquiry (HMI)? You\u2019re looking at full implementation of the NHI by 2025. Is that fair? It presents the Minister's answers. He notes that the NHI envisages a society based on values, justice, fairness and social solidarity. Health care is a social investment, therefore it should not be subject to the normal market forces and treated as a normal commodity. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Health System Global call for multimedia for the Global Symposium for Health Systems Research, November 2016","field_subtitle":"Deadline for submissions: April 28 2016","URL":"http://healthsystemsresearch.org/hsr2016/call-for-multimedia/","body":"Health system global is calling for short films, documentaries, animated films, photo-essays, and other multimedia, that address any of the six symposium themes of the 4th Global Symposium for Health Systems Research in Vancouver this year (14-18 November).  Submissions welcomed from health researchers, film-makers, activists and artists engaging with the content outlined in themes. Submissions will be peer reviewed and selected on the basis of the relevance of the content to the symposium and the ability to convey the message of the thematic areas. Please note that the technical quality of the media (cinematography, animation, professional editing) will not be the primary criteria for selection. Full details on submissions found at the website indicated.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health Systems Trust Conference 2016","field_subtitle":"4th-6th May 2016, Gauteng, South Africa","URL":"http://www.hstconference2016.org.za","body":"Health Systems Trust (HST) is hosting a conference from 4-6 May 2016 at the Birchwood Conference Centre, Boksburg, Gauteng.  Under the banner of Health for all through strengthened health systems: sharing, supporting, synergising, the event is designed to advance the global public health agenda in improving health outcomes. The conference will provide a forum in which those who contribute in various ways to the South African health system can exchange ideas, develop support mechanisms for common challenges, and foster synergies between interested groups. The three-day conference will convene approximately 300 healthcare workers from the public and private sectors as well as policy- and decision-makers, civil society groupings and academics. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"How Kenya confirmed the deathbed of WTO","field_subtitle":"Campbell H: Pambuzuka News 756, 8 January 2016","URL":": http://www.pambazuka.net/en/category.php/features/96304/print","body":"The author argues that the outcome of the last WTO Ministerial, the 'Nairobi Package', was in fact a slap in the face for the peoples of the South. He observes it to be especially egregious that the US used the 10th Ministerial, with the help of the Kenyan leadership, to undermine the future of Pan-African trading relations and to drive a wedge between the BRICS societies and those that the US wants to manipulate in the poor countries.  He further argues that the 10th Ministerial has hastened the demise of the WTO in an article which charts the various trade agreements and roles played by state actors in the North and South in achieving unfair and unequal global agreements.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Human rights approaches can advance maternal health: Lessons from Uganda","field_subtitle":"Mulumba, Moses, Primah Kwagala, The Center for Health, Human Rights and Development","body":"\r\nOne question being asked in relation to the recently adopted Sustainable Development Goals (SDGs) is how they relate to human rights based approaches. In the health sector for instance, SDG 3 aims to ensure healthy lives and the promotion of well-being for all ages. This includes a target of reducing the global ratio of women dying in childbirth to less than 70 in every 100 000 live births. While maternal mortality has fallen by almost 50 per cent since 1990, fourteen times more mothers do not survive childbirth in developing countries than in developed countries. \r\n\r\nBy 2014, Uganda\u2019s maternal mortality rate was amongst the highest, with 360 mothers dying in every 100 000 live births, according to Uganda\u2019s 2014/5 Annual Health Sector Performance Report. The country has failed by a large margin to realise the target set for maternal mortality in the Millennium Development Goals (MDGS), and what should be a healthy reproductive event continues to claim women\u2019s lives in the country. The 2014 figures indicate that 6 000 Ugandan mothers die in childbirth annually, which is an average of sixteen daily, or one death every 90 minutes. \r\n\r\nThere have been a number of promising policy statements and interventions suggested by government to address this unacceptable level of mortality. Bottlenecks in the financing, delivery and uptake of maternal health services have however led to a shortfall in the delivery of these interventions. We view this situation as a complete failure by the state to deliver its constitutionally mandated obligations under Article 33 of the Constitution to provide the facilities and opportunities needed for women to realise their full potential; and to protect women and their rights, including their reproductive rights and functions in society. \r\n\r\nThe shortfall in maternal health services has been a focus of civil society advocacy in Uganda for some time. Civil society has consistently argued for the state to resolve the poor conditions in which mothers have to give birth in Uganda. It has used a human rights based approach in this, framing the demands in the language of legal rights and constitutional obligations. There is evidence of some success in this. A group of civil society organisations, led by the Center for Health, Human Rights and Development (CEHURD), acting together with two aggrieved families brought before the courts the deaths of two mothers. This was led as a constitutional challenge, arguing that the deaths occurred as a result of failures in the health system to provide basic commodities for safe deliveries.  In this case, the Supreme Court directed the Constitutional Court to hear the case, on the basis that the failure by the government of Uganda to provide women with basic essential care was being challenged as a contravention of Uganda\u2019s Constitution and the women\u2019s rights. \r\n\r\nThe legal battle did not go without challenges. There were constant delays, with frequent adjournments due to non-appearances by the state or the failure to assemble a full panel of judges to hear the case. The state objected to the case, claiming that the judiciary had no authority to question the political decisions of the state.  Initially the Constitutional court agreed with the state and dismissed the case. This was, however, reversed on appeal to the Supreme Court. In his judgment at the Supreme Court, Chief Justice Bart Katureebe stated that \u201c\u2026.if a citizen alleges that a health policy or actions and omissions made under that policy are inconsistent with the constitution\u2026., then the constitutional court has a duty to come in\u2026\u201d. The case is thus now before the Constitutional Court, as directed by the Supreme Court. The process to date raises an important point of law for the SDGs, and particularly Goal 16. This goal focuses on promoting peaceful and inclusive societies for sustainable development. It emphasizes access to justice for all and building effective, accountable and inclusive institutions at all levels. For the health sector, traditionally a reserve of public health and medical actors, the SDGs and human rights approaches indicate that other actors will now have a significant role to play. \r\n\r\nThe experience in Uganda already raises learning on this: The court process motivated civil society to advocate for health issues with one voice. It created awareness that social and economic rights are justiciable in Uganda, and that citizens can seek justice in the courts if other arms of government do not deliver on their obligations. The Ministry of Health has since pushed for increased funding for maternal health and parliament has made resolutions to support increased health financing and asked government to recruit more health workers to strengthen health services. The Ministry of Health has also now developed guidance on the mainstreaming of human rights in the provision of health care in Uganda.\r\n\r\nThe judiciary has also increased its understanding of health rights.  Subsequent court judgments have, for instance, pronounced that access to emergency obstetric care is a human right, which was not the case previously. The courts have also held a local government authority accountable for a mother\u2019s death where it failed to properly supervise the health professionals falling within its mandate. \r\n\r\nWhile there is still a lot to be done, and while the constitutional case is still pending, the experience indicates that framing health demands in the language of legal rights and constitutional obligations, including through litigation and other legal processes, can assist to place health rights as a more central issue for the court of judges and the court of public opinion. Our experience indicates that such human rights based approaches have a role to play in taking action to implement global goals to ensure healthy lives and the promotion of well-being for all ages. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Implications of dual practice for universal health coverage","field_subtitle":"McPake B, Russo G, Hipgrave D, Hort K, Campbell J: Bulletin of the World Health Organization 2016;94:142-146","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750430/","body":"Over the last five years, universal health coverage (UHC) has become an agreed goal of global health policy and planning initiatives. However, scholars and health policy-makers have noted that attaining this goal will require a sufficient number of prepared and motivated health workers. The World Health Organization (WHO) is developing a global strategy on human resources for health. A consultation has concluded that progress towards UHC will require integrated, people-centred health services, a motivated health workforce and adequate financing from domestic and other sources. While the importance of human resources in UHC and the SDG agenda has been recognized, the extent and impact of health workers\u2019 dual practice \u2013 that is, concurrent clinical practice in public and private sectors \u2013 has not received much attention. However, given the pervasiveness of dual practice and the growing prominence of the private sector in the provision of health services worldwide, its dynamics and impact on the attainment of UHC should not be ignored. Failure to understand why, how and to what extent health workers engage in dual practice may compromise attempts to regulate it and undermine progress. This paper presents dual practice examples, focusing on UHC-associated policy relevance of the available evidence, especially in low- and middle-income countries. It presents regulatory options in a range of contexts and future research needs.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"International AIDS Conference","field_subtitle":"17-22 July 2016, Durban, South Africa","URL":"http://www.aids2016.org/","body":"The International AIDS Conference is a gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess state of affairs, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.  The AIDS 2016 programme will present new scientific knowledge and offer many opportunities for structured dialogue on the major issues facing the global response to HIV. A variety of session types \u2013 from abstract-driven presentations to symposia, bridging and plenary sessions \u2013 will meet the needs of various participants. Other related activities, including the Global Village, satellite meetings, exhibitions and affiliated independent events, will contribute to an exceptional opportunity for professional development and networking. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"International AIDS Conference","field_subtitle":"International Convention Centre, Durban, South Africa, 17-22 July 2016","URL":"http://www.aids2016.org/","body":"The International AIDS Conference is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess where we are, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward. Keynote speakers will cover areas such as Universal Access: Systems for health in the immediate treatment era, medicines and intellectual property, human rights and stigma.\r\n","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"It\u2019s time for African leaders to take decisive action on vaccines","field_subtitle":"Ajayi A: Pambazuka News, 761, February 2016","URL":"http://pambazuka.net/en/category/comment/96556","body":"The first-ever ministerial conference on immunization in Africa was held in February in Addis Ababa. According to the author it presents the perfect opportunity to acknowledge the benefits of vaccine programs, celebrate the successes on the continent, look seriously at what needs to be done to make sure all children get the vaccines they need, and then commit to making that happen. A new study from the Johns Hopkins Bloomberg School of Public Health estimates that between 2011 and 2020, the majority of countries in Africa will collectively see a net economic benefit of $224 billion by investing in immunization programs. The study also found that, in 94 low- and middle-income countries around the world, for every dollar invested in vaccines during the decade, there will be an estimated return of 16 times the costs, taking into account treatment costs and productivity losses. Unfortunately, at the current rate of progress, we are not on track to meet the ultimate goal of reaching all children with vaccines. Right now, one in five African children still do not receive the vaccinations they need. Of the 10 countries around the world with the most unvaccinated children, five are African: the Democratic Republic of the Congo, Ethiopia, Nigeria, South Africa and Uganda.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Knowledge, Equity and Health in post-Apartheid South Africa...What's Race got to do with it?","field_subtitle":"University of Cape Town South Africa: September 2013","URL":"https://www.youtube.com/watch?v=UEDF3rKx_68","body":"The School of Public Health and Family Medicine hosted a seminar and panel discussion, \"Knowledge, Equity and Health in post-Apartheid South Africa...What's Race got to do with it?\" on 1 August 2013. The guest speaker was Professor Lundy Braun from Browns University, USA. As part of its on-going programme on transformation, Professor Mohamed Jeebhay, head of the School of Public Health and Family Medicine the School of Public Health and Family Medicine invited Professor Braun to draw on her own research in reflecting on the topic. The panellists included Professor Raj Ramesar (human genetics), Glenda Wildschut (Transformation Services Office), Dr Sophia Kisting-Cairncross. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Lay Health Workers experience of a tailored knowledge translation intervention to improve job skills and knowledge: a qualitative study in Zomba district Malawi","field_subtitle":"Ritchie L;  van Lettow M; Barnsley J; Chan A; Schull M; Martiniuk A; Makwakwa A; Zwarenstein M: BMC Medical Education 16(54), 9 February 2016, doi: 10.1186/s12909-016-0580-x","URL":"https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-016-0580-x","body":"Like many sub-Saharan African countries, Malawi is facing a critical shortage of skilled healthcare workers. In response to this crisis, a formal cadre of lay health workers (LHW) has been established and now carries out several basic health care services, including outpatient TB care and adherence support. While ongoing training and supervision are recognised as essential to the effectiveness of LHW programs, information is lacking as to how these needs are best addressed. The objective of this qualitative study was to explore LHWs responses to a tailored knowledge translation intervention they received, designed to address a previously identified training and knowledge gap. Forty-five interviews were conducted with 36 healthcare workers. Fourteen to sixteen interviews were done at each of 3 evenly spaced time blocks over a one year period, with 6 individuals interviewed more than once to assess for change both within and across individuals overtime. Reported benefits of the intervention included: increased TB, HIV, and job-specific knowledge; improved clinical skills; and increased confidence and satisfaction with their work. Suggestions for improvement were less consistent across participants, but included: increasing the duration of the training, changing to an off-site venue, providing stipends or refreshments as incentives, and adding HIV and drug dosing content. Despite the significant departure of the study intervention from the traditional approach to training employed in Malawi, the intervention was well received and highly valued by LHW participants. Given the relative low-cost and flexibility of the methods employed, this appears a promising approach to addressing the training needs of LHW programs, particularly in Low- and Middle-income countries where resources are most constrained.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Lessons from the Ebola Outbreak: Action items for emerging infectious disease preparedness and response","field_subtitle":"Jacobsen K; Aguirre A; Bailey C; Baranova A; Crooks A; Croitoru A; Delamater P; Gupta J; Kehn-Hall K; Narayanan A; Pierobon M; Rowan K; Schwebach J; Seshaiyer P; Sklarew D; Stefanidis A; Agouris P: EcoHealth, 1-13,  February 2016","URL":"http://link.springer.com/article/10.1007/s10393-016-1100-5","body":"As the Ebola outbreak in West Africa wanes, the author argues that it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. The interdisciplinary author team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, they argue there is a need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Making a Killing: How tax scams are robbing poor countries of life-saving healthcare","field_subtitle":"O\u2019Meara C; Hanna L; Gugushvili D: Save the Children, UK, 2015","URL":"http://www.savethechildren.org.uk/resources/online-library/making-killing#sthash.a9K8mGmt.dpuf","body":"The authors report that the world\u2019s poorest countries are losing billions of potential tax revenue each year as a result of illicit financial flows and the tax dodging schemes associated with them. These complex and shadowy tax dealings are robbing developing countries of revenue they need to spend on essential public services. Making a Killing analyses one part of the web of illicit financial flows, the \u2018misinvoicing\u2019 of international trade \u2013 a way of hiding the true value of imports and exports, shifting profits and evading taxes. The figures are staggering. The sums being lost are comparable to the amounts currently missing from the health budgets of very poor countries \u2013 lost money that could boost total budgets and pay for desperately needed doctors, nurses, clinics, hospitals and medicines, and provide the basic minimum of decent healthcare to mothers and children. If the world is to meet its ambitious targets on health and child survival, let alone the broader objectives of the Sustainable Development Goals, illicit financial flows must be urgently addressed. This reports sets out recommendations for action by the international community.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Making Medicines in Africa: The Political Economy of Industrialising for Local Health","field_subtitle":"Mackintosh M; Banda G;  Tibandebage P;  Wamae W: Palgrave Connect, December 2015","URL":"http://www.palgraveconnect.com/pc/doifinder/10.1057/9781137546470","body":"The importance of the pharmaceutical industry in Sub-Saharan Africa, its claim to policy priority, is rooted in the vast unmet health needs of the sub-continent. Making Medicines in Africa is an open access online book that is a collective endeavour, by a group of contributors with a strong African and more broadly Southern presence, to find ways to link technological development, investment and industrial growth in pharmaceuticals to improve access to essential good quality medicines, as part of moving towards universal access to competent health care in Africa. The authors aim to shift the emphasis in international debate and initiatives towards sustained Africa-based and African-led initiatives to tackle this huge challenge. The authors argue that without the technological, industrial, intellectual, organisational and research-related capabilities associated with competent pharmaceutical production, and without policies that pull the industrial sectors towards serving local health needs, the African sub-continent cannot generate the resources to tackle its populations' needs and demands. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Making public in a privatised world: The struggle for essential services","field_subtitle":"McDonald D: Zed Books, 15 February 2016","URL":"http://tinyurl.com/jgh9d7s","body":"In the wake of recent widespread failures of privatisation efforts, many communities in the global south now seek new, progressive ways to revitalise the public sector. From rural Guatemalan towns holding the state accountable for public health to an alliance of waste pickers in India and decentralised solar electricity initiatives in Africa, people worldwide are rising up with innovative public service solutions to difficult issues. Making Public in a Privatised World explores such cases, with essays that uncover the radically different ways grassroots movements have proved themselves as successful alternatives in providing essential public services where privatised efforts have failed. Using numerous in-depth case studies, this book offers probing insights from a diverse range of contributors from across the world, including academics, activists, unionists, and social movement organisers. Making Public in a Privatised World addresses the growing worldwide interest in exciting alternatives to privatisation in both developed and developing countries.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Maternal mental health in primary care in five low- and middle-income countries: a situational analysis","field_subtitle":"Baron E; Hanlon C; Mall S; Honikman S; Breuer E; Kathree T; Luitel N; Nakku J; Lund C; Medhin G; Patel V; Petersen I; Shrivastava, S; Tomlinson M: BMC Health Services Research 16(53), 16 February 2016, doi: 10.1186/s12913-016-1291-z","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754802/","body":"The integration of maternal mental health into primary health care has been advocated to reduce the mental health treatment gap in low- and middle-income countries (LMICs). This study reports findings of a cross-country situation analysis on maternal mental health and services available in five LMICs, to inform the development of integrated maternal mental health services integrated into primary health care. The situation analysis was conducted in five districts in Ethiopia, India, Nepal, South Africa and Uganda, as part of the Programme for Improving Mental Health Care (PRIME). The analysis reports secondary data on the prevalence and impact of priority maternal mental disorders (perinatal depression, alcohol use disorders during pregnancy and puerperal psychosis), existing policies, plans and services for maternal mental health, and other relevant contextual factors, such as explanatory models for mental illness. Limited data were available at the district level, although generalizable data from other sites was identified in most cases. Community and facility-based prevalences ranged widely across PRIME countries for perinatal depression (3\u201350 %) and alcohol consumption during pregnancy (5\u201351 %). Maternal mental health was included in mental health policies in South Africa, India and Ethiopia, and a mental health care plan was in the process of being implemented in South Africa. No district reported dedicated maternal mental health services, but referrals to specialised care in psychiatric units or general hospitals were possible. No information was available on coverage for maternal mental health care. Challenges to the provision of maternal mental health care included; limited evidence on feasible detection and treatment strategies for maternal mental disorders, lack of mental health specialists in the public health sector, lack of prescribing guidelines for pregnant and breastfeeding women, and stigmatising attitudes among primary health care staff and the community. It is difficult to anticipate demand for mental health care at district level in the five countries, given the lack of evidence on the prevalence and treatment coverage of women with maternal mental disorders. Limited evidence on effective psychosocial interventions was also noted, and must be addressed for mental health programmes, such as PRIME, to implement feasible and effective services.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Measuring health inequities in low and middle income countries for the development of observatories on inequities and social determinants of health","field_subtitle":"Guerra G; Borde E; Salgado de Snyder V: International Journal for Equity in Health 15(9), January 2016,","URL":"http://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0297-9","body":"Almost seven years after the publication of the final report of the World Health Organisation\u2019s Commission on Social Determinants of Health (CSDH), its third recommendation has not been attended to properly. Measuring health inequities (HI) within countries and globally, in order to develop and evaluate evidence-based policies and actions aimed at the social determinants of health (SDH), is still a pending task in most low and middle income countries (LMIC) in the Latin American region. In this paper the authors discuss methodological and conceptual issues to measure HI in LMIC and suggest a three-stage methodology for the creation of observatories on health inequities (OHI) and social determinants of health, based on the experience of the Brazilian Observatory on Health Inequities. The authors describe the three stages and discuss the replicability of this methodology in other Latin American countries. The authors also carried out a search of suitable national information systems to feed an OHI in Mexico, along with an outline of the institutional infrastructure to sustain it. When implementing the methodology for an OHI in LMIC such as Mexico, the authors found that having strong infrastructure of information systems for measuring HI is required, but not sufficient to build an OHI. Adequate funding and intersectoral network collaborations lead by a group of experts is a requirement for the consolidation and sustainability of an OHI in LMIC. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"New SADC regional standards for HIV care along road transport corridors","field_subtitle":"Southern African Development Community: Botswana, November 2015","URL":"http://www.africanstrategies4health.org/uploads/1/3/5/3/13538666/rmsb_for_hiv_and_other_health_services_along_the_road_transport_corridors_in_the_sadc_region.print.pdf","body":"Expanded mobility and cross-border trading across the road transport sector in Southern Africa have contributed to increased HIV prevalence rates among key populations and communities living in the region. To support a strengthened and co-ordinated response to the unique public health challenges this presents, the Southern African Development Community (SADC) approved the Regional Minimum Standards and Brand for HIV and other Health Services Along Road Transport Corridors in the SADC Region (RMSB) in November 2015. It includes guiding principles on the right to health; health-promoting workplaces; gender mainstreaming; empowerment of commercial sex workers and effective partnership. It sets minimum standards on service delivery and a minimum package of services for those involved in road transport corridors. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"No cause for panic stations over SA Zika case, says expert","field_subtitle":"Skosana I: Bhekisisa Centre for Health Journalism, February 2016","URL":"http://bhekisisa.org/article/2016-02-22-no-cause-for-panic-stations-over-sa-zika-case-says-expert","body":"South African health authorities say the visitor diagnosed with the mosquito-spread Zika virus has recovered and there is minimal likelihood of a local outbreak. The visiting Colombian businessperson who was diagnosed with the Zika virus in South Africa last week is \u201ccompletely well\u201d and \u201cposes no risk to anybody\u201d, says Lucille Blumberg, the deputy director of the National Institute for Communicable Diseases. Blumberg says the man presented with a mild illness four days after his arrival in the country. After he underwent a number of tests, \u201cZika was confirmed as the cause of his illness\u201d.  Blumberg further confirmed, \u201cWe\u2019re not going to have local transmissions because of one incoming traveller with Zika. You\u2019ll need multiple people with the virus in their blood and many mosquitoes around with the competent vectors to set off a local outbreak.\u201d ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Regional monitoring and review mechanism for effective implementation of the Post-2015 Development Agenda","field_subtitle":"Bhattacharya D: Southern Voice, February 2016","URL":"http://southernvoice-postmdg.org/regional-monitoring-and-review-mechanism-for-effective-implementation-of-the-post-2015-development-agenda/","body":"Inadequate regional provisions have been one of the weak links in the global monitoring of, and accountability for, implementation of the Millennium Development Goals (MDGs). As a result, the question now is how does the regional monitoring and review process need to improve as a more demanding post-2015 development agenda is introduced? To address this question, the paper follows three analytical approaches. First, by reviewing various global-level inputs channelled towards articulating the Sustainable Development Goals (SDGs), it teases out the implications of the new agenda for a Regional Monitoring and Review Mechanism (RMRM). Second, by revisiting the experiences of various existing frameworks for a regional mechanism, it highlights the strengths and weaknesses of their varying approaches and instruments. Third, the paper tries to identify the critical attributes of the institutional structure and modalities that have to characterize such a mechanism in the new context. In conclusion, the paper underscores the need to bolster regional statistical capacity, particularly in the field of regional public goods and the proposed regional indicators of the sustainable development goals. It also proposes elements of a possible mechanism, building on the existing practices of the Economic and Social Commission for Asia and the Pacific (ESCAP).","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Rejoinder: In defence of the Alternative Mining Indaba","field_subtitle":"Capel J; Lorgat H: Pambuzuka News 763, February 2016","URL":"http://www.pambazuka.net/en/category.php/features/96672","body":"In a response to critiques of the 2016 Alternative Mining Indaba, the Bench Marks Foundation asserts their commitment to a popular movement of workers and poor people in contesting corporate power and elite control over mining processes.  The authors define their approach as evidence or research-based activism, accompanied by community organising and monitoring of corporate conduct with the view of challenging corporate power and continuing to agitate wherever power lies. To date, they have followed an advocacy strategy built on research, community organising, building alliances with organised workers and other communities. The organisers of the Alternative Mining Indaba argue that it is a time for governments to rededicate themselves with concrete deeds to protect and prevent harm for poor people.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Reporting guidelines for implementation and operational research","field_subtitle":"Hales S, Trevino A, Ford N, Maher D, Ramsay A, Tran N: Bulletin of the World Health Organization 94:58-64; 2016","URL":"http://www.who.int/bulletin/volumes/94/1/15-167585/en/","body":"New reporting guidelines have been published for the growing area of implementation and operational research. The field utilises a range of different research designs, so existing reporting guidelines only partially cover the need for guidance. Wide consultation through the World Health Organization (WHO), the Alliance for Health Policy & Systems Research (AHPSR) and TDR resulted in these recommendations. The paper provides a practical reference for funders, researchers, policymakers, implementers, reviewers and editors working with implementation and operational research. Given that this is an evolving field, they plan to monitor the use of these guidelines and develop future versions as required.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Social efficiency and the future of water operators\u2019 partnerships","field_subtitle":"B\u00e9langer Dumontier M, McDonald D, Spronk S, Baron C, Wartchow D: MSP Occasional paper, February 2015","URL":"http://municipalservicesproject.org/publication/social-efficiency-and-future-water-operators-partnerships","body":"Much of the benchmarking that takes place in the water sector today focuses on financial and technical performance, making it difficult for water operators to pursue broader social, political and environmental objectives. As an alternative this paper introduces the concept of social efficiency; to widen the scope of performance evaluation by adding new indicators that emphasize equity and promote publicness, informed by extensive field research in Africa and Latin America. We argue that advancing social efficiency could be the most important contribution the Global Water Operators Partnerships Alliance (GWOPA) makes to knowledge transfer in the water sector, given the relatively small budgets it can leverage. WOPs may be the proverbial drop in the bucket when it comes to improving water and sanitation services around the world, but they could be a significant drop in that bucket.The paper examines two WOPs. The first is between Morocco Office National de \u00c9lectricit\u00e9 et de l'Eau Potable (ONEE) and Burkina Faso Office National de Eau et de Assainissement (ONEA). The second is between Uruguay Obras Sanitarias del Estado (OSE) and Porto Alegre Departamento Municipal de \u00c1gua e Esgotos (DMAE) in Brazil. The research shows that both of these partnerships reflect the general trend of prioritizing technical and financial efficiency. Despite having innovative social programs at home, neither WOP has formal pro-poor objectives or evaluation mechanisms to assess pro-poor outcomes, highlighting the untapped potential for knowledge sharing on this type of expertise. Platforms such as GWOPA could provide the necessary guidance and incentives to match water operators interested in pro-poor initiatives and prioritize social efficiency in partnership activities.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Strengthening national capacities for researching on Social Determinants of Health (SDH) towards informing and addressing health inequities in Tanzania","field_subtitle":"Mtenga S, Masanja I, Mamdani M: International Journal for Equity in Health, 15:23; January 2016","URL":"http://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0308-x","body":"Tanzania\u2019s socio-economic development is challenged by sharp inequities between and within urban and rural areas, and among different socio-economic groups. This paper discusses the importance of strengthening SDH research, knowledge, relevant capacities and responsive systems towards addressing health inequities in Tanzania.The conceptualization of SDH varies considerably among stakeholders and their professional background, but with some consensus that it is linked to \u201cinequities\u201d being a consequence of poverty, poor planning, limited attention to basic humanity and citizenship rights, weak governance structures and inefficient use of available resources. Commonly perceived SDH factors include age, income, education, beliefs, cultural norms, gender, occupation, nutritional status, access to health care, access to safe water and sanitation and child bearing practices. SDH research is in its infancy but gaining momentum. In the absence of a specific \u201cSDH portfolio\u201d, SDH research is scattered and hidden within disease specific, poverty-related research and research on universal health coverage. Research is mainly externally funded, which has implications on the focus of context specific SDH research, national priorities and transfer to policy. This create mismatch with population and research capacity needs. Establishing a system to promote collaboration across sectors and strengthen collective capacities for individuals and institutions researching in SDH will augment existing SDH research initiatives and better inform appropriate intersectoral policies towards addressing prevailing health inequities across the country.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Strengthening pharmaceutical systems for palliative care services in resource limited settings: piloting a mHealth application across a rural and urban setting in Uganda","field_subtitle":"Namisango E; Ntege C; Luyirika E; Kiyange F; Allsop M: BMC Palliative Care 15(20), 19 February 2016, doi: 10.1186/s12904-016-0092-9","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759774/","body":"Medicine availability is improving in sub-Saharan Africa for palliative care services. There is a need to develop strong and sustainable pharmaceutical systems to enhance the proper management of palliative care medicines, some of which are controlled. One approach to addressing these needs is the use of mobile technology to support data capture, storage and retrieval. Utilizing mobile technology in healthcare (mHealth) has recently been highlighted as an approach to enhancing palliative care services but development is at an early stage. An electronic application was implemented as part of palliative care services at two settings in Uganda; a rural hospital and an urban hospice. Measures of the completeness of data capture, time efficiency of activities and medicines stock and waste management were taken pre- and post-implementation to identify changes to practice arising from the introduction of the application. Improvements in all measures were identified at both sites. The application supported the registration and management of 455 patients and a total of 565 consultations. Improvements in both time efficiency and medicines management were noted. Time taken to collect and report pharmaceuticals data was reduced from 7 days to 30 min and 10 days to 1 h at the urban hospice and rural hospital respectively. Stock expiration reduced from 3 to 0.5 % at the urban hospice and from 58 to 0 % at the rural hospital. Additional observations relating to the use of the application across the two sites are reported. A mHealth approach adopted in this study was shown to improve existing processes for patient record management, pharmacy forecasting and supply planning, procurement, and distribution of essential health commodities for palliative care services. An important next step will be to identify where and how such mHealth approaches can be implemented more widely to improve pharmaceutical systems for palliative care services in resource limited settings.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"To corporatise or not to corporatise (and if so, how?)","field_subtitle":"McDonald D: Utilities Policy, 2016, doi: http://dx.doi.org/ 10.1016/j.jup.2016.01.002","URL":"http://tinyurl.com/jcw7vy7","body":"Governments around the world are increasingly turning to the use of stand-alone, state-owned utilities to deliver core services such as water and electricity. This article reviews the history of such \u2018corporatisation\u2019 and argues that its recent resurgence has been heavily influenced by neoliberal theory and practice, raising important questions about whether it should be adopted as a public service model. Not all corporatisations promote commercialisation, however. The article also discusses stand-alone utilities that have managed to stave off market pressures and develop in more equity-oriented directions. The scope for non-commercialised corporatisation is narrow, but given the expansion of this organisational model, the author argues that it is important that we understand both its limitations and potentials, particularly in low-income countries where service gaps are large and equity is a major challenge.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Towards elimination of mother-to-child transmission of HIV in Ghana: an analysis of national programme data","field_subtitle":"Dako-Gyeke P; Dornoo B; Ayisi Addo S; Atuahene M; Addo NA;  Yawson AE: Int Jo Equity Health. 15: 5.2016","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711073/","body":"Sub-Saharan Africa alone contributes more than 90 % of global Mother-to-Child Transmission (MTCT) burden. As part of efforts to address this, African countries were earmarked in 2009 for rapid Preventing Mother to child HIV Transmissions (PMTCT) interventions scale-up within their primary care system for maternal and child health. In this study, the authors reviewed records in Ghana, on ANC registrants eligible for PMTCT services to describe regional disparities and national trends in key PMTCT indicators. They also assessed distribution of missed opportunities for testing pregnant women and treating those who are HIV positive across the country. Although there was a decline in HIV prevalence among pregnant women, untested ANC registrants increased from 17 % in 2011 to 25 % in 2013. There were varying levels of missed opportunities for testing across the ten regions of Ghana. Overall, HIV positive pregnant women initiated onto ARVs remarkably increased from 57% (2011) to 82 % (2013). Missed opportunities to test pregnant women for HIV and also initiate those who are positive on ARVs across all the regions pose challenges to the quest to eliminate mother-to-child transmission of HIV in Ghana. For some regions these missed opportunities mimic previously observed gaps in continuous use of primary care for maternal and child health in those areas. The authors contend that increased national and regional efforts aimed at improving maternal and child healthcare delivery, as well as HIV-related care, is paramount for ensuring equitable access across the country.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Universal access to immunization as a cornerstone for health and development in Africa","field_subtitle":"African Ministers of Health, Finance, Education, Social Affairs, Local Governments:  Ministerial Conference on Immunization in Africa, February 2016","URL":"http://immunizationinafrica2016.org/ministerial-declaration-english/","body":"African Ministers of Health, Finance, Education, Social Affairs, Local Governments attended the Ministerial Conference on Immunization in Africa in February 2016 in Addis Ababa, Ethiopia, convened by the World Health Organization in collaboration with the African Union Commission. The ministers collectively and individually commited themselves to keeping universal access to immunisation at the forefront of efforts to reduce child mortality, morbidity and disability; to increasing and sustaining domestic investments and funding, including innovative financing, to meet the cost of traditional vaccines and fulfil new vaccine financing requirements, and to support EPI programs. They sought to address persistent barriers in vaccine and healthcare delivery systems, especially in the poorest, vulnerable and most marginalized communities, including through strengthening data collection, reporting and use and building effective and efficient supply chains and integrated procurement systems as part of strong and sustainable primary health care systems. The agreed to develop a capacitated African research sector and to work with communities, civil society organizations,  traditional and religious leaders, health professional associations and parliamentarians to promote universal access to vaccines, and to invest in regional capacities for the development and production of vaccines in line with the African Union Pharmaceutical Manufacturing Plan. They called on African development banks and regional economic communities to support the implementation of the Declaration, and on member states and partners to negotiate with vaccine manufacturers to facilitate access to vaccines at affordable prices and to increase price transparency in line with resolution WHA68.6. They called on GAVI to consider refugees and internally displaced populations as eligible recipients of support for vaccines and operational costs. ","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Universal Health Coverage Assessment: Zambia","field_subtitle":"Chitah B; Jonsson D: Global Network for Health Equity (GNHE), June 2015","URL":"http://gnhe.org/blog/wp-content/uploads/2015/05/GNHE-UHC-assessment_Zambia1.pdf","body":"This document provides a preliminary assessment of the Zambian health system relative to the goal of universal health coverage, with a particular focus on the financing system and related aspects of provision. Zambia is making continuous progress in all the key areas of its health system. However, there are gaps which need to be resolved for the country to be able to realise the goal of universal coverage, including universal financial protection and access to care. First, a more equitable distribution of resources between urban and rural areas is required. Second, resources need to be allocated to promote access to, and utilisation of, health care by the poorer socio-economic groups. The higher consumption of public inpatient health care services by wealthier groups is a striking example of inequitable utilisation, as is the relatively greater levels of government subsidy received by wealthier groups, even for primary health care. Third, the impoverishing effect of out-of-pocket payments exposes poorer households to financial risk, driving households into poverty or further into poverty. This requires reconsideration of public hospital user fees, both in terms of the level of fees and the application of bypass fees (which are charged when patients bypass primary\r\nhealth care facilities, including because of the severity of their conditions and their proximity to higher-level health facilities). Finally, Zambia\u2019s ambition to introduce social health insurance as a mechanism for improving the pooling and purchasing of services needs to be scrutinised for its possible impacts on equity. The proposed social health insurance scheme would require co-payments and perhaps other contributions, which would increase the financial burden on households. This means that the proposed scheme could effectively run counter to the ambition of attaining universal health coverage. There should be a critical evaluation of the alternative option of simply continuing \u2013 and strengthening - the current tax-based financing system.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"WHO Framework of engagement with non-state actors (FENSA) ","field_subtitle":"People's Health Movement: Youtube, 5 February 2016","URL":"http://www.youtube.com/watch?v=MelXUq1hAOE","body":"This video shows a recording of the statement made by People's Health Movement and Medicus Mundi International at the Executive Board 138 of the World Health Organisation (WHO) in January 2016.  In it they highlight their assertion that the FENSA proposal constitutes a Trojan horse, which will legitimise the influence of private sector interests in WHO decision-making. They argue that FENSA is symbolic of a more fundamental issue - that of WHO\u2019s independence - which is compromised by its financial crisis, lack of member contributions and crippling dependency on tightly earmarked voluntary contributions. They call for the WHO to have strong safeguards to protect it from undue influence from funders and conflicts of interests on the part of industry partners and a robust conflict of interest policy should also include appropriate protection of whistleblowers.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Zika Virus Fact Sheet","field_subtitle":"World Health Organisation: Geneva, 2016","URL":"http://www.who.int/mediacentre/factsheets/zika/en/","body":"This fact sheet provides information on the Zika virus, a mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys, and subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific. The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days. Zika virus disease is caused by a virus transmitted by Aedes mosquitoes. People with Zika virus disease usually have symptoms that can include mild fever, skin rashes, conjunctivitis, muscle and joint pain, malaise or headache lasting for 2-7 days. There is no specific treatment or vaccine currently available. The leaflet provides updated information on the virus given its recent spread in Latin America.","php":"","field_issue_date":"2016-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"#FeesMustFall and the campaign for universal health coverage","field_subtitle":"Doherty J; McInytre D: The South African Medical Journal 105(12), 1014-1015,  2015","URL":"http://www.samj.org.za/index.php/samj/article/view/10339","body":"This article reflects on how #FeesMustFall highlighted the political and social upheaval that results from extreme income inequity and inequitable access, problems that beset the health sector as well. It presents data showing how per capita health expenditure declined for a decade after 1994, despite the burgeoning HIV/AIDS epidemic, a blow from which the health system is still trying to recover. The underlying reason for this was a macroeconomic policy that placed constraints on taxation and government expenditure on social services. The article shows how South Africa (SA)'s tax-to-GDP ratio is much lower than other middle-income countries, and argues that raising this limit is essential for development. Spending on health and education should be seen as an investment in the SA economy. The authors suggest that the Department of Health needs to argue this case in Cabinet and demonstrate the effectiveness of health spending through efficient service delivery and fighting corruption.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"A Resolve to Reform - A look at the Director-General's Opening Address at the 138th Meeting of the Executive Board (EB138)","field_subtitle":"People\u2019s Health Movement: Geneva, 25 January 2016","URL":"http://www.ghwatch.org/who-watch/eb138","body":"The 138th Meeting of the Executive Board (EB138) of the World Health Organisation (WHO) taking place from 25 to 30 January 2016 in Geneva includes a host of issues, including reviews of the WHO\u2019s governance, finance and emergency structure.  In the opening remarks of WHO Director-General Margaret Chan, the topics touched on ranged widely from Ebola to Road Safety, with an emphasis on Universal Health Coverage in her final paragraph. A pointed reference to the \u201cexplosive spread of Zika virus in new geographical areas\u201d, was a conscious effort to highlight the potential threats of infectious disease beyond Ebola, and the much needed reform of the WHO\u2019s emergency structures. She commented on Universal Healthcare Coverage as \u201cthe most efficient way to respond to the rise of non-communicable diseases\u201d , although the PHM note the debates on how the proposal for UHC has shifted the focus from how services should be provided to how services should be financed, with private sector providers and private insurance assumed to be part of the solution, despite evidence that this can lead to \u2018health-defeating\u2019 market failures. The Director General noted, however, that some policy recommendations on child obesity \u201cpick a fight with powerful economic interests\u201d. These remarks were welcomed by PHM if followed through with changes in the organisation\u2019s relationship with big business. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A Trojan horse of the private sectors interests at the World Health Organisation","field_subtitle":"People\u2019s Health Movement; Medicus Mundi International: 26 January 2016","URL":"http://tinyurl.com/jnh4gzk","body":"A January 2016 statement of the People's Health Movement (PHM) and Medicus Mundi International (MMI) identified that the Framework of Engagement with Non-State Actors (FENSA) currently under discussion at the World Health Organisation (WHO) fails to provide a robust framework against undue influence of the corporate sector and its philanthropies. In the statement the PHM and MMI argue that FENSA is symbolic of a more fundamental issue of the compromise to WHO\u2019s independence due to its under-funding and tightly earmarked voluntary contributions making it vulnerable to such influence. They argue for an end to the dual freeze on the WHO Programme Budget and on assessed contributions which severely limits WHO\u2019s functioning. \"Until and unless this is addressed, WHO stands at risk of private sector capture and further loss of its integrity, independence, and credibility\", the statement warned. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Anchoring universal health coverage in the right to health: What difference would it make?","field_subtitle":"World Health Organisation Policy Brief: November 2015","URL":"http://apps.who.int/iris/bitstream/10665/199548/1/9789241509770_eng.pdf","body":"Universal Health Coverage UHC is a critical component of the new Sustainable Development Goals (SDGs) which include a specific health goal: \u201cEnsure healthy lives and promote wellbeing for all at all ages\u201d. Within this health goal, a specific target for UHC has been proposed: \u201cAchieve UHC, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all\u201d. In this context, the opportunity exists to unite global health and the fight against poverty through action that is focussed on clear goals. For WHO, \u201cUHC is, by definition, a practical expression of the concern for health equity and the right to health\u201d; thus promoting UHC advances the overall objective of WHO, namely the attainment by all peoples of the highest possible standard of health as a fundamental right, and signal a return to the ideals of the Declaration of Alma Ata and the WHO Global Strategy for Health for All by the Year 2000. Yet some argue that the \u201ccurrent discourse on UHC is in sharp contrast with the vision of Primary Health Care envisaged in the Alma Ata declaration of 1978\u201d. The underlying assumption of this paper is that efforts towards achieving UHC do promote some, but not necessarily all, of the efforts required from governments for the realisation of the right to health. While this publication explores how efforts to advance towards UHC overlap with efforts to realise the right to health, its main focus is the gaps that exist between UHC efforts and right to health efforts.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Announcement on the newsletter and website","field_subtitle":"Editor","body":"The EQUINET website and bibliography and newsletter databases will be undergoing a significant software upgrade in February 2016 so we will not be producing a March issue of the newsletter on 1 March 2016. We hope we have given you alot of interesting material ranging from papers, reports, bibliographies, online books and graphics in this issue the meantime and the newsletter will resume on 1 April 2016. We aim to ensure that any periods in which the bibliography databases will be unavailable during the upgrade are as brief as possible. Please email us on admin@equinetafrica.org if you have any queries or feedback, and we also look forward to receiving submissions, reports and articles from you!","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Assessing Coverage, Equity and Quality Gaps in Maternal and Neonatal Care in Sub-Saharan Africa: An Integrated Approach","field_subtitle":"Wilunda C; Putoto G; Dalla Riva D; Manenti F; Atzori A; Calia F; Assefa T; Turri B; Emmanuel O; Straneo M; Kisika F; Tamburlini G; Tarmbulini G: PloS one 10(6), May 2015","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127827","body":"The authors present the base-line data of a project aimed at simultaneously addressing coverage, equity and quality issues in maternal and neonatal health care in five districts belonging to three African countries. Data were collected in cross-sectional studies with three types of tools. Coverage was assessed in three hospitals and 19 health centres (HCs) utilising emergency obstetric and newborn care needs assessment tools developed by the Averting Maternal Death and Disability program. Emergency obstetrics care (EmOC) indicators were calculated. Equity was assessed in three hospitals and 13 HCs by means of proxy wealth indices and women delivering in health facilities were compared with those in the general population to identify inequities. All the three hospitals qualified as comprehensive EmOC facilities but none of the HCs qualified for basic EmOC. None of the districts met the minimum requisites for EmOC indicators. In two out of three hospitals, there were major quality gaps which were generally greater in neonatal care, management of emergency and complicated cases and monitoring. Higher access to care was coupled by low quality and good quality by very low access. Stark inequities in utilisation of institutional delivery care were present in all districts and across all health facilities, especially at hospital level. The authors findings confirm the existence of serious issues regarding coverage, equity and quality of health care for mothers and newborns in all study districts. Gaps in one dimension hinder the potential gains in health outcomes deriving from good performances in other dimensions, thus confirm the need for a three-dimensional profiling of health care provision as a basis for data-driven planning.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for case studies: Reducing the risk of exporting unethical practices to low and middle income countries","field_subtitle":"Deadline: 2 March 2016","URL":"http://announcementsfiles.cohred.org/competition_trust.pdf","body":"TRUST Equitable Research Partnerships invites the submission of case studies identifying the risks of exporting non-ethical research practices to low and middle income countries. The TRUST project addresses the risks of ethics dumping - that is the export of research practices that would be considered unethical in Europe - for both public and privately funded research. With the globalisation of research activities, there is an increasing risk of research involving sensitive ethical issues being conducted by European organisations outside the European Union, without proper compliance structures and follow-up. To contribute to the research, TRUST are launching this bottom-up call. Five full case studies will be funded from successful applicants to this competition. These cases must refer to research undertaken in low or middle income countries by researchers, sponsors or funders from high income countries; in any field of research (e.g. life sciences, social sciences, agriculture, environment, animals, security, etc.). The deadline for submission of abstracts is March 2nd, 2016 with full submission of selected proposals on May 2nd 2016. The five winners will each receive \u20ac2,000. The competition is part of the TRUST project, co-funded by the European Commission under grant number 664771.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for contributions: UN Secretary-General\u2019s High-Level Panel on Access to Medicines","field_subtitle":"Closing date for contributions: 18 February 2016 ","URL":"http://www.unsgaccessmeds.org/call-for-contributions/","body":"The United Nations Secretary-General\u2019s High-Level Panel on Access to Medicines is calling for contributions by interested stakeholders that address the misalignment between the rights of inventors, international human rights law, trade rules and public health where it impedes the innovation of and access to health technologies. In particular the High-Level Panel will consider contributions that promote research, development, innovation and increase access to medicines, vaccines, diagnostics and related health technologies to improve the health and wellbeing of all, as envisaged by Sustainable Development Goal 3, and the 2030 Agenda for Sustainable Development more broadly. Submitted contributions should be evidence-informed and include references to the principles, literature and models upon which the contribution is based. The contributions should reflect, align and demonstrate how it will support the attainment of the 2030 Agenda for Sustainable Development and in particular, Sustainable Development Goal 3, that aims to improve the health and wellbeing for all, and where applicable, indicate the political, financial or other requirements to the implement of the proposed ideas.  ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for individual abstracts: Fourth Global Symposium on Health Systems Research, 2016","field_subtitle":"Closing date for submission: 20 Mar 2016","URL":"http://tinyurl.com/gq9j3n5","body":"The Symposium invites abstracts for individual presentations, linked to the following sub-themes: Enhancing health system resilience: absorbing shocks and sustaining gains in every setting; Equity, rights, gender and ethics: maintaining responsiveness through values-based health systems; Engaging power and politics in promoting health and public value; Implementing improvement and innovation in health services and systems; New partnerships and collaborations for health system research and development; Future reciprocal learning and evaluation approaches for health system development. Abstracts in a given sub-theme may address any of the Symposium\u2019s traditional \u2018field-building dimensions\u2019: Cutting-edge research, Innovative research approaches and measures, Novel strategies for developing capacity, Learning communities and knowledge translation, Innovative practice in health systems development. See website for details. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Common Declaration for Responsible Partnerships","field_subtitle":"International Forum on Public-Private Partnerships for Sustainable Development, December 2015","URL":"http://www.un-ppp.org/common-declaration-responsible-partnerships","body":"In the context of the 2015 Paris Climate Conference, COP 21, an International Forum on Public-Private Partnerships (PPPs) for Sustainable Development has been held in Annemasse. Within this framework and in view of the Sustainable Development Goals defined by the UN, the Cit\u00e9 de la Solidarit\u00e9 Internationale organised on October 30 2015 a collective intelligence workshop gathering representatives from the civil society as well as public and private stakeholders. The assembly called for PPPs that guarantee access for all to common goods and the respect of Human Rights to foster an economy of human dimension. They recommended to: Include the civil society in the entire process of public-private partnerships, upstream to downstream, by identifying the genuine needs, promoting the general interest as the final goal and avoiding conflict of interest and controlling the services of which they are the main beneficiaries. They argued that it is necessary to create a legal framework and appropriate tools to strengthen civil society legitimacy, to guarantee co-construction of equal win partnerships with general interest as a common objective to avoid an unbalanced or competitive approach and to consider alternative approaches and initiatives of collaboration (such as social and solidarity-based economy) as an evolution towards more balanced and inclusive partnerships favouring a participatory democracy. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Council for the Development of Social Science Research in Africa (CODESRIA) Job Vacancy Senior Programme Officer ","field_subtitle":"Closing date for applications: 28 February 2016","URL":"http://www.codesria.org/spip.php?article2513&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites applications from African scholars to fill the vacant position of Senior Programme Officer (Research) in its pan-African Secretariat located in Dakar, Senegal. This position is categorised as belonging to the senior staff of the Council and as such is filled on the basis of an international announcement. The successful candidate will work as a senior member of the Secretariat under the overall supervision of the Executive Secretary of the Council. Candidates wishing to apply for the position are requested to note the following: The Senior Programme Officer (Research) has as his/her primary responsibility the management of the Council\u2019s Research Programme including overseeing National, Multinational and Trans-National Working Groups, Comparative Research Networks, as well as thematic and issue-specific research programmes, special initiatives and projects. In this connection, the Senior Programme Officer will be responsible for managing all aspects of the portfolio of programmes entrusted to him/her, and overseeing the work of Programme Officers managing programme clusters within the Research Programme, each of which may include several of the following programmes: the Gender Programme, the Academic Freedom Programme, the African Humanities Programme, the Governance Programme, the Health, Politics and Society Programme, the Programme on Children and Youth, the Higher Education Leadership Programme, the Environmental Governance Programme, the Economic Policies Programme, the Lusophone Initiative, and the South-South Tri-continental Collaborative Programme. The Research Programme also organises major conferences tied to the Council\u2019s programmes and strategy. In addition to his/her specific responsibilities, the successful candidate will be called upon to perform the following functions: initiate, develop and, where appropriate, manage new projects and programmes; lend support for the realisation of the other scientific activities of the Council; organise academic and policy meetings; promote contacts with researchers, professional associations and regional organisations; prepare research and funding proposals on themes connected to his/her areas of expertise as may be requested by the Executive Secretary; and where appropriate, liaise with funding organisations under the direction of the Executive Secretary.See website for application details. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Discussion paper 106: Responding to inequalities in health in urban areas: A review and annotated bibliography","field_subtitle":"Loewenson R; Masotya M: TARSC, EQUINET, Harare","URL":"http://www.equinetafrica.org/bibl/docs/Diss%20106%20Ann%20Bib%20Urban%20health%20in%20ESA%20Dec2015.pdf","body":"Training and Research Support Centre (TARSC) as cluster lead of the \u201cEquity Watch\u201d work in EQUINET is following up on the findings of the 2012 Regional Equity Watch and the country Equity Watch reports with a deeper systematic analysis of available evidence on inequalities in health and its determinants within urban areas and the responses to urban inequalities from the health sector and through health promoting interventions of other sectors and communities acting on public health and the social determinants of health. This document presents evidence from 105 published papers in English post 2000 on patterns of and responses to urban inequalities in health in east and southern African countries. The evidence is presented in an annotated bibliography and analysis. It is being used to identify key areas of focus and parameters for deeper review and analysis. The picture presented in the literature is not a coherent one- it is rather a series of fragments of different and often disconnected facets of risk, health and care within urban areas. There is also limited direct voice of those experiencing the changes and limited report of the features of urbanisation that promote wellbeing. The literature found was significantly more focused on the challenges than on the solutions. The papers sourced confirmed the relevance of primary care and community-based approaches, with CHWs, to carry out participatory assessments, promote new PHC approaches, use social media and support service uptake to address urban determinants. However the documented interventions made weak links between PHC services, urban public health and the work of other sectors. The rapid, diverse and multifactorial changes taking place in urban areas, some of which are poorly documented, also call for participatory approaches that include the direct voice of those experiencing urban life.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Do financial contributions from \u2018pharma\u2019 violate WHO Guidelines?","field_subtitle":"Gopakumar K: Third World Network (TWN) Info Service on Health Issues Dec 15(01), December 2015","URL":"http://www.twn.my/title2/health.info/2015/hi151201.htm","body":"Millions of dollars given by major pharmaceutical companies to the World Health Organisation (WHO) raise questions of compliance with the organisation\u2019s guidelines on interactions with commercial enterprises. Currently, WHO\u2019s relations with commercial enterprises are guided by the \u201cGuidelines on interaction with commercial enterprises to achieve health outcomes\u201d . The 107th Session of the Executive Board in 2001 \u201cnoted\u201d the Guidelines that cover cash donations, contributions in kind, seconded personnel, collaboration for product development, collaboration for meetings etc.  Compliance with the Guidelines has essentially been left to the Secretariat. According to paragraph 11 of the Guidelines, \u201cCommercial enterprises working with WHO will be expected to conform to WHO public health policies in the areas of food safety, chemical safety, ethical promotion of medicinal drug products, tobacco control, and others\u201d. It is notable that the draft Framework of Engagement with Non-State Actors (FENSA) currently being finalised by WHO Member States does not contain a provision that requires a commercial enterprise to conform to WHO\u2019s polices, norms and standard. In the absence of such a clear provision FENSA could legitimise engagement with the private sector, which does not follow WHO\u2019s policies in the areas of food safety, chemical safety, ethical promotion of medicinal drug products, tobacco control, and others. WHO Member States at the resumed session of the Open Ended Intergovernmental Meeting (OEIGM) on FENSA is expected to look at the regulation of WHO\u2019s engagement with the private sector.  The experience with the implementation of the Guidelines on interaction with commercial enterprises to achieve health outcomes would be useful for the consideration of Member States. In 2014, WHO received USD 6,158,153 from GlaxoSmithKline (GSK). It received USD 5,785,000 and USD 8,266,284 in 2012 and 2013 respectively from GSK. GSK Biologics paid USD 17,000.  Novartis AG donated USD 5,300,000 in 2014 and USD 4,500,000 in 2013.  Hoffmann-La Roche donated USD 6,158,153 in 2014 and USD 4,806,492 in 2013.  The purposes of those donations were not disclosed.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Eliminating stigma and discrimination in health-care systems","field_subtitle":"UNAIDS: Geneva, November 2015","URL":"http://www.unaids.org/en/resources/presscentre/featurestories/2015/november/20151113_healthcare","body":"Widespread HIV-related stigma and discrimination in the health-care sector impedes access to services and impairs the quality of health-care delivery for people living with HIV and other key populations. It also undermines efforts to achieve the highest attainable standard of health for everybody. At a two-day meeting held in Geneva, Switzerland, on 10 and 11 November 2015, key stakeholders came together to discuss ways to eliminate all forms of discrimination in health-care settings, using the lessons learned from the AIDS response as an entry point. The event, organised by UNAIDS and the Global Health Workforce Alliance, also focused on the UNAIDS 2016\u20132021 Strategy and the upcoming Global Strategy on Human Resources for Health: Workforce 2030. Stigma and discrimination in health takes many forms\u2014the denial of health care and unjust barriers to service provision, inferior quality of care and a lack of respect. Abuse and other forms of mistreatment, violation of physical autonomy, mandatory testing or treatment and compulsory detention are other forms of stigma and discrimination encountered by people living with HIV. The meeting concluded with a clear call for more coordinated action. UNAIDS and the Global Health Workforce Alliance were asked to develop a plan before next year\u2019s Zero Discrimination Day, on 1 March 2016, to work towards ending discrimination in health-care settings. Priorities include political advocacy, strengthening accountability mechanisms, sharing existing evidence and best practices and building evidence-informed policy for implementation and scale-up of programmes to reduce stigma and discrimination at all levels.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 180: Will the Sustainable Development Goals deliver on African solutions to African problems?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Header"}},{"node":{"title":"Equity in Maternal Health in South Africa: Analysis of Health Service Access and Health Status in a National Household Survey","field_subtitle":"Wabiri N; Chersich M; Zuma K; Blaauw D; Goudge J; Dwane N: PLoS One 8(9), 2013","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0073864","body":"South Africa is increasingly focused on reducing maternal mortality. Documenting variation in access to maternal health services across one of the most inequitable nations could assist in re-direction of resources. This analysis draws on a population-based household survey that used multistage-stratified sampling. Women, who in the past two years were pregnant (1113) or had a child (1304), completed questionnaires and HIV testing. Poorest women had near universal antenatal care coverage (ANC), but only 39.6% attended before 20 weeks gestation; this figure was 2.7-fold higher in the wealthiest quartile. Women in rural-formal areas had lowest ANC coverage (89.7%), percentage completing four ANC visits (79.7%) and only 84.0% were offered HIV testing. Testing levels were highest among the poorest quartile (90.1% in past two years), but 10% of women above 40 or with low education had never tested. Skilled birth attendant coverage (overall 95.3%) was lowest in the poorest quartile (91.4%) and rural formal areas (85.6%). Around two thirds of the wealthiest quartile, of white and of formally-employed women had a doctor at childbirth, 11-fold higher than the poorest quartile. Overall, only 44.4% of pregnancies were planned, 31.7% of HIV-infected women and 68.1% of the wealthiest quartile. Self-reported health status also declined considerably with each drop in quartile, education level or age group. Aside from early ANC attendance and deficiencies in care in rural-formal areas, inequalities in utilisation of services were mostly small, with some measures even highest among the poorest. Considerably larger differences were noted in maternal health status across population groups. This may reflect differences between these groups in quality of care received, HIV infection and in social determinants of health.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Fellowships to Support Doctoral Research on Gender-Based Violence (GBV)/ Violence Against Women and Girls (VAWG)","field_subtitle":"Closing date for applications: 31 March 2016 (11:59pm, Nairobi time)","URL":"http://tinyurl.com/hj5pvpb","body":"As part of efforts to increase capacity to conduct research on GBV/VAWG in the continent, the African Population and Health Research Center, in partnership with the London School of Hygiene & Tropical Medicine, International Rescue Committee and the Department for International Development has announced a call for applications to support 3 doctoral students interested in working in and contributing to this field of research. The expectation is that the fellows will contribute to the field through their doctoral research and, in future, will work in this field, applying their knowledge and expertise. The award of these fellowships is contingent on funding availability. See website for details.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Framework for monitoring equity in access and health systems issues in antiretroviral therapy Programmes in southern Africa","field_subtitle":"Kalanda B; Kemp J; Makwiza I: Malawi Medical Journal19(1) 20\u201324, 2007","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615312/","body":"Universal provision of antiretroviral therapy (ART), while feasible, is expensive. In light of this limitation, the World Health Organisation (WHO) has launched the 3 \u00d7 5 initiative, to provide ART to 3 million people by the end of the year 2005. In Southern Africa, large-scale provision of ART will likely be achieved through fragile public health systems. ART programmes should therefore be developed and expanded in ways that will not aggravate inequities or result in the inappropriate withdrawal of resources from other health interventions or from other parts of the health system. This paper, proposes a framework for monitoring equity in access and health systems issues in ART programmes in Southern Africa. It proposes that an equity monitoring system should comprise seven thematic areas. These thematic areas encompass a national monitoring system which extends beyond one agency or single data collection method. Together with monitoring of targets in terms of numbers treated, there should also be monitoring of health systems impacts and issues in ART expansion, with reporting both nationally and to a regional body.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Global health as seen by Congo's sapeurs","field_subtitle":"Muvudi M: Health Financing Africa, 22 December 2015","URL":"http://www.healthfinancingafrica.org/home/global-health-as-seen-by-congos-sapeurs","body":"Health Financing Africa host a cartoon showing a satirical response to the global development agendas. This cartoon draws on the \"Sape\" movement (The Society of Ambiance-Makers and Elegant People) in Brazzaville and Kinshasa. Universal Health Coverage figures into the new Sustainable Development Goals and, with a wink, Michel Muvudi (Democratic Republic of the Congo) warns us not to be overly optimistic about the impact of such international objectives at the country level.  ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Global health leadership training in resource-limited settings: a collaborative approach by academic institutions and local health care programs in Uganda","field_subtitle":"Nakanjako D; Namagala E; Semeere A; et al: Afya Bora Consortium members: Human Resources for Health 13(87), November 2015","URL":"http://www.human-resources-health.com/content/13/1/87","body":"Due to a limited health workforce, many health care providers in Africa must take on health leadership roles with minimal formal training in leadership. Hence, the need to equip health care providers with practical skills required to lead high-impact health care programs. In Uganda, the Afya Bora Global Health Leadership Fellowship is implemented through the Makerere University College of Health Sciences (MakCHS) and her partner institutions. Lessons learned from the program, presented in this paper, may guide development of in-service training opportunities to enhance leadership skills of health workers in resource-limited settings. The Afya Bora Consortium, a consortium of four African and four U.S. academic institutions, offers 1-year global health leadership-training opportunities for nurses and doctors. Applications are received and vetted internationally by members of the consortium institutions in Botswana, Kenya, Tanzania, Uganda, and the USA. Fellows have 3 months of didactic modules and 9 months of mentored field attachment with 80% time dedicated to fellowship activities. Fellows\u2019 projects and experiences, documented during weekly mentor-fellow meetings and monthly mentoring team meetings, were compiled and analysed manually using pre-determined themes to assess the effect of the program on fellows\u2019 daily leadership opportunities. Between January 2011 and January 2015, 15 Ugandan fellows (nine doctors and six nurses) participated in the program. Each fellow received 8 weeks of didactic modules held at one of the African partner institutions and three online modules to enhance fellows\u2019 foundation in leadership, communication, monitoring and evaluation, health informatics, research methodology, grant writing, implementation science, and responsible conduct of research. In addition, fellows embarked on innovative projects that covered a wide spectrum of global health challenges including critical analysis of policy formulation and review processes, bottlenecks in implementation of national HIV early infant diagnosis and prevention of mother-to-child HIV-transmission programs, and use of routine laboratory data about antibiotic resistance to guide updates of essential drug lists. In-service leadership training was feasible, with ensured protected time for fellows to generate evidence-based solutions to challenges within their work environment. With structured mentorship, collaborative activities at academic institutions and local health care programs equipped health care providers with leadership skills.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Health Equity: The Key for Transformational Change","field_subtitle":"Garay J; Kelley N; Chiriboga D: Editorial Nacional de Salud y Seguridad Social (EDNASSS), Costa Rica,  2015","URL":"http://www.dropbox.com/s/bd0k0ey7u95koka/Dualbook%20EQUIDAD%20EN%20SALUD%20CCSS%20Ingl%C3%A9s%20WEB.pdf?dl=0","body":"The authors of this paper, drawing also on experience in primary health care in Zimbabwe, developed a \"healthy, feasible and sustainable (HFS)\" model utilising trends in readily available data from 1960s onwards in detailed tables, figures and maps and identifying specific countries which fit the criteria of the model. They also identify countries and population subgroups affected by inequity, with practical insights to eliminate global health inequities.  They quantify the cost of bridging the global health equity gap, and outline mechanisms to finance the necessary interventions through a binding global redistribution system. This is compared with what is considered to be an outdated, arbitrary and inefficient international cooperation model. The approach considers global levels of poverty and excessive global accumulation, which abuses natural resources in such a way as to deprive current and future generations from the access they deserve, making reference to the concept of inter-generational equity. The online book discusses the difference between equity and equality, the global burden of health equity, the minimum income threshold for dignity, the maximum threshold of income above which excessive accumulation or hoarding occurs, and how resource hoarding is directly linked to the burden of health equity; while also proposing a holistic health index, including healthy life expectancy by gender, the happiness index, and life-years lost of others due to the hoarding effect and to exhausting effect. The methodology provides tools to defend the right to health for all by supporting the development of binding instruments linked to concrete health standards attainable through a financially sustainable mechanism. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Health governance in Sub-Saharan Africa","field_subtitle":"Mooketsane K; Phirinyane M: Global Social Policy15(3): 345\u2013348, December 2015","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639823/","body":"The interdependence of states and increasing movement of people, the spread of contagious diseases and the heightened complexity of global health issues make cooperation among countries indispensable. Unfortunately resourcing remains a critical challenge to effective health governance. The authors argue that financial resources are not really a major challenge for Sub-Saharan Africa as it is usually perceived. According to the International Monetary Fund (IMF), Sub-Saharan Africa\u2019s economic growth has been robust and capital inflows  higher than the developing countries\u2019 average. Notwithstanding threats to the region seems poised for better prospects. The authors argue that health governance should be given a higher significance if growth rates are to be sustained and strategies developed for collaboration between governments and non-state actors. Many Sub-Saharan Africa countries still view non-state actors with suspicion, but the authors argue that those that have embraced them as development partners have reaped some positive results in the provision of health services, such as in the role of mission services in health care provision in Botswana and Malawi. They suggest enhancing a multi-pronged cooperation between African state and non state actors and that the porous borders across countries necessitate regional cooperation to effectively combat the spread of diseases.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Health Systems Trust Conference 2016","field_subtitle":"4-6 May 2016, Gauteng, South Africa","URL":"http://www.hstconference2016.org.za","body":"Health Systems Trust is hosting a conference from 4-6 May 2016 at the Birchwood Conference centre, Gauteng South Africa.  Under the banner of Health for all through strengthened health systems: sharing, supporting, synergising, the event is designed to advance the global public health agenda in improving health outcomes.  The three-day conference will convene approximately 300 healthcare workers from the public and private sectors as well as policy- and decision-makers, civil society groupings and academics. The conference will provide an opportunity to discuss challenges faced and solutions adopted at various levels in the health system. See website for details. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Making Medicines in Africa: The Political Economy of Industrializing for Local Health","field_subtitle":"Mackintosh M; Banda G; Tibandebage P;  Wamae W: Palgrave Connect Open Access International Political Economy Series, 2015","URL":"http://www.palgraveconnect.com/pc/doifinder/10.1057/9781137546470","body":"The importance of the pharmaceutical industry in Sub-Saharan Africa, its claim to policy priority, is rooted in the vast unmet health needs of the sub-continent. Making Medicines in Africa, an open access book under a CC-BY license, is a collective endeavour by a group of contributors with a strong African and more broadly Southern presence, to find ways to link technological development, investment and industrial growth in pharmaceuticals to improve access to essential good quality medicines, as part of moving towards universal access to competent health care in Africa. The authors aim to shift the emphasis in the international debate and initiatives towards sustained Africa-based and African-led initiatives to tackle this huge challenge. The authors argue that without the technological, industrial, intellectual, organisational and research-related capabilities associated with competent pharmaceutical production, and without policies that pull the industrial sectors towards serving local health needs, the African sub-continent cannot generate the resources to tackle its populations' needs and demands.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Measuring Regional Policy Change and pro-Poor Health Policy Success: A PRARI Toolkit of Indicators for the Southern African Development Community ","field_subtitle":"Amaya A; Choge I; De Lombaerde P; et al.,:  UNU CRIS,  Open University, December 2015","URL":"http://www.open.ac.uk/socialsciences/prari/files/indicator_tookit_1_eng_dec_2015.pdf","body":"Developed collaboratively with actors in the region, this toolkit is a guide to the implementation of an indicator system to measure regional policy change and pro-poor regional health policy successes targeted at the pilot areas of HIV/AIDS, TB and malaria in the SADC context. The toolkit also aims to capture the limitations the health sectors in many countries may have in addressing structural issues that make the poor more vulnerable or at risk. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Migration Governance and Migrant Rights in the Southern African Development Community (SADC) Attempts at Harmonization in a Disharmonious Region","field_subtitle":"Dodson B; Crush J: United Nations Research Institute for Social Development (UNRISD) Research Paper 2015\u20133, October 2015","URL":"http://tinyurl.com/jq6gy8p","body":"This paper examines prospects for enhanced regional migration governance and protection of migrants\u2019 rights in the Southern African Development Community (SADC). Migration in this region is substantial in scale and diverse in nature, incorporating economic, political and mixed migration flows. In addition to movements between countries within the region, migrants also come from across the African continent and even further afield. At its foundation in 1992, SADC as an institution initially embraced a vision of intra-regional free movement, but this has not become a reality. If anything, there has been a hardening of anti-migrant attitudes, not least in the principal destination country of South Africa. There have also been serious violations of migrants\u2019 rights. Attempts at regional coordination and harmonisation of migration governance have made limited progress and continue to face formidable challenges, although recent developments at national and regional levels show some promise. In conjunction with the 2003 SADC Charter of Fundamental Social Rights and 2008 Code on Social Security, incorporation of migrants into the SADC 2014 Employment and Labour Protocol could signal a shift towards more rights-based migration governance. The paper concludes by arguing that there can be no robust rights regime, either regionally or in individual countries, without extension of labour and certain other rights to non- citizens, nor a robust regional migration regime unless it is rights-based.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"More than cooking stoves: need for an ambitious plan on air pollution","field_subtitle":"People\u2019s Health Movement; Medicus Mundi International: 27 January 2016","URL":"http://tinyurl.com/hnc2jzq","body":"In a statement People's Health Movement (PHM) and Medicus Mundi International (MMI) pointed out the weaknesses of the draft roadmap established by the WHO for an enhanced global response to the adverse health effects of air pollution.  In it, they argue that this draft misses an analysis of the current economic and trade-related rules that would prevent the establishment of a robust plan of action. PHM and MMI see serious barriers for the transfer to clean technologies due to the continuing pressure for higher levels of intellectual property protection and investor state dispute settlements in trade agreements. PHM and MMI urge member states to insist on a more strategic and focused approach to the social and economic determinants of air pollution and to address these fundamental issues.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"One Million Signatures to Have a Clear Law on Abortion","field_subtitle":"Centre for Health Human Rights and Development (CEHURD): Uganda, September 2015","URL":"http://tinyurl.com/jde63pl","body":"The Centre for Health Human Rights and Development(CEHURD) through the Coalition to Stop Maternal Mortality due to Unsafe Abortion, marked the Global Day of Action on Safe and Legal Abortion on the 28th of September 2015. The global trending hash tag on social media was #BustTheMyth that all messages on myths and facts on abortion were attached to while sending out to followers on social media. A petition was read in line with the theme; Because every woman and Girl Counts and a campaign to have 1 million signatures was launched. The campaign sought to have one million signatures to be presented to parliament and the Speaker of Uganda Parliament, the Rt. Hon. Rebecca Kadaga and entire legislative council, to consider having a proper and clear law on abortion.  Two social media campaigns in line with the theme were launched to boost the main campaign with the hash tags; #BustTheMyth and #LetHerSpeak: Because every woman and girl counts. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"People's Commission of Inquiry: Free State in Chains","field_subtitle":"Report back from the People's Commission of Inquiry into the Free State Healthcare System - 7-8 July 2015: Treatment Action Campaign, November 2015","URL":"http://tinyurl.com/j5n2o9j","body":"A two-day long People\u2019s Commission of Inquiry into the Free State Health System was held in Bloemfontein, Free State on July 7th and 8th 2015. The inquiry was organised and hosted by the Treatment Action Campaign (TAC) but was set up as a public forum to enable people in the province to give testimony in front of an independent commission of inquiry through verbal and written testimony from more than 60 people representing 15 communities in the province. Civil society, activists and healthcare professionals also spoke or made submissions to the commissioners and the Free State Department of Health was also invited to testify and to make submissions. The key findings that emerged from the testimonies were that: The South African government, in particular the provincial Free State government, are failing to assume their responsibility to protect access to healthcare services, especially for the poor in the province. It reports shortages and stock outs of medication and medical supplies; broken or unavailable equipment; inadequate health workers; long waiting times for provincial emergency medical services and patient transport systems and unreliability and indignity experienced in these services. Many of the oral testimonies spoke of people having to pay out-of-pocket payments for transport to health facilities. Whistle-blowing and engagement is reported to be discouraged and at times met with intimidation. The report offers recommendations to improve access to quality services. The report indicates that the commission is committed to working together with communities, healthcare professionals, the provincial government and all other interested parties to improve conditions.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Primary Health Care Performance Initiative Toolkits","field_subtitle":"Primary Health Care Performance Initiative Website","URL":"http://phcperformanceinitiative.org/tools","body":"The Primary Health Care Performance Initiative (PHCPI) is a new partnership that brings together country policymakers, health system managers, practitioners, advocates and other development partners to catalyse improvements in primary health care (PHC) in low- and middle-income countries through better measurement and knowledge-sharing. PHCPI aims to help countries to track key performance indicators for their PHC systems, identifying which parts of the system are working well and which ones aren\u2019t. It aims to enhance accountability and provide decision-makers with essential information, to provide a platform for countries to share lessons and best practices an advocacy toolkit, and a compare tool which allows users to simultaneously compare multiple countries across multiple indicators. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Relationship between power, communication, and violence among couples: results of a cluster-randomised HIV prevention study in a South African township","field_subtitle":"Minnis A; Doherty I; Kline T; Zule W; Myers B; Carney T; Wechsberg W: International Journal of Women's Health, 7, 517\u2013525, 2015","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435250/","body":"Inequitable gender-based power in relationships and intimate partner violence contribute to persistently high rates of HIV infection among South African women. The authors examined the effects of two group-based HIV prevention interventions that engaged men and their female partners together in a couples intervention (Couples Health CoOp [CHC]) and a gender-separate intervention (Men\u2019s Health CoOp/Women\u2019s Health CoOp [MHC/WHC]) on women\u2019s reports of power, communication, and conflict in relationships. Of the 290 couples enrolled, 255 women remained in the same partnership over 6 months. Following the intervention, women in the CHC arm compared with those in the WHC arm were more likely to report an increase in relationship control and gender norms supporting female autonomy in relationships. Women in the MHC/WHC arm were more likely to report increases in relationship equity, relative to those in the CHC arm, and had a higher odds of reporting no victimisation during the previous 3 months. Male partner engagement in either the gender-separate or couples-based interventions led to modest improvements in gender power, adoption of more egalitarian gender norms, and reductions in relationship conflict for females. The aspects of relationship power that improved, however, varied between the couples and gender-separate conditions, highlighting the need for further attention to development of both gender-separate and couples interventions.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Right to sanitation, a distinct human right","field_subtitle":"Heller L; Sadi W: United Nations Human Rights Office of the Commissioner, New York, December 2015","URL":"http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=16903&LangID=E","body":"The United Nations Special Rapporteur on the human right to water and sanitation, L\u00e9o Heller, and the Chair of the UN Committee on Economic, Social and Cultural Rights, Waleed Sadi,  welcomed the explicit recognition of the \u2018human right to sanitation\u2019 as a distinct right, together with the \u2018human right to safe drinking water\u2019 by the UN General Assembly in December. Over 2.5 billion people still lack access to improved sanitation - the sanitation target under Goal 7 has been missed by one of the widest margins of all the 18 targets under the Millennium Development Goals. One billion people practise open defecation, nine out of ten in rural areas across the world. The experts explained that while sanitation does not necessarily have to be water-borne, governments tend to focus on this type, rather than on-site sanitation such as pit latrines and septic tanks, which are still widely used. As a result, individual households which rely on on-site sanitation often have to operate the entire system themselves, including collection and disposal, without government support. \u201cThe right to sanitation also requires privacy and dignity,\u201d the experts stressed. In the UN General Assembly resolution, adopted by consensus on 17 December 2015, Member States recognized that \u2018the human right to sanitation entitles everyone, without discrimination, to have physical and affordable access to sanitation, in all spheres of life, that is safe, hygienic, secure, socially and culturally acceptable and that provides privacy and ensures dignity.\u2019 \u201cWe urge all Member States, in both their national budgeting and international development cooperation, to target the allocation of resources to sanitation in particular to the most marginalised and disadvantaged groups and individuals, as those living in urban informal settlements and in rural areas,\u201d the experts said.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Strategies for achieving global collective action on antimicrobial resistance","field_subtitle":"Hoffman S; Caleo G; Daulaire N; Elbe S; Matsoso P; Mossialos E; Rizvi Z; R\u00f8ttingen JA: Bulletin of the World Health Organisation 93(12), 867-876, 2015","URL":"http://www.who.int/bulletin/volumes/93/12/15-153171/en/","body":"Global governance and market failures mean that it is not possible to ensure access to antimicrobial medicines of sustainable effectiveness. Many people work to overcome these failures, but their institutions and initiatives are insufficiently coordinated, led and financed. Options for promoting global collective action on antimicrobial access and effectiveness include building institutions, crafting incentives and mobilising interests. No single option is sufficient to tackle all the challenges associated with antimicrobial resistance. Promising institutional options include monitored milestones and an inter-agency task force. A global pooled fund could be used to craft incentives and a special representative nominated as an interest mobiliser. There are three policy components to the problem of antimicrobials \u2013 ensuring access, conservation and innovation. To address all three components, the right mix of options needs to be matched with an effective forum and may need to be supported by an international legal framework.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The environmental profile of a community\u2019s health: a cross-sectional study on tobacco marketing in 16 countries","field_subtitle":"Savell E; Gilmore AB; Sims M; Mony PK; Koon T; et al: Bulletin of the World Health Organisation 93(12), 93:851-861G., December 2015","URL":"http://www.who.int/bulletin/volumes/93/12/15-155846/en/","body":"The objective of the study was to examine and compare tobacco marketing in 16 countries while the Framework Convention on Tobacco Control requires parties to implement a comprehensive ban on such marketing. Between 2009 and 2012, a kilometre-long walk was completed by trained investigators in 462 communities across 16 countries to collect data on tobacco marketing. The authors interviewed community members about their exposure to traditional and non-traditional marketing in the previous six months. To examine differences in marketing between urban and rural communities and between high-, middle- and low-income countries, the authors used multilevel regression models controlling for potential confounders. Compared with high-income countries, the number of tobacco advertisements observed was 81 times higher in low-income countries and the number of tobacco outlets was 2.5 times higher in both low- and lower-middle-income countries. Of the 11 842 interviewees, 1184 (10%) reported seeing at least five types of tobacco marketing. Self-reported exposure to at least one type of traditional marketing was 10 times higher in low-income countries than in high-income countries. For almost all measures, marketing exposure was significantly lower in the rural communities than in the urban communities. Despite global legislation to limit tobacco marketing, it appears ubiquitous. The frequency and type of tobacco marketing varies on the national level by income group and by community type, appearing to be greatest in low-income countries and urban communities.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The International Health Regulations 10 years on: the governing framework for global health security","field_subtitle":"Gostin L: DeBartolo M; Friedman E: The Lancet 386(10009), 2222\u20132226, 2015","URL":"http://tinyurl.com/hxl77a7","body":"Fundamental revisions to the International Health Regulations in 2005 were meant to herald a new era of global health security and cooperation. Yet, 10 years later, the International Health Regulations face criticism, particularly after the west African Ebola epidemic. Several high-level panels are reviewing the International Health Regulations' functions and urging reforms.  The Global Health Security Agenda, a multilateral partnership focused on preventing, detecting, and responding to natural, accidental, or intentional disease outbreaks, has similar capacity building aims, but operates largely outside the International Health Regulations.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Least Developed Countries Report 2015: Transforming Rural Economies","field_subtitle":"United Nations Conference on Trade and Development(UNCTAD): New York, November 2015","URL":"http://unctad.org/en/pages/PublicationWebflyer.aspx?publicationid=1393","body":"The United Nations Conference on Trade and Development Least Developed Countries (LDC\u2019s) Report 2015 focuses on the transformation of rural economies.  Assessing LDCs\u2019 progress in agricultural productivity, the extent and nature of their rural economic diversification, and gender issues in rural transformation, it shows that agricultural productivity began to increase in LDCs in 2000, following decades of stagnation or decline, but has risen strongly only in Asian LDCs. The report also shows that rural economic diversification varies widely between LDCs, but only a few have passed beyond the stage in which non-farm activities are centred on agriculture, and that urban linkages are limited. Further, the report highlights that women comprise half the rural workforce in LDCs, but face serious constraints on realising their productive potential, slowing rural transformation. The 2030 Agenda both highlights the need and provides the opportunity for a new approach to rural development centred on poverty-oriented structural transformation (POST), to generate higher incomes backed by higher productivity. In rural areas, this means upgrading agriculture, developing viable non-farm activities, and fully exploiting the synergies between the two, through appropriately designed and sequenced efforts to achieve the SDGs. The Report argues that differentiation is needed between peri-urban, intermediate, remote and isolated rural areas and a key priority is to overcome the contradiction between need and opportunity, by which more remote areas and poorer households have the greatest need but also the most limited opportunities for income diversification. Gender-specific measures are needed to overcome disadvantages arising directly from gender norms, and more inclusive gender-sensitive approaches to address their poverty-related consequences. Access to appropriate technologies, inputs, skills and affordable finance needs to be fostered. Effective policy coordination is required nationally, while producers\u2019 associations, cooperatives and women\u2019s networks can play a key role locally. Innovative approaches to trade and cross-border investment could make a substantial contribution. Finally, the report highlights the importance of adequate support from the international community to achieve structural transformation and fulfil the SDGs, based on the principle that \u201cto will the end is to will the means\u201d. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Training needs for research in health inequities among health and demographic researchers from eight African and Asian countries","field_subtitle":"Haafkens J; Blomstedt Y; Eriksson M; Becher H; Ramroth H; Kinsman J:  BMC Public Health 14(1254), 2014","URL":"http://www.biomedcentral.com/1471-2458/14/1254","body":"To support equity focussed public health policy in low and middle income countries, more evidence and analysis of the social determinants of health inequalities is needed. This requires specific know how among researchers. The INDEPTH Training and Research Centres of Excellence (INTREC) collaboration identified learning needs among INDEPTH researchers from Ghana, Tanzania, South Africa, Kenya, Indonesia, India, Vietnam, and Bangladesh to conduct research on the causes of health inequalities in their country. Using an inductive method, online concept-mapping, participants were asked to generate statements in response to the question what background knowledge they would need to conduct research on the causes of health inequalities in their country. Of the 150 invited researchers, 82 participated in the study: 54 from Africa; 28 from Asia. African participants assigned the highest importance to further training on methods for assessing health inequalities. Asian participants assigned the highest importance to training on research and policy. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Universal health coverage: The strange romance of The Lancet, MEDICC, and Cuba","field_subtitle":"Waitzkin H: Social Medicine 9(2) 93 -97, 2015","URL":"http://socialmedicine.info/index.php/socialmedicine/article/view/845/1607","body":"As a key supporter of universal health coverage (UHC), The Lancet recently partnered with Medical Education Cooperation with Cuba (MEDICC), a non-governmental organisation based in the United States, to produce a Spanish-language translation of The Lancet\u2019s series on UHC in Latin America. This translation was launched as part of Cuba Salud 2015, an international health conference held during April 2015 in Havana, Cuba. Despite its often ambiguous definition, UHC is often used to refer to a financial reform extending insurance coverage in varying degrees to a larger part of a country\u2019s population. This is different to \u201chealthcare for all\u201d (HCA) \u2013 a healthcare delivery system that provides equal services for the entire population regardless of an individual\u2019s or family\u2019s financial resources. UHC as a more limited insurance concept has received wide criticism because it does not necessarily create a unified, accessible system; because it usually encourages a role for private, for- profit insurance corporations; and because it involves tiered benefits packages with differing benefits for the poor and non-poor. Although the UHC orientation has become \u201chegemonic\u201d in global health policy circles, its ideological assumptions have not been confirmed empirically. The authors urge that the Lancet and MEDICC Review provide \u201cequal time\u201d for critiques of UHC and presentations of endeavours to achieve HCA. ","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Will the Sustainable Development Goals deliver on African solutions to African problems?","field_subtitle":"Garrett Brown, Rene Loewenson, Rangarirai Machemedze, Nancy Malema, EQUINET","body":"The theme for the November 2015 62nd East, Central and Southern African Health Community (ECSA-HC) Health Ministers Conference on transitioning from Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs) provided a timely opportunity for countries in the region to frame priorities for health for the next 15 years. In his opening remarks to the Health Ministers Conference, the Minister of Health for Mauritius, the Honorable Anil Kumarsingh Gayan pointed to the SDGs as an ambitious framework that looked at health holistically in terms of healthy lives, including and beyond health care.  As detailed also by the World Health Organisation representative Dr Rufaro Chatora at the conference, the transition is from a disease and poverty focused agenda to one that is more focused on the policy goals that apply to all countries. Hon Minister Gayan cautioned that the goals must not remain \u2018in a state of aspiration\u2019, and called for them to be addressed through \u2018African solutions to African problems\u2019. \r\n\r\nWhile many of the SDGs contribute to health, SDG 3 raises the need to \u2018ensure healthy lives and promote well-being for all at all ages\u2019 and lists a daunting array of ambiguous targets (such as universal health coverage). Many of these are open to interpretation and strategic thinking in regards to their implementation, including in terms of how they are integrated into national, regional and continental development plans, such as the African Union\u2019s Agenda 2063: \u2018The Africa we want\u2019. With global discussion underway on indicators, funding and other ways of operationalizing the SDGs, the region has a window of opportunity to shape these agendas, rather than react to those set outside the region. \r\n\r\nMinister Gayan highlighted the importance of inspiring regional leadership and collective action across countries to steer the SDG agenda to advance health and address mutual concerns across countries in the region through an agenda set within the region. This, he indicated, called for regional organisations to be \u2018innovative, responsive, imaginative and effective\u2019. \r\n\r\nThe ECSA HC Best Practices Forum (BPF), Directors Joint Consultative Conference and Health Ministers Conference, this year involving about 150 delegates from ministries of health, health experts and researchers, heads of health research and training institutions from ECSA countries and diverse collaborating partners in and beyond the region, provided a unique opportunity to blend experience, evidence, exchange, policy review and networking to contribute to such features.  It included inputs from diverse actors in the region on universal health coverage (UHC), on health financing, on regional collaboration in the surveillance and control of communicable diseases, on the situation and responses to non- communicable diseases (NCDs), on global health diplomacy and on innovations in health professional training. \r\n\r\nThe BPF conference raised a number of key recommendations aimed at supporting the transition from the MDGs to the SDGs, including; strengthening mandatory pre\u2013payment for health, and monitoring, evaluation and shared learning across the ESCA-HC members on measures for this and on progress towards UHC; strengthening and sharing capacities and knowledge for tracking and reporting communicable diseases and for responding to outbreaks; increasing ECSA initiatives for health professional training and recognition of qualifications across countries in the region; strengthening regional capacity and evidence in global health negotiations; strengthening investment in research and the use of evidence in health policy, and facilitating \u2018south-south knowledge exchange\u2019 in various areas, including on multi-sectoral measures and capacities to detect and control NCDs and traumas; and in global health diplomacy. \r\n\r\nSuch regional exchange, co-ordination and voice was found in EQUINET\u2019s research as one factor - amongst others-  in effective engagement in global health negotiations.  In the ECSA HC conference, regional co-operation was raised in various discussions as an important platform for solving a number of problems, including for countries with excess to deploy skilled professionals to countries with scarcities, or for more rapid deployment of capacities for response to emergencies. At the same time, EQUINET\u2019s research also found that regional organisations are often bypassed or lack formal voice in global processes. It was thus interesting that the ECSA HC Director General Professor Yoswa Dambisya launched one of the few examples of a successfully secured regionally based Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GF) grant, which will align programs and provide increased capacity for tuberculosis monitoring and response in the region. This capacity will not only increase the ability of states in the region to detect new cases of tuberculosis, but also provides the possibility for new capacity scale-up to detect other neglected communicable diseases (NCDs) as laboratory resources and expertise increase. \r\n\r\nThere were, however, a number of signals on the challenges to further strengthen such regional roles. Minister Gayan in his opening speech pointed to how shortfalls in payment of membership fees to the regional body weakens the financial forecasting and planning needed to take forward a proactive agenda. The recent experience of weak implementation of the WHO Code of Practice on the International Recruitment of Health Personnel signaled deficits in technical follow through on policies. At the same time the conference also raised the role of domestic investment in country driven research and ministerial leadership to effectively support and coordinate such follow through.  \r\n\r\nWith the long-term nature of the issues being tackled, these annual regional conferences need a consistency of focus on issues that are key for the region and strategic use of time to share and review the learning from implementation of regional recommendations as \u2018African solution to African problems\u2019.  The involvement of many of the countries in several regional economic communities also necessitates co-ordination of efforts across these regional bodies. \r\n\r\nNotwithstanding the challenges, the conference highlighted the potential of ECSA-HC and other regional processes in facilitating the exchange and sharing of policy relevant evidence and \u2018south-south\u2019 learning. The contribution of such institutional resources and processes should not be overlooked in asserting African health priorities in the global health agenda. While this is more a \u2018marathon\u2019 than a \u2018sprint\u2019, for the window of opportunity of current discussions on the SDG indicators and financing, the time to voice African health priorities in this global SDG process is now. \r\n\r\nPlease send feedback or queries on the issues raised in this editorial to the EQUINET secretariat: admin@equinetafrica.org. For further information on the ECSA HC Regional Conferences please visit the ECSA HC website at http://www.ecsahc.org/","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"World Health Organisation Executive Board meeting 138 ","field_subtitle":"World Health Organisation: Geneva, January 2016","URL":"http://apps.who.int/gb/e/e_eb138.html","body":"The WHO Executive Board is composed of 34 members technically qualified in the field of health. Members are elected for three-year terms. The main Board meeting, at which the agenda for the forthcoming Health Assembly is agreed upon and resolutions for forwarding to the Health Assembly are adopted, is held in January, with a second shorter meeting in May, immediately after the Health Assembly, for more administrative matters. The main functions of the Board are to give effect to the decisions and policies of the Health Assembly, to advise it and generally to facilitate its work. The full set of documents under consideration at the 138th WHO Executive Board meeting are available online at the organisation's website.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"\u201cYou are wasting our drugs\u201d: health service barriers to HIV treatment for sex workers in Zimbabwe","field_subtitle":"Mtetwa S; Busza J; Chidiya S; Mungofa S; Cowan F: BMC Public Health 13(698), July 2013, ","URL":"http://www.biomedcentral.com/1471-2458/13/698","body":"In Zimbabwe, despite the existence of well-attended services targeted to female sex workers (SWs), fewer than half of women diagnosed with HIV took up referrals for assessment and ART initiation; just 14% attended more than one appointment. The authors conducted a qualitative study to explore the reasons for non-attendance and the high rate of attrition, through three focus group discussions (FGD) in Harare with HIV-positive SWs. SWs emphasised supply-side barriers, such as being demeaned and humiliated by health workers, reflecting broader social stigma surrounding their work. Sex workers were particularly sensitive to being identified and belittled within the health care environment. Demand-side barriers also featured, including competing time commitments and costs of transport and some treatment, reflecting SWs\u2019 marginalised socio-economic position. Improving treatment access for SWs is critical for their own health, programme equity, and public health benefit. The authors suggest that programmes working to reduce SW attrition from HIV care need to proactively address the quality and environment of public services. Sensitising health workers through specialised training, refining referral systems from sex-worker friendly clinics into the national system, and providing opportunities for SW to collectively organise for improved treatment and rights might help alleviate the barriers to treatment initiation and attention currently faced by SW.","php":"","field_issue_date":"2016-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Africa-China FOCAC Summit makes good progress on South-South cooperation","field_subtitle":"SOUTHNEWS No. 99, 15 December 2015","URL":"http://www.southcentre.int/category/publications/southnews/","body":"The Forum on China-Africa Cooperation (FOCAC) under the theme: \"China-Africa Progressing Together: Win-Win Cooperation for Common Development\" was held on 4-5 December in Johannesburg, South Africa. This was the first time that a leaders\u2019 summit level of FOCAC is held in Africa. The Summit which also celebrated the 15th anniversary of the partnership was co-chaired by Chinese President Xi Jinping and South African President Jacob Zuma. The FOCAC was established fifteen years ago with its first Ministerial Forum held in Beijing in 2000. With six Ministerial Meetings and two at Summit level already organised, FOCAC has evolved over the years to become a prominent example of South-South cooperation. In the two-day event, Chinese President Xi Jinping and over 50 African leaders gathered in South Africa to discuss together the blueprints of cooperation and show to the world the power of solidarity among developing countries. To build China-Africa comprehensive strategic and cooperative partnership, the conference was informed that China will implement ten cooperation plans with Africa in the next three years. Guided by the principle of government guidance, businesses being the major actors, market operation and win-win cooperation, these plans aim at addressing three bottleneck issues holding back Africa\u2019s development, namely, inadequate infrastructure, lack of professional and skilled personnel, and funding shortage, accelerating Africa\u2019s industrialization and agricultural modernization, and achieving sustainable self-development.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Aid and International Development Forum (AIDF) Africa Summit 2016","field_subtitle":"2-3 February 2016, United Nations Conference Centre, Addis Ababa, Ethiopia","URL":"http://africa.aidforum.org","body":"Gathering 250+ senior representatives and advisors from regional governments, UN agencies, international and regional NGOs, CBOs, investors and donors, research institutes and the private sector, this summit looks at how technological innovations and best practice can improve aid delivery and development strategy in East Africa. The summit demonstrates best practice approaches, current initiatives and latest innovations, offering trans-disciplinary discussions with participants from all relevant stakeholder groups. The agenda has been developed in consultation with UN organisations. The specific objectives of this summit are: to showcase expertise, approaches and innovations by different global stakeholders, to discuss best practice, guidelines and policy that support technological innovations and to provide an opportunity for knowledge exchange and networking amongst public, private and civil society stakeholders.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Ambassador Zhong Jianhua \u2013 on trade, aid and jobs","field_subtitle":"Interview with Edward Paice: Africa Research Institute, August 2014","URL":"http://tinyurl.com/nlm6m52","body":"In this online interview with Edward Paice, Director of Africa Research Institute, Zhong Jianhua, China\u2019s Special Representative on African Affairs, responds to common criticisms of China\u2019s policy and conduct in Africa. He rejects any analogy between China-Africa trade patterns and those of the colonial era but agrees that Africa must regard China as a competitor pursuing its own interests. Ambassador Zhong observes many similarities between the policy choices facing African governments in the 2000s and those confronted by China during the 1980s and 1990s. He emphasises that China itself is still a developing country \u2013 and one which has a great deal to learn about Africa. He insists that it is China\u2019s responsibility to help African nations compete in the global economy. While acknowledging the imperative shared by all developing economies to maximise agricultural potential, attract capital, create a more skilled workforce and industrialise, he concludes that \u201cfinally the chance has come\u201d to Africa.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Bringing stakeholders together for urban health equity: hallmarks of a compromised process","field_subtitle":"Katz A; Cheff R; O\u2019Campo P: International Journal for Equity in Health 2015, 14(138), 2015","URL":"http://www.equityhealthj.com/content/14/1/138","body":"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.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Conceptualising the impacts of dual practice on the retention of public sector specialists - evidence from South Africa","field_subtitle":"Ashmore J; Gilson L: Human Resources for Health 13(3), 2015, ","URL":"http://www.human-resources-health.com/content/13/1/3","body":"\u2018Dual practice\u2019, or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries\u2019 public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Findings suggest dual practice can impact both positively and negatively on specialists\u2019 intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a \u2018stepping stone\u2019 to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"CSO conference on Global Health and Universal Health Coverage: Dakar, February 2014 Workshop Report ","field_subtitle":"Action for Global Health (AfGH); Network of West African NGO Platforms, (REPAOC): 8 December 2015","URL":"http://tinyurl.com/z3dk5ph","body":"Action for Global Health (AfGH) in partnership with the Network of West African NGO Platforms, (REPAOC) convened a conference in Dakar, Senegal, 17-19th February 2014, which brought together civil society actors from 23 countries and five continents.  The main purpose of the workshop was to gain clarity and consensus on what Universal Health Coverage (UHC) incorporates, building upon Civil Society Organisation\u2019s (CSO) country experiences from a grassroots level; develop a common understanding of the strengths of the UHC concept and the pitfalls of its implementation; define a clear position on how UHC should be framed to achieve the highest attainable standard of health for all; and outline a course of action for CSO advocacy on the right to health.  The meeting concluded with a declaration \u2013 Ensuring UHC is fit for contributing to the right to health \u2013 which captured the main discussion points and reflections of the CSOs present. ","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Ebola\u2019s lessons for Universal Health Coverage (UHC)","field_subtitle":"Kamal-Yanni M: Global Health Check, 11 December 2015","URL":"http://www.globalhealthcheck.org/?p=1846","body":"The 2015 UHC day comes after a year of the international community being busy in producing numerous reports on learning from the Ebola crisis. Most of the learning from these documents has focused on mechanisms for effective global response to outbreaks. However, the author argues that more attention should be directed to learning from the role of local institutions in tackling the Ebola outbreak including how critically needed advances towards UHC can be achieved. Two key ingredients for effective epidemic prevention and response require particular focus:  community engagement and health systems strengthening. The WHO interim panel\u2019s report on Ebola  recognised that \u201cRisk assessment was complicated by factors such as weak health systems, poor surveillance, little early awareness of population mobility, spread of the virus in urban areas, poor public messaging, lack of community engagement, hiding of cases, and continuing unsafe (e.g. burial) practices\u201d.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 179: We're listening out for your voice and practice on health justice in 2016","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Header"}},{"node":{"title":"Equity in utilisation of antiretroviral therapy for HIV-infected people in South Africa: a systematic review","field_subtitle":"Tromp N; Michels C; Mikkelsen,E; Hontelez J; Baltussen R: International Journal for Equity in Health 13(60) 2014","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4448289/","body":"About half a million people in South Africa are deprived of antiretroviral therapy (ART), and there is little systematic knowledge on who they are \u2013 e.g. by severity of disease, sex, or socio-economic status (SES). The authors performed a systematic review to determine the current quantitative evidence-base on equity in utilisation of ART among HIV-infected people in South Africa. The authors conducted a literature search based on the Cochrane guidelines. A study was included if it compared for different groups of HIV infected people (by sex, age, severity of disease, area of living, SES, marital status, ethnicity, religion and/or sexual orientation (i.e. equity criteria)) the number initiating/adhering to ART with the number who did not. The authors considered ART utilisation inequitable for a certain criterion (e.g. sex) if between groups (e.g. men versus women) significant differences were reported in ART initiation/adherence. Twelve studies met the inclusion criteria. For sex, 2 out of 10 studies that investigated this criterion found that men are less likely than women to utilise ART, while the other 8 found no differences. For age, 4 out of 8 studies found inequities and reported less utilisation for younger people. For area of living, 3 out of 4 studies showed that those living in rural areas or certain provinces have less access and 2 out of 6 studies looking at SES found that people with lower SES have less access. One study which looked at the marital status found that those who are married are less likely to utilise ART. For severity of disease, 5 out of 6 studies used more than one outcome measure for disease stage and reported within their study contradicting results. One of the studies reported inconclusive findings for ethnicity and no study had looked at religion and sexual orientation. It seems that men, young people, those living in certain provinces or rural areas, people who are unemployed or with a low educational level, and those being unmarried have less access to ART. As studies stem from different contexts and use different methods conclusions should be taken with caution.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Evidence-informed policymaking in practice: country-level examples of use of evidence for iCCM policy","field_subtitle":"Rodr\u00edguez D; Shearer J; Mariano A; Juma P; Dalglish S; Bennet S: Health Policy and Planning 30 (suppl 2): ii36-ii45, December 2015","URL":"http://heapol.oxfordjournals.org/content/30/suppl_2/ii3.full","body":"Integrated Community Case Management of Childhood Illness (iCCM) is a policy for providing treatment for malaria, diarrhoea and pneumonia for children below 5 years at the community level, which is generating increasing evidence and support at the global level. This article explores whether, how and why evidence influenced policy formulation for iCCM in Niger, Kenya and Mozambique, and explains the use of evidence in these contexts. Findings indicate that all three countries used national monitoring data to identify the issue of children dying in the community prior to reaching health facilities, whereas international research evidence was used to identify policy options. Nevertheless, policymakers greatly valued local evidence and pilot projects proved critical in advancing iCCM. World Health Organisation and United Nations Children's Fund (UNICEF) functioned as knowledge brokers, bringing research evidence and experiences from other countries to the attention of local policymakers as well as sponsoring site visits and meetings. Both Mozambique and Kenya exhibit Problem-Solving research utilisation with different outcomes. ","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health Systems Trust Conference 2016","field_subtitle":"Call for Abstracts and Pre Conference Workshops: Deadline 10 January 2016","URL":"http://hstconference2016.org.za/news/30-11-2015/conference-update-2","body":"The abstract reviewers are looking forward to receiving outlines for oral and poster presentations demonstrating innovations and good practice in Primary Health Care projects and programmes.  Knowledge sharing and skills transfer are an important component of the Conference.  To this end, the organisers also invite abstract submissions for the pre-conference workshops which should include interactive participation and offer practical outcomes to the delegates. Through the media of storytelling, drama, film, music or art, the organisers aim to create a platform for thought-provoking discussions through a non-conventional Conference experience. The organisers would like to hear from all those who work in and around South Africa\u2019s health system, especially: district- and facility-based healthcare workers and community members of facility governance structures; development partners; universities; district, provincial and municipal structures; the National Department of Health; AIDS councils; private health sector; non-governmental and community-based organisations; health communicators; film producers; and artists.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health worker migration from South Africa: causes, consequences and policy responses","field_subtitle":"Labont\u00e9 R; Sanders D; Mathole T; Crush J; Chikanda A; Dambisya Y; Runnels V; Packer C; MacKenzie A; Murphy G; Bourgeault I: Human Resources for Health,13(92), December 2015","URL":"http://www.human-resources-health.com/content/13/1/92","body":"This paper arises from a four-country study that sought to better understand the drivers of skilled health worker migration, its consequences, and the strategies countries have employed to mitigate negative impacts. This paper presents the findings from South Africa. The study began with a scoping review of the literature on health worker migration from South Africa, followed by empirical data collected from skilled health workers and stakeholders. The study found that there has been a decrease in out-migration of skilled health workers from South Africa since the early 2000s largely attributed to a reduced need for foreign-trained skilled health workers in destination countries, limitations on recruitment, and tighter migration rules. Low levels of worker satisfaction persist, although the Occupation Specific Dispensation (OSD) policy (2007), which increased wages for health workers, has been described as critical in retaining South African nurses. Return migration was reportedly a common occurrence. The consequences attributed to skilled health worker migration are mixed, but shortages appear to have declined. Most promising initiatives are those designed to reinforce the South African health system and undertaken within South Africa itself. In the near past, South Africa\u2019s health worker shortages as a result of emigration were viewed as significant and harmful. Currently, domestic policies to improve health care and the health workforce including innovations such as new skilled health worker cadres and OSD policies appear to have served to decrease shortages to some extent. ","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Informality as an urban challenge","field_subtitle":"Interview with Gustave Massiah: UrbanAfrica.net, 16 November 2015","URL":"http://www.urbanafrica.net/urban-voices/informality-as-an-urban-challenge/","body":"Agenda 2063 - The Africa We Want is a flagship campaign of the African Union. This policy argues for using the opportunity offered by urbanisation and the demographic shift to fulfil the vision of an African renaissance. With urbanisation firmly on the agenda across Africa there is a need for a constructive policy dialogue on what exactly urbanisation in Africa might mean. To support such a process the Cities Alliance secretariat has awarded a grant to the African Centre for Cities (ACC) at the University of Cape Town to establish an independent think tank dedicated to this issue. In this video Gustave Massiah, an Urban Specialist with the United Cities and Local Governments of Africa, discusses the key challenges facing African urbanisation in a post-industrial period. Gustave sees the main challenges of African urbanisation to be those faced by the continent as a whole: inequality, unemployment and the resistance of external exploitation. He proposes a new conception of informality based on the dynamism and power of the individual. With no obvious answer to informality, society then has to review its definition of informal and to better understand people's own  experience of their conditions.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Integrated community case management in Malawi: an analysis of innovation and institutional characteristics for policy adoption","field_subtitle":"Rodr\u00edguez D; Banda H; Namakhoma I: Health Policy and Planning 30 (suppl 2): ii74-ii83, December 2015","URL":"http://heapol.oxfordjournals.org/content/30/suppl_2/ii74.full","body":"In 2007, Malawi became an early adopter of integrated community case management for childhood illnesses (iCCM), a policy aimed at community-level treatment for malaria, diarrhoea and pneumonia for children below 5 years. Through a retrospective case study, this article explores critical issues in implementation that arose during policy formulation through the lens of the innovation and of the institutions involved in the policy process. iCCM was compatible with the Malawian health system due to the ability to build on an existing community health worker cadre of health surveillance assistants (HSAs) and previous experiences with treatment provision at the community level. In terms of institutions, the Ministry of Health (MoH) demonstrated leadership in the overall policy process despite early challenges of co-ordination within the MoH. WHO, United Nations Children\u2019s Fund (UNICEF) and implementing organisations played a supportive role in their position as knowledge brokers. Greater challenges were faced in the organisational capacity of the MoH. Regulatory issues around HSA training as well as concerns around supervision and overburdening of HSAs were discussed, though not fully addressed during policy development. Similarly, the financial sustainability of iCCM, including the mechanisms for channeling funding flows, also remains an unresolved issue. This analysis highlights the role of implementation questions during policy development.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Learning from Ebola: readiness for outbreaks and emergencies","field_subtitle":"Chan M: Bulletin of the World Health Organisation 2015, 93(12), 818-818A, December 2015","URL":"http://www.who.int/bulletin/volumes/93/12/15-165720/en/","body":"For almost 70 years, the World Health Organisation (WHO) has coordinated the norms and technical standards required to improve global health. This is the role people most often associate with WHO. However, the organisation\u2019s constitution also calls on it to \u201cfurnish technical assistance and, in emergencies, necessary aid\u201d to governments, a role WHO has played on countless occasions. Despite initial delays in the western Africa Ebola outbreak response, the tide of this unprecedented health crisis has now been turned. While still requiring intense and focused action to bring new cases to zero, the outbreak is now limited to only a few cases per week. Deficiencies in capacity, expertise and approach revealed by WHO\u2019s response to Ebola suggest that organisation-wide change is needed:WHO must ensure it can prepare for and respond to outbreaks and emergencies in a way that genuinely supports national efforts and fully integrates with international partners. WHO has begun reviewing systems and capacities throughout the organisation to streamline the way it works in outbreaks and emergencies.These changes focus on six key areas: (i) a unified WHO platform for outbreaks and emergencies with health and humanitarian consequences; (ii) a global health emergency workforce, to be effectively deployed in support of countries; (iii) core capacities at country-level under the International Health Regulations; (iv) functioning, transparency, effectiveness and efficiency of the International Health Regulations; (v) a framework for research and development preparedness and capacity during outbreaks or emergencies; and (vi) adequate international financing for pandemics and other health emergencies, including a 100 million United States dollars contingency fund and a pandemic emergency financing facility. No single organisation can deliver the wide range of services and systems needed for a truly global mechanism that prepares for and responds to outbreaks and emergencies. This is why WHO will continue seeking advice from our partners inside and outside the UN system to make needed change. With their collaboration and support, WHO will be well positioned to deliver what the world needs when outbreaks and emergencies occur: a timely response that rapidly contains the consequences \u2013 for economies and societies as well as for human health.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Prioritizing action on health inequities in cities: An evaluation of Urban Health Equity Assessment and Response Tool (Urban HEART) in 15 cities from Asia and Africa","field_subtitle":"Prasad A; Kano M; Dagg K; Mori H; Senkoro H; Ardakani M; Elfeky S; Good S; Engelhardt K; Ross A; Armada F: Social Science & Medicine145, 237\u2013242 November 2015","URL":"http://www.sciencedirect.com/science/article/pii/S0277953615301337","body":"Following the recommendations of the Commission on Social Determinants of Health (2008), the World Health Organisation (WHO) developed the Urban Health Equity Assessment and Response Tool (HEART) to support local stakeholders in identifying and planning action on health inequities. This report analysed the experiences of cities in implementing Urban HEART to inform how the tool could support local stakeholders better in addressing health inequities. Independent evaluations were conducted in 2011\u201312 on Urban HEART piloting in 15 cities from seven countries in Asia and Africa: Indonesia, Iran, Kenya, Mongolia, Philippines, Sri Lanka, and Vietnam. Local or national health departments led Urban HEART piloting in 12 of the 15 cities. Improving access to safe water and sanitation was a priority equity-oriented intervention in 12 of the 15 cities, while unemployment was addressed in seven cities. Cities who piloted Urban HEART displayed confidence in its potential by sustaining or scaling up its use within their countries. Engagement of a wider group of stakeholders was more likely to lead to actions for improving health equity. Indicators that were collected were more likely to be acted upon. Quality of data for neighbourhoods within cities was one of the major issues.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Regional health governance: A suggested agenda for Southern African health diplomacy","field_subtitle":"Penfold E: Global Social Policy 15(3), 278-295, 2015","URL":"http://gsp.sagepub.com/content/15/3/278.full.pdf+html","body":"Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South\u2013South management of the regional social policy, health governance and health diplomacy agenda.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Resolutions of the 62nd Health Ministers Conference","field_subtitle":"East, Central and Southern African Health Community, Mauritius, 4th December 2015","URL":"http://tinyurl.com/pwbu2dk","body":"The 62nd ECSA Health Ministers\u2019 Conference (HMC) was held at InterContinental Resort Balaclava Fort, Republic of Mauritius under the theme: Transitioning from Millennium Development Goals to Sustainable Development Goals with the following sub-themes; Enhancing Universal Health Coverage Through Innovations in Health Financing for Risk Protection; Surveillance and Control of Emerging Conditions: (NCDs and Trauma); Regional Collaboration in the Surveillance and Control of Communicable Diseases; Innovations in Health Professional Training Using the ECSA College of Health Sciences Model.  The Conference passed Resolutions on: Transitioning From MDGs to SDGs in the ECSA Region; Enhancing UHC through innovation in Health Financing for Risk Protection; Surveillance and Control of Non- Communicable Diseases and Trauma; Regional Collaboration in the Surveillance and Control of Communicable Diseases; Innovations in Health Professional Training using the ECSA College of Health Sciences Model; Global Health Diplomacy and Strengthening Ministries of Health Leadership and Governance Capacity for Health in the ECSA-HC Region; and Strengthening the Use of Evidence in Health Policy. ","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The environmental and health impacts of tobacco agriculture, cigarette manufacture and consumption","field_subtitle":"Novotny T; Bialous S; Burt L; Curtis C; da Costa V; Iqtidar S; Liu Y; Pujari S; d\u2019Espaignet E: Bulletin of the World Health Organization 93(12), 877-880, December 2015","URL":"http://www.who.int/bulletin/volumes/93/12/15-152744/en/","body":"The health consequences of tobacco use are well known, but less recognised are the significant environmental impacts of tobacco production and use. The environmental impacts of tobacco include tobacco growing and curing; product manufacturing and distribution; product consumption; and post-consumption waste. The World Health Organisation\u2019s Framework Convention on Tobacco Control addresses environmental concerns in Articles 17 and 18, which primarily apply to tobacco agriculture. Article 5.3 calls for protection from policy interference by the tobacco industry regarding the environmental harms of tobacco production and use. The authors detail the environmental impacts of the tobacco life-cycle and suggest policy responses.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The Ideal Clinic Programme 2015/16","field_subtitle":"Steinhobel R; Massyn N; Peer N: Health Systems Trust, 2015","URL":"http://www.hst.org.za/publications/ideal-clinic-programme-201516","body":"The Ideal Clinic programme was initiated by the South African National Department of Health (NDoH) in July 2013 in order to systematically improve Primary Health Care (PHC) facilities and the quality of care they provide. Provinces have submitted their three-year scale-up plans that indicate in which year each facility will reach Ideal Clinic status. Typically, the purpose of a health facility is to promote health and prevent illness and further complications through early detection, treatment and appropriate referral. An Ideal Clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicine and supplies, good administrative processes, and sufficient adequate bulk supplies. It uses applicable clinical policies, protocols and guidelines, and it harnesses partner and stakeholder support. It also collaborates with other government departments, the private sector and non-governmental organisations to address the social determinants of health.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The Ninth Call for Applications for the African Doctoral Dissertation Research Fellowships (ADDRF)","field_subtitle":"Deadline: 15 January 15, 2016","URL":"http://aphrc.org/african-doctoral-dissertation-research-fellowships-2016-call/","body":"The African Population and Health Research Center (APHRC), in partnership with the International Development Research Centre (IDRC), is pleased to announce the ninth call for applications for the African Doctoral Dissertation Research Fellowships (ADDRF). The ADDRF Fellowship Program seeks to facilitate more rigorous engagement of doctoral students in research, strengthen their research skills, and provide them an opportunity for timely completion of their doctoral training. The Program targets doctoral students with strong commitment to a career in training and/or research. The overall goal of the ADDRF Program is to support the training and retention of highly-skilled, locally-trained scholars in research and academic positions across the region. The ADDRF will award about 20 fellowships in 2016 to doctoral students who are within two years of completing their thesis at an African university. In this phase of funding and in consideration of IDRC\u2019s health programming priorities, candidates whose dissertation topics address health policy or health systems issues will be given special consideration. The application form and supporting documents (attached) must be submitted on email (see website for details).","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"We're listening out for your voice and practice on health justice in 2016","field_subtitle":"Editor, EQUINET newsletter","body":"\r\nThe EQUINET steering committee wishes you a healthy new year, and one that brings greater justice in our communities, countries and globally. \r\n\r\nThis is a short newsletter, given the time of year. However, the EQUINET newsletter is now 15 years old, and the monthly issues share a growing number of stories of both the challenges to health equity, and the many examples of innovative practice within the region. At a recent regional conference in 2015, delegates raised that in our east and southern African region, we still do not adequately document or publish what we are doing, so that our story is often told by others, or not at all. Until the lions write their story, tales of the hunt will always glorify the hunter. We have used the EQUINET newsletter to give more profile to publication from and on our region, and have included journal papers and reports, but also new media such as videos, online interviews, maps, tools, graphics and exhibits. We will be listening even more for this in 2016. \r\n\r\nSo we are asking you to please speak out and share your ideas, work and stories on health! Please send us your reports, papers, news, conference announcements   or other forms of information [to admin@equinetafrica.org], or write a short piece that we can use as an editorial. \r\n\r\nWe also invite you to be involved in the work that EQUINET will be carrying out in 2016 to inform and strengthen learning and action on health equity. Our website (www.equinetafrica.org) provides more information on these activities. \r\n\r\nWe look forward to working with you in the coming year! ","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"White paper: National Health Insurance for South Africa","field_subtitle":"Department of Health, Republic of South Africa, December 2015","URL":"http://tinyurl.com/hq8uanj","body":"This white paper outlines South Africa\u2019s path to universal health coverage over 14 years and proposes dramatic changes in the role of private medical aid among others. Released on the 10th of December 2015, the long awaited white paper begins by providing the background and justification of the country\u2019s moves to join other countries like the Brazil, the United Kingdom and Thailand in introducing universal healthcare coverage. The document notes that healthcare in South Africa is comprised of a two-tiered system divided along socio-economic lines. The private medical aid sector is comprised of 83 medical aid schemes that fund healthcare services for about 16 percent of the population. The paper noted that spending through medical schemes in South Africa is the highest in the world and is six times higher than in Organisation for Economic Co-operation and Development (OECD) countries. The paper argues that this two-tiered system has led to fragmented funding and risk pools in healthcare and posits that the creation of a National Health Insurance (NHI) will improve healthcare equity by combining fragmented private and public health funding pools and eliminating out-of-pocket payments.The paper notes that the NHI will ultimately deliver a comprehensive package of health services that include services such as rehabilitation and palliative care, mental health care including that related to substance abuse and maternal and child health care. The paper is made available to call for stakeholder feedback.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"World AIDS Day 2015 : The fast track map","field_subtitle":"UNAIDS: Geneva, 2015","URL":"http://www.unaids.org/wad2015/","body":"The world has committed to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals. This ambitious yet wholly attainable objective represents an unparalleled opportunity to change the course of history for ever - something our generation must do for the generations to come. If the world is to end the AIDS epidemic by 2030, rapid progress must be made by 2020. Quickening the pace for essential HIV prevention and treatment approaches will limit the epidemic to more manageable levels and enable countries to move towards the elimination phase. This graphic shows visually in a map the content and geographical areas for scale up to achieve global targets.","php":"","field_issue_date":"2016-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":" A Global Fund for Social Protection Floors: Eight Good Reasons Why It can Easily be Done","field_subtitle":"Chichon M: United Nations Research Institute for Social Development (UNRISD), Think Piece, 2015","URL":"http://www.unrisd.org/road-to-addis-cichon","body":"The author argues that social protection is the most direct tool we have to combat poverty and inequality and that implementation can begin when countries are at a relatively early stage of development. However, there are today a few countries which need the solidarity of others to close the social protection gap. This think piece puts forward eight good reasons why a global fund for social protection is needed and can easily be initiated. Here are eight good reasons why a global fund for social protection floors is needed and can easily be initiated, which the author elaborates on more fully in his think piece:  there already is a global consensus on social protection floors for all, the global community has already accepted that global solidarity may be needed to achieve social protection for all, there is no need to create a new fund, there already is one that can be used, the mandate and the supervisory mechanism for the fund do not have to be invented and the fund can start modestly, the potential direct impact on poverty could be huge. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"20 Years Later \u2013 The Role of Art and Justice in South Africa\u2019s Democracy","field_subtitle":"Sachs A; Justice Cameron E: African Futures, Essays, 2015","URL":"http://tinyurl.com/qb963zg","body":"At the entrance to the Constitutional Court of South Africa stands a sculpture of a large man yoked to a cart. His burden is a human one: a man and woman who themselves are seated on the back of a fourth figure kneeling on the cart. At first glance, the sculpture resonates with the history of servitude that marked the dehumanising institution of apartheid. On closer reflection, the sculpture reveals a more complex message. The sculptor, South African artist Dumile Feni, did not create any racial differentiation between the four figures, and the man drawing the cart is the only figure large and strong enough to accomplish this task. The title of the work is History, and the four figures carry each other in a way that reflects the dependence, the interconnectedness and the tension that have always characterised human relationships. History is the first of many artworks that challenge a visitor to the Constitutional Court to reflect on South Africa\u2019s tortured past and the country\u2019s transition to a constitutional order. The Constitutional Court Art Collection (CCAC)[1] is both a living monument to the ideals on which South Africa\u2019s post-apartheid Constitution is based and a reminder of the work that remains.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"African responses to the 2014/5 Ebola Virus Disease Epidemic","field_subtitle":"Loewenson R, Papamichail A, Ayagah I: EQUINET Brief, Harare, 2015","URL":"http://tinyurl.com/op2awdf","body":"There has been significant documentation on the various international responses to the 2014/5 Ebola epidemic in West Africa. There is also evidence that the epidemic\r\ntriggered new developments in epidemic prevention and response from Africa. In April 2015 the AU called for the lessons learned to be identified for future responses. This brief summarises the publicly available documentation on the response of African countries to the epidemic. It is based on 63 documents accessed through key word search in July\u2013August 2015 of online databases, supplemented by documents obtained from snowballing in September 2015. The brief presents evidence on\r\na. The actions taken by African governments and institutions at national, regional and continental level to support the response to the epidemic.\r\nb. The identified positive features and challenges in the African response.\r\nc. The links between the African emergency response to the EVD epidemic and health system strengthening.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Beyond the 'Single Story': 3Bute Turns African Lit Into Crowdsourced Comics","field_subtitle":"Kennedy C: Colorlines, July 2012","URL":"http://tinyurl.com/okp5mdc","body":"Artist Bunmi Oloruntoba and editor Emmanuel Iduma collaborate with reporters and creative writers to furnish \u201cthe contexts often missing when African stories are reported.\u201d Every two weeks, 3bute [pronounced \u201ctribute\u201d] publishes a three-page comic from a different African country in which readers tag the images like a wiki page with links to videos, articles, slide shows, twitter posts, music tracks, and other media. The resulting comic is dotted with icons that appear as you touch or move your mouse over its surface. The interactive features blink and pop as you shift from panel to panel in the site\u2019s effort to undermine \u201cthe single, one-dimensional story of poverty, sickness, conflict\u201d that far too often disparages the continent. 3bute uses new technology to explore the contours of African modernity through \u201cmultifaceted stories\u201d. This review includes excerpts of 3bute comics, worth reading while the 3bute website is temporarily being reconstructed. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Buen Vivir: Today's tomorrow","field_subtitle":"Gudynas E: Development 54(4), 441\u2013447, 2011","URL":"http://tinyurl.com/kjztzqa","body":"Eduardo Gudynas looks at the main trends of the discourse around Buen Vivir in South America as a political platform for different visions of alternatives to development. He notes that any alternative to development must open paths to move beyond the modern Western culture. Buen Vivir, he argues gives that opportunity. Buen Vivir or Vivir Bien, are the Spanish words used in Latin America to describe alternatives to development focused on the good life in a broad sense. The term is actively used by social movements, and it has become a popular term in some government programs and has even reached its way into two new Constitutions in Ecuador and Bolivia. It is a plural concept with two main entry points. On the one hand, it includes critical reactions to classical Western development theory. On the other hand, it refers to alternatives to development emerging from indigenous traditions, and in this sense the concept explores possibilities beyond the modern Eurocentric tradition. The richness of the term is difficult to translate into English. It includes the classical ideas of quality of life, but with the specific idea that well-being is only possible within a community. Furthermore, in most approaches the community concept is understood in an expanded sense, to include nature. Buen Vivir therefore embraces the broad notion of well-being and cohabitation with others and with nature. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Call for Expressions of Interests: Consultants","field_subtitle":"Deadline: 30 January 2016","URL":"http://www.ngopulse.org/opportunity/2015/09/18/call-expressions-interest","body":"Formed in 2006, the One in Nine Campaign is a network of organisations and individuals driven by feminist principles and the desire to live in a society where women are the agents of their own lives, including their sexual lives. The Campaign supports and advocates for the rights of women who speak out against sexual violence as well as other survivors in five ways: Solidarity in Action and Building Feminist Activism, Feminist Knowledge Production and Research, Media Advocacy, Justice and Legal Transformation and Direct Action. The One in Nine Campaign is calling for application from all interested individuals/service providers in the following fields: Organisational Development, Strategic planning and reviews, Resource Mobilisation /Fundraising for NGOs, Research, Documentation (written and/or visual), Monitoring and Evaluation, Staff development/Team building, Creative Arts for social change (all art forms welcomed), Health and Wellness, Marketing (especially for small businesses, NGOs, Cooperatives) and Setting up and registering of Cooperatives.  The organisation seeks to update its Consultants database and preference will be given to individuals who identify as Women and feminists and registered service providers that are led by Women.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Communities Deliver \u2013 The critical role of communities in reaching global targets to end the AIDS epidemic","field_subtitle":"UNAIDS; Stop AIDS Alliance: 2015","URL":"http://www.hst.org.za/sites/default/files/UNAIDS_CommunitiesDeliver_v24_original.pdf","body":"There is now wide recognition that community responses must play an increasing role in addressing the HIV epidemic in the years ahead. The UNAIDS Strategic Investment Framework, published in 2011, identifies community responses as a \u201ccritical enabler\u201d of service delivery. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has estimated that to achieve bold HIV treatment and prevention targets set in 2014, investments in community mobilisation and services must increase more than threefold between 2015 and 2020. Much of the critically important work in making progress in the response to HIV and implementing a Fast-Track approach that lies ahead\u2014including broadening the reach of services, supporting retention in care, increasing demand, monitoring quality, advancing human rights and combatting stigma and discrimination\u2014can only be achieved with a strong community voice and presence. This report draws on multiple sources to document the many ways in which communities are advancing the response to AIDS, and the evidence for the effectiveness of these responses. Core areas of community-based activities include advocacy, service provision, community- based research and financing; each of these areas is illustrated by examples of community- based actions.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Democratic Nursing Organisation of South Africa (DENOSA) 3rd South African Nurses' Conference","field_subtitle":"24 - 26 February 2016, Gauteng, South Africa","URL":"http://www.sanursesconference.co.za","body":"DENOSA is hosting the Third South African Nurses\u2019 Conference from the 24th to the 26th February 2016.This is a biannual event born out of a need to build capacity and create an enabling environment for South African nurses to effectively and positively influence health policy. It further affords the cadre an opportunity to critically analyse the South African health system and propose solutions. The Third South African Nurses\u2019 Conference 2016 explores the theme: Together we can strengthen the theory and the clinical practice; inspire unity in seeking solutions to challenges facing the profession. The theme will be explored according to the following track of interest: Advancing a Holistic Nursing practice; Investing in Nursing: The Human Capital in health; Contemporary Nursing Issues; The Threshing floor: Teaching and learning; Students voice as the rising nurse leaders.  The 3rd Conference intends to showcase the critical role nurses play in delivering holistic quality care. The Conference promises thought provoking plenary sessions, workshops and networking opportunities; with focus on the following tracks of interest: Advancing a Holistic Nursing practice; Investing in Nursing: The Human Capital in health; Contemporary Nursing Issues; The Threshing floor: Teaching and learning; Students voice as the rising nurse leaders. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"District Health Barometer, South Africa 2014/15","field_subtitle":"Massyn N; Peer N; Padarath A; Barron P; Day C: Health Systems Trust, 2015","URL":"http://www.hst.org.za/publications/district-health-barometer-201415-1","body":"The annually published District Health Barometer (DHB) in South Africa is designed and compiled to assist South Africa\u2019s National Department of Health in making health and related information available for monitoring progress in health service delivery at district level.  The Barometer provides current information on functioning and associated fluctuations in all the country\u2019s health districts, describing performance over time in relation to previous years as well as between districts. Each edition highlights problem areas, data quality issues, sustained and notable progress, and aspects requiring deeper research into underlying factors contributing to the indicator values and trends. This 10th edition of the DHB presents data on 44 indicators, with trend illustrations and health profiles for South Africa as a whole, the nine provinces and the 52 districts, as well as a chapter on the country\u2019s burden of disease. As in previous years, a varied picture emerges in terms of the national profile. Significant gains are noted in the rates of stillbirth; early mother-to-child transmission of HIV; cure among new pulmonary smear-positive TB patients; couple year protection; women under age 18 delivering babies in hospital; case fatality among children under five years of age from diarrhoea with dehydration and from pneumonia; and antenatal clients initiated on ART. However, persistent challenges prevail with regard to the Caesarean section rate in district hospitals, the school Grade 1 screening coverage, the measles 2nd dose coverage, and the case fatality rate for severe acute malnutrition in children under five years of age.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 178: Imagining healthy urban futures: from the back of our minds to the front of our streets","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Equity and Noncommunicable Disease Reduction under the Sustainable Development Goals","field_subtitle":"Bangura Y: United Nations Research Institute for Social Development (UNRISD), Think Piece, 2015","URL":"http://www.unrisd.org/road-to-addis-bangura","body":"Africa has enjoyed a growth momentum since 2000 after the wasted years of the 1980s and much of the 1990s. However, eradicating poverty will require huge resources, which existing funding strategies will be unable to generate. Global commodity prices have fallen sharply; capacity to mobilise domestic revenues is waning; and aid has been insufficient in plugging funding gaps. Revenue bargains in which states extract revenues from citizens in exchange for investments that impact positively on well-being may be key to financing Africa\u2019s development. They can substantially increase revenues, nurture effective state-citizen relations, force companies to pay correct taxes, push fragmented systems of service provision in the direction of universalism, improve policy space and make aid more effective.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Exploring the Future of Africa","field_subtitle":"AfroCyberPunk: 2015","URL":"http://www.afrocyberpunk.com","body":"AfroCyberPunk is a blog dedicated to exploring the future of Africa through various expressions of Afrofuturism in science and speculative fiction across all forms of media, relevant news and current events about ongoing socioeconomic, political, and technological developments, as well as academic discourses on issues and trends concerning the future of this incredibly diverse continent. As Africa enters a new phase of accelerated development, this blog aims to create a unique conceptual space in which to explore the various scenarios the continent is likely to encounter in the near and distant future, and to imagine how people might begin to address the enormous challenges and incredible opportunities that may soon become reality. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Fourth Global Symposium on Health Systems Research, 14-18 November 2016","field_subtitle":"Call For Abstracts And Organised Sessions","URL":"http://healthsystemsresearch.org/hsr2016/","body":"Health System Global announces the Call for Abstracts for the Fourth Global Symposium on Health Systems Research on the Symposium website. The theme is Resilient and responsive health systems for a changing world. Submissions are invited for both organized sessions and individual abstracts. Please visit the site to find out about: key dates and deadlines, how to submit your abstract and other details on taking part in the Symposium. Please also make sure to visit the site regularly as HSG will keep updating it with announcements and relevant resources in the coming months. Please share the call with colleagues and anyone else who might be interested. The deadline to submit a proposal for an Organized Session at the Fourth Global Symposium on Health Systems Research is 24 January 2016. If you haven\u2019t already, please have a look at the Call for Abstracts page on the Symposium website. Proposals can be submitted for Participatory Sessions and Panel Presentations.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Gender Blind: Rebuilding Health Systems in Conflict-Affected States - Mozambique","field_subtitle":"Building Back Better: Rebuild consortium. UK, 2015","URL":"http://www.buildingbackbetter.org/case-studies-2/mozambique","body":"Mozambique\u2019s health system reconstruction supports the team\u2019s conclusion that the reconstruction of health systems is mainly \u201cgender blind\u201d. In order to review whether the health system is gender equitable, the team assessed the country\u2019s progress against the framework of WHO\u2019s six aspirational building blocks of the health system. From the evidence the authors suggest that policy-makers in Mozambique have not adequately considered the role of gender in contributing to health or addressed women\u2019s and men\u2019s different health needs. Despite government commitment to gender mainstreaming, the health system is far from gender equitable. Donors have shied away from tackling the thorny issue of the social and cultural norms, including gender, which drive ill health. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Health Systems Trust Conference 2016","field_subtitle":"4-6 May 2016, Gauteng, South Africa","URL":"http://www.hstconference2016.org.za","body":"Health Systems Trust (HST) is hosting a conference from 4-6 May 2016 at the Birchwood Conference Centre, Boksburg, Gauteng.  Under the banner of Health for all through strengthened health systems: sharing, supporting, synergising, the event is designed to advance the global public health agenda in improving health outcomes.  The conference will provide a forum in which those who contribute in various ways to the South African health system can exchange ideas, develop support mechanisms for common challenges, and foster synergies between interested groups. The vision of the organisers is of a vibrantly non-conventional conference experience. The three-day conference will convene approximately 300 healthcare workers from the public and private sectors as well as policy- and decision-makers, civil society groupings and academics. The past decade has seen an unprecedented wave of change and reform in order to strengthen the effectiveness of health systems, primarily through the introduction of primary health care re-engineering, National Health Insurance, and quality improvement and assurance. In addition, a range of programmatic activities designed to move towards increasing life expectancy, decreasing maternal and child mortality and combating HIV and AIDS and decreasing the burden of disease from TB have been implemented on a wide scale. New initiatives such as the 90-90-90 targets and attainment of the Sustainable Development Goals bring a further dimension to health systems strengthening. Collaborations among healthcare workers and stakeholders have researched, devised and applied a range of strategies and models to translate these reforms into reality. The HST conference will provide an opportunity to discuss challenges faced and solutions adopted at various levels in the health system. To avoid losing the opportunity to share these lessons and curate related good practice as broadly as possible, the organisers encourage interested parties to be a part of this conference. Applications for pre-conference workshops, individual and poster abstracts, and for media submissions close Sunday 10 January 2016.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Honouring the value of people in public health: a different kind of p-value","field_subtitle":"Bishai D; Ghaffar A; Kelley E; Kieny M: Bulletin of the World Health Organization 93, 661-662, 2015","URL":"http://www.who.int/bulletin/volumes/93/9/14-149369/en/","body":"When faced with a complex public health problem there is a natural urge to find solutions. People hire consultants, gather data, test hypotheses and examine P-values to identify risk factors: data-driven technological fixes get implemented every day. In the right situation, there is nothing wrong with solutionism \u2013 the belief that all difficulties have technical solutions. Solutionism works well for circumscribed problems involving a small number of motivated individuals, where every element of the prescribed solution can be implemented as planned. However, complex problems in public health usually have elements that defy planning, because health involves people, and people are unpredictable. Recent research has shown that integrating community participation in the planning and implementation of health reforms is a key factor in supporting health improvements.  The approach has been applied in a variety of areas including: the control of infectious disease; reducing maternal deaths and improved birth outcomes; enabling better health seeking behaviours; improving quality of life by promoting healthy environments through improvements to housing, reducing crime and building social cohesion. Critical factors for achieving trust include allowing participants to see their common concerns and building strong relationships within health committees or participatory groups. There must be a commitment to sustain long-lasting relationships between the community, local health workers and managers. Technical solutions for health problems are still needed. The authors argues there is still need the familiar P-value because biological evidence is necessary, but public health practice also needs to recognize the value of people. Regardless of the political environment, the power of the state to alter health decisions inside the home has limits. Only an approach that values, honours and engages people can alter how they make decisions about their health.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"iCCM policy analysis: strategic contributions to understanding its character, design and scale up in sub-Saharan Africa","field_subtitle":"George A; Rodr\u00edguez D; Rasanathan K; Brandes N; Bennett S: Health Policy and Planning 30 (suppl 2): ii3-ii11, 2015","URL":"http://heapol.oxfordjournals.org/content/30/suppl_2/ii3.full","body":"Pneumonia, diarrhoea and malaria remain leading causes of death for children under 5 years of age and access to effective and appropriate treatment for sick children is extremely low where it is needed most. Integrated community case management (iCCM) enables community health workers to provide basic lifesaving treatment for sick children living in remote communities for these diseases. While many governments in sub-Saharan Africa recently changed policies to support iCCM, large variations in implementation remain. As a result, the collaboration represented in this supplement examined the policy processes underpinning iCCM through qualitative case study research in six purposively identified countries (Niger, Burkina Faso, Mali, Kenya, Malawi and Mozambique) and the global context. The authors introduce the supplement, by reviewing how policy analysis can inform: (a) how to frame iCCM and negotiate its boundaries, (b) how to tailor iCCM for national health systems and (c) how to foster accountability and learning for iCCM. In terms of framing, iCCM boundaries reflect how an array of actors use evidence to prioritise particular aspects of child mortality (lack of access to treatment), and how this underpins the ability to reach consensus and legitimate specific policy enterprises. When promoted at national level, contextual health system factors, such as the profile of CHWs and the history of primary health care, cannot be ignored. Adaptation to these contextual realities may lead to unintended consequences not forseen by technical or managerial expertise alone. Further scaling up of iCCM requires understanding of the political accountabilities involved, how ownership can be fostered and learning for improved policies and programs sustained. Collectively these articles demonstrate that iCCM, although often compartmentalised as a technical intervention, also reflects the larger and messier real world of health politics, policy and practice, for which policy analysis is vital, as an integral component of public health programming.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Imagining healthy urban futures: from the back of our minds to the front of our streets","field_subtitle":"Thandiwe Loewenson, PhD student, Bartlett School of Architecture ","body":"\r\n\u2018Life is a series minor explosions whose echo, fading away, settles comfortably at the back of our minds\u2019 - Dambudzo Marechera\r\n\r\nBy 2050, over 1.2 billion people will live in sub-Saharan Africa's cities, with a potential for growing differences on what people gain from them and in their quality of life. Young people today will be living that future and wonder what kind of healthy, or unhealthy futures the cities hold for them. Health literature is full of talk of targets and data, but speaks little of these dreams and fears. \r\n\r\nWhen a fee hike of nearly 12% was proposed in South Africa this year, students took to the streets in protest. The protests against the exclusion the fees implied for poor families linked street action to social media using the hashtag \u2018#feesmustfall\u2019. They connected with student protests against racial inequalities in academia earlier in the year and ended with a statement from President Zuma that fee rises would be ruled out for the next year. Spread on twitter, facebook, blogs and news outlets, the images of protest by students, \u2019born frees\u2019 who never experienced apartheid rule, evoked images of 1976 student protests against apartheid language policies. These protests, nearly 40 years apart, have very different contexts, notwithstanding the generational rift that some say has grown in these four decades in South Africa between those who fought the \u2018struggle\u2019 who are now in government, and those \u2018born free\u2019 after 1994, resisting policies of exclusion, new and old. However, both previous and current struggles appear to have been driven by imagining a different future. In a 2013 interview, Achille Mbembe noted how the promise and vision of a different, just future was a key driver in the anti-colonial struggle. Youth today continue to envision a just future, and protest where the actions of the present governing institutions take them away from it. \r\n\r\nHow we imagine, visualize, communicate and share the imaginings of our futures appears to be important for how we organise to realise them. One force affecting future wellbeing in east and southern Africa is urbanisation. Masterplans for many African cities were shaped by colonial policies of segregation, at a time where today\u2019s growth and poverty levels were not anticipated. The way cities and people have grown in and around these initial urban plans can appear disorganised, violent and unhealthy, with infrastructural and social challenges, where formal institutions and services struggle to cope using current resources and tools. For example, Lusaka, Zambia was built to a colonial garden city plan that has been taken over by \u2018unplanned\u2019, and formerly illegal, settlements on its North, South and Western fringes. A new masterplan is being implemented in the city, drawn up in 2009 by the Japan International Cooperation Agency, commissioned by the Zambia Ministry of Local Government and Housing and Lusaka City Council. It seeks to address the challenges by restructuring the city and demolishing homes and businesses in the formerly \u2018unplanned\u2019 settlements, all of which are sites of Lusaka\u2019s significant informal activity. Aspects of such plans, which include \u2018multi-facility economic zones\u2019 to attract foreign investment and low density gated developments, portray a vision of an African urban future which excludes some and privileges others. \r\n\r\nIronically, those engaged in informal waste recycling in the city are currently drawing some income from these developments, as they have created a source of construction waste which can be collected and recycled into further building materials in the city. Women, facing significantly lower earnings than men, play a significant role in recycling construction waste, innocently contributing to the construction of spaces that will ultimately exclude them, economically and physically, pushing them into less healthy and more marginal spaces. Filip De Boeck in \u2018The Johannesburg Salon\u2019 in 2011, highlights this irony, pointing to a similar process in Kinshasa. He adds that this not only affects peoples\u2019 physical conditions, but also their imaginings of their cities and even their own self-image and perceived place within the cities. Farmers at risk of relocation due to a \u2018Cit\u00e9 du Fleuve\u2019 development commented to him, \"Yes, we'll be the victims, but still it will be beautiful.\" \r\n\r\nAlternative practices reflect and support different imaginings of urban futures and the power residents have to affect them. A recently formed Master\u2019s in Spatial Planning program at the University of Zambia (UNZA) has, for example, investigated informal sites in Lusaka, home to nearly three quarters of the city\u2019s inhabitants, according to C. Swope in 2014. The University is advancing a \u2018Community Led Slum Upgrading and Planning Studio\u2019 project in collaboration with the Lusaka City Council and the non- government organisation \u2018People\u2019s Process on Housing and Poverty in Zambia\u2019. This work brings together students, local government officers, civil society members and residents to decentralise how urban plans are made, sharing and learning from their different experiences, capacities and visions  of the city and its future. For example, in the Mahopo Enumeration Project in 2015, the university and the Peoples Process on Housing and Poverty in Zambia, Zambia Homeless and Poor Peoples Federation and Lusaka City Council collectively surveyed the Mahopo Informal Settlement in Lusaka. They engaged young people living in the area to survey their own environments and analyse the information gathered. Through this the community identified health and education facilities as priority areas of concern, followed by the quality of housing units and access to markets. The actions proposed by residents, students and council involve all stakeholders in their implementation. \r\n \r\nIn the battle for ideas, there is power in who draws, controls and shares visions, even more so with the expansion of information and social media. Beyond the statistics of mortality and disease, or the numbers of toilets and coverage rates, those who seek to build healthy cities should not forget to engage with our visions of the future, especially those we hold as young people. Edgar Pieterse of the African Centre for Cities described, at an International workshop on African cities in 2012, how imagined visions of the future in the speculative design of cities have been used in neoliberal discourse to assess risk and promote designs that contribute to social exclusion. But speculation of the future, in design, art, writing, science and politics, also provides a space that can be occupied by communities to imagine and share alternative futures. Speculation and visioning is by definition born from the inside, from one\u2019s imagination. As seen with South Africa\u2019s students or the alternative urban design in Lusaka, when residents, students and other social groups are given space to shape and communicate vision, it can be a potent motive force in bringing people together to resist harmful practice, and more importantly to realise fairer, more inclusive alternatives. \r\n\r\nThis issue of the newsletter highlights some of the spaces where this kind of imagining is taking place. For example, Justices Sachs and Cameron, of South Africa\u2019s Constitutional Court, describe how the Court\u2019s Art Collection provides a repository of visions of the ideals of human dignity, equality and freedom in the country. These pieces communicate the values of the court and engage the collective imagination in ways that words cannot. Jonathan Dotse, curator and writer on AfroCyberPunk, explores a future Accra in his short story \u2018Virus!\u2019 in which a young woman\u2019s control of her health is mediated by an internal \u2018biocore\u2019 computer connected to a city wide digital grid, which 3bute hyperlink to videos, drawings and other imagined narratives from the continent on people\u2019s scenarios of future urban epidemics. OpenParlyZW is an online non-partisan initiative created by a group of young people to demystify what is taking place in parliament for young people, using social media, opening new conversations around these \u2018houses of power\u2019 in their futures. These and other examples in the newsletter provide many ways in which sites of dreaming, counterfactual thinking and urban speculation are taking place, all aiming to reinvigorate the social and political imaginary and open opportunities for inclusion in the thinking about and struggle for healthy African urban futures. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Improved identification and enrolment into care of HIV-exposed and -infected infants and children following a community health worker intervention in Lilongwe, Malawi","field_subtitle":"Ahmed S; Kim MH; Dave AC; Sabelli R; Kanjelo K; Preidis GA; Giordano TP; Chiao E; Hosseinipour M; Kazembe PN; Chimbwandira F; Abrams EJ: Journal of the International AIDS Society 18(1),19305, 2015","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287633/","body":"Early identification and entry into care is critical to reducing morbidity and mortality in children with HIV. The objective of this report is to describe the impact of the Tingathe programme, which utilises community health workers (CHWs) to improve identification and enrolment into care of HIV-exposed and -infected infants and children. Three programme phases are described. During the first phase, Mentorship Only (MO) (March 2007\u2013February 2008) on-site clinical mentorship on paediatric HIV care was provided. In the second phase, Tingathe-Basic (March 2008\u2013February 2009), CHWs provided HIV testing and counselling to improve case finding of HIV-exposed and -infected children. In the final phase, Tingathe-PMTCT (prevention of mother-to-child transmission) (March 2009\u2013February 2011), CHWs were also assigned to HIV-positive pregnant women to improve mother-infant retention in care. The authors reviewed routinely collected programme data from HIV testing registers, patient mastercards and clinic attendance registers from March 2005 to March 2011. During MO, 42 children (38 HIV-infected and 4 HIV-exposed) were active in care. During Tingathe-Basic, 238 HIV-infected children (HIC) were newly enrolled, a six-fold increase in rate of enrolment from 3.2 to 19.8 per month. The number of HIV-exposed infants (HEI) increased from 4 to 118. During Tingathe-PMTCT, 526 HIC were newly enrolled over 24 months, at a rate of 21.9 patients per month. There was also a seven-fold increase in the average number of exposed infants enrolled per month (9.5\u201370 patients per month), resulting in 1667 enrolled with a younger median age at enrolment (5.2 vs. 2.5 months). During the Tingathe-Basic and Tingathe-PMTCT periods, CHWs conducted 44,388 rapid HIV tests, 7658 (17.3%) in children aged 18 months to 15 years; 351 (4.6%) tested HIV-positive. Over this time, 1781 HEI were enrolled, with 102 (5.7%) found HIV-infected by positive PCR. Additional HIC entered care through various mechanisms (including positive linkage by CHWs and transfer-ins) such that by February 2011, a total of 866 HIC were receiving care, a 23-fold increase from 2008. A multipronged approach utilising CHWs to conduct HIV testing, link HIC into care and provide support to PMTCT mothers can dramatically improve the identification and enrolment into care of HIV-exposed and -infected children.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity","field_subtitle":"Stasse S; Vita D; Kimfuta J; da Silveira VC; Bossyns P; Criel B: Global Health Action 8(25480), 2015","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307026/","body":"Commercialisation of health care has contributed to widening inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalisation of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalise the use of resources. The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"In Memory of Chimusoro Sam Moyo ","field_subtitle":"","body":"In deep sorrow we mourn the sudden and untimely death of Sam Moyo, profound scholar and progressive activist, beloved comrade, Member of the Executive Committee of IDEAs. Sam was in New Delhi, India to participate in a conference on \"Labour Questions in the Global South\" when a car he was travelling in was involved in a terrible accident. Sam was critically hurt and passed away on 22 November 2015. We send sympathies to his family. The words below are by Bella Matambanadzo.  \"An unimaginable loss has happened. Our phenomenal intellectual pan African giant on land issues, Professor Sam Moyo, has died following injuries sustained during a terrible car accident in New Delhi, India. We are in disbelief. We are waiting for him to come home. We feel ripped apart with pain....\"","php":"Further details: /newsletter/id/56574","field_issue_date":"2015-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Interview with Jean Pierre Bekolo","field_subtitle":"Simo D: Goethe-Institut e.V., 2015","URL":"http://tinyurl.com/nb2x6d2","body":"Memory and African identity are of primordial importance to Jean Pierre Bekolo, who through his films, highlights the desire to \u201cwrite from a particular place and not for an audience\u201d because one can be easily manipulated by the expectations of an audience. Bekolo spends time in Europe, US and Africa. Travelling becomes a substantial part of his creative process.\r\nEach of his movies stands out as a phase or the break with a phase of his artistic development: Quartier Mozart symbolises origins, family and identity, Aristotle\u2019s Plot represents the identity of an African cineaste, while Les Saignantes is speculation or science fiction. Despite his numerous sojourns, Bekolo\u2019s energy is always focused on Africa and Cameroon in particular, where he believes cinema has to go beyond representation and shed more light on questions which will lead to change, a concept noticeable in his latest movie Le President. Bloke, who describes himself as not just an artist but \u2018a radiologist of the society\u2019 emphasises the role that film and fiction has to play in affecting change, \u2018we must not forget the aesthetic dimension, because the beauty and the real have a link: aesthetic and ethics.\u2019","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"New Media in Africa and the Global Public Sphere","field_subtitle":"Jacobs S: African Futures, Essays, 21 February 2013","URL":"http://tinyurl.com/o3pmtwz","body":"In analysing the relationship between a \u201cglobal public sphere\u201d and social media on the African continent, the generalisations are argued to hide a far more interesting set of observations. Debates and discussions about what passes for a global public sphere often overlook and obscure dynamics of power. What is defined as the global public sphere by most observers and scholars is still very much limited to the industrial north and their public and private broadcasting systems, twitter handlers, and blogs. The term also refers, by default, it is argued, to debates and deliberation solely in English. This ignores the discussions in media in the Global South, especially social media. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Notes on Imagination ","field_subtitle":"Gamedze T: Johannesburg Workshop in Theory and Criticism, The Salon (8), 2015","URL":"http://jwtc.org.za/the_salon/volume_9/thuli_gamedze.htm","body":"The author argues that psychological violence of colonialism today only exists as a re-enactment, or a reframing of the original physical warfare between colonialist and colonized bodies. He argues that contemporary images and representation still repeat the violence  within popular culture, within academic curricula, literature, mainstream music, art, architecture, theatre, that pervades the contemporary world in ways that continue to suppress imagination. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Obesity trends and risk factors in the South African adult population","field_subtitle":"Cois A; Day C: BMC Obesity 2(42), October 2015,","URL":"http://www.biomedcentral.com/2052-9538/2/42","body":"Obesity prevalence is increasing globally and contributes substantially to the burgeoning burden of non-communicable diseases. South Africa is particularly affected by this increasing trend and cross-sectional evidence suggests socioeconomic and behavioural variables as possible drivers. However, no large scale longitudinal study has attempted the direct identification of risk factors for progression towards obesity. This study analysed data on 10,100 South African adults (18 years and over) randomly selected in 2008 and successfully recontacted in 2010 and 2012. Latent Growth Modelling was used to estimate the average rate of change in body mass index (BMI) during the study period, and to identify baseline characteristics associated with different trajectories. The overall rate of change in BMI during the study period was +1.57 kg/m 2 per decade, and it was higher among women than among men. Female gender, younger age, larger waist circumference, white population group and higher household income per capita were baseline characteristics associated with higher rates of change. The association between tobacco use and obesity was complex. Smoking was associated with greater waist circumference at baseline but lower rates of increase in BMI during the study period. Quitting smoking was an independent predictor of BMI increase among subjects with normal weight at baseline. Among subjects with baseline BMI lower than 25 kg/m 2 , rates of changes were higher in rural than urban areas, and inversely related to the frequency of physical exercise. A strong positive trend in BMI remains in South Africa and obesity prevalence is likely to increase. Trends are not homogeneous, and high risk groups (subjects with high socioeconomic status, rural dwellers, young women) and modifiable risk factors (physical inactivity) can be targeted. Subjects quitting smoking should receive additional weight-loss support in order that the numerous health benefits of cessation are not reduced by increasing BMI. Centrally obese subjects should be targeted in campaigns.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"On the Nairobi Ministerial of the WTO: A joint statement by African and Indian civil society","field_subtitle":"Pambuzuka News 748, 2015","URL":"http://www.pambazuka.org/en/category/features/95908","body":"In a joint statement released and endorsed by nearly 200 organisations across Africa and India on the occasion of the Third India-Africa Forum Summit taking place in New Delhi this week, African and Indian civil society reminds their governments of the key issues at stake at the forthcoming WTO Ministerial which will take place in Nairobi in December. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"PASS presents: Revolting Songs with Neo Muyanga ","field_subtitle":"Muyanga N: Pan African Space Station, Chimurenga Magazine, 2015","URL":"https://www.youtube.com/watch?v=ggM9mG05REw","body":"This Pan African Space Station (PASS) broadcast recorded at the Chimurenga headquarters features Neo Muyanga, Soweto-born composer and musician living in Cape Town. Revolting Music is a survey of the songs of protest that liberated South Africa. Muyanga argues that it often comes as something of a surprise to many visitors to find that people in South Africa, sang and danced throughout the decade of the 1980\u2019s \u2013 a period many agree was one of the most violent phases in the struggle against the system of apartheid, and yet the people sang and made art fervently during this time. These acts were not merely stratagems for fun but the songs were a part of the arsenal in the fight to secure democratic rights for all and to overthrow the government. During his recording, Neo Muyanga presents a series of anecdotes and medleys of songs of protest from the era of the 80\u2019s \u2013 songs of his youth \u2013 juxtaposed against new songs he has composed in response to the challenges of new socio-political realities in South Africa today.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy?","field_subtitle":"Chilundo B; Cliff J; Mariano A; Rodr\u00edguez D; George A: Health Policy and Planning 30 (suppl 2): ii36-ii45, 2015","URL":"http://heapol.oxfordjournals.org/content/30/suppl_2/ii54.full","body":"In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. The authors undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded \u2018old\u2019 CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. The authors\u2019 analysis represents a nuanced assessment of the various domains that influence CHW programme sustainability, highlighting strategic areas such as CHW payment and programme financing. These organizational and contextual determinants of sustainability are central to CHW programme strengthening and iCCM policy support.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Results Report","field_subtitle":"The Global Fund: Geneva, 2015","URL":"https://digital.theglobalfund.org/Share/g7v2p4o7rn15uy4r1318kedpoemivsla","body":"This report delivers a summary of the impact and results the Global Fund partnership was able to achieve by 2015, showing cumulative progress since the Global Fund was created in 2002. It is a collective effort, combining the strong contributions made by governments, civil society, the private sector and people affected by HIV, TB and malaria. Here are the cumulative highlights: 17 million lives saved; on track to reach 22 million lives saved by the end of 2016, a decline of one-third in the number of people dying from HIV, TB and malaria since 2002, in countries where the Global Fund invests, 8.1 million people on antiretroviral treatment for HIV, 13.2 million people have received TB treatment and 548 million mosquito nets distributed through programs for malaria. Building resilient and sustainable systems for health is critically important to end HIV, TB and malaria as epidemics. Overall, more than one-third of the Global Fund\u2019s investments go to building resilient and sustainable systems for health. The Global Fund estimates that approximately 55 to 60 percent of its investments benefit women and girls, with a positive impact on reproductive health. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Spoken Word Performance on Female Gential Mutilation (FGM)","field_subtitle":"Ali A: afro\u2019disiatic Xpressions, 2015","URL":"https://www.youtube.com/watch?v=MRVDGYqeVk4&feature=youtu.be","body":"This video production/story is about women and female gentital mutilation (FGM). The video narrative is an amalgamation of many women's stories. The story is created under the notion that \"it takes a village to tell a woman's story; it takes a village for a woman's voice to be heard.\" The work is part of a wider project entitled \"Dear Mother\" created by Daapo Reo. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The Modern Titanic. Urban Planning and Everyday Life in Kinshasa.","field_subtitle":"De Boeck F: Johannesburg Workshop in Theory and Criticism, The Salon (4), 2011","URL":"http://jwtc.org.za/volume_4/filip_de_boeck.htm","body":"The author raises that the covert violence, the risk, the uncertainty and the possibility of daily life in Kinshasa resides in the gap between official visions and unofficial reality. Using two cases in which water is being turned into land, Filip De Boeck reveals the need to envision a \u2018near future' that hyphenates dream and reality; a plan predicated on incremental transformation rather than destructive, radical, exclusionary change.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The Re-emerging African Debt Crisis","field_subtitle":"Azikiwe A: Pambuzuka News (750), November 2015","URL":"http://www.pambazuka.net/en/category.php/features/96007","body":"By the end of the 1990s, significant portions of the African debt had been written off or re-scheduled. Today this problem is re-emerging due to several factors including the decline in commodity prices, growing class divisions and reliance on foreign direct investment. In 2015, Africa\u2019s sovereign debt levels rose to 44 percent of GDP,  a 10 percent rise from 2010. The author argues this follows patterns of previous years which problems arising from several factors including the decline in commodity prices, growing class divisions and reliance on foreign direct investment.  This financial crisis emanates from Wall Street and other centres of borrowing throughout capitalist states. Within the leading industrialised countries of the West, there has still not been a full recovery from the economic crisis of 2007-2009. Unemployment remains high and consumer spending is low due to the loss of wages and household wealth. Consequently, the availability of credit to African states will be far more limited during the second decade of the 21st century than what prevailed in the 1980s, 1990s and the 2000s. The continuing dependency on the neo-colonial system will serve as an impediment to not only national but regional and continental integration and economic planning. The author argues that these issues require more of a political response rather than economic and that genuine political independence and sovereignty of African states must lead to the rejection of the conditions established by the IMF and World Bank. ","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The State of the World's Antibiotics, 2015","field_subtitle":"Gelband H; Miller-Petrie M; Pant S; Gandra S; Levinson J; Barter D; White A; Laxminarayan R: Centre for Disease Dynamics, Economics and Policy, 2015  ","URL":"http://www.cddep.org/publications/state_worlds_antibiotics_2015_executive_summary","body":"The State of the World\u2019s Antibiotics summarises the status of antibiotic use and resistance around the globe. The report challenges the prevailing argument that the biggest obstacle facing antibiotic resistance is a lack of new drugs in the \u201cantibiotic pipeline.\u201d New antibiotics are part of the solution, but only when coupled with conservation: strong antibiotic stewardship in its broadest sense, which involves limiting overuse of antibiotics in humans and livestock. CDDEP\u2019s Global Antibiotic Resistance Partnership (GARP) of low- and middle-income countries provided both data and insight into the challenges in those countries and how they can be met successfully.  Chapters cover human antibiotic resistance and use, resistance and use in agriculture and the environmental consequences of all use, maintaining the supply of antibiotic effectiveness and what works at the country level to minimise the spread of antibiotic resistance and maximise the positive impact of antibiotics.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Youth in Zimbabwe Have Just Opened the Doors to Parliament","field_subtitle":"Mutizamhepo T: Kalabash Media, November 2015","URL":"http://tinyurl.com/pqpy7jz","body":"Since independence, Parliament and its processes have been treated by young people as something alien to them, their needs, views and aspirations. As a result, for years the youth has had certain conceptions, some true and some false over the business that is conducted within the walls of parliament in Harare. As such, the author argues that Zimbabwean youths\u2019 views were never put into consideration, decisions with a direct bearing on them were made without their input, simply put, the youth saw Parliament business in Zimbabwe as having nothing of interest to them and as a mere preserve for the older generation. However, all this is set to be a thing of the past. Parliament debates, bills, thrills, spills and lighter moments will soon be easily accessible in just a few clicks on a smartphone, anywhere, anytime, thanks to OpenParlyZW, an online non-partisan initiative created by a group of enthusiastic youths with the aim of bridging the gap and demystifying misconceptions existing between the youth and Parliamentarians. The group believes that to move forward the youth need to be a part of this conversation and should at least know what\u2019s going on in the houses of power and participate in the future of the nation. OpenParlyZW will run as a standalone platform but also on Twitter and Facebook among other social media platforms capturing events each time Parliament sits and providing young people with vital information.","php":"","field_issue_date":"2015-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"'Sembene!'","field_subtitle":"Obenson TA: Shadow and Act, October 2015","URL":"http://tinyurl.com/oqlmjwp","body":"\"Sembene!\" is a feature documentary on continental Africa's most celebrated filmmaker, the late Ousmane Sembene, from co-directors Samba Gadjigo (author of Sembene\u2019s official biography) and Jason Silverman. SEMBENE! tells the true story of the self-taught novelist and filmmaker who fought, against enormous odds, a 50-year battle to give Africans the power to tell their own stories. SEMBENE! is told through the never-before-seen archival footage and verite footage. It follows an ordinary man who transforms himself from a manual labourer into a fearless and often polarizing spokesman for the marginalized, becoming a hero to millions. The film is about, not only Sembene, but also about the importance of reclaiming African stories. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Achieving universal health coverage in East and Southern Africa: what role for for-profit providers?","field_subtitle":"Doherty J: Paper presented at the Panel session T03P13: Private sector and universal health coverage - examining evidence and deconstructing rhetoric International Conference on Public Policy, 1-4 July 2015, Milan, Italy","URL":"http://www.equinetafrica.org/bibl/docs/PRIVATE%20PRACT%20T03P13Jane%20Doherty.pdf","body":"This paper considers evidence on the effectiveness, equity and sustainability of for-profit private provision, and the effectiveness of government\u2019s stewardship of the sector, in East and Southern Africa. It draws conclusions about policy and regulatory requirements to encourage for-profit providers to make a more useful contribution towards achieving universal health coverage in the region. The author observes a recent increase in the size of a formerly relatively small for-profit private sector in some countries in the region, but also the emergence of 'boutique\u2019 hospitals (targeted at the high-income local market, expats and foreign NGO workers, as well as medical tourism) in otherwise underdeveloped settings. As warned by the international literature that critiques the commercialisation of health care, such developments could worsen inequity and destabilise national health systems if inadequately regulated.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"African leaders discuss future of Africa beyond 2015","field_subtitle":"Bridges Africa, September 2015","URL":"http://tinyurl.com/o5xn948","body":"Africa\u2019s development agenda beyond 2015 was at the heart of discussions at the 15th International Economic Forum in Africa: \u201cAfrica beyond 2015\u201d, in Berlin in September 2015. According to the OECD, Africa\u2019s gross domestic product (GDP) growth is expected to strengthen to 2016 but poverty and hunger rates remain stubbornly high, progress in health and education is uneven, and huge inequalities persist between and within countries, and between women and men. Furthermore, low productivity and investment as well as weak or non-existent infrastructure are holding back economic and development progress. A panel of African leaders suggested that regional development strategies and local assets provide possible solutions to these challenges, and discussed special economic zones, economic corridors, strategies for lagging regions and slum upgrading for promoting regional development, overcoming spatial inequalities, mobilising local resources and creating productive employment opportunities. The importance of the Common African Position on the Post-2015 Development Agenda \u201cto speak with one voice and to act in unity to ensure that Africa\u2019s voice is heard and is fully integrated into the global development agenda,\u201d was highlighted.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Africa\u2019s new institution to promote food security","field_subtitle":"Nakweya G: SciDevNet, September 2015","URL":"http://tinyurl.com/nz4zzf9","body":"Agricultural experts and policymakers have formed a new institution to promote sustainable food systems in Sub-Saharan Africa and to deal with the challenges posed by climate change. The African Ecosystem Based Adaptation for Food Security Assembly (EBAFOSA) which aims to advocate for sustainable ecosystem-friendly agricultural systems was formed during the 2nd Africa Ecosystem Based Adaptation for Food Security Conference held in Kenya on 30-31 July, 2015. Africa loses about six million of productive land a year through deforestation, with almost 65 per cent of the continent\u2019s land being under pressure from land degradation, the conference heard. The EBAFOSA will work towards achieving food security, ecological productivity, job creation, poverty reduction, value addition and sustainable industrial development in Africa.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Call for an interested consultant","field_subtitle":"Submissions by November 24 2015","body":"EQUINET is seeking a consultant with experience in writing media and promotional materials and knowledge of health and health systems for work in early 2016 to produce a document, drawing on existing materials and inputs provided by institutions in EQUINET, on EQUINETs nature, composition, work, and the impact it has had, that can be used to better explain and promote EQUINETs nature and role with partners and funders in and beyond the region. We ask consultants to submit a CV and a sample of similar work they have produced by November 24th 2015 to admin@equinetafrica.org ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Call for Expressions of Interests: Consultants","field_subtitle":"Deadline: 30 January 2016","URL":"http://www.ngopulse.org/opportunity/2015/09/18/call-expressions-interest","body":"Formed in 2006, the One in Nine Campaign is a network of organisations and individuals driven by feminist principles and the desire to live in a society where women are the agents of their own lives, including their sexual lives. The Campaign supports and advocates for the rights of women who speak out against sexual violence as well as other survivors in five ways: Solidarity in Action and Building Feminist Activism, Feminist Knowledge Production and Research, Media Advocacy, Justice and Legal Transformation and Direct Action. The One in Nine Campaign is calling for application from all interested individuals/service providers in the following fields: Organisational Development, Strategic planning and reviews, Resource Mobilisation /Fundraising for NGOs, Research, Documentation (written and/or visual), Monitoring and Evaluation, Staff development/Team building, Creative Arts for social change (all art forms welcomed), Health and Wellness, Marketing (especially for small businesses, NGOs, Cooperatives) and Setting up and registering of Cooperatives.  The organisation seeks to update its Consultants database and preference will be given to individuals who identify as Women and feminists and registered service providers that are led by Women.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for participation to delphi study : NHWA - Compendium of HWF Indicators","field_subtitle":"WHO, 1-15 November 2015","URL":"http://www.who.int/hrh/documents/brief_nhwfa/en/","body":"The World Health Organization Health Workforce Department is inviting you to participate in a Delphi study to be conducted as part of a broader agenda to develop and implement National Health Workforce Accounts (NHWA) in support of the implementation of the Global strategy on human resources for health: health workforce 2030  (GSHRH) which will be submitted to the Sixty-ninth World Health Assembly in May 2016. The concept of NHWA calls for a harmonized, integrated approach for annual and timely collection of health workforce information. Fundamentally, the purpose of NHWA is to structure the information architecture and interoperability, to define core workforce indicators, to enable strategic workforce planning and to facilitate comparability of the health workforce landscape (within countries and across regions). The purpose of this study is to acquire the views of a global group of health systems experts on the relevance, availability and use of existing health workforce indicators working towards a core set of well-defined indicators. These  indicators will be mapped against the proposed NHWA modules. Should you be interested to participate, the study tool will be available on line from 1-15 November 2015 and would require about 30 minutes to complete. Please confirm your interest and availability by return email to workforce2030@who.int  with a subject line: NHWA \u2013 Delphi Study, with the following information: First name; Surname; professional title; \r\naffiliation; country; email address  and telephone.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for watchers: 138th Executive Executive Board (EB138) World Health Organisation meeting ","field_subtitle":"25-30 January 2016, Geneva, Switzerland","URL":"http://www.phmovement.org/en/wwvolunteerinfo","body":"People's Health Movement (PHM) is preparing for another round of watching at the 138th Executive Executive Board (EB138) meeting taking place from 25 to 30 January 2016 in Geneva, Switzerland. PHM believes that the World Health Organisation (WHO) is the legitimate space for global health policy making. Through the WHO Watch initiative, PHM intervenes in the discussion of WHO's key decisions making bodies and brings the voice of the movements struggling for Health for All. PHM are in the early stages of putting together the Watch and hope to get more and new watchers from around the world involved, consulting with country circles on key issues, and developing a solid commentary on issues of interest discussed at the meetings. During the meeting, PHM will have a skype channel open where the key points of the discussions will be shared.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Can world\u2019s worst case of inequality be fixed with Pikettian posturing?","field_subtitle":"Bond P: Pambuzuka News, Issue 745, October 2015","URL":"http://www.pambazuka.net/en/category.php/features/95689","body":"Among the hot ideological wars South Africans wage, the author suggests that none is as violent to the truth as the rejigging of the Gini Coefficient measuring income inequality. (This number is zero if everyone shares income perfectly equally, and one if only a sole person gets it all.) The author suggests that if you measure income prior to state redistribution, South Africa\u2019s Gini \u2013 as measured in November 2014 by the World Bank \u2013 is 0.77, the highest of any major country. The World Bank\u2019s Pretoria office is reported to claim that the Gini is reduced from 0.77 to 0.59 once all manner of state social spending (social grants, education and health) is included in the calculation. The author projects, however, that the National Development Plan (NDP) will reduce the Gini only from 0.69 (in 2012 measured slightly differently from the Bank) to 0.60, i.e., with the income share earned by the poorest 40 percent rising from 6 to just 10 percent. This, it is noted, will make South Africa's levels of inequality higher than any other major country in the world. Bond indicates that a policy of growth-through-redistribution is needed for the country but that advancing this depends on the balance of political forces more than ideological debates. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"CFH Grants 2016 Round 1for NGOs Working for the Development of Conservation, Food and Health in Developing Countries","field_subtitle":"Deadline for submission of concepts: 1 January 2016","URL":"http://tinyurl.com/ncdulhl","body":"The Conservation, Food and Health Foundation is currently accepting concept notes for its first round of 2016 Grants. Non-profit organisations in developing countries that are focusing in one of the three fields \u2013 conservation, food and health are invited to apply. The foundation supports projects that demonstrate strong local leadership, promote professional development in the conservation, agricultural, and health sciences; develop the capacity of local organisations; and address a particular problem in the field. Average grant size is US$17,000. Grant request can be made for maximum US$25,000. Conservation Grants aims to improve ecological and environmental conditions in the developing world. Research activities, training, and technical assistance efforts are supported under Conservation Grants. Food Grants are allocated to efforts aimed at improving access to food for consumption in developing countries.  Health Grants are focused at programs that are preventive in nature. Research, technical assistance, and training projects are supported under Health Grants. It supports research, technical assistance, and training projects that improve public health through community-based efforts that address health promotion, disease prevention, family planning, and reproductive health; and increase the understanding and treatment of tropical diseases. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities","field_subtitle":"George  AS; Mehra V; Scott K; Sriram V: PLOS One, DOI: 10.1371/journal.pone.0141091, October 23, 2015 ","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0141091","body":"This paper explores the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries.\r\nIt used  peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion interventions (78%, 202/260), even though they were less participatory than other health systems areas. Community involvement in governance and supply chain management was less common (12%, 30/260 and 9%, 24/260 respectively), but more participatory. Articles cut across all health conditions and varied by scale and duration, with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service availability, accessibility and acceptability, with fewer efforts focused on quality, and few designs able to measure impact on health outcomes. With regards to participation, most articles supported community\u2019s in implementing interventions (95%, n = 247/260), in contrast to involving communities in identifying and defining problems (18%, n = 46/260). Many articles did not discuss who in communities participated, with just over a half of the articles disaggregating any information by sex. Articles were largely under theorized, and only five mentioned power or control. Majority of the articles (57/64) described community participation processes as being collaborative with fewer describing either community mobilization or community empowerment. Intrinsic individual motivations, community-level trust, strong external linkages, and supportive institutional processes facilitated community participation, while lack of training, interest and information, along with weak financial sustainability were challenges. Supportive contextual factors included decentralization reforms and engagement with social movements. Despite positive examples, community participation in health systems interventions was variable, with few being truly community directed. Future research should more thoroughly engage with community participation theory, recognize the power relations inherent in community participation, and be more realistic as to how communities participate and cognizant of who decides that.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Competition: African Voices Photography ","field_subtitle":"Deadline: 1 December 2015","URL":"http://www.ucl.ac.uk/african-studies/african-voices","body":"University College London (UCL) invite staff members or students of any African university to submit photographs which capture personal stories and experiences of contemporary Africa. The winning selections will be exhibited in physical form and online as part of the AfricanVoices season at UCL and then displayed by the UCL African Studies Research Centre (Institute of Advanced Studies) on walls, online and at other events with the photographer\u2019s name displayed clearly in each case. The best overall entry will be awarded a tablet and there will be four runners-up prizes for the best photograph in each category. Photographs will be judged in four categories: Cities, Health, Human Wellbeing and Intercultural Interaction. The competition is not open to professional photographers.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Declaration of the 3rd World Social Science Forum","field_subtitle":"Council for the Development of Social Science Research in Africa (CODESRIA): September 2015","URL":"http://codesria.org/spip.php?article2447","body":"The World Social Science Forum 2015 served as a platform for presenting new knowledge and insights, re-thinking received wisdom, charting new directions, promoting innovation in the research-policy-action nexus, and nurturing new international partnerships. Issues of justice and growing inequalities at global, regional, national and local levels and their impact on the quality of life of populations as well as on the sustainability of resources justified the theme: 'Transforming Global Relations for a Just World'. Participants declared their concern with the consequences of injustice and inequality for the quality of life for global populations as well as with the sustainability of global resources.  The participants declared to:  (a) Pursue theoretical and empirical research including development of reliable and multi-dimensional indicators on inequalities and injustices; (b) Produce evidence to highlight issues requiring urgent attention and action, support advocacy and inform policies to respond to them; (c) Support efforts to address asymmetries, disparities, divides, and lack of autonomy in knowledge production through the creation of transformative knowledge programs; (d) Participate in programs and efforts that aim to end injustice and inequality; (e) Make every effort to reduce income inequalities and promote equity, starting with scientific institutions where they have influence; (f) Support measurable progress to overcome inequalities, including through the implementation of the Sustainable Development Goals; (g) Promote policies, programs, and values that act to end gender inequality; (h) Promote the integration of youth in work places through providing them with the necessary skills to enter the labour force; (i) Support efforts to achieve legally binding and universal agreement on avoiding dangerous anthropogenic interference with the climate system; and (j) Promote inclusive societies based on universal values and human rights. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era? An Analysis of Trends and Determinants across 74 Low- and Middle-Income Countries","field_subtitle":"Alkenbrack S; Chaitkin M; Zeng W; Couture T; Sharma S: PLoS ONE 10(9), September 2015, doi:10.1371/journal.pone.0134905","URL":"http://media.wix.com/ugd/35c673_015bd4d0defc4b1fb9238be8c10b86ef.pdf","body":"Despite widespread gains toward the 5th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country\u2019s progress, or lack thereof, toward more equitable RH and MH service coverage. The authors used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014 in both relative and absolute equity. Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measured as the share of government spending allocated to health) were significantly associated with higher equity of service coverage. Neither country income, i.e., GDP per capita, nor better governance were significantly associated with equity.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Differences in essential newborn care at birth between private and public health facilities in eastern Uganda","field_subtitle":"Waiswa P; Akuze J; Peterson S; Kerber K; Tetui M; Forsberg BC; Hanson C: Global Health Action 8(10),  March 2015, doi: 10.3402/gha.v8.24251","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385204/","body":"In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. This study described the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. The authors collected data from mothers with infants at baseline and endline using a structured questionnaire among private and public health facilities. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both private and public sector facilities, and a greater emphasis on tracking access to and quality of care in private sector facilities.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 177: Poorest countries still begging for access to medicines, while rich countries reap super- profits","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evaluating Universal Health Coverage as a Sustainable Development Goal","field_subtitle":"Chapman A: Health and Human Rights Journal, Blog, September 2015","URL":"http://tinyurl.com/ornum2h","body":"The Sustainable Development Goals (SDGs) identify achieving universal health coverage (UHC) as one component of the omnibus health goal, \u201cto ensure healthy lives and promote well-being for all at all ages.\u201d The components of UHC specified in goal 3.8 of the SDGs reflect World Health Organisation\u2019s policy documents and include financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all. On the positive side, UHC can be considered to be an expression of the right to health. Indeed, several health and human rights advocates had earlier proposed replacing the various health-related goals in the MDGs with the single overarching health goal of UHC in the SDGs, provided that it specify that international assistance is essential, not optional, for countries otherwise unable to pursue UHC. Significant progress toward UHC, consistent with the requirements of the right to health, would have the potential of enabling the one billion people currently estimated to not have access to the health services they need each year to obtain them. The author argues, however, that not all potential paths to a universal health system are consistent with human rights requirements, even ones that result in some expansion of health coverage. For that reason it is important that health and human rights advocates and scholars identify the essential features of UHC and policies for advancing toward this goal from a human rights perspective. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Financing sustainable development and developing sustainable finance: A DESA Briefing Note on the Addis Ababa Action Agenda ","field_subtitle":"Third International Conference on Financing for Development, Addis Ababa, Ethiopia, 13-16 July 2015","URL":"http://tinyurl.com/qj7gdf9","body":"Achieving the 2030 Agenda for Sustainable Development requires trillions of dollars annually. The authors indicate that global public and private investment would be sufficient \u2013 but only if financial resources were invested in and aligned with sustainable development. This requires a comprehensive approach, which mobilises public finance, sets appropriate public policies and regulatory frameworks, unlocks the transformative potential of people and the private sector, and incentivises changes in consumption, production and investment patterns in support of sustainable development. The Addis Ababa Action Agenda (AAAA) presents a policy framework that realigns financial flows with public goals. Official development assistance (ODA) remains crucial, particularly for countries most in need, but alone is not be sufficient. The AAAA addresses all sources of finance: public and private, domestic and international and stresses the importance of long-term investment, and the need for all financing to be aligned with sustainable development. It includes several new commitments by Governments: A new social compact to provide social protection and essential public services for all; A global infrastructure forum to bridge the infrastructure gap; An \u2018LDC package\u2019 to support the poorest countries; A Technology Facilitation Mechanism to advance to the SDGs; Enhanced international tax cooperation to assist in raising resources domestically; Mainstreaming women\u2019s empowerment into financing for development. Additional cross-cutting issues include scaling up efforts to end hunger and malnutrition, promoting inclusive and sustainable industrialisation, full and productive employment and decent work for all, peaceful and inclusive societies, and protecting the ecosystem.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Fourth Global Symposium on Health Systems Research, 14-18 November  2016","field_subtitle":"Call for abstracts and organised sessions","URL":"http://healthsystemsresearch.org/hsr2016/","body":"Health System Global announces the Call for Abstracts for the Fourth Global Symposium on Health Systems Research on the Symposium website. The theme os Resilient and responsive health systems for a changing world. Submissions are invited for both organized sessions and individual abstracts. Please visit the site to find out about: key dates and deadlines, how to submit your abstract and other details on taking part in the Symposium. Please also make sure to visit the site regularly as HSG will keep updating it with announcements and relevant resources in the coming months. Please share the call with colleagues and anyone else who might be interested.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation","field_subtitle":"You D; Hug L; MA; Ejdemyr S; Idele P; Hogan D; Mathers C; Gerland P; Rou New J; Alkema L; The Lancet, September 2015, doi: http://dx.doi.org/10.1016/S0140-6736(15)00120-8","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00120-8/fulltext","body":"In 2000, world leaders agreed on the Millennium Development Goals (MDGs). MDG 4 called for a two-thirds reduction in the under-5 mortality rate between 1990 and 2015. The authors aimed to estimate levels and trends in under-5 mortality for 195 countries from 1990 to 2015 to assess MDG 4 achievement and then intended to project how various post-2015 targets and observed rates of change will affect the burden of under-5 deaths from 2016 to 2030. To provide insights into the global and regional burden of under-5 deaths associated with post-2015 targets, the authors constructed five scenario-based projections for under-5 mortality from 2016 to 2030 and estimated national, regional, and global under-5 mortality rates up to 2030 for each scenario. The global under-5 mortality rate has fallen from 90\u00b76 deaths per 1000 livebirths (90% uncertainty interval 89\u00b73\u201392\u00b72) in 1990 to 42\u00b75 (40\u00b79\u201345\u00b76) in 2015. The global under-5 mortality rate reduced by 53% (50\u201355%) in the past 25 years and therefore missed the MDG 4 target. Based on point estimates, two regions\u2014east Asia and the Pacific, and Latin America and the Caribbean\u2014achieved the MDG 4 target. 62 countries achieved the MDG 4 target, of which 24 were low-income and lower-middle income countries. Between 2016 and 2030, 94\u00b74 million children are projected to die before the age of 5 years if the 2015 mortality rate remains constant in each country, and 68\u00b78 million would die if each country continues to reduce its mortality rate at the pace estimated from 2000 to 2015. If all countries achieve the Sustainable Development Goal of an under-5 mortality rate of 25 or fewer deaths per 1000 livebirths by 2030, the authors project 56\u00b70 million deaths by 2030. About two-thirds of all sub-Saharan African countries need to accelerate progress to achieve this target. Despite substantial progress in reducing child mortality, concerted efforts remain necessary to avoid preventable under-5 deaths in the coming years and to accelerate progress in improving child survival further. Urgent actions are needed most in the regions and countries with high under-5 mortality rates, particularly those in sub-Saharan Africa and south Asia.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Guidance on using needs-based formulae and gap analysis in the equitable allocation of health care resources in East and Southern Africa","field_subtitle":"McIntyre D; Anselmi L: EQUINET Discussion Paper 93 updated. Health Economics Unit (UCT), EQUINET: Harare","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20RA%20manual%20Sep2015.pdf","body":"The equitable allocation of limited public sector health care resources across population groups is a critical mechanism for promoting health system equity and efficiency. The population groups are often defined by geographic areas that correspond to administrative authorities. The use of a needs-based resource allocation formula to calculate target allocations for each province or region and each district is becoming increasingly popular in countries where health care is publicly funded and provided. Target allocations are defined according to the relative need for health services in each geographic area, quantified using indicators such as population size, demographic composition, levels of ill health and socio-economic status. EQUINET has supported the development of needs-based resource allocation formulae in a number of east and southern African countries in the past. The methods for developing such a formula are summarised in this paper. Our work in the region has persuaded us that it is necessary to supplement the development of a formula with other initiatives to support the successful implementation of the resource allocation processes. To facilitate the gradual shifting of resources, the equity target allocations calculated through the formula must be linked explicitly to national and local planning and budgeting processes.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Inequity in costs of seeking sexual and reproductive health services in India and Kenya","field_subtitle":"Haghparast-Bidgoli H et al:  International Journal for Equity in Health 14(84), 2015","URL":"http://www.equityhealthj.com/content/14/1/84/","body":"Information on access to SRH services, the direct costs of seeking care and a range of socio-economic variables were obtained through structured exit interviews with female SRH service users in Mysore (India) and Mombasa (Kenya). The costs of seeking care were analysed by household income quintile (as a measure of socio-economic status). The Kakwani index and quintile ratios are used as measures of inequitable spending. Catastrophic spending on SRH services was calculated using the threshold of 10 % of total household income. The results showed that spending on SRH services was highly regressive in both sites, with lower income households spending a higher percentage of their income on seeking care, compared to households with a higher income. Spending on SRH as a percentage of household income ranged from 0.03\u20137.5 % in Kenya, with a statistically significant difference in the proportion of spending on SRH services across income quintiles. The poorest households in Kenya spent ten times more on seeking care than the least poor households. The most common coping mechanisms were receiving [money] from partner or household members and using own savings or regular income. Highly regressive spending on SRH services highlights the heavier burden borne by the poorest when seeking care in resource-constrained settings. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Insights for taking Results Based Financing to scale","field_subtitle":"Health Partners International, Montrose International: Policy Brief, Northern Uganda Health, UK, August 2015","URL":"http://resources.healthpartners-int.co.uk/wp-content/uploads/2015/10/Insights-for-taking-RBF-to-scale_Policy-Brief_NU-Health-2015.pdf","body":"There is increasing interest in understanding how Results Based Financing (RBF) can improve efficiency, effectiveness and accountability in programming towards\r\nUniversal Health Coverage and improved health outcomes at scale. The Northern Uganda Health (NU Health) is a controlled implementation study to assess the costs and benefits of RBF relative to conventional Input Based Financing (IBF). The study design aimed to isolate the main effect of the financing modality in terms of quality and quantity of health service provision.  Programme data and the results of an independent evaluation confirm a range of key findings.  These include: A significant reduction in barriers to access and increase in health service utilisation; a three to eight fold improvement in adherence to standard treatment algorithms/quality of care for the major childhood killers:  diarrhoea, malaria and pneumonia; and, particularly dramatic improvements in care and utilisation at the lowest level facilities, harbouring the promise of real progress toward Universal Health Coverage.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Let\u2019s Walk Our Talk: Making Concrete Commitments on Financing the Sustainable Development Agenda","field_subtitle":"Schmidt H; Barnhill A: PLoS Med 12(9), 8 September 2015, doi:10.1371/journal.pmed.1001872","URL":"http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001872","body":"Despite criticism, the MDGs are widely praised for having galvanised national and international development efforts in unprecedented ways. Currently proposed successor Sustainable Development Goals (SDGs) seek to address newly emerged policy issues and include a call to significantly reduce the burden of non-communicable diseases (NCDs). NCDs directly impact health inequality and poverty. Their recognition is timely and to be welcomed categorically. However, ambiguity in the SDGs\u2019 current guidance risks that states\u2019 efforts to reduce NCDs exacerbate socioeconomic and health inequalities, rather than reduce them. The authors urge that more attention needs to be given to improving the situation of the worst off and make three concrete proposals towards this end. Existing policy guidance highlights cost-effective interventions for NCDs, but focusing just on cost-effectiveness risks exacerbating socioeconomic and health inequalities rather than reducing them. The authors suggest that in implementing the SDGs, targets and interventions that benefit the worst off should be prioritised. The United Nations should develop practical guidance to assist policy makers at the country level with incorporating equity considerations.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"MSF seeks international probe into Kunduz hospital hit, possible war crime","field_subtitle":"Raja K: Third World Network (TWN) Info Service on Health Issues, 8 October 2015","URL":"http://www.twn.my/title2/health.info/2015/hi151005.htm","body":"Medecins Sans Frontieres (MSF) has called for an investigation by an international humanitarian fact-finding commission into a US airstrike on its hospital in the Afghanistan city of Kunduz and for one of the States, party to the Additional Protocols to the Geneva Conventions, to invoke it. MSF said the attacks took place despite the fact that it had provided the GPS coordinates of the trauma hospital to Coalition and Afghan military and civilian officials as recently as Tuesday, 29 September. The attack continued for more than 30 minutes after MSF first informed US and Afghan military officials in Kabul and Washington that it was a hospital that was being hit. The International Humanitarian Fact-Finding Commission was established under the Additional Protocols to the Geneva Conventions and was officially constituted in 1991 to investigate allegations of violations of international humanitarian law. According to the Commission's website, some 76 countries have recognised the Commission, which is based in Bern, but so far, it has not yet been called upon to conduct any investigation. In her remarks to the media, MSF President Liu said that international humanitarian law is not about \u2018mistakes'. \"It is about intention, facts and why....This was not just an attack on our hospital - it was an attack on the Geneva Conventions. This cannot be tolerated. These Conventions govern the rules of war and were established to protect civilians in conflicts - including patients, medical workers and facilities. They bring some humanity into what is otherwise an inhumane situation.\"","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Nairobi, Kenya to host 10th WTO Ministerial Conference","field_subtitle":"World Trade Organisation (WTO), 10 December 2014","URL":"https://www.wto.org/english/news_e/news14_e/minis_10dec14_e.htm","body":"The General Council, on 10 December 2014, agreed that the 10th Ministerial Conference be held in Nairobi, Kenya from 15 to 18 December 2015. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"New Household Economy Approach software developed by Evidence for Development","field_subtitle":"Seaman J: Evidence for Development, July 2015","URL":"http://tinyurl.com/p3qjw9n","body":"The household economy approach (HEA) is a method for assessing the vulnerability of rural populations to economic shocks and changes, based on their livelihood patterns and market information. It is now widely used as a method of famine early warning by many governments and humanitarian agencies, and also has important applications for managing the impacts of climate change on poverty and food security in developing countries. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Politics and Organizational Capacities of Selected Key Fiscal and Social Institutions in Uganda","field_subtitle":"Katusiimeh MW; Kangave J: United Nations Research Institute for Social Development (UNRISD), Working Paper, August 2015","URL":"http://www.unrisd.org/katusiimeh-kangave","body":"This paper is part of a series of outputs from the research project on The Politics of Domestic Resource Mobilisation for Social Development. It examines the linkages between resource mobilisation and social outcomes by looking at institutions that play a key role with respect to resource mobilisation and social spending in Uganda. It looks at three institutions\u2014the Uganda Revenue Authority (URA), Kampala Capital City Authority (KCCA) and the Ministry of Health (MoH)\u2014which were selected because they are key organisations in either revenue collection or social service delivery or both, and all three were targets of reforms with varying degrees of success. The paper analyses how these institutions compare with respect to political prioritization, and in particular, to what extent they benefit from key institutional reforms and organizational capacity. The analysis reveals how varying political interests in, and priorities of, public institutions serve to explain differences in the delivery of public services and their organizational capacity. It illustrates the bigger picture that only politically important organizations\u2014those perceived to be key for the political survival of the ruling elite\u2014are well equipped with resources. The findings also stress the point that organizations that tend to perform better do so because they are politically prioritized and offered political protection. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Poorest countries still begging for access to medicines, while rich countries reap super- profits ","field_subtitle":"Riaz K Tayob, South Africa","body":"\r\nThe poorest countries in the world have been unable to reach agreement at the World Trade Organisation (WTO) on relief from global rules that would allow access to much needed medicines for their citizens. The 16 October 2015 meeting to resolve the impasse has been suspended indefinitely according to reports by IP-Watch in Geneva.  \r\n\r\nAt the forefront of resistance to this application from least developed countries  (LDCs) were the United States, Canada and Australia, in positions raised in June and again on 16 October.  The LDCs have a two-fold demand that amounts to a request for a waiver from the application of WTO rules on intellectual property (IP) rights, such as patents (which protect owners of new medicines), data and marketing rights. Firstly, they have requested an extension of the 2013 waiver related to pharmaceutical products, currently expiring on 1 January 2016. Secondly, they have petitioned through Uganda, as LDC representative, for a general exemption from applying the WTO intellectual property rights agreement (TRIPS), granted until 2021. Their position is that it ought to be granted for as long as countries remain designated as least developed according to the United Nations.  Most LDCs are in Africa.\r\n\r\nOver 140 non-governmental organisations have come out in support of the LDC petition. M\u00e9decins Sans Fronti\u00e8res accused the US, Australia and Canada of seeking to worsen access to medicines in LDCs by weakening the exceptions granted to them. \r\nSome reports imply that  LDCs were \u2018collateral damage\u2019 for other IP interests for the US. The US Trade Representative failed to reach the high standards of protection sought in the mega-regional trade and regulatory agreement called the Trans-Pacific Partnership (TPP). Commercial US stakeholders were reported in an October 2015 paper by Knowledge Ecology International (KEI) to be upset with the concessions made in this flagship trade deal, with an informed but unnamed source stating, \"the TPP did not deliver as expected on IP [Intellectual Property] and so we are under a lot of pressure not to give in more on IP.\" \r\nIn contrast, the LDCs\u2019 proposals were supported by developing countries, including Cambodia, Cuba, Brazil, China, Uruguay and by the Africa Group. Norway and the European Commission also supported the LDCs request, as did the World Health Organization (WHO), the United Nations Development Programme and UNAIDS. \r\n\r\nThe costly nature of pharmaceutical drug production and the complex rules on production for export to countries with public health needs requires the certainty of a permanent waiver. According to James Love of KEI, \"A permanent waiver of drug patent obligations is needed. No country will amend its patent laws if the waiver is limited in time, like the previous extensions...\u201d\r\n\r\nThe public health basis for the LDC application is also evident. In a statement in June 2015, Uganda\u2019s representative put the case to WTO members that 63% of people living with HIV in LDC countries still had no access to appropriate treatments. The United Nations Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States in its 2014 report indicated that most LDCs had not yet met the Millennium Development Goals on health, stating that LDCs \u201calso need financial and technological support to derive maximum development benefits from the waivers granted under the WTO TRIPS agreement.\u201d  \r\n\r\nLDCs, as the poorest countries in the world, serve as some measure of the level of civilisation of the global economic order. These countries are in effect asked to repeatedly expend scarce domestic resources and diplomatic capital supplicating rich countries at the WTO for exemptions from international rules that clearly do not take their interests into account. It is refreshing that the WHO is taking the side of the LDCs and access to medicines in this instance as the position has been less clear in the past. For example, Third World Network raised in 2010 that the WHO initiatives on \u201ccounterfeit\u201d drugs threatened medicines access by conflating legitimately produced generic drugs with drugs that were illegally produced or traded, given that the term \u2018counterfeit\u2019 is used to denote trademark infringements in intellectual property rules. \r\n\r\nThe LDCs request for a waiver signals that the access to medicines activism that secured the 2001 WTO Doha Declaration on Public Health was just the start of a battle against vested interests pursuing profits at the expense of human life. The 2001 Declaration was in fact a statement of legal rights that all countries enjoyed already, but over which poor countries had to ensure legal certainty at global level as they were under threat. For example, the US Special 301 list designated countries deemed to violate intellectual property rights, as unilaterally imposed sanctions with negative economic and reputational effects. Given that the WTO disciplines unilateral action by states that affects multilateral trade, the US undertook to not use Special 301 in violation of the WTO, according to Chakravarthi Raghavan in 2000. However the US repeatedly breached this undertaking, such as in its placement of Thailand on the 2007 watch list for issuing compulsory licenses for patented pharmaceutical products. \r\n\r\nThe industry has significant lobbying power and the preponderantly US-based branded products pharmaceutical industry is one of the most profitable in the world. According to a 2014 BBC report, the sector made a 42% margin of profit in 2013 in the US, compared to about 29% for the banks. Many US pharmaceutical companies held tens of billions of dollars offshore to avoid US taxes, according to Bloomberg\u2019s Richard Rubin on 4 March 2014.The cost of such concentrated corporate power is evident in the fact that US medicines prices are almost twice that compared to other developed countries.  US policies are rationalised with ideas of free trade, competition and the full functioning of markets. The super-profits being made by branded pharmaceutical companies should lead even free trade proponents to be concerned about the enormous rents they extract from the market. The suspension of discussions on the LDC waiver on Friday coincided with the US and developed countries stating they would also not make binding commitments for special treatment of LDCs on other issues at the next WTO Ministerial meeting scheduled for 15 to 18 December in Nairobi. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Providing guidance to empower LMIC health teams","field_subtitle":"British Medical Journal; University of Cape Town Lung Institute's Knowledge Translation Unit: BMJ, UK, 2015","URL":"http://tinyurl.com/ng3v45n","body":"BMJ has partnered with the University of Cape Town Lung Institute's Knowledge Translation Unit (UCTLI KTU), to develop and distribute the Practical Approach to Care Kit (PACK) programme to healthcare workers in low to middle income countries. The PACK programme is a comprehensive clinical practice aid that enables healthcare practitioners to diagnose and manage common conditions. It covers 40 common symptoms and 20 conditions including cardiovascular disease, respiratory diseases, tuberculosis, HIV/AIDS, women\u2019s health, and end-of-life care. PACK is updated annually to comply with local clinical policy, regulations and essential drug lists, and is translated where necessary. It incorporates regular evidence updates from BMJ and other credible sources including WHO, to ensure that it is relevant and provides the latest best practice guidance. The programme has been implemented in Botswana and in the Zomba district of Malawi. Extensive interest in PACK has been received from other middle to low income countries. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Reflections on global economic governance at the \u201cstart of a new era\u201d","field_subtitle":"Mel\u00e9ndez-Ortiz R: Bridges Africa 4(8), October 2015","URL":"http://tinyurl.com/od5ojso","body":"With the recent adoption of a new global development agenda for the next 15 years and negotiations on a new climate regime ongoing, what\u2019s changed for governance of the global economy in the last two decades, and what have we learned? This article maps the shifting context for trade, investment, and sustainable development. It puts global governance efforts into historical context of a globalised economy with lesser attention paid to questions of equity and social inclusion, and an underestimation of persistent and deep-rooted asymmetries in capabilities among countries at different levels of development and perilous levels of inequality among and within most countries around the world. The author suggests that global governance will continue to be a matter of striking the balance between global direction-setting, monitoring the ongoing leadership role of government policy, and supporting the subsidiary implementation of commitments at ground level. The paper points to aligning national policies and ensuring trade and investment systems work for sustainable development rather than funding discrete projects. The author argues that policies, their frameworks and the institutions needed to implement them constitute the most powerful lever for change.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Revenue Bargains Key to Financing Africa\u2019s Development","field_subtitle":"Bangura Y: United Nations Research Institute for Social Development (UNRISD), Think Piece, UNRISD, Geneva, 2015","URL":"http://www.unrisd.org/road-to-addis-bangura","body":"Africa has enjoyed a growth momentum since 2000 after the wasted years of the 1980s and much of the 1990s. However, eradicating poverty will require huge resources, which existing funding strategies will be unable to generate. Global commodity prices have fallen sharply; capacity to mobilise domestic revenues is waning; and aid has been insufficient in plugging funding gaps. Revenue bargains in which states extract revenues from citizens in exchange for investments that impact positively on well-being may be key to financing Africa\u2019s development. They can substantially increase revenues, nurture effective state-citizen relations, force companies to pay correct taxes, push fragmented systems of service provision in the direction of universalism, improve policy space and make aid more effective.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Shaking the Habitual: End Extreme Wealth ","field_subtitle":"The Knife: October 2015","URL":"http://theknife.net/shaking-the-habitual/","body":"This satirical presentation by Swedish electronic music duo The Knife explores \u201cthe newest millennium goal\u201d  \u2013 end extreme wealth. More than 40 panels feature various experts expounding on the problems faced by the extremely wealthy using much of the same language that is used to describe the world\u2019s poorest. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Solidarity and responsibility: Struggle between two lines","field_subtitle":"Tandon Y: Pambuzuka News 747, 22 October 2015","URL":"http://www.pambazuka.net/en/category.php/features/95834","body":"The author writes that the World Trade Organisation (WTO) is firmly located in an old ethical order which puts profit over people; where those in power make the rules to suppress the powerless; and where this iniquitous and unjust world \u201corder\u201d (disorder) is legitimised by the ideology of neoliberalism. He states that progressive people must defy this iniquitous system and overturn it as it is not reformable. He observes that it is one that could be neutralised if Africa was united to challenge the WTO and the \"Big and Powerful\". At the Seattle WTO Ministerial in November 1999 Africa and the global South neutralised the WTO with the help of world peoples' movements fighting for justice for the weak in the international trading system. The Tenth Ministerial Conference (MC10) of the WTO in Nairobi is not just Africa\u2019s war. Trade negotiations in Geneva are said to be carried out in a \"surreal\" atmosphere where the forest is missed for the trees. In this piece the author argues that the Nairobi negotiations will be behind closed doors where the 'Empire' will use all means at its command to secure a \"consensus\" that serves its interest and where those from the grassroots resist being drawn into that consensus if that does not do justice to grassroots people and communities. He notes that economics is girded firmly in the politics of power and that power, in turn, is legitimised by an ideology, in this case the ideology of neoliberalism. Those who are fighting for justice thus have to tackle all three levels \u2013 economic, political and ideological. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"South African Health Review 2015/16 Call for Chapters","field_subtitle":"Deadline for submission of abstracts: 30 November 2015 Deadline for full manuscripts:  29 February 2016","URL":"http://www.hst.org.za/news/south-african-health-review-201516-call-chapters","body":"The South African Health Review (SAHR), published annually by Health Systems Trust (HST) for 18 years, is an accredited peer-reviewed journal that is widely respected as an authoritative source of research, analysis and reflection on health systems. The SAHR advances knowledge agenda-setting, production and sharing. Being published in the Review affords authors the opportunity to participate in and contribute to a recognised and established community of expertise which offers a South African perspective on prevailing local and international public health issues. Concepts for chapter submissions should represent manuscripts that highlight critical commentary on current areas of significant interest or debate, and offer empirical understandings for improving South Africa\u2019s health systems reform and application of health policy, focusing on innovative and good practice models. Researchers, educators, students, policy-makers, planners, capacity-builders, managers and specialist practitioners in the field of health systems and related health development disciplines are invited to submit abstracts for the 2015/16 SAHR to editor@hst.org.za Guidelines for authors can be downloaded via the below link. Strict adherence to these guidelines is essential. Submission of an abstract for the SAHR does not guarantee acceptance. All manuscripts will undergo systematic peer review according to documented standards.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Astronomy of Africa's Health Systems Literature During the MDG Era: Where Are the Systems Clusters?","field_subtitle":"Phillips JF; Sheff M; Boyer CB: Global Health: Science and Practice 3(3), 482-592, 2015","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570019/","body":"Growing international concern about the need for improved health systems in Africa has catalysed an expansion of the health systems literature. This review applies a bibliometric procedure to analyse the acceleration of scientific writing on this theme. The authors focus on research published during the Millennium Development Goal (MDG) era between 1990 and 2014, reporting findings from a systematic review of a database comprised of 17,655 articles about health systems themes from sub-Saharan African countries or subregions. Using bibliometric tools for co-word textual analysis, the authors analysed the incidence and associations of keywords and phrases to generate and visualise topical foci on health systems as clusters of themes. Results show that African health systems research is dominated by literature on diseases and categorical systems research topics, rather than on systems science that cuts across diseases or specific systemic themes. Systems research is highly developed in South Africa but relatively uncommon elsewhere in the region. Results identify several themes that are unexpectedly uncommon in the country-specific health systems literature. This includes research on the processes of achieving systems change, the health impact of systems strengthening, processes that explain the systems determinants of health outcomes, or systematic study of organisational dysfunction and ways to improve system performance. Research quantifying the relationship of governance indicators to health systems strengthening is nearly absent from the literature. Long-term experimental studies and statistically rigorous research on cross-cutting themes of health systems strengthening are rare. Studies of organisational malaise or corruption are virtually absent. Trend analysis shows the emergence of organisational research on specific priority diseases, such as on HIV/AIDS, malaria, and tuberculosis, but portrays a lack of focus on integrated systems research on the general burden of disease. If health systems in Africa are to be strengthened, then organisational change research must be a more concerted focus in the future than has been the case in the past.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The Mandela Washington Fellowship for Young African Leaders","field_subtitle":"Application deadline: 9:00pm GMT Wednesday 11 November, 2015","URL":"https://youngafricanleaders.state.gov/washington-fellowship/","body":"The Mandela Washington Fellowship for Young African Leaders, begun in 2014, is the flagship program of President Obama\u2019s Young African Leaders Initiative (YALI) that empowers young people through academic coursework, leadership training, and networking. In 2016, the Fellowship will provide 1,000 outstanding young leaders from Sub-Saharan Africa with the opportunity to hone their skills at a U.S. higher education institution with support for professional development after they return home. The Fellows should be between the ages of 25 and 35, have established records of accomplishment in promoting innovation and positive change in their organizations, institutions, communities, and countries. The 2016 fellowships include: A six-week Academic and Leadership Institute at U.S. colleges and universities; A Summit with President Obama in Washington, DC and an optional six-week professional development experience (PDE) at a U.S.company, civil society organization, or public sector agency. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The role of quality improvement in achieving effective large-scale prevention of mother-to-child transmission of HIV in South Africa","field_subtitle":"Barker P; Barron P; Bhardwaj S; Pillay Y: AIDS 29 (Suppl), S137\u2013S143","URL":"http://tinyurl.com/q99wkqf","body":"After a late start and poor initial performance, the South African Prevention of Mother-To-Child Transmission (PMTCT) programme achieved rapid progress in achieving effective national-scale implementation of a complex intervention across a large number of different geographic and socioeconomic contexts. This study shows how quality-improvement methods played a significant part in PMTCT improvements. The South African rollout of the PMTCT programme underwent significant evolution, from a largely ineffective, context-insensitive, top-down cascaded training approach to a sophisticated bottom-up health systems\u2019 intervention that used modern adaptive designs. Several demonstration projects used quality-improvement methods to improve the performance of the PMTCT programme. These results prompted a national redesign of key elements of the PMTCT programme which were rapidly scaled up across the country using a unified, simplified data-driven approach. The scale up of the quality-improvement approach contributed to a dramatic fall in the nationally reported transmission rate for mother to child transmission of HIV. By 2012, measured infection rate of HIV-exposed infants at around 6 weeks after birth was 2.6%, close to the reported transmission rates under clinical trial conditions. Quality-improvement methods can be used to improve reliability of complex treatment programmes delivered at primary-care level. Rapid scale up and effective population coverage can be accomplished through a sequence of demonstration, testing and rapid spread of locally tested implementation strategies supported by real-time feedback of a simplified indicator dataset and multilevel leadership support.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The Slippery Target for Child Survival in the 2030 Agenda for Sustainable Development","field_subtitle":"Gibbons E: Health and Human Rights Journal, Blog, September 2015","URL":"http://tinyurl.com/o4t6rfw","body":"The 2030 Agenda for Sustainable Development has been agreed, along with 17 Sustainable Development Goals (SDGs) and their 169 targets seek to build on the Millennium Development Goals (MDGs) and \u201ccomplete what these did not achieve\u201d. MDG4: Reduce Child Mortality is one the goals which failed to achieve its single target to \u201cReduce by two-thirds, between 1990 and 2015 the under-five mortality rate (U5MR).\u201d MDG4 mobilised global efforts to promote child survival and health, (and indeed between 1990 and 2013, the annual number of under-five deaths declined by half to 6.3 million) but was also critiqued from many diverse perspectives. Despite global progress towards MDG4, the poorest children and indeed the poorest countries, have been left behind. SDG Target 3.2, states: 'By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under five mortality to at least as low as 25 per 1,000 live births'. For SDGs to build on the lessons of the MDGs, the author indicates that the targets should be framed in the unambiguous terms of reducing inequalities. The author suggests that it is difficult to predict how target 3.2 will be measured, and how countries will be held globally accountable, but proposes that all countries should at least report on the gap in child survival between the richest and the poorest, and their progress towards equality of outcomes. To make sure this happens, civil society and human rights mechanisms need to be mobilized around the child\u2019s right to survival and to health, without discrimination.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Towards a New Global Business Model for Antibiotics: Delinking Revenues from Sales ","field_subtitle":"Clift C; Outterson K; R\u00f8ttingen JA et al: Chatham House, October 2015","URL":"http://tinyurl.com/onukp69","body":"This report aims to inform the ongoing discussions and processes on developing a new business model for antibiotics. It is based on the premise that delinkage, seeking to separate the return on investment from antibiotic sales volume, should be the principle underpinning any new business model. It calls on governments to invest significantly in antibiotic R&D by financing a broad menu of incentives across the antibiotic life-cycle, with the highest incentives targeted at the development of antibiotics directed at the greatest health threats arising from antibiotic resistance. Contributions from countries should be coordinated within a globally agreed framework. Finally, global access should, together with conservation, be a priority for any new business model fostering innovation. The report makes several recommendations based on findings.  The authors suggest that a new business model needs to be developed in which the return on investment in R&D on antibiotics is delinked from the volume of sales.There should be increased public financing of a broad menu of incentives across the antibiotic life-cycle is required, targeted at encouraging the development of antibiotics to counter the greatest microbial threats. The assessment of current and future global threats arising from resistance should be updated periodically in order to identify which classes of product are a priority for incentives. The delinkage model should prioritize both access and conservation. Domestic expenditures on the model need to be globally coordinated, including through the establishment of a secretariat, and global participation in the model is the ultimate goal.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"UN Special Rapporteur on right to culture recommends new IP regime for pharmaceuticals","field_subtitle":"Gopakumar KM: Third World Network (TWN) Info Service on Health Issues, October 2015","URL":"http://www.twn.my/title2/health.info/2015/hi151007.htm","body":"The United Nations Special Rapporteur in the field of right to culture recommended a new intellectual property regime for pharmaceutical products stressing that there is no human right to patent protection. This recommendation was made in the report to the 70th Session of the UN General Assembly. The Special Rapporteur recommended that \u201cthe United Nations should convene a neutral, high-level body to review and assess proposals and recommend a new intellectual property regime for pharmaceutical products that is consistent with international human rights law and public health requirements, and simultaneously safeguards the justifiable\u201d.  This is drawn from the recommendation of the Global Commission on HIV and the Law appointed by the UN Development Programme (UNDP). The report also recommends that states have a positive obligation to provide for a robust and flexible system of patent exclusions, exceptions and flexibilities based on domestic circumstances, including through the establishment of compulsory and government use licences when needed.  The report further argues that states have a human rights obligation not to support, adopt or accept intellectual property rules, such as TRIPS-Plus provisions, that would impede them from using exclusions, exceptions and flexibilities and thus from reconciling patent protection with human rights. International agreements that do not provide sufficient flexibility should be renounced or modified. The report highlights Article 27 of the Universal Declaration of Human Rights and Article 15 of the International Covenant on Economic, Social and Cultural Rights which ensure that measure be put in place to ensure affordability of and access to technologies essential to life and realisation of all human rights.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Where have all the mosquito nets gone? Spatial modelling reveals mosquito net distributions across Tanzania do not target optimal Anopheles mosquito habitats","field_subtitle":"Acheson E; Plowright A; Kerr J: Malaria Journal 14(322) 2015","URL":"http://www.malariajournal.com/content/pdf/s12936-015-0841-x.pdf","body":"The United Republic of Tanzania has implemented countrywide anti-malarial interventions over more than a decade, including national insecticide-treated net (ITN) rollouts and subsequent monitoring. While previous analyses have compared spatial variation in malaria endemicity with ITN distributions, no study has yet compared Anopheles habitat suitability to determine proper allocation of ITNs. This study assesses where mosquitoes were most likely to thrive before implementation of large-scale ITN interventions in Tanzania and determine if ITN distributions successfully targeted those areas. The spatial distribution of ITN ownership across Tanzania was near-random spatially. Mosquito habitat suitability was statistically unrelated to reported ITN ownership and very weakly to the proportion of households with &#8805;1 ITN. ITN ownership declined significantly toward areas with the highest vector habitat suitability among households with lowest ITN ownership. In areas with lowest habitat suitability, ITN ownership was consistently higher. Insecticide-treated net ownership is critical for malaria control. While Tanzania-wide efforts to distribute ITNs has reduced malaria impacts, gaps and variance in ITN ownership are unexpectedly large in areas where malaria risk is highest. Supplemental ITN distributions targeting prime Anopheles habitats are likely to have disproportionate human health benefits. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"WIPO African ministerial should embrace a pro-competitive and pro-development IP vision","field_subtitle":"Abdel-Latif A; Kawooya D; Oguamanam C: Bridges Africa 4(8), 4 October 2015","URL":"http://tinyurl.com/ncbp67l","body":"The World Intellectual Property Organization (WIPO) is holding with the Japan Patent Office (JPO) an African ministerial conference on intellectual property (IP), in Senegal, November 3-5, in cooperation with the African Union (AU) and the Government of Senegal. The ministerial conference on \u2018IP for an Emerging Africa\u201d aims to \u201cexplore the opportunities as well as the challenges facing Africa in building a vibrant innovation system and in effectively using the IP system,\u201d according to meeting\u2019s provisional programme. The authors argue that the ministers should embrace a balanced and development-oriented approach to intellectual property. Such an approach ought to take into account the needs, priorities and socio-economic circumstances of African countries as well as the most recent empirical evidence on the dynamics of intellectual property and innovation on the continent.","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"\u201cWhy should I have come here?\u201d - a qualitative investigation of migration reasons and experiences of health workers from sub-Saharan Africa in Austria","field_subtitle":"Jirovsky E; Hoffmann K; Maier M; Kutalek R: BMC Health Services Research 15(74),  2015","URL":"http://www.biomedcentral.com/1472-6963/15/74","body":"This paper explored the reasons African health workers raised for migration to Austria, as well as their personal experiences concerning the living and working situation in Austria. The authors conducted semi-structured, qualitative interviews with African health workers approached via professional networks and a snowball system. For most of the participants, the decision to migrate was not professional but situation dependent. Austria was not their first choice as a destination country. Several study participants left their countries to improve their overall working situation. The main motivation for migrating to Austria was partnership with an Austrian citizen. Other immigrants were refugees. Most of the immigrants found the accreditation process to work as a health professional to be difficult, resulting in some not being able to work in their profession. There was also reported experience of discrimination, but also of positive support. ","php":"","field_issue_date":"2015-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"2015 TrustAfrica / UKZN Post Doctoral Fellowships.","field_subtitle":"Deadline for bursary applications: 15 October 2015","URL":"http://www.pambazuka.net/en/category.php/jobs/95469","body":"TrustAfrica, under the administration of the School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa is pleased to announce 2 Post-Doctoral Fellowships for 2015. The fellowship awards are for R200,000 per annum and there is the possibility for a maximum of 2 years. The selected fellowships will be attached to the DST/NRF Research Chair (SARChI) in Applied Poverty Reduction Assessment. Funding for two fellowships has been made possible by TrustAfrica. The purpose is to promote and undertake research on government, private sector and civil society interventions that have been designed to reduce poverty. The two TrustAfrica fellowships will follow research topics around the political economy of illicit financial flows. Preference will be given to South African applicants.The deadline for bursary applications is 15 October 2015.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Addressing bottlenecks to local production of medicines: Issues for international co-operation in East and Southern Africa","field_subtitle":"Mulumba M; Machemedze R: Journal of Health Diplomacy 1(3), 1-17, 2015","URL":"http://media.wix.com/ugd/35c673_88aa7a9ef7ed42c2be90955c17eda2ff.pdf","body":"African countries are highly dependent on imported medicines and related products despite a stated policy intention in the African Union and regional bodies to develop local pharmaceutical production, which is expected to facilitate responsiveness to local health needs and has stated advantages for employment, skills retention, and foreign currency savings. Noting these policy intentions, this paper explores how the stated policy of local production in African Union (AU), Southern African Development Community (SADC) and East African Community (EAC) policies is being implemented and the bottlenecks to implementation. The paper examines the efforts made in selected countries to overcome these obstacles and the role of international and south-south co-operation. Drawing upon document reviews and key informant interviews, it presents case studies of Uganda, Kenya and Zimbabwe and their co-operation agreements with China and India. The study found limited evidence of operational co-operation, especially that which is based on south-south collaborations, despite the potential contribution of such collaborations to overcoming bottlenecks to local medicines production. Although the evidence from the case studies had limitations, the research suggests that a convergence of interests between countries in east and southern Africa and emerging economies on trade and investment cannot be assumed and that national and regional economic and social interests need to be actively negotiated to overcome identified bottlenecks. The authors thus recommend measures to strengthen the enabling policy, legal, trade and investment environments, to strengthen oversight and regulation of medicines, and to enhance technical and strategic capacities in the east and southern African region needed to support local production of medicines.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Africa Analysis: Welcoming African science home","field_subtitle":"Nordling L: SciDevNet, 18 September 2015","URL":"http://www.scidev.net/sub-saharan-africa/r-d/analysis-blog/africa-analysis-welcoming-african-science-home.html","body":"The new Alliance for Accelerating Excellence in Science in Africa (AESA) was launched on the 10th of September 2015 in Nairobi, Kenya. AESA, which is hosted at AAS headquarters in Nairobi, is intended to bring the centre of gravity for health research funding decision-making from places such as Seattle in the United States and London in the United Kingdom to Africa itself. Its African backers include the New Partnership for Africa\u2019s Development, a continental policy implementation agency.   Three big international research funders \u2014 the UK-based Wellcome Trust, the UK's Department for International Development (DFID) and the Bill and Melinda Gates Foundation in the United States \u2014 have earmarked funding programmes that they plan to let AESA administer.   From next year, AESA is expected to take over the management of the Wellcome Trust's five-year US$70 million DELTAS programme, which involves seven new African centres of health research and training excellence in subjects ranging from biostatistics to mental health in six African countries: Ghana, Kenya, Mali, South Africa, Uganda and Zimbabwe.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Albinism in Africa: a medical and social emergency","field_subtitle":"Brilliant M: International Health 7(4): 223-225, 2015","URL":"http://inthealth.oxfordjournals.org/content/7/4/223.full","body":"People with albinism (PWA) face a variety of medical and social problems, ranging from poor vision and skin cancer to murder for their body parts for witchcraft in East Africa. PWAs are reported to face enormous challenges in East Africa. They have very poor, uncorrectable vision and, as a result, they are disadvantaged in schools and in employment opportunities. At best, the authors report, they are discriminated against; at worst, they are hunted and often killed for their body parts for witchcraft use. If they survive these attacks, they are very likely to develop skin cancer that is most often untreated, leading to a preventable premature death. However, awareness and activism can help PWAs to lead more normal lives by addressing their medical and social needs. Above all, the authors urge people to make efforts to stop atrocities against PWA. ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Black Rural Women: Carrying the Burden of the Gold Mining Industry\u2019s Neglect","field_subtitle":"Charles T: Sonke Gender Justice, August 2015 ","URL":"http://www.genderjustice.org.za/article/black-rural-women-carrying-the-burden-of-the-gold-mining-industrys-neglect/","body":"The mining industry in South Africa is argued by the authors to contribute significantly to the hardship experienced by black women in rural areas of South Africa. For decades, mining houses have drawn in young black men for labour. Those who have contracted the preventable but incurable lung disease, silicosis, come home to die a slow and painful death. It is then the women in rural communities who are left to provide support and care under the most adverse conditions. As part of its efforts to support pending litigation against the mining industry to secure long overdue compensation to mineworkers who contracted silicosis and for the women who took care of them, Sonke Gender Justice (Sonke) has been conducting research in the rural Eastern Cape. The research is making visible how the gold mining industry\u2019s failure to prevent silicosis has forced rural black women further into the margins of society. There are several ongoing cases on this. The Legal Resources Centre, Richard Spoor Attorneys and Abrahams Kiewitz are representing 56 applicants in a class action lawsuit where current and former mineworkers and surviving dependants of mineworkers who died from the disease are demanding their right to compensation for silicosis and TB contracted in mines. The case will be heard in the South Gauteng High court in October 2015.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Business as usual? The role of BRICS co- operation in addressing health system priorities in East and Southern Africa","field_subtitle":"Brown G; Loewenson R;  Modisenyani M; Papamichail A; Cinar B: Journal of Health Diplomacy 1(3), 1-23, 2015","URL":"http://media.wix.com/ugd/35c673_b4cfdbae1f334eb0b07c1656d96d0380.pdf","body":"There has been increased interest in whether \u201cSouth-South\u201d co-operation by Brazil, Russia, India, China and South Africa (BRICS) advances more equitable initiatives for global health. This article examines the extent to which resolutions, commitments, agreements and strategies from BRICS and Brazil, India and China (BIC) address regionally articulated policy concerns for health systems in East and Southern Africa (ESA) within areas of resource mobilisation, research and development and local production of medicines, and training and retention of health workers. The study reviewed published literature and implemented a content analysis on these areas in official BRICS and ESA regional policy documents between 2007 and 2014. The study found encouraging signals of shared policy values and mutuality of interest, especially on medicines access, although with less evidence of operational commitments and potential divergence of interest on how to achieve shared goals. The findings indicate that African interests on health systems are being integrated into south-south BRICS and BIC platforms. It also signals, however, that ESA countries need to proactively ensure that these partnerships are true to normative aims of mutual benefit, operationalise investments and programs to translate policy commitments into practice and strengthen accountability around their implementation.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Cost\u2013effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya","field_subtitle":" McPake B et al: Bulletin of the  World Health Organisation 93(9), 589-664, 2015","URL":"http://www.who.int/bulletin/volumes/93/9/14-144899-ab/en/","body":"The objective of this study was to assess the cost\u2013effectiveness of community-based practitioner programmes in Ethiopia, Indonesia and Kenya. Incremental cost\u2013effectiveness ratios for the three programmes were estimated from a government perspective. Cost data were collected for 2012. For Ethiopia and Kenya, estimates of coverage before and after the implementation of the programme were obtained from empirical studies. Based on the results of probabilistic sensitivity analysis, there was greater than 80% certainty that each programme was cost-effective. Community-based approaches are likely to be cost-effective for delivery of some essential health interventions where community-based practitioners operate within an integrated team supported by the health system. The authors suggest  that community-based practitioners may be most appropriate in rural poor communities that have limited access to more qualified health professionals. Further research is required to understand which programmatic design features are critical to effectiveness.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Delivery outcomes and patterns of morbidity and mortality for neonatal admissions in five Kenyan hospitals","field_subtitle":"Aluvaala J et al: Journal of Tropical Medicine 61(4), 255-259, 2015,","URL":"http://tropej.oxfordjournals.org/content/61/4/255.full","body":"A cross-sectional survey was conducted in neonatal and maternity units of five Kenyan district public hospitals. Data for 1 year were obtained: A fifth of the admitted neonates died. Compared with normal birth weight, odds of death were significantly higher in all of the low birth weight (LBW, ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"ECSA HC  Regional Forum on Best Practices; 23 - 24 November 2015: Call for abstracts","field_subtitle":"Submission of Abstracts deadline: October 26, 2015","URL":"http://www.ecsahc.org/wp-content/uploads/2015/09/62-HMC-call-for-abstracts1.pdf","body":"The East, Central and Southern Africa Health Community (ECSA-HC), in collaboration with the Ministry of Health and Quality of Life, Mauritius will host the 62nd ECSA Health Ministers Conference from 23 - 27 November 2015 in Mauritius. The Regional Forum on Best Practices is 23 - 24 November 2015 under the theme: Transitioning from Millennium Development Goals to Sustainable Development. The Conference will address its theme through the following specific sub-themes;a) Enhancing Universal Health Coverage Through innovations in Health Financing for Risk Protection b) Surveillance and Control of Emerging Health Conditions (NCDs and Trauma) c) Regional Collaboration in the Surveillance and Control of Communicable Diseases\r\nand d) Innovations in Health Professional Training using the College of Health Sciences Mode. The ECSA-HC is inviting abstracts and scientific papers that are relevant to the conference sub-themes. The scientific papers and best practices should consist of case studies and evidence based programme experiences that are innovative, unique or have added value and new thinking in health. The abstracts and scientific papers will form the basis for the resolutions that will be passed by the Health Ministers. ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 176: Learning from research on health diplomacy in Africa","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Header"}},{"node":{"title":"Explaining the role of the social determinants of health on health inequality in South Africa","field_subtitle":"Ele-Ojo Ataguba J; Day C; McIntyre D: Global Health Action 8(28865) September 2015","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/28865","body":"+This paper assesses health inequalities in SA and explains the factors (i.e. SDH and other individual level factors) that account for large disparities in health. The relative contribution of different SDH to health inequality is also assessed. A cross-sectional design is used. Data come from the third wave of the nationally representative National Income Dynamics Study. A subsample of adults (18 years and older) is used. The main variable of interest is dichotomised good versus bad self-assessed health (SAH). Income-related health inequality is assessed using the standard concentration index (CI). A positive CI means that the rich report better health than the poor. A negative value signifies the opposite. Good SAH is significantly concentrated among the rich rather than the poor. Social protection and employment, knowledge and education, and housing and contribute significantly to the disparities in good SAH in SA. After accounting for these other variables, the contribution of income and poverty is negligible. Addressing health inequalities is noted to require an increased government commitment in terms of budgetary allocations to key sectors (i.e. employment, social protection, education, housing, and other appropriate infrastructure). The authors argue that attention should also be paid to equity in benefits from government expenditure. In addition, the health sector needs to play its role in providing a broad range of health services to reduce the burden of disease.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Financing universal health coverage\u2014effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries","field_subtitle":"Reeves A; Gourtsoyannis Y; Basu S; McCoy, D; McKee M; Stuckler D: The Lancet 386(9990), 274\u2013280, 2015","URL":"http://www.sciencedirect.com/science/article/pii/S0140673615605748","body":"How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. The authors investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. The authors used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995\u20132011. Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9\u00b786, adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income, but not for consumption taxes on goods and services. In countries with low tax revenues (","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Food sovereignty, food security and health equity: a meta-narrative mapping exercise","field_subtitle":"Weiler A; Hergesheimer C; Brisbois B; Wittman H; Yassi A; Spiegel J: Health Policy and Planning 30(8), 1078-1092, 2014","URL":"http://heapol.oxfordjournals.org/content/30/8/1078.full","body":"There has been growing policy interest in social justice issues related to both health and food. The authors sought to understand the state of knowledge on relationships between health equity and food systems, where the concepts of \u2018food security\u2019 and \u2018food sovereignty\u2019 are prominent. Combinations of health equity and food security (1414 citations) greatly outnumbered pairings with food sovereignty (18 citations). Prominent crosscutting themes that were observed included climate change, biotechnology, gender, racialization, indigeneity, poverty, citizenship and HIV as well as institutional barriers to reducing health inequities in the food system. The literature indicates that food sovereignty-based approaches to health in specific contexts, such as advancing healthy school food systems, promoting soil fertility, gender equity and nutrition, and addressing structural racism, can complement the longer-term socio-political restructuring processes that health equity requires. The authors\u2019 conceptual model is argued to offer a useful starting point for identifying interventions with strong potential to promote health equity. ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Guidelines for Maternity Care in South Africa","field_subtitle":"National Department of Health, South Africa:  July 2015","URL":"http://www.hst.org.za/sites/default/files/Maternal%20Care%20Guidelines%202015_FINAL-21.7.15.pdf","body":"The South African National Department of Health has identified maternal health care as a priority area requiring urgent action in South Africa. Progress towards this goal in South Africa demands national co-ordination and co-operation with the major role players in provision of health services, addressing causes of maternal and perinatal deaths and in making available clinical management protocols to ensure that high quality health services are rendered. Maternity care is an integral component of primary health care and a free health service for pregnant women. These guidelines are intended for use in clinics, community health centres and district hospitals where specialist services are not normally available. The emphasis is on the practical identification and correct management of problems, including referral to higher levels of care. The guidelines are based on the best available evidence from published research, modified where necessary to suit local conditions. ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health Systems Trust Conference, 4-6 May 2016, Gauteng","field_subtitle":"Deadline for abstracts: 31 October 2015","URL":"http://www.hstconference2016.org.za/Abstract%20submission%20guidelines.pdf","body":"The theme of the Health Systems Trust (HST) Conference is \"Strengthened health systems for sustainable development: sharing, supporting, synergising\". The sub-themes are the general heading under which abstracts should be submitted: Track 1 Overcoming the Burden of Disease, Track 2 Strengthening Service Delivery and Access; Track 3 Better Policy Design, Implementation and Practice; Track 4 Sustainable Development Post 2015. All abstract submissions should be written in Arial type, font size 11 if completing the downloadable form on the conference website. As of 1 September 2015, all abstracts should be submitted online through the conference website.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Human resources for primary health care in sub-Saharan Africa: progress or stagnation?","field_subtitle":"Willcox ML; Peersman W; Daou P; Diakit\u00e9 C; Bajunirwe F; Mubangizi V; Mahmoud EH; Moosa S; Phaladze N; Nkomazana O; Khogali M; Diallo D; De Maeseneer J; Mant D: Human Resources for Health 13(76), 2015","URL":"http://www.human-resources-health.com/content/13/1/76","body":"The World Health Organization defines a \u201ccritical shortage\u201d of health workers as being fewer than 2.28 health workers per 1000 population and failing to attain 80% coverage for deliveries by skilled birth attendants. The authors aimed to quantify the number of health workers in five African countries and the proportion of these currently working in primary health care facilities, to compare this to estimates of numbers needed and to assess how the situation has changed in recent years. This study is a review of published and unpublished \u201cgrey\u201d literature on human resources for health in Mali, Sudan, Uganda, Botswana and South Africa. Health worker density has increased steadily since 2000 in South Africa and Botswana which already meet WHO targets but has not significantly increased since 2004 in Sudan, Mali and Uganda which have a critical shortage of health workers. In all five countries, a minority of doctors, nurses and midwives are working in primary health care, and shortages of qualified staff are greatest in rural areas. In Uganda, shortages are greater in primary health care settings than at higher levels. Even South Africa has a shortage of doctors in primary health care in poorer districts. Although most countries recognize village health workers, traditional healers and traditional birth attendants, there are insufficient data on their numbers. There is an \u201cinverse primary health care law\u201d in the countries studied: staffing is inversely related to poverty and level of need, and health worker density is not increasing in the lowest income countries. Unless there is money to recruit and retain staff in these areas, training programmes will not improve health worker density because the trained staff will simply leave to work elsewhere. The author argues that information systems need to be improved in a way that informs policy on the health workforce. It may be possible to use existing resources more cost-effectively by involving skilled staff to supervise and support lower level health care workers who currently provide the front line of primary health care in most of Africa.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Is South-South cooperation just a catchphrase?","field_subtitle":"Owings L: SciDevNet, 15 September 2015","URL":"http://www.scidev.net/global/cooperation/scidev-net-at-large/south-south-cooperation-catchphrase.html","body":"The term global South is often used to lump together the nations of Africa, Central and South America and parts of Asia. It is much more diverse in capacity and economic activity than the label implies \u2014 its emerging markets offer numerous opportunities for economic growth, investment and cultural contribution.   At the World Social Science Forum 2015 in Durban, South Africa the debate focused on how countries in the global South can join forces to become the facilitators of their own, collective growth. According to Jurek Seifert, from the Institute of Development Research and Development Policy in Germany, South-South development cooperation is framed as help among equals and as being fundamentally different from the North-South approach. But there are problems with this view, argues the author. This article discusses the use of \u2018South South\u2019 as rhetoric and the implications of this. But there are problems with this view. It was argued that there is no recognised concept or framework for South-South cooperation. Essentially, all providers are doing what they want and calling it cooperation, without any strategic approach.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Learning from research on experiences of health diplomacy in Africa","field_subtitle":"Loewenson R; Molenaar-Neufeld B: Journal of Health Diplomacy 1(3), 1-18, 2015","URL":"http://media.wix.com/ugd/35c673_015bd4d0defc4b1fb9238be8c10b86ef.pdf","body":"This paper presents the findings of research conducted under a wider two-year project (2012-14) that examined the role of African agency in global and south-south health diplomacy in addressing selected key challenges to health and health systems in east and southern Africa (ESA). This research synthesis draws from two desk reviews and a content analysis of three case studies on: (i) the involvement of African actors in global health governance on financing for health systems; (ii) overcoming bottlenecks to local medicine production, including through south-south co-operation; and (iii) health worker migration and the implementation of the World Health Organisation (WHO) Global Code of Practice on the International Recruitment of Health Personnel. Based on the content analysis, the paper reviews evidence on African intervention in four key areas of health diplomacy: agenda setting, policy development, policy selection and negotiation and implementation. The evidence highlights the political and complex nature of global health diplomacy. Effective engagement is enabled in ESA by political leadership and champions with clearly articulated policy positions, regional interaction and unified platforms across African countries and good communication between sectors within countries, between national actors and embassies and with allies in the international community. Negotiators\u2019 understanding of issues and access to credible evidence mattered in policy development and selection. Technical actors, the domestic private sector and civil society appeared to play a weak role relative to the influence of development aid. The case studies suggest there is an opportunity cost in framing health diplomacy in the region within a \u2018development aid\u2019 paradigm, if the compromises agreed to lead to a dominance of remedial, humanitarian engagement in African international relations on health, with less sustained attention to structural determinants.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Learning from research on health diplomacy in east and southern Africa ","field_subtitle":"Rene Loewenson, Training and Research Support Centre and Bente Molenaar-Neufeld, Centre for Trade Policy and Law, Carleton University","body":"\r\nAfrican governments have influenced global health negotiations on a range of issues, including on intellectual property rights, access to medicines, migration of health workers, control of breast milk substitutes and food security. While there have been debates about whether public health  is best served by being elevated to a foreign policy concern, the realities of globalization, the level of external financing of African health systems and rising international interest in African resources have intensified the demand for effective African engagement in global and international negotiations, including to protect or promote public health.  \r\n\r\nFrom 2012 to 2014 EQUINET implemented through various institutions a research programme in east and southern Africa (ESA) that examined the role of global and south-south health diplomacy. It did so by addressing selected priority challenges to health and strengthening health systems raised in the region.  The programme explored African actors\u2019 involvement in negotiations on design of global financing for health systems; in negotiating co-operation in overcoming bottlenecks to local medicine production; in advancing ESA priorities within the \u2018BRICS\u2019 and health worker migration and the implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel (termed the \u2018Code\u2019).  A set of papers presenting the findings and conclusions from the work are included in the current issue of the Journal of Health Diplomacy co-edited with EQUINET, at www.journalofhealthdiplomacy.org/#!v1i3/xzwum . \r\n\r\nHealth has been positioned by African actors within a demand for greater global justice, such as in challenging losses to health systems from health worker migration from low to high income countries, or in negotiating fairer global measures on innovation and intellectual property. These forms of structural diplomacy challenged current global norms. \r\n\r\nBringing such ESA policy concerns to global agendas implied engaging in often complex processes over long periods, in the face of competing interests and power imbalances. In this context, negotiating African positions appears to have been facilitated by efforts to build unified positions across African countries, alliances with other regions, and to draw support from other sectors, from technical inputs and from civil society. \r\n\r\nThe issue of health worker migration was, for example, successfully escalated from regional to global level backed by policy positions developed at regional level that were amplified by political, policy and technical \u2018champions\u2019 in  ministerial, multilateral and other forums. The experience highlighted the importance in policy negotiation of links between capitals and embassies, the positive role of prior bilateral or multilateral instruments, as with the Code, and of positive role models in ESA countries, such as in bilateral co-operation on local production.  \r\n\r\nHowever, as negotiations evolved, the research indicated that compromises were made and forms of co-operation agreed that appeared to be shaped more by application of development aid \u2013 such as to fund medicines or health worker incentives - than by efforts to address global inequality or structural determinants of health, such as from lost public investments in critical skills, or from trade, tariff and patent barriers.  The findings highlighted a consistent influence in agenda setting and policy selection of global and bilateral technical partners and funders, particularly for African health systems. Consultants from global and international agencies appeared to play a more visibly influential role in policy development and selection than local technical personnel.  In negotiations on performance based financing (PBF), for example, the research found that while external funders were open to concerns, Africans were also cautious in raising concerns over targets and design fragmenting their health systems, given a \u2018bottom line\u2019 of not threatening access to the additional external health system funding accompanying PBF for their often underfunded health systems.  \r\n\r\nThe efforts made in negotiating global agreements may be dwarfed by those needed to bring them into reality. After sometimes years of negotiating agreements, implementation can be weakened by a turnover and loss of leading national and regional voices. The research found that the implementation stage often brought a new set of actors to translate negotiated agreements/policy into health system change, with implementation affected by weaknesses in dissemination and awareness of the instruments negotiated, by poor communication with other sectors affected and weak follow-up support from global agencies. A perception that agreements represent the end, rather than the start, of the process limits the momentum for implementation. As one key informant in the study on the Code noted, \u201cFor the Code, it was mission accomplished, and we didn\u2019t have any more energy for it\u201d.  At the same time, the research questioned whether global agreements adequately include the support for capacities to facilitate implementation. \r\n\r\nThe different research studies raised a number of proposals for strengthening the promotion and protection of health in foreign policy dialogue. They also, however, raised a concern that the \u2018development aid\u2019 paradigm influencing health diplomacy not displace a demand by ESA countries for more transformative, developmental forms of international co-operation needed to address the more structural global determinants of health. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For the papers in the issue of the Journal of Health Diplomacy see www.journalofhealthdiplomacy.org/#!v1i3/xzwum  and discussion papers on the EQUINET website. ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Limits to diplomacy: Learning from the Implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel in east and southern Africa","field_subtitle":"Dambisya Y; Malema N; Dulo C; Matinhure S: Journal of Health Diplomacy 1(3), 1-18, 2015","URL":"http://media.wix.com/ugd/35c673_e2f919f53d224fcb9b43e177007dcc7e.pdf","body":"The WHO Global Code of Practice on the International Recruitment of Health Personnel (the Code) provides a global architecture that includes ethical norms and institutional and legal arrangements to guide international co-operation on the management of health worker migration and serves as a platform for continuing dialogue. This paper explores how the policy interests of African countries informed the development of the Code and how east and southern African (ESA) countries have used, implemented and monitored the Code. Data were collected using four approaches: literature review, policy dialogue at the 66th World Health Assembly, a regional questionnaire survey and three country studies in Kenya, Malawi and South Africa. Three years after adoption of the Code, the main concerns relating to human resources for health (HRH) in the region were internal migration and absolute shortages of health professionals, rather than external, or out-, migration. The final version of the Code was not perceived to adequately cover African policy interests on compensation and mutuality of benefits. Concern was also expressed about the voluntary nature of the Code. Dissemination and implementation of the Code was lacking in all countries in the region, and only one country had a designated authority. Beyond the shift in policy concerns, barriers to implementation included lack of champions or designated authorities, poor preparedness, weak mobilisation of stakeholders and low involvement of civil society. The authors recommend that negotiations on international instruments should include provisions relating to their implementation, that deliberate efforts should be made to plan for the mechanisms and resources for their implementation after their adoption, and that the involvement of civil society be promoted at all stages.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Local data underpins Tanzania\u2019s next malaria plan","field_subtitle":"Ngereza C: SciDevNet, 08 September 2015","URL":"http://www.scidev.net/global/malaria/news/data-underpins-tanzania-malaria-plan.html","body":"Tanzania\u2019s health ministry is set to revisit the way it goes about collecting data to control malaria following new insights into the disease. The ministry will focus more on data collection at village and district level to intensify the national fight against malaria. This revision is needed because changing temperatures and growing travel habits among Tanzania\u2019s people are spreading malaria-bearing mosquitoes, say policymakers. In addition, recent research revealed that existing anti-malaria methods in Tanzania, such as mosquito net distribution, do not always reach the people most in need because of a lack of knowledge about local disease hotspots. In Tanzania, annual deaths from malaria are estimated at around 60,000, with 80 per cent of these children under five. ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Locating Health Diplomacy through African Negotiations on Performance-based Funding in Global Health","field_subtitle":"Barnes A; Brown G; Harman S: Journal of Health Diplomacy 1(3), 1-18, 2015","URL":"http://media.wix.com/ugd/35c673_c5741d5e3c8542c09d909132a0ed5a95.pdf","body":"This article examines how national health actors in South Africa, Tanzania and Zambia perceive the participatory quality of negotiation processes associated with the performance&#8208;based funding mechanisms of the Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Bank. Through analysis of qualitative fieldwork consisting of 101 interviews within the case countries as well as in Geneva and Washington DC, the research results show that African actors within national governments generally set and negotiate performance targets of performance&#8208;based funding schemes. Nevertheless, the results also show that the quality of those negotiations with external funders were inconsistent, suggesting the existence of asymmetrical power and influence in relation to the quality of those negotiations. This raises questions about the level of power and influence being exerted by external funders and how much leverage African political actors have available to them within global health diplomacy. It also provides evidence that certain key aspects of these negotiated processes are closed off from negotiation for African actors, therefore undermining African participation in significant ways.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Mortality risks in children aged 5\u201314 years in low-income and middle-income countries: a systematic empirical analysis","field_subtitle":"Hill K; Zimmerman L; Jamison D: The Lancet Global Health, 3: e609\u201316, 2015","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00044-3/fulltext","body":"Health priorities since the UN Millennium Declaration have focused strongly on children younger than 5 years. The health of older children (age 5\u20139 years) and younger adolescents (age 10\u201314 years) has been neglected until recently, especially in low-income and middle-income countries, and mortality measures for these age groups have often been derived from overly flexible models. The authors report global and regional empirical mortality estimates for children aged 5\u201314 years in low-income and middle-income countries, and compare them with ones from existing models, using birth-history data from a 25-year period from 1986 of Demographic and Health Surveys programme for 84 World Bank low-income and middle-income countries, and data about household deaths in China from their 1990 and 2010 censuses. The mean risk of a child dying at age 5\u201314 years in low-income and middle-income countries is about 19% of the risk of dying between birth and age 5 years (12% at age 5\u20139 plus 7% at age 10\u201314). According to their estimates, the total number of deaths at ages 5\u201314 years in low-income and middle-income regions fell from about 2\u00b74 million in 1990 to about 1\u00b75 million in 2010. From estimates the authors concluded there to have been 200&#8200;000 (16%) more deaths at ages 5\u201314 than in the UN report;  however, the estimates exceeded GBD estimates by more than 700&#8200;000 (87%). The average annual rate of decline in mortality at age 5\u20139 years (about 3%) slightly exceeded that for ages 0\u20134 years (2\u00b78%), but progress has been slower for age 10\u201314 years (about 2%). Their analysis suggests that mortality risks nowadays in the age range 5\u201314 years in low-income and middle-income countries are rather higher (relative to mortality in children younger than 5 years) than would be expected on the basis of historical evidence. The authors argue that global policy emphasis on reduction of mortality in children younger than 5 years should be broadened to include older children and adolescents.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Relationship Between Family Economic Resources, Psychosocial Well-being, and Educational Preferences of AIDS-Orphaned Children in Southern Uganda: Baseline Findings","field_subtitle":"Ssewamala, F; Nabunya P; Vilma I; Mukasa M; Ddamulira C: Global Social Welfare 2(2) 75-86, 2015","URL":"http://link.springer.com/article/10.1007/s40609-015-0027-z","body":"This study examines the relationship between economic resources, psychosocial well-being, and educational preferences of AIDS-orphaned children in southern Uganda. The authors use baseline data from a sample of 1410 AIDS-orphaned children (defined as children who have lost one or both biological parents to AIDS) enrolled in the Bridges to the Future study, a National Institute of Child Health and Human Development (NICHD) funded study. Analyses from both bivariate and multiple regression analyses indicate the following: 1) despite the well-documented economic and psychosocial challenges AIDS-orphaned children face, many of these children have high educational plans and aspirations; 2) educational aspirations differ by orphanhood status (double orphan vs. single orphan); 3) regardless of orphanhood status, children report similar levels of psychosocial well-being; 4) high levels of family cohesion, positive perceptions of the future, school satisfaction, and lower levels of hopelessness (hopefulness) are associated with high educational aspirations; and 5) reported family economic resources at baseline, all seem to play a role in predicting children\u2019s educational preferences and psychosocial well-being. These findings suggest that the focus for care and support of orphaned children should not be limited to addressing their psychosocial needs. Addressing the economic needs of the households in which orphaned children live is equally important. Indeed, in the context of extreme poverty\u2014in which most of the children represented in this study lived\u2014addressing structural factors, including poverty  are argued to be a key driver in addressing their psychosocial functioning.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Rising School Enrollment and Declining HIV and Pregnancy Risk Among Adolescents in Rakai District, Uganda, 1994\u20132013","field_subtitle":"Santelli J; Mathur, S; Song X; Huang T; Wei Y; Lutalo T; Nalugoda F; Gray R; Serwadda D: Global Social Welfare 2(2), 87-103, 2015","URL":"http://link.springer.com/article/10.1007/s40609-015-0029-x","body":"Poverty, family stability, and social policies influence the ability of adolescents to attend school. Likewise, being enrolled in school may shape an adolescent\u2019s risk for HIV and pregnancy. In this paper the authors identified trends in school enrolment, factors predicting school enrolment (antecedents), and health risks associated with staying in or leaving school (consequences). Data from the Rakai Community Cohort Study (RCCS) were examined for adolescents 15\u201319 years. School enrolment and socioeconomic status (SES) rose steadily from 1994 to 2013 among adolescents; orphanhood declined after availability of antiretroviral therapy. Antecedent factors associated with school enrolment included age, SES, orphanhood, marriage, family size, and the percent of family members ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"SDGs and the Importance of Formal Independent Review: An Opportunity for Health to Lead the Way","field_subtitle":"Hunt P: Health and Human Rights Journal, Perspectives, September 2015","URL":"http://tinyurl.com/oar2n7c","body":"It is widely recognised that the Sustainable Development Goals (SDGs) need to be supported by more effective follow-up and review\u2014or accountability\u2014processes than were available to the Millennium Development Goals (MDGs). But what should these processes be? In the last three or four years, this question has generated a wealth of literature within the UN and beyond. Here the author highlights five key points: Monitoring is not accountability, but one step towards accountability;  although experts have a significant role to play, accountability should not be reduced to a technocratic exercise; it should be as transparent, accessible and participatory as possible. Accountability at the global level is important, but the primary locus for accountability must be at the national and sub-national levels; it is difficult for States at the national-level to hold accountable stakeholders, including non-state actors, for their transnational contributions and commitments to development, such as SDG17. One of the most important roles for global-level accountability is to strengthen accountability for these transnational contributions and commitments - because the SDGs are a colossal challenge of extraordinary complexity, they need to be supported by diverse accountability arrangements, including independent review of stakeholders\u2019 progress, promises and commitments.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Surgical and anaesthetic capacity of hospitals in Malawi: key insights","field_subtitle":"Henry J; Frenkel E; Borgstein E; Mkandawire N; Goddia C: Health Policy and Planning 30(8), 985-994, 2014","URL":"http://heapol.oxfordjournals.org/content/30/8/985.full","body":"In partnership with the Malawi Ministry of Health, the authors quantified government hospitals\u2019 surgical capacity through workforce, infrastructure and health service delivery components. From November 2012 to January 2013, the authors surveyed district and mission hospital administrators and clinical staff. Twenty-seven government hospitals were surveyed (90% of the district hospitals, all central hospitals). Non-surgeons and anaesthesia clinical officers (ACOs) were the only providers of surgical services and anaesthetic services in 85% and 88.9% of hospitals, respectively. No specialists served the district hospitals. All of the hospitals experienced periods without external electricity. Most did not always have a functioning generator or running water. None of the district hospitals had an Intensive Care Unit (ICU). Every hospital provided general anaesthesia but some did not always have a functioning anaesthesia machine . Clinical officers form the backbone of Malawi\u2019s surgical and anaesthetic workforce and the authors argue that they should be supported with improvements in infrastructure as well as training and mentorship by specialist surgeons and anaesthetists.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The 62nd ECSA Health Ministers Conference","field_subtitle":"23rd to 27th November 2015, Port Louis, Mauritius","URL":"http://www.ecsahc.org/the-62nd-ecsa-health-ministers-conference/","body":"The East, Central and Southern Africa Health Community (ECSA-HC), in collaboration with the Ministry of Health and Quality of Life, in the Republic of Mauritius will host the 62nd ECSA Health Ministers Conference (HMC) from 23rd \u2013 27th  November 2015 in Mauritius. The Health Ministers Conference will be preceded by the 9th Best Practices Forum and the 25th Directors\u2019 Joint Consultative Committee. The Conference will bring together Ministers of Health, Senior Officials from Ministries of Health, Heads of Health Research and Training Institutions from Member States, Health Experts and diverse collaborating Partners in the region and beyond with the aim of identifying policy issues and making recommendations to facilitate the transitioning from MDGs to Sustainable Development Goals.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The Access to Medicine Index and Accountability of Pharmaceutical Companies","field_subtitle":"de Felice D; Edwards D: Health and Human Rights Journal, September 2015","URL":"http://tinyurl.com/padu83g","body":"The UN post-2015 development agenda includes 17 Sustainable Development Goals (SDGs) and a \u201crevitalized\u201d Global Partnership to ensure their implementation. Formal inclusion of the private sector (in addition to governments, civil society, the UN system and other actors) is one of the defining features of this Global Partnership. Plenty of studies have shown how corporate actions can have significant impacts, positive and negative, for vulnerable people and for marginalised communities. However the author argues that it also raises an important question. How will the private sector be held accountable for its contribution to the Global Partnership? The latest draft of the 2030 Agenda for Sustainable Development provides that a High Level Political Forum (HLPF) under the auspices of the General Assembly and the Economic and Social Council will have the central role in overseeing follow-up and review at the global level. Interestingly, the HLPF will be tasked to carry out regular reviews that will include relevant stakeholders, including the private sector. The author argues that measuring businesses is as fundamental as measuring governments and that rigorous benchmarking of pharmaceutical companies will be crucial.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"The individual household method","field_subtitle":"Evidence for Development: UK, 2015","URL":"http://www.efd.org/our-work/methods/the-individual-household-method-ihm/","body":"The individual household method (IHM) provides estimates of household income, with detailed information on household assets, demography and specific income sources. This data can be used to support the design and evaluation of programmes, and seeks to collect information on actual households directly from their members. This enables IHM studies to identify more complex variation across populations and to model the impact of changes on a much wider range of population groups, with data disaggregated by demographics (gender and age), income levels and other chosen characteristics.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The World\u2019s Poor are Being Denied the Right to Share in Scientific Advancement","field_subtitle":"Yamey G: Health and Human Rights Journal, September 2015","URL":"http://tinyurl.com/p3jx7b8","body":"Transforming Our World, the 2030 Agenda for Sustainable Development, which is likely to be adopted by UN Member States, contains astonishingly bold and ambitious aspirations for transforming global health. The Agenda includes a series of \u201czero targets\u201d to be achieved by 2030, including to \u201cend preventable deaths of newborns and children under 5 years of age\u201d and to \u201cend the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases.\u201d The author argues that such targets are simply unattainable unless there\u2019s a massive scale-up in research and development (R&D) for conditions that disproportionately affect poor communities in low- and middle-income countries (LMICs). Unfortunately, the SDGs as currently written say way too little on the essential role of scientific innovation in achieving SDG 3 (the health goal) and they say nothing at all about the crucial importance of monitoring progress in global health R&D. A compelling August 2015 report by Policy Cures, an independent research group, made the case that the SDG 3 targets \u201cwill not be achieved without R&D to develop new health technologies\u2014such as new and improved drugs, vaccines, diagnostics, and other critical innovations\u2014and to improve our understanding of how to best target the tools we already have.\u201d  The author argues that the SDG health targets are a fairytale without a renewed global commitment to meet the R&D needs\u2014and rights\u2014of the world\u2019s poor people.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Training course: Health Impact Assessment for extractive industry projects in LMIC","field_subtitle":"12-16, October 2015, Solwezi, Zambia","URL":"https://www.phasa.org.za/training-course-hia-for-extractive-industry-projects-in-lmic/","body":"SHAPE Consulting Limited, in collaboration with the Swiss Tropical and Public Health Institute (Swiss TPH) and First Quantum Minerals, announce a training course in Health Impact Assessment (HIA) for the energy, mining and infrastructure sectors, with a focus on low- and middle-income countries. The course will be held at the First Quantum Kalumbila Mine in North-Western Zambia. This setting will allow the unique experience of gaining theoretical knowledge and practical experience in an actual operational mine in its human and natural environment. The objectives of the course are to introduce the concept of HIA and equip participants with knowledge, methods and tools to undertake an HIA in a low- and middle-income country context; to enable participants to apply the theoretical knowledge provided in the course into real life situations through use of case studies and field visits in the project area; and to equip attendees with the ability to commission and review HIA\u2019s, including development of adequate terms of reference and effective review of outputs.The content of the course will include theoretical and practical elements specific to the extractive industry sector: Introduction to the concept of HIA and current global practice; HIA standards, guidelines and links to relevant best practice documents; The phases of HIA and respective tools and methods; Application of the phases of HIA based on case studies.; Integration of HIA into social and biophysical studies and sustainable development planning.; Field visits to the First Quantum Kalumbila Mine project area, where specific contents of the course will be revisited in real life situations (ongoing activity throughout the course) A certificate of attendance will be presented on completion of the course.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Urbanisation: where, why, when?","field_subtitle":"SciDevNet: UK, 2015","URL":"http://www.scidev.net/global/cities/data-visualisation/urbanisation-where-why-when-interactive.html","body":"This series of infographics and a video show urbanization by region and separate countries. It identifies factors which are driving urbanization and shows through graphics how birth rates, fertility and migration are drivers of urban growth. It compares through bar charts the differences between urban and rural housing and explores whether the rural \u2013 urban gap may be shrinking. Finally, it shows some projections for the future of urbanization.  ","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Vital need to engage the community in HIV control in South Africa","field_subtitle":"Hanson S; Zembe Y; Ekstr\u00f6m AM: Glob Health Action 8 (27450),  2015","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/27450","body":"According to the latest 2014 UNAIDS report, which was based on the 2012 South African National HIV Prevalence, Incidence & Behaviour Survey, there were between 6.3 and 6.4 million HIV infected people in South Africa. Although the number of new infections appears to have declined in the past 5 years, 370,000 new infections were still estimated to occur in 2013. Young, black women were most at risk with a very high incidence of 4.5%. Of the infected, only 2.2 million were on antiretroviral therapy (ART), meaning that the majority living with HIV was not virally suppressed and thus at risk of infecting somebody else. Eight out of 10 South Africans still believed they were at low risk of HIV infection. Condom use was declining and multiple sexual partnerships were increasing. These findings raise questions about whether current control efforts are properly addressing the drivers of the epidemic. Recent behaviour change campaigns target intergenerational sex and blame the high transmission rates among girls on \u2018sugar daddies\u2019 thus diverting attention away from common risk behaviours in the general population. Reduction of new infections is argued to be crucial. Much of the current global HIV debate focuses on treatment as prevention (TasP) \u2013 an approach hampered by resource problems and the fact that most people are infected by someone who is unaware of his/her HIV status. This raises doubts TasP alone is a sufficient and sustainable solution to prevention. It is not enough to mainly treat those already infected; there is also a need to allocate more resources to address the root causes \u2013 ART plus norm and behaviour change. The authors thus propose increased attention to common sexual and social norms and behaviours. New and harmful community norms are one of the major drivers of the ongoing spread of HIV among young women and men in black communities. Addressing sexual risk behaviours and the gender and sexual norms that influence them to scale requires ensuring communities are provided with skills to reflect on the individual and social mechanisms by which these risk behaviours are generated and normalised. To achieve this, partnerships must be formed between political leaders, researchers, technocrats and affected communities. Considering the severity of the epidemic and the continued high incidence of HIV, it is high time to review the current strategy to HIV control in South Africa and allocate more resources to approaches that emphasise community driven norm and behaviour change.","php":"","field_issue_date":"2015-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":" Emergency care in 59 low- and middle-income countries: a systematic review","field_subtitle":"Obermeyer Z;  Abujaber S; Makar M; Stoll S; Kayden SR; Wallis LA; Reynolds TA; the Acute Care Development Consortium: Bulletin of the World Health Organization 93 (8), August 2015","URL":"http://www.who.int/bulletin/volumes/93/8/14-148338-ab/en/","body":"This systematic review of emergency care in low- and middle-income countries (LMICs) analysed reports published from 1990 onwards. The authors identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"\"How AIDS changed everything\u201d Fact Sheet","field_subtitle":"UNAIDS: August 2015","URL":"http://www.unaids.org/sites/default/files/media_asset/20150714_FS_MDG6_Report_en.pdf","body":"The UNAIDS 2014 Global HIV/AIDS Statistics contains key data from the recent publication \"How AIDS changed everything\u201d. Global statistics include: 15 million people accessing antiretroviral therapy  as of March 2015.  36.9 million [34.3 million\u2013 41.4 million] people globally were living with HIV and 2 million [1.9 million \u2013 2.2 million] people became newly infected with HIV. In 2014, 1.2million [980 000 \u2013 1.6 million] people died from AIDS-related illnesses.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"18th International Conference on AIDS and STIs in Africa","field_subtitle":"29 November to 4 December 2015, Harare, Zimbabwe","URL":"http://icasa2015zimbabwe.org/overview/icasa-2015-background/","body":"As ICASA Zimbabwe coincides with the MDG target year, the International Conference on AIDS and STIs in Africa is offering the strategic first forum for post-MGD to leaders, activists, scientists and community to take stock of the outcomes of the MDG high level meeting challenges and to pave the way for a new, innovative and efficient approach towards an Africa AIDS free generation.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A qualitative study of the experiences of care and motivation for effective self-management among diabetic and hypertensive patients attending public sector primary health care services in South Africa","field_subtitle":"Murphy K; Chuma T; Mathews C; Steyn K; Levitt N: BioMed Central 15(303), 1 August 2015","URL":"http://www.biomedcentral.com/1472-6963/15/303","body":"Diabetes and hypertension constitute a significant and growing burden of disease in South Africa. Presently, few patients are achieving adequate levels of control. In an effort to improve outcomes, the Department of Health is proposing a shift to a patient-centred model of chronic care, which empowers patients to play an active role in self-management by enhancing their knowledge, motivation and skills. This study explored patients\u2019 current experiences of chronic care, as well as their motivation and capacity for self-management and lifestyle change. The study involved 22 individual, qualitative interviews with a purposive sample of hypertensive and diabetic patients attending three public sector community health centres in Cape Town. Participants were a mix of Xhosa and Afrikaans speaking patients and were of low socio-economic status. The concepts of relatedness, competency and autonomy from Self Determination Theory proved valuable in exploring patients\u2019 perspectives on what a patient-centred model of care may mean and what they needed from their healthcare providers. Overall, the findings indicate that patients experience multiple impediments to effective self-management and behaviour change, including poor health literacy, a lack of self-efficacy and perceived social support. With some exceptions, the majority of patients reported not having received adequate information; counselling or autonomy support from their healthcare providers. Their experiences suggests that the current approach to chronic care largely fails to meet patients\u2019 motivation needs, leaving many of them feeling anxious about their state of health and frustrated with the quality of their care. In accordance with other similar studies, most of the hypertensive and diabetic patients interviewed were found to be ill equipped to play an active and empowered role in self-care. It was clear that patients desire greater assistance and support from their healthcare providers. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"ALARA 9th Action Learning Action Research and 13th Participatory Action Research World Congress, 4-7 November, Pretoria, South Africa","field_subtitle":"4-7 November 2015, Pretoria, South Africa","URL":"http://www.alarassociation.org/pages/events/alara-world-congress-2015","body":"The theme of this World Congress is a challenge to Action Learning / Action Research practitioners the world over, whether working in resource rich or more socio-economically challenged contexts, to explain how they are contributing to the creation of a fairer world. The ALARA World Congress 2015 will create a space for dialogue as we ponder questions such as: How do we know we are asking the right questions to promote sustainable learning? How do we capacitate people to address the intricate interplay of social, economic, political and cultural factors that combine to preserve injustice? How do we ensure authentic collaboration between stakeholders across all levels? How do we use AL/AR to forge innovative, sustainable responses to contemporary complex challenges? How do we know we are successful in mediating sustainable change?","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"An assessment of community health workers' ability to screen for cardiovascular disease risk with a simple, non-invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study","field_subtitle":"Gaziano T; Abrahams-Gessel S; Denman C; Montano C; Khanam M; Puoane T; Levitt N: The Lancet Global Health 3 (9), e556\u2013e563, 2015, ","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00143-6/fulltext","body":"Cardiovascular disease contributes substantially to the non-communicable disease (NCD) burden in low-income and middle-income countries, which also often have substantial health personnel shortages. In this observational study the authors investigated whether community health workers could do community-based screenings to predict cardiovascular disease risk as effectively as could physicians or nurses, with a simple, non-invasive risk prediction indicator in low-income and middle-income countries. This observation study was done in Bangladesh, Guatemala, Mexico, and South Africa. Each site recruited at least ten to 15 community health workers based on usual site-specific norms for required levels of education and language competency. Community health workers had to reside in the community where the screenings were done and had to be fluent in that community's predominant language. These workers were trained to calculate an absolute cardiovascular disease risk score with a previously validated simple, non-invasive screening indicator. Community health workers who successfully finished the training screened community residents aged 35\u201374 years without a previous diagnosis of hypertension, diabetes, or heart disease. Health professionals independently generated a second risk score with the same instrument and the two sets of scores were compared for agreement. The study found that community health workers can be adequately trained to effectively screen for, and identify, people at high risk of cardiovascular disease. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Are We Prepared for the Next Global Epidemic? The Public Doesn't Think So","field_subtitle":"Kim JY: World Post, 5 August 2015","URL":"http://www.huffingtonpost.com/jim-yong-kim/are-we-prepared-for-the-n_b_7939812.html","body":"This article incudes evidence from a public opinion poll on pandemic preparedness.\r\nIt highlights three concrete actions on how we can be better prepared for the next global epidemic. The author states \"First, let's ensure that all countries invest in better preparedness. This starts with a strong health system that can deliver essential, quality care; disease surveillance; and diagnostic capabilities. We should expand successful efforts such as those by Ethiopia and Rwanda to train cadres of community health workers, who can expand access to care and serve as the frontline response to future disease outbreaks. The goal must be universal health coverage - both to ensure everyone can get the care they need, and also because those areas without adequate coverage put everyone at risk.\" He also calls for a smarter, better coordinated global epidemic preparedness and response system that draws upon the expertise of many more players - including a better-resourced WHO; and a pandemic emergency financing facility that can respond more quickly to epidemics. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Call for  ideas: A picture is worth a thousand words : what if we sketched Universal Health Coverage together ?","field_subtitle":"Submission deadline: 30th of September 2015, midnight GMT","URL":"http://www.healthfinancingafrica.org/home/a-picture-is-worth-a-thousand-words-what-if-we-sketched-universal-health-coverage-together","body":"What are the challenges the UHC system is facing in your country? Is it a learning system? Do the government actors who are leading the charge know how to dialogue with and involve other stakeholders (civil society, NGOs, the media\u2026)?  In your own organisation, do experts on UHC share their knowledge and experience with other team members? What analytical capacity is in place? Are there mechanisms for identifying good practices and promoting and verifying they are being applied well? These are some of the questions asked in this competition. To enter put the idea on paper - describe the situation you want to share. To make a good cartoon, your idea must be clear and precise. This contest is NOT limited to Africa. You can submit as many ideas as you have. A jury made up of experts familiar with UHC challenges and learning organisations will then select the best ideas to submit to the cartoonist. All those participants selected in this first round will get a prize. And it is from this pool that the cartoonist will choose what to draw. To participate in this competition, please send your ideas in English or in French, in a Word document (one scenario per file please) to Yamba Kafando, FAHS CoP facilitator (cdpafss@gmail.com). You will get a confirmation you\u2019re your scenario has been received, as well as a number for that scenario. Include your name and surname, the country in which you work, and your job title or role. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers: Fourth CODESRIA Conference on Electronic Publishing on The Open Access Movement and the Future of Africa\u2019s Knowledge Economy","field_subtitle":"Submission deadline: December 30, 2015","URL":"http://www.codesria.org/spip.php?article2402&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) announced the fourth in its electronic publishing conference series. This year\u2019s theme focuses on the open access publishing model with particular attention to its possible impact on the future knowledge economy in Africa.  This conference will explore core concepts and ideas, and help identify new technological and conceptual configurations. It will provide a rare opportunity for academics, librarians, publishers and policy-makers to come together for dialogues, discuss new research directions, methods and theories, and reflect upon the evolutionary issues about open access and their implications on research dissemination in Africa. With this scope in mind, the major topics of interest include, but are not limited to: Open access in the context of Africa; Value-added and marketing of African scientific information in the open access era; Africa  in the emerging global politics of open access;  Opening indigenous knowledges; Open access and Africa\u2019s knowledge economy; The politics of open access. CODESRIA will provide funding support to paper presenters who show evidence that they are unable to cater for their participation. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Proposals: 2015 Postdoctoral Fellowship Competition African Diaspora Support to African Universities Program","field_subtitle":"CODESRIA: Application Deadline:15th September 2015","URL":"http://www.codesria.org/spip.php?article2276&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) has launched an African Diaspora support to African Universities program. This call for proposals targets academics based in African universities, and those in the Diaspora within Africa and outside Africa (Europe, North America, Canada, Australia), in the SSH, both of whom have attained their PhDs in the last five years, or are at the advanced stage of their PhDs, to submit proposals for post-doctoral research, preferably, but not exclusively on issues related to one of the following themes: The African academic Diaspora and the revitalisation of Higher education in Africa; Current trends in economic theorisation on African social and economic development; The Social Sciences and the Place of African Higher Education in the World; African Citizenship, migration and economic mobility within and outside Africa. Individual applicants selected under this call will be invited to attend a methodological workshop in the early stages of implementation of their research projects.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"CSOs voice concerns over corporate takeover of WHO","field_subtitle":"Raja K: Third World Resurgence, 298/299, 35-37, 2015","URL":"http://www.twn.my/title2/resurgence/2015/298-299/cover05.htm","body":"At the World Health Assembly in May, civil society organisations criticised the rich countries for refusing an increase in their assessed contributions to WHO and opposing actions by the agency which would be contrary to the interests of their corporations. THE Framework for Engagement with Non-State Actors (FENSA), initiated to safeguard the independence, integrity and credibility of the World Health Organisation (WHO), now seems to bear the threat of facilitating and legitimising corporate capture of the organisation, civil society groups have charged. 'Many proposals by rich countries in draft FENSA text [are] promoting corporate capture of WHO in the name of promotion of engagements without discussion on any comprehensive mechanism to avoid conflict of interest. These proposals, if accepted, would institutionalise the undue corporate influence on WHO,' said Lida Lhotska of the International Baby Food Action Network (IBFAN) in a press release. Over the last 20 years, the proportion of WHO's budget which is met through mandatory assessed contributions has fallen from 75% to 20%. This is a consequence of continuing new functions being added to the organisation and a continuing freeze on assessed contributions. The remaining 80% is met by voluntary donations, including from the rich countries, the World Bank and the Bill & Melinda Gates Foundation.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Debt is back!","field_subtitle":"Jubilee Debt Campaign: Third World Resurgence 298/299, 5-7, 2015","URL":"http://www.twn.my/title2/resurgence/2015/298-299/special1.htm","body":"Rising inequality, along with financial deregulation, has spurred the significant increase in global debt levels. Although much of the media spotlight has focused on Greece recently, the fact is that more than 90 countries are either in or at risk of a new debt crisis. This articles presents the executive summary of a new report by the Jubilee Debt Campaign which highlights this phenomenon. Debt crises have become dramatically more frequent across the world since the deregulation of lending and global financial flows in the 1970s. An underlying cause of the most recent global financial crisis, which began in 2008, was the rise in inequality and the concentration of wealth. This made more people and countries more dependent on debt, and increased the amount of money going into speculation on risky financial assets. International debt has been increasing since 2011, after falling from 2008-11. The total net debts owed by debtor countries, by both their public and private sectors, which are not covered by corresponding assets owned by those countries, have risen from $11.3 trillion in 2011 to $13.8 trillion in 2014. We at the Jubilee Debt Campaign predict that in 2015 they will increase further to $14.7 trillion. Overall, net debts owed by debtor countries will therefore have increased by 30% - $3.4 trillion - in four years. Alongside this increase in global debt levels, there is also a boom in lending to impoverished countries, particularly the most impoverished - those called 'low-income' by the World Bank. Foreign loans to low-income-country governments trebled between 2008 and 2013, driven by more 'aid' being provided as loans - including through international financial institutions, new lenders such as China, and private speculators searching overseas for higher returns because of low interest rates in Western countries.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 175: Examining evidence on the private for-profit healthcare sector","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Examining evidence on the private for-profit healthcare sector ","field_subtitle":"Jessica Hamer, Health Policy Adviser, Oxfam GB ","body":"\r\nChallenges of high costs, out of pocket spending, regulation and quality affect the contribution the for-profit private sector makes in healthcare, according to presenters in a session on \u2018Private sector and Universal Health Coverage: Examining evidence and deconstructing rhetoric\u2019 hosted by Oxfam and Dr. Anuj Kapilashrami, of the Global Public Health Unit, University of Edinburgh, in the July 2015 International Conference on Public Policy.  \r\n\r\nThe session aimed to look at new and existing evidence on the role of the private for-profit sector in health, and to critically evaluate this in the context of achieving UHC in low- and middle-income countries. The five papers on experiences in Asia and Africa presented at the session looked at a wide range of private sector actors in health care delivery but raised a number of common themes and challenges. \r\n\r\nOne common feature was high levels of out-of-pocket spending (OOPS), or cash payments by households for services, medicines and other charges.  This was found for example where state insurers pay for services from private providers. Asha Kilaru presented study findings that people covered by state insurance schemes in Karnataka, India still had out of pocket spending for services, even for schemes where all costs should be covered. The study found that 93% of those insured by at least one government scheme sought care from a private hospital, and that only 8% reported receiving completely free care. Even where healthcare was provided for free, additional costs, such as multiple hospital referrals for different tests and treatment, meant OOPS still occurred.  One of the respondents\u2019 interviewed in the study stated: \r\n\u2018Only the operation [C-section] was free. At the government hospital, a C-section would be only Rs3-4000, but we went to a private hospital since we had insurance and wound up spending so much. It seems like government are agents that send us to a private hospital. In this yojana [Yeshasvini insurance scheme] the government spends and we also spend\u2019.\r\n\r\nAs the respondent indicated, high costs of care can be a burden to both households and the state. While this particular scheme (Yeshasvini)  claimed to be self-funded, Kilaru  found that it received Rs. 40 crore (equivalent to more than US$6 million) as a government grant in 2012-13 and Rs. 45 (or almost US$7 million) crore in the 2013-14 budget. \r\n\r\nJane Doherty, from University of the Witwatersrand, South Africa presented evidence in the session on the for-profit private healthcare sector in east and southern Africa. She noted that out of sixteen countries, \u2018no country places a ceiling on the prices that its private hospitals may charge\u2019 (although there may be some limitations to reimbursement payments made by insurers in two of the countries). Her study found \u2018little control of the fees charged by health professionals or limits placed on their total incomes, except in Kenya\u2019.\r\n\r\nThese challenges in controlling out of pocket spending and the overall costs of private healthcare present significant obstacles to achieving universal health coverage, and especially to ensuring access to healthcare for the poorest. Another recurring barrier to equitable access that was highlighted is the location of private services. Indranil Mukhopadhyay of the Public Health Foundation of India reported from a mapping of India\u2019s private healthcare provision that urban, metropolitan areas have the majority of private hospitals. In rural areas, where more poor people live, the private sector is largely comprised of individual practitioners. Moreover, almost half of India\u2019s private hospitals were located in cities with a population of more than 5 million. Mumbai alone has 16% of all India\u2019s private hospitals. The same bias towards urban provision was reported by Jane Doherty in east and southern Africa.\r\n\r\nIornumbe Usar, of Queen Margeret University, Edinburgh, investigated perceptions of shops selling medicines in Nigeria. His paper for the session highlighted major concerns around \u2018pervasive regulatory infringements\u2019 by these shops, especially in selling medicines beyond the scope of their licenses, as well as the lack of training of their staff. The paper raised  the challenges of regulating medicine vendors in Nigeria in order to improve their quality, highlighting how this has been constrained by inadequate funding, weak institutional capacity, the often-remote location of the shops, and conflicts between the different agencies responsible for regulation.\r\n\r\nThe same problem of poor regulation was reported by Jane Doherty in relation to for-profit private providers in east and southern Africa. Both an absence of regulation, and poor enforcement of regulation where it exists, were found to contribute to distortions in the wider health system, such as in treatment decisions or in the brain drain of health personnel from the public sector.  She observed that \u2018there is little monitoring by governments of quality and health outcomes, or attention to how the private health sector supports national health objectives\u2019. She observed that there is also little regulation to guard against anti-competitive behaviour, such as when insurers, providers and pharmacies are all owned  by the same company. She flagged in her presentation the challenges to regulation in the region, including patchy regulatory frameworks, the high cost of introducing new regulation, limited available information on the private sector, and the resistance of key stakeholders to regulation, or their \u201ccapture\u201d of regulation to safeguard their own interests. In South Africa, for example, attempts to regulate dispensing fees for pharmacists have been resisted heavily.\r\n \r\nAs Doherty concluded, these \u2018legislative gaps and enforcement problems, together with the fact that prices are not contained in any meaningful way, either through price controls or active reimbursement mechanisms, mean that for-profit private care in the region is likely to become increasingly unaffordable for any but the wealthiest\u2019. Yet, Doherty also concluded that the for-profit private sector is growing, so that these impacts need to be addressed. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org.  For more information see the full papers from the meeting at http://tinyurl.com/psma5ov; Oxfam\u2019s 2009 paper \u201cBlind Optimism: Challenging the Myths about Private Health Care in Poor Countries,\u201d www.oxfam.org/en/research/blind-optimism and the EQUINET discussion papers 87 http://tinyurl.com/3gky5k2 and 99 http://tinyurl.com/ou2dh4n on the growth and legislation of the private health sector in east and southern Africa.  Oxfam will be hosting additional discussion on its Global Health Check blog on the issues raised in the coming months.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Facilitators and Obstacles in Youth Saving: Perspectives from Ghana and Kenya","field_subtitle":"Zou L; Tlapek S; Njenga G; Appiah E; Opai-Tetteh D; Sherraden M: Global Social Welfare 2(2) 65-74, 2015","URL":"http://link.springer.com/article/10.1007/s40609-015-0028-y","body":"Youth are a rapidly growing percentage of the Sub-Saharan African population, and many are economically vulnerable. Financial inclusion for youth, particularly the promotion of savings behaviour, is associated with a number of positive social and economic outcomes and is an international priority. However, the majority of youth in Sub-Saharan Africa are not saving, and limited qualitative research exists to aid understanding of the possible explanations. This paper aims to increase the understanding of factors that facilitate and obstruct youth saving by exploring the savings behaviour of youth participating in the YouthSave Project in Ghana and Kenya. The authors conducted in-depth interviews with four triads comprised of youth, a parent or caregiver, and a school stakeholder in each country to develop case studies for the YouthSave Project. Findings indicate that support from parents, school staff, and financial institutions is conducive to youth participation in saving, even though youth participants struggle with limited financial resources and conflicting demands for money. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"First malaria vaccine given green light by European regulators ","field_subtitle":"Kollewe J: The Guardian, July 2015","URL":"http://tinyurl.com/p4tw3dn","body":"The world\u2019s first malaria vaccine has been given the green light by European regulators and could protect millions of children in sub-Saharan Africa from the life-threatening disease. The European Medicines Agency (EMA) recommended that RTS,S, or Mosquirix, should be licensed for use in young children in Africa who are at risk of the mosquito-borne disease. The shot has been developed by GlaxoSmithKline (GSK) and part-funded by the Bill and Melinda Gates Foundation. It has taken 30 years to develop vaccine, at a cost of more than $565m (\u00a3364m) to date. It will now be assessed by the World Health Organisation, which has promised to give its guidance on how and where it should be used before the end of the year. GSK will then apply to the WHO for a scientific review of the vaccine, which will be used by the UN and other agencies to help make purchasing decisions. The roll-out of the vaccine, which also has to be approved by national health authorities in sub-Saharan Africa, is likely to be funded by GAVI.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"How many people lack access to health care? (Hint: More than WHO and the World Bank report)","field_subtitle":"Freidman E: O Neil Institute, August 2015","URL":"http://www.oneillinstituteblog.org/how-many-people-lack-access-to-health-care-hint-more-than-who-and-the-world-bank-report/","body":"A recent World Bank press release on a World Bank and WHO report announced that \"400 million people do not have access to essential health services.\u201d The author argues in this article that this would be a highly over-optimistic misread of what WHO and the World Bank found. By more reasonable understandings of how many people lack access to essential health services, untold hundreds of millions more than 400 million people lack access to essential health services. He notes that the road ahead to universal health coverage is considerably longer than the headline figure implies. The report itself \u2013 beneath the headlines \u2013 covers many concerns and raises issues of quality and other concerns in a more complex reality. The author of this article notes that official monitoring should capture this complexity as what is monitored may well affect what governments prioritize, and the health services people actually receive, and so that a singular focus on access does not hide other aspects of people\u2019s right to health \u2013 including the quality of health services and their acceptability.  ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"How to build a theory of change for an impact evaluation","field_subtitle":"3ie International Initiative for Impact Evaluation","URL":"http://tinyurl.com/qbcqem2","body":"3ie\u2019s How-To videos use a simple step-by-step approach for explaining theoretical concepts. The How-To videos on impact evaluation draw from examples of impact evaluations to show viewers how to apply technical concepts. The videos in this series explore various topics related to designing, implementing and using impact evaluations. A short quiz at the end of each lecture will help assess your understanding of the subject covered in the video. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Influence of parental factors on adolescents\u2019 transition to first sexual intercourse in Nairobi, Kenya: a longitudinal study","field_subtitle":"Okigbo C; Kabiru C; Mumah J; Mojola S; Beguy D: Reproductive Health 12(73), 2015","URL":"http://www.reproductive-health-journal.com/content/12/1/73","body":"The objective of the study was to assess the influence of parental factors (monitoring, communication, and discipline) on the transition to first sexual intercourse among unmarried adolescents living in urban slums in Kenya. Longitudinal data collected from young people living in two slums in Nairobi, Kenya were used. The sample was restricted to unmarried adolescents aged 12\u201319 years. Parental factors were used to predict adolescents\u2019 transition to first sexual intercourse. Relevant covariates including the adolescents\u2019 age, sex, residence, school enrollment, religiosity, delinquency, and peer models for risk behaviour were controlled for. Approximately 6 % of the sample transitioned to first sexual intercourse within the one-year study period; there was no sex difference in the transition rate. In the multivariate analyses, male adolescents who reported communication with their mothers were less likely to transition to first sexual intercourse compared to those who did not. This association persisted even after controlling for relevant covariates. However, parental monitoring, discipline, and communication with their fathers did not predict transition to first sexual intercourse for male adolescents. For female adolescents, parental monitoring, discipline, and communication with fathers predicted transition to first sexual intercourse; however, only communication with fathers remained statistically significant after controlling for relevant covariates.  This study provides evidence that cross-gender communication with parents is associated with a delay in the onset of sexual intercourse among slum-dwelling adolescents. Targeted adolescent sexual and reproductive health programmatic interventions that include parents may have significant impacts on delaying sexual debut, and possibly reducing sexual risk behaviours, among young people in high-risk settings such as slums.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Lesser Known International Funders","field_subtitle":"fundsforNGOs: 6 August 2015","URL":"http://www.fundsforngos.org/free-download-lesser-known-donors-you-should-apply-for-funding-this-year/","body":"fundsforNGOs are offering a free download to their resource on \u2018Lesser Known International Donors You should look for Funding in 2015\u2019. It contains a list of profiles of those funding agencies that are not very well known but do offer active grants to NGOs around the world. Their application process is not as complex as that of traditional donors and there is less competition for seeking grants from them. These agencies also fund ideas for social change. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Long-term outcomes of a pediatric HIV treatment program in Maputo, Mozambique: a cohort study","field_subtitle":"Walter J; Molfino L;  Moreno V; Edwards CG; Chissano M; Prieto A; Bocharnikova T; Antierens A; Lujan J: Glob Health Action 8 (26652),  2015","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/26652","body":"This paper describes long-term treatment outcomes of a paediatric HIV cohort in Mozambique, in the Chamanculo Health District of Maputo. The subjects involved a total of 1,335 antiretroviral treatment (ART) na\u00efve children ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"National health accounts data from 1996 to 2010: a systematic review","field_subtitle":"Bui AL; Lavado R; Johnson EK; Brooks B; Freeman MK; Graves, CM; Haakenstad A; Shoemaker B; Hanlon M; Dieleman JL: Bulletin of the WHO 93 (8), August 2015","URL":"http://www.who.int/bulletin/volumes/93/8/14-145235-ab/en/","body":"The paper reports on work to collect, compile and evaluate publicly available national health accounts (NHA) reports produced worldwide between 1996 and 2010. The authors compiled data in the four main types used in these reports: (i) financing source; (ii) financing agent; (iii) health function; and (iv) health provider. The authors identified 872 NHA reports from 117 countries containing a total of 2936 matrices for the four data types. Most countries did not provide complete health expenditure data: only 252 of the 872 reports contained data in all four types. Some countries reported substantial year-on-year changes in both the level and composition of health expenditure that were probably produced by data-generation processes. All study data are publicly available at http://vizhub.healthdata.org/nha/. Data from NHA reports on health expenditure are often incomplete and, in some cases, of questionable quality. Better data would help finance ministries allocate resources to health systems, assist health ministries in allocating capital within the health sector and enable researchers to make accurate comparisons between health systems.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"New International Study Reveals South Africa has Saltiest Kiddies Chicken Burger Globally","field_subtitle":"Heart and Stroke Foundation South Africa, World Action on Salt and Health: Sangonet Pulse, August 2015","URL":"http://tinyurl.com/o2s2ano","body":"World Action on Salt and Health (WASH), with the support of the Heart and Stroke Foundation South Africa, has conducted a survey which investigated the salt content of 387 popular kid\u2019s meal combinations. The study found that of all countries surveyed, South Africa\u2019s brand chicken burger and chips aimed at children, have the highest salt content of all kiddies chicken burgers globally (more than \u00bd a teaspoon) per meal. The study also warns that too much salt in childhood, habituates children to the taste of salt, which could increase their blood pressure, and lead to strokes and heart failure later in life. \u201cWith South Africa having one of the highest rates of high blood pressure worldwide and 1 in 10 children already suffering from high blood pressure, we simply cannot afford to allow such high levels of salt in popular children\u2019s meals,\u201d argues Christelle Crickmore, science and programme development manager at WASH.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Nurses who moonlight strain the health system","field_subtitle":"Rispel L: Business Day Live (BDLive), July 2015","URL":"http://www.bdlive.co.za/opinion/2015/07/02/nurses-who-moonlight-strain-the-health-system","body":"Between 2009 and 2010, the author reports that the South African government spent about R1.49bn hiring nurses for the public health sector from nursing agencies. In that period, the provincial spending on agency nurses ranged from a low of just under R36.4m in Mpumalanga to a high of R356.4m in the Eastern Cape. In that financial year, this article reports that more than 5,300 registered nurses could have been employed by provincial governments instead of agency nurses, according to the published research. The government\u2019s spending on agency nursing is argued to be a result of nursing vacancies, poorly managed staff absenteeism, sub-optimal planning for patient loads and not involving nurses in decisions on their shifts or how best to cover hospital wards. Nursing agencies provide a vehicle for nurses to moonlight, as they could be employed concurrently in a public or private sector hospital as well as the agency. These agencies are not obliged to ask nurses whether they have concurrent employment. The author argues that the nursing agency spending is, however, an indication of the bigger crisis in South African nursing.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Private healthcare is \u2018wasteful\u2019","field_subtitle":"Culling K: Health-e News, 28 July 2014","URL":"http://www.health-e.org.za/2015/07/28/private-healthcare-is-wasteful/","body":"Private healthcare is wasteful and over-dependent on hospitals, which makes it too expensive for a large group of working people to join medical schemes, Health-e news reports.  As a result, scheme membership has stagnated at around 8,5 million people and is skewed towards older, sicker members. This was the assessment of healthcare consultant Dr Brian Ruff, speaking at the opening day of the Board of Healthcare Funders (BHF), the group that represents medical schemes and administrators in South Africa. Ruff said that families with an income of R7000 to R12000 a month may be able to afford membership of around R300 a month, yet no medical scheme could provide such a cheap service. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Profile of people with hypertension in Nairobi\u2019s slums: a descriptive study","field_subtitle":"Hulzebosch A; van de Vijver S; Oti S;, Egondi T;  Kyobutungi C: Globalization and Health 11(26), 27 June 2015","URL":"http://www.globalizationandhealth.com/content/11/1/26","body":"Cardiovascular disease is a rising health burden among the world\u2019s poor with hypertension as the main risk factor. In sub-Saharan Africa, hypertension is increasingly affecting the urban population of which a substantial part lives in slums. This study aims to give insight into the profile of patients with hypertension living in slums of Nairobi, Kenya. Socio-demographic and anthropometric data as well as clinical measurements including BP from 440 adults with hypertension aged 35 years and above living in Korogocho, a slum on the eastern side of Nairobi, Kenya, was be collected at baseline and at the first clinic visit. The study population showed high prevalence of overweight and abdominal obesity as well as behavioural risk factors such as smoking, alcohol and a low vegetable and fruit intake. Furthermore, the majority of hypertensive patients do not take anti-hypertensive medication and the ones who do show little adherence.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Public-private partnerships in Uganda cost the country dearly","field_subtitle":"Harper P: Jubilee Debt Campaign, August 2015","URL":"http://jubileedebt.org.uk/wp-content/uploads/2015/08/Uganda-case-study_08.15.pdf","body":"Privatisation of the Ugandan electricity sector, initiated in 1999 as a condition of the debt relief programme, was supposed to mean the end of state support. Yet, by 2013 a special committee of the Ugandan Parliament reported that subsidies were higher than ever before, preventing the government supporting critical development programmes. Between 2005 and 2012 the government had paid out subsidies totalling $600m to the privatised companies, alongside nearly $300m in rebates for \u2018losses\u2019 under their deal with the new electricity distribution company. An independent report is calling for the plant to be brought into public ownership because\r\n\u201cThe high cost of electricity in Uganda has reached unsustainable levels that are severely eroding local industries\u2019 competitiveness and domestic consumers\u2019 disposable income\u201d. The head of the government-owned Uganda Electricity Generation Company, has confirmed that discussions are ongoing to explore the viability of this proposal, which is designed to rein in costs and re-establish a degree of sovereign control over Uganda\u2019s national energy sector.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Reclaim our future. Oppose the Corporate Development Agenda ","field_subtitle":"People\u2019s Health Movement, 27 July 2015","URL":"http://peoplesgoals.org/wp-content/uploads/2015/07/Reclaim-our-future.-Oppose-the-Corporate-Development-Agenda15.pdf","body":"In September 2015 Heads of States and Governments will gather at the United Nations (UN) headquarters in New York City to agree on a new set Sustainable Development Goals (SDGs) and a 'global plan of action for people, planet and prosperity'.  The latest draft of this declaration which promises to 'transform our world' by 2030 and ensure that no one will be left behind in the process has just recently been released. However, the PHM notes that many of these same governments, particularly the more powerful ones among them, are also currently negotiating new 'free trade' deals that will have far-reaching implications for peoples in both the global North and South and for the future of the world economy and the planet. These agreements as they are currently framed and when adopted side-by-side, will not usher a new dawn for humanity.  Instead they are likely to further concentrate power and wealth in the hands of the 1% on the one hand, and deepen the dispossession, exploitation and oppression of peoples and environmental plunder on the other. A call, initiated by the Campaign for People's Goals for Sustainable Development, notes that people will not accept a development agenda that will serve as a vehicle for strengthening corporate power, re-legitimise the global capitalist growth model and perpetuate neoliberal globalisation.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Redefining shared sanitation","field_subtitle":"Rheinl\u00e4nder T; Konradsen F; Keraita B; Apoya P; Gyapong M: Bulletin of the World Health Organization 93 (7) 509-510, July 2015","URL":"http://www.who.int/bulletin/volumes/93/7/14-144980/en/","body":"According to the latest estimates from the World Health Organization/United Nations Children\u2019s Fund Joint Monitoring Programme for water and sanitation (JMP), 2.5 billion people worldwide do not have access to any type of improved sanitation. Current definitions do not account for the diversity of shared sanitation: all shared toilet facilities are by default classified as unimproved by JMP because of the tendency for shared toilets to be poorly managed and unhygienic. However, the authors argue that shared sanitation should not be automatically assumed to be unimproved. They also argue that it is necessary to have a new look at how we define shared sanitation and to use specific subcategories including household shared (sharing between a limited number of households who know each other), public toilets (intended for a transient population, but most often the main sanitation facility for poor neighbourhoods) and institutional toilets (workplaces, markets etc.). This sub-classification will, it is argued, identify those depending on household shared sanitation, which the authors consider to be only a small step away from achieving access to private and improved sanitation. This subcategory of shared sanitation is, therefore, worth discussing in greater detail. The authors argue that the focus for future sanitation programmes should be on improving the hygienic standards of shared facilities to a level that satisfies and protects sanitation users. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Research on health inequalities: A bibliometric analysis (1966\u20132014)","field_subtitle":"Bouchard L, Albertini M, Batista R, de Montigny J: Social Science & Medicine, 141,  100-108, 2015","URL":"http://www.sciencedirect.com/science/article/pii/S0277953615300381","body":"This study reported on research production and publications on health inequalities through a bibliometric analysis covering publications from 1966 to 2014 and a content analysis of the 25 most-cited papers. A database of 49,294 references was compiled from the search engine Web of Science. The first article appears in 1966 and deals with equality and civil rights in the United States and the elimination of racial discrimination in access to medical care. By 2003, the term disparity has gained in prominence relative to the term inequality which was initially elected by the researchers. The paper shows that research on health inequalities grown exponentially in the last 30 years; the terms inequity, inequality and disparity have been inconsistently used over time; the most-cited papers studied socioeconomic factors and impacts on health inequities with first reports studying relations of socioeconomic conditions and health outcomes and research growing toward theoretical models and proposals on methodological approaches.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Researcher - Southern Africa (Lusaphone) for Amnesty International ","field_subtitle":"Closing Date: 13 September 2015, Location: Johannesburg","URL":"http://www.pambazuka.org/en/category/jobs/95346","body":"The mobile revolution, geopolitical power shifts and a radically altered global economy constitute some of the evidence to demonstrate that the world is changing, and so is the way that people fight for their rights. In order to be effective, Amnesty International\u2019s (AI) International Secretariat needs to change how it works. That\u2019s why the Southern Africa Regional Office needs  research expertise on the ground and is advertising for this position. This is a permanent position. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Rising School Enrollment and Declining HIV and Pregnancy Risk Among Adolescents in Rakai District, Uganda, 1994\u20132013","field_subtitle":"Santelli J; Mathur S; Song X; Huang T; Wei Y; Lutalo T; Nalugoda F; Gray R; Serwadda D: Global Social Welfare 2(2), 87-103, 2015","URL":"http://link.springer.com/article/10.1007/s40609-015-0029-x","body":"Poverty, family stability, and social policies influence the ability of adolescents to attend school. Likewise, being enrolled in school may shape an adolescent\u2019s risk for HIV and pregnancy. The authors identified trends in school enrollment, factors predicting school enrollment (antecedents), and health risks associated with staying in or leaving school (consequences). Data from the Rakai Community Cohort Study (RCCS) were examined for adolescents 15\u201319 years (n&#8201;=&#8201;21,735 person-rounds) from 1994 to 2013. Trends, antecedents, and consequences were assessed. Qualitative data were used to explore school leaving among HIV+ and HIV&#8722; youths (15\u201324 years). School enrollment and socioeconomic status (SES) rose steadily from 1994 to 2013 among adolescents and orphanhood declined after availability of antiretroviral therapy. Antecedent factors associated with school enrollment included age, SES, orphanhood, marriage, family size, and the percent of family members ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Sexual health, human rights and the law","field_subtitle":"WHO: WHO, Geneva, 2015","URL":"http://www.who.int/reproductivehealth/publications/sexual_health/sexual-health-human-rights-law/en/","body":"This report demonstrates the relationship between sexual health, human rights and the law. Drawing from a review of public health evidence and extensive research into human rights law at international, regional and national levels, the report shows how states in different parts of the world can and do support sexual health through legal and other mechanisms that are consistent with human rights standards and their own human rights obligations.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"South stress balanced approach to patents for public health and development","field_subtitle":"TWN Info Service on Intellectual Property Issues, Aug15/01, August 2014","URL":"http://www.twn.my/title2/intellectual_property/info.service/2015/ip150801.htm","body":"Developing countries stressed the need for a balanced approach to patents to ensure public health and development interests at the 22nd session of the Standing Committee on the Law of Patents (SCP) of the World Intellectual Property Organisation (WIPO). Nigeria on behalf of the African Group stated that it recognises the instrumental role of the SCP in building knowledge, understanding the application of various patent related norms and effective use of the international patent system. However, Nigeria pointed out that SCP\u2019s activities \u201cinclude enabling factors encapsulated in the Development Agenda Recommendations, with the objective of enhancing patent related uses for social, technological and economic development and noted their disposition to actively engage within the SCP, on identified issues that support the objectives of the region, giving due regard to the different levels of development of WIPO Member States\u201d. It stressed that the \u201cpolicy space for Member States will therefore be of utmost relevance in SCP discussions and their outcomes\u201d. Pakistan on behalf of the Asia Pacific Group (Japan is not part of the Group) stressed the need for balanced discussions on all topics on the agenda. It stated that, \u201c The work of this committee is critical in balancing the rights of patent owners and public interest particularly in the area of public health, technology transfer and patent flexibilities.  It is essential to find the right balance between patent rights and the right to health in light of the differences in the levels of social, economic and technological development among members, TRIPS flexibilities and respect for intellectual property law and the needs of all Member States\u201d. It further stated that the balanced approach to patents \u201cnot only allow governments, especially in resource-constrained countries, with the necessary policy space to meet health needs but also promote further innovation\u201d. Brazil on behalf of GRULAC stated that it was \u201cimportant for Member States to learn from each other\u2019s experiences and practices under these two topics. While acknowledging similar practices in some countries, it is important to recognise that IP policies and legislation should address national economic and scientific issues as well as development concerns\u201d. Third World Network remarked that 22nd Session of the Standing Committee on the Law of Patents is taking place exactly after the 20th year of the TRIPS Agreement. During the last twenty years there is plenty of evidence to show that the TRIPS Agreement has failed to fulfil its promises especially in the context of addressing developmental challenges of developing countries. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Tanzania's Countdown to 2015: an analysis of two decades of progress and gaps for reproductive, maternal, newborn, and child health, to inform priorities for post-2015","field_subtitle":"Afnan-Holmes H; Magoma M; John T; Levira F; Msemo G; Armstrong C; Mart\u00ednez-\u00c1lvarez M; Kerber K; Kihinga C; Makuwani A; Rusibamayila N; Hussein A; Lawn J; Tanzanian Countdown Country Case Study Group: The Lancet Global Health 3(7) e396\u2013e409, 2015","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00059-5/abstract","body":"Tanzania is on track to meet Millennium Development Goal (MDG) 4 for child survival, but is making insufficient progress for newborn survival and maternal health (MDG 5) and family planning. To understand this mixed progress and to identify priorities for the post-2015 era, Tanzania was selected as a Countdown to 2015 case study. The authors analysed progress made in Tanzania between 1990 and 2014 in maternal, newborn, and child mortality, and unmet need for family planning, in which they used a health systems evaluation framework to assess coverage and equity of interventions along the continuum of care, health systems, policies and investments, while also considering contextual change (eg, economic and educational). In the past two decades, Tanzania's population has doubled in size, necessitating a doubling of health and social services to maintain coverage. Trends along the continuum of care varied, with preventive child health services reaching high coverage (&#8805;85%) and equity (socioeconomic status difference 13\u201314%), but lower coverage and wider inequities for child curative services (71% coverage, socioeconomic status difference 36%), facility delivery (52% coverage, socioeconomic status difference 56%), and family planning (46% coverage, socioeconomic status difference 22%). Mixed progress in reproductive, maternal, newborn, and child health in Tanzania were found to indicate a complex interplay of political prioritisation, health financing, and consistent implementation. ","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The invisibility of men in South African violence prevention policy: national prioritisation, male vulnerability, and framing prevention","field_subtitle":"van Niekerk A; Tonsing S; Seedat M; Jacobs R; Ratele K; McClure R: Glob Health Action 8( 27649),  2015","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/27649","body":"In the last two decades, there have been a plethora of South African policies to promote safety. However, indications suggest that the policy response to violence is not coherently formulated, comprehensive, or evenly implemented. This study examines selected South African national legislative instruments in terms of their framing and definition of violence and its typology, vulnerable populations, and prevention. This study comprises a directed content analysis of selected legislative documents from South African ministries mandated to prevent violence and its consequences or tasked with the prevention of key contributors to violence. The legislative documents recognised the high levels of violence, confirmed the prioritisation of selected vulnerable groups, especially women, children, disabled persons, and rural populations, and above all drew on criminological perspectives to emphasise tertiary prevention interventions. There is a policy focus on the protection and support of victims and the prosecution of perpetrators, but near absent recognition of men as victims. The authors argue for the policy framework to be broadened from primarily criminological and prosecutorial perspectives to include public health contributions, and to enlarge the conceptions of vulnerability to include men alongside other vulnerable groups.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"WHO reform: opening the floodgates to the private sector?","field_subtitle":"Richter J: Third World Resurgence 298/299, 20-23, 2015","URL":"http://www.twn.my/title2/resurgence/2015/298-299/cover02.htm","body":"The author presents in this paper how in the name of 'reform', against a backdrop of a funding crisis, a greater collaboration between WHO and big business is being justified.  She provides a historical overview of the process which began in 1992 with the drive for UN 'reforms', naming it as a euphemism for the neoliberal restructuring of the world body. Both the idea of attracting more funding from private foundations and the commercial sector and the notion of dealing with global health and nutrition matters through multi-stakeholder approaches are argued to carry major risks to WHO's role as the highest authority in international public health. Even though the regular World Health Forum is abandoned at the moment, the notion of greater involvement of the private sector as legitimate 'stakeholders' in public health affairs is not. She calls for an urgent reflection on whether this path should be pursued, noting that the 'privatisation' of public agencies and spaces increases the reliance on private sector funding, as well as inviting profit-motivated actors into public decision-making forums, and sometimes removing specific public issues from the public sphere altogether. This is seen to be the opposite of ensuring financial independence of public institutions and safeguarding and enlarging of spaces for public debate.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Xenophobia under spotlight during SADC Parliamentary Forum","field_subtitle":"Buthelezi Z: SABC News, 7 July 2015","URL":"http://tinyurl.com/ohpg9g6","body":"South Africa has continued to face questions about the recent xenophobic violence directed at African immigrants. The issue was raised during a discussion on migration on the side-lines of the 37th Session of the South African Development Community (SADC) Parliamentary Forum meeting at Zimbali north of Durban. Lawmakers, experts and government officials were among those who participated in the discussion on migration. At least seven people were killed and thousands others displaced from their homes during attacks on foreign nationals that started in KwaZulu-Natal in April. Speakers called for the movement of people around the continent - including of South Africans - to be encouraged. The Director of the United Nations African Institute for Economic Development and Planning, Professor Adebayo Olukoshi, argued that African countries need to take a developmental approach to migration policies - in the same way that countries like the US have done.  A South African provincial special reference group led by former UN Human Rights Chief Navi Pillay is looking into the causes of xenophobic violence and what should be done to prevent it from re-emerging. The group is expected to conclude its work in October.","php":"","field_issue_date":"2015-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A comparative analysis of national HIV policies in six African countries with generalised epidemics","field_subtitle":"Church K; Kiweewa F; Dasgupta A; Mwangome M; Mpandaguta E; G\u00f3mez-Oliv\u00e9 F; Oti S; Todd J; Wringe A; Geubbels E; Crampin A; Nakiyingi-Miiro J; Hayashi C; Njage M; Wagner R; Ario A; Makombe S; Mugurungi O; Zaba B: Bulletin of the WHO 93(7) 437-512, July 2015","URL":"http://www.who.int/bulletin/online_first/BLT.14.147215.pdf","body":"This study compared national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. A policy extraction tool was developed and used to review national HIV policy documents and guidelines published in Kenya, Malawi, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe between 2003 and 2013. Key informant interviews helped to fill gaps in findings. National policies were categorized according to whether they explicitly or implicitly adhered to 54 policy indicators, identified through literature and expert reviews. The authors also compared the national policies with WHO guidance. There was wide variation in policies between countries; each country was progressive in some areas and not in others. Malawi was particularly advanced in promoting rapid initiation of antiretroviral therapy. However, no country had a consistently enabling policy context expected to increase access to care and prevent attrition. Countries went beyond WHO guidance in certain areas and key informants reported that practice often surpassed policy. Evaluating the impact of policy differences on access to care and health outcomes among people living with HIV is challenging. Certain policies will exert more influence than others and official policies are not always implemented. It is proposed that future research assess the extent of policy implementation and link these findings with HIV outcomes.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Bretton Woods Institution Narratives about Inequality and Economic Vulnerability on the Eve of South African Austerity","field_subtitle":"Bond P: International Journal of Health Services . 45(3) 415-42, 2015 ","URL":"http://ccs.ukzn.ac.za/default.asp?2%2C68%2C3%2C3497","body":"In South Africa, at a time when National Health Insurance should be generously funded (7 years after its approval as public policy by the ruling party), the author argues in this paper that state fiscal austerity appears certain to nip the initiative in the bud. The World Bank and the International Monetary Fund issued separate reports about South Africa in late 2014, following a new finance minister's mid-term budget speech. In justifying austerity, they revealed 2 important conceptual blockages regarding inequality and international financial relations, giving neoliberal policy advocates intellectual weaponry to impose deeper austerity. In contrast, it is suggested that a \"united front\" of labour, community-based and social movement activists, along with a vigorous left opposition party in Parliament, could ensure that the class struggle ratchets up in intensity in the years ahead.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"BRICS: The strategic road map","field_subtitle":"Klomegah K: Pambuzuka News 735, July 2015","URL":"http://www.pambazuka.net/en/category.php/features/95177","body":"After three days of high-level summit deliberations, the BRICS group of emerging nations (Brazil, Russia, India, China and South Africa), have laid out the strategic road map that will tackle development and infrastructure projects, and seek close economic cooperation under a 'Strategy of Economic Partnership' that will run till 2020. The Strategy identifies priority areas of BRICS cooperation - in power, manufacturing, mining, agribusiness, innovative technologies and other areas. It is aimed at expanding multilateral business cooperation with the goal of stepping up social and economic development, and increasing the competitiveness of BRICS countries in the global economy. The document refers to collaboration in developing technology and innovation in pharmaceuticals in 'mutually beneficial joint projects'.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Bridging Waters Film Series","field_subtitle":"SADC: Botswana 2015","URL":"http://www.sadc.int/media-centre/image-video-audio-library/video-library/bridging-waters-videos/","body":"The Southern African Development Community (SADC) region is home to more than 260 million people, with transboundary rivers, lakes and groundwater bodies: 15 great rivers with their respective river basins in Southern Africa are shared between two or more countries. Water, however, does not recognise international boundaries. The joint management, protection and utilisation of water in Southern Africa is therefore not an option - it is a necessity. Bridging Waters is a docu-drama series illustrating how water in Southern Africa is sustainably managed according to SADC's Protocol on Shared Watercourses. Narrated through the lives of those living along Southern Africa's rivers and depicting their daily challenges, Bridging Waters connects local settings with transboundary management and exemplifies the local impacts of improved cooperation between countries in the region. Shot in 10 countries over a period of two years, the series delves into the waters of the Zambezi, the Limpopo, the Kunene, the Ruvuma and the Orange-Senqu. Rivers are the lifelines of Africa, and the film shows the shared responsibility to keep them flowing: clean and jointly managed for the benefit of all.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Call for Applications: Constitution of the College of Mentors for African Post-Graduate Students","field_subtitle":"CODESRIA: Deadline: August 31, 2015","URL":"http://www.codesria.org/spip.php?article2249","body":"The Council for the Development of Social Science Research in Africa (CODESRIA), with support from the Carnegie Corporation of New York has recently launched a program that seeks to encourage and facilitate African Diaspora support to African universities. As part of this initiative, CODESRIA intends to constitute a \u2018college of mentors\u2019, a grouping of senior academics from the African academic diaspora who are willing to devote some time to mentoring students enrolled in post-graduate (masters\u2019 and doctoral) programs in African universities. Mentors will be put in touch with one or several students who they would guide by reading draft chapters of their theses and dissertations, and journal article manuscripts; suggesting relevant reading material; and exposing them to scholarly debates they need to be aware of. Mentors might also be called upon to provide academic leadership in some of the initiatives that will be undertaken under the program. Interested mentors should send in a detailed current CV and a 5 page concept/ expression of interest note outlining their areas of interest and their vision in the program.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Choosing impertinence to provoke debate: global cartoonists express the SDGs","field_subtitle":"Editor, EQUINET newsletter","body":"\r\nAt Rio+20 in 2012, country leaderships promised to strive for a world that is just, equitable and inclusive, and committed to work together to promote sustained and inclusive economic growth, social development and environmental protection for the benefit of all. They set a mandate to develop a set of sustainable development goals (SDGs) for consideration by the UN General Assembly at its 68th session in 2013. These SDGs should be coherent with and integrated into the UN development agenda beyond 2015.\r\n\r\nThe 17 Sustainable Development Goals are:\r\n\u2022\tGoal 1\tEnd poverty in all its forms everywhere\r\n\u2022\tGoal 2\tEnd hunger, achieve food security and improved nutrition and promote sustainable agriculture\r\n\u2022\tGoal 3\tEnsure healthy lives and promote well-being for all at all ages\r\n\u2022\tGoal 4\tEnsure inclusive and equitable quality education and promote lifelong learning opportunities for all\r\n\u2022\tGoal 5\tAchieve gender equality and empower all women and girls\r\n\u2022\tGoal 6\tEnsure availability and sustainable management of water and sanitation for all\r\n\u2022\tGoal 7\tEnsure access to affordable, reliable, sustainable and modern energy for all\r\n\u2022\tGoal 8\tPromote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all\r\n\u2022\tGoal 9\tBuild resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation\r\n\u2022\tGoal 10 Reduce inequality within and among countries\r\n\u2022\tGoal 11 Make cities and human settlements inclusive, safe, resilient and sustainable\r\n\u2022\tGoal 12 Ensure sustainable consumption and production patterns\r\n\u2022\tGoal 13 Take urgent action to combat climate change and its impacts\r\n\u2022\tGoal 14  Conserve and sustainably use the oceans, seas and marine resources for sustainable development\r\n\u2022\tGoal 15  Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss\r\n\u2022\tGoal 16 Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels\r\n\u2022\tGoal 17  Strengthen the means of implementation and revitalize the global partnership for sustainable development\r\n\r\nThey are simple statements with great intent. They respond to a harsh reality of spectacular progress and spectacular inequality.\r\n\r\nHow widely are these goals known by those most affected by the situations they seek to address?  The SDGs add to many other current global commitments: the Universal Declaration of Human Rights, the Programme of Action for the Least Developed Countries for the Decade 2011-2020 (the Istanbul Programme of Action), the political declaration on Africa\u2019s development needs, the Doha Declaration on Financing for Development, the United Nations Framework Convention on Climate Change and the Millennium Development Goals, amongst others.  Over the years these statements of international cooperation have built a growing vocabulary of aspiration. No doubt the 17 goal statements will also attract many words and terms, targets and data, discussions, interpretations and explanations. \r\n\r\nIf words and targets begin to mystify intent and to obscure reality, particularly for those most directly affected, we may need other tools. Cartoonists from sixteen countries globally in the Cartooning for Peace network have, for example, portrayed their lens on the 17 SDGs in a book published in June 2015, and found at http://fr.calameo.com/read/002524839b003362c3438 . They present images of the goals for sustainable development as \u201cwork that is still precarious\u201d. Visit the link and you will see some that are aspirational, and many that are picture codes, communicating without a word the contradictions that exist in the face of the SDGs. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For information on the SDGs see https://sustainabledevelopment.un.org/focussdgs.html . Cartooning for Peace is an initiative born in 2006 that now brings together 125 cartoonists globally. For more information see http://www.cartooningforpeace.org/?lang=en.  ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"CODESRIA: Director of Publications","field_subtitle":"Closing date for applications: 10 September 2015. ","URL":"http://www.codesria.org/spip.php?article2407&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites applications from suitably qualified African professionals to fill the vacant position of Director of Publications in its pan-African Secretariat located in Dakar, Senegal. The position is a senior one and the successful candidate will work as a member of the Secretariat management team under the overall supervision of the Executive Secretary of the Council. The ideal candidate will be a scholar who also has a robust experience in academic publishing. African professionals who combine a robust experience in academic publishing with a solid training in the social sciences/humanities can also apply. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Contributions of global health diplomacy to equitable health systems in east and southern Africa","field_subtitle":"EQUINET: Harare, July 2015","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20GHD%20Summary%20brief%20June2015.pdf","body":"Do global health platforms provide meaningful opportunities to advance equitable health systems and population health in east and southern Africa? What factors have supported effective negotiation of African policy goals on health systems within international and global health diplomacy? This brief outlines, with hyperlinks to the relevant reports, the findings and proposals for follow up policy review, action and research from a three year EQUINET led policy research programme with government officials, technical institutions, civil society and other stakeholders and in association with the East, Central and Southern Africa Health Community (ECSA \u2013HC). The first two pages provide the broad findings, proposed actions and research agenda. Subsequent text presents the findings and proposals from the specific themes investigated in the programme.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Coping with the Challenges of Urbanization in Low Income Areas: An Analysis of the Livelihood Systems of Slum Dwellers of the Wa Municipality, Ghana","field_subtitle":"Abubakari Abu-Salia R; Kanton Osmannu I; Ahmed A: Current Urban Studies 3(2), 2015","URL":"http://www.scirp.org/Journal/PaperInformation.aspx?PaperID=57005#.VYQfpVxRfuI","body":" In Ghana, unplanned and spontaneous urbanization has trapped many in slum dwellings with its attendant poverty, insecurity, and poor housing and general environmental conditions. Slum dwellers\u2019 choices of livelihood activities are restricted under various socio-economic and planning constraints. Using mixed methods, this paper explored the conditions under which slum dwellers can maximize the prospects of their environment and minimize the challenges therein. The findings indicate that slum dwellers have a diversity of livelihood assets and potentials, yet limited access to planned adaptation remains a main challenge. Many dwellers result to autonomous supplementary occupations to cope with the challenges of urbanization. The authors argue for a redefinition of the mandate of urban planning, as a response to spontaneous urbanization, and for tools for sustainable livelihood at the local level. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Critical Maternal Health Knowledge Gaps in Low- and Middle-Income Countries for Post-2015: Researchers\u2019 Perspectives","field_subtitle":"Kendall, T: Paper No. 2. Women and Health Initiative, Harvard T.H. Chan School of Public Health: Boston, 2015","URL":"http://wordpress.sph.harvard.edu/mhtf-2/wp-content/uploads/sites/32/2015/02/Knowledge_gaps_MH_post2015.pdf","body":"Between June and October 2014, the Maternal Health Task Force (MHTF) consulted 26 international maternal health researchers to gather perspectives on the most critical and neglected areas for knowledge generation to improve maternal health in low- and middle-income countries. The MHTF asked respondents to identify research and evaluation priorities in three broad areas: 1) persistent and critical knowledge gaps that need to be filled to accelerate reductions in maternal mortality and morbidity in low-and middle income countries; 2) crucial maternal health issues that have not been given adequate attention by research and donor communities; and 3) new situations and emerging challenges that require research to improve maternal health outcomes. The report presents the results of the interview responses on issues that will shape the landscape of maternal health over the next decade. This included strengthening health service delivery; improving distribution and retention of healthcare workers; the increasing burden of non-communicable diseases among pregnant women and women of reproductive age; the persistence of social and economic inequality and vulnerability; and urbanization. The need to attend to geopolitical determinants of maternal health, such as climate change and food insecurity, the proliferation of conflict and humanitarian crises, and the rise of religious fundamentalism, was also mentioned.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Determining the competences of community based workers for disability-inclusive development in rural areas of South Africa, Botswana and Malawi","field_subtitle":"Lorenzo T; van Pletzen E; Booyens M: The International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy 15(2), 2015","URL":"http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=2919","body":"This article analyses the work of community disability workers (CDWs) in three southern African countries to demonstrate the competencies that these workers acquired to make a contribution to social justice for persons with disabilities and their families. It points to some gaps and then argues that these competencies should be consolidated and strengthened in curricula, training and policy. Purposive sampling was used to select and interviews held with 16 CDWs who had at least 5 years experience of disability-related work in a rural area. Three main themes emerged, related to the integrated management of health conditions and impairments within a family focus; disability-inclusive community development and coordinated intersectoral management systems.  The CDWs were found to facilitate change and manage the multiple transitions experienced by the families at different stages of the disabled person\u2019s development. Disability-inclusive development is argued to require a workforce equipped with skills to work intersectorally and in a cross-disciplinary manner to operationalise the community-based rehabilitation guidelines that are designed to promote delivery of services in remote and rural areas. The author argues for their recognition as a CDWs as a cross-disciplinary profession.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"E-Huesped: An information platform on transmissible diseases","field_subtitle":"Fundaci\u00f3n Hu\u00e9sped: July 2015","URL":"http://www.e-huesped.org/about","body":"e-huesped aims at communicating news about the progress made in the fields of HIV/aids, viral hepatitis and other transmissible diseases, in a swift and dynamic way using an online platform which allows the continuous collaboration and updating and information exchange with professionals throughout the world. The platform is accessible at any time and from any place.  It is implemented on the Edx platform developed by MIT and Harvard with online courses to update professionals in the health team. E-huesped was developed by Fundaci\u00f3n Hu\u00e9sped an Argentinean organization with projects that reach throughout Latin America responding to HIV/AIDS as both an infectious disease and a social challenge.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Ebola Report Misses Mark on International Health Regulations","field_subtitle":"Fidler D: Chatham House, July 2015","URL":"http://tinyurl.com/q56r74m","body":"The author argues that the report on the WHO\u2019s Ebola response fails to adequately address the problems in global health governance it exposed. The Ebola outbreak was a disaster for the International Health Regulations (IHR)\u2014the main international legal rules supporting global health security. The outbreak highlighted dismal compliance with IHR obligations on building national core public health capacities. During the outbreak, WHO failed to exercise authority it has under the IHR. Many WHO member states violated the IHR by implementing travel measures more restrictive than WHO recommended under the IHR and that lacked scientific and public health rationales as the IHR requires. The final report of the Ebola Interim Assessment Panel asserted that \u2018the global community does not take seriously\u2019 its IHR obligations. However the panel\u2019s IHR recommendations are argued by the author to be largely recycled old, ineffective ideas and to reflect weak analysis of the outbreak, difficulties the IHR experienced before Ebola, and challenges confronting IHR reform after this crisis. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Ensuring universal health coverage for key populations","field_subtitle":" UNAIDS: Geneva 2015","URL":"http://www.unaids.org/en/resources/presscentre/featurestories/2015/may/20150520_universalhealthcoverage","body":"Without addressing HIV among marginalized populations and human rights, this report argues that it will not be possible to end the AIDS epidemic as a public health threat by 2030. A high-level panel, which included UNAIDS Executive Director Michel Sidib\u00e9, called on health ministers to remove structural barriers to accessing HIV services and health care for all. Ensuring that marginalized populations are not excluded from the universal health coverage target of the next sustainable development goals was noted to be vital, noting a risk that countries could seek to advance progress towards universal health coverage by focusing on easier to reach populations. In order to ensure that no one is left behind, the report argues that measures will be needed to reduce the discrimination facing all marginalized groups and to ensure their meaningful participation in the development and implementation of health strategies.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 174: Choosing impertinence to provoke debate: global cartoonists express the SDGs ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Header"}},{"node":{"title":"Health impacts of household energy use:  indicators of exposure to air pollution and other risks","field_subtitle":"Williams K; Northcross A; Graham J: Bulletin of the World Health Organization 93 (7) 507-508, 2015","URL":"http://www.who.int/bulletin/volumes/93/7/14-144923/en/","body":"Recent evidence of the negative impact of household air pollution on health suggests that it is time to upgrade national surveys to inform decision-making on improved fuels and cookstoves. More than 40% of the world\u2019s population rely on solid fuels such as wood, crop residues or dung for their cooking and heating needs. Household air pollution, caused by cooking indoors with solid fuels, is the third leading risk factor for morbidity and mortality globally. In 2010, 3.5 million deaths and 4.3% of global disability adjusted life years were attributable to household air pollution. Pollutants from inefficient combustion of solid fuels, especially black carbon particles, also contribute to global climate change. This study discusses the implications of cooking apparatus, fuel collection practices, air pollution exposure and fuels for other purposes. The morbidity and mortality linked to cooking with solid fuels are significant, with particular implications for women and children. The impetus for assessing new indicators is motivated by a need to more fully understand how the household energy sector is changing in low- and middle-income countries. The information gained from improved indicators has the potential to better inform the targeting of resources and design of strategies for reducing household air pollution.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Healthcare service providers\u2019 and facility administrators\u2019 perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study","field_subtitle":"Lang\u2019a E; Mwanri L: Reproductive Health 12(59), 27 June 2015","URL":"http://www.reproductive-health-journal.com/content/12/1/59","body":"In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. The authors note that implementation of the policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitised on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and collaboration with other key stakeholders be fostered in addressing poor maternal health outcomes in the country.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Hidden in Plain Sight: A statistical analysis of violence against children","field_subtitle":"UNICEF: Geneva 2014","URL":"http://www.unicef.org/publications/index_74865.html","body":"Interpersonal violence has a grave effect on children: Violence undermines children\u2019s future potential; damages their physical, psychological and emotional well-being; and in many cases, ends their lives. This report sheds light on the prevalence of different forms of violence against children, with global figures and data from 190 countries. Where relevant, data are disaggregated by age and sex, to provide insights into risk and protective factors. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"In Search of Global Health Justice: A Need to Reinvigorate Institutions and Make International Law","field_subtitle":"Harmon S: Health Care Analysis, 26 June 2015","URL":"http://paperity.org/p/73573996/in-search-of-global-health-justice-a-need-to-reinvigorate-institutions-and-make","body":"The author argues that responses to the recent outbreak of Ebola in West Africa were varied and many ineffective. More generally, the author suggests that it stems from a failure of international health justice as articulated by a range of legal institutions and instruments, and that it should prompt us to question the state and direction of approaches to the governance of global public health. This paper queries what might be done to lift global public health as a policy arena to the place of prominence that it deserves. It presents critical reasons for the failings of the global public health regime, including the marginalisation of health and equity in current economic individualist, monetised, market-focussed models and goals, and a fragmented, patchwork and ad hoc nature of the global public health architecture, with wide dispersion of the authority to act and a treatment-oriented and disease-specific focus. The paper articulates a new way forward, identifying three courses of action that might be adopted in realising better health outcomes and global health justice, namely value, institutional and legal reform.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Inequalities in health: definitions, concepts, and theories","field_subtitle":"Arcaya M;  Arcaya A; Subramanian S: Global Health Action 8 (27106), June 2015 ","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/27106","body":"This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. The authors describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behaviour, environmental, and selection explanations. Concepts of relative versus absolute; dose\u2013response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. The authors close by reflecting on what conditions make health inequalities unjust, and consider the merits of policies that prioritise the elimination of health disparities versus those that focus on raising the overall standard of health in a population.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Investing in the future we want: What will it require?","field_subtitle":"ECOSOC High Level Political Forum on Sustainable Development: Brief for Session 11b, New York, July 2015","URL":"https://sustainabledevelopment.un.org/content/documents/1807BN%2011b_2%20July%20final.pdf","body":"The post-2015 development agenda will have at its core the sustainable development goals (SDGs). The SDGs are a set of universal goals covering a range of sustainable development issues. The challenge for the international community will be to match this agenda with adequate means to implement it. This translates into large financing needs. In its report issued in August 2014, the Intergovernmental Committee of Experts on Sustainable Development Financing estimated the investment requirements in different sectors. More recently, a group of multilateral development banks and the IMF have coined the term 'from billions to trillions' to characterise the financing demand. Globally, they estimate that achieving the proposed SDGs will require US$ 135 billion in ODA, and nearly 1 trillion in philanthropy, remittances, South-South flows and other official assistance, and foreign direct investment that needs to be used effectively for the SDGs.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Modern African Remedies: Herbal Medicine and Community Development in Nigeria","field_subtitle":"Africa Research Institute, April 2015","URL":"http://www.africaresearchinstitute.org/publications/modern-african-remedies/","body":"Pax is a private sector rural manufacturing enterprise in Edo State Nigeria that is a joint endeavour of the monastic and local communities. It has professionalised the production of traditional natural remedies to demonstrate that herbal medicines can be a force for innovation and progress in health care. An estimated two-thirds of Nigerians are reported in this paper to use these products, often in tandem with other medicines. The company holds that open dialogue, scrutiny and regulation are crucial if the economic potential of the sector is to be realised, and that traditional medicine must be modern, professional and based on science if it is to contribute to improving health systems and outcomes. More than 30 Pax products are reported to be government-certified. The paper argues that traditional medicine and pharmaceutical industries could be fostered in Nigeria; but that indigenous knowledge, resources and enterprise still remain under-exploited.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Monitoring pro-poor health-policy success in the SADC region","field_subtitle":"Amaya AB; Bagapi K; Choge I; De Lombaerde P; Kingah S; Kwape I; Luwabelwa M; Mathala O; Mhehe E; Moeti T; Mookodi L; Ngware Z; Phirinyane M: PRARI Policy Brief 1, April 2015","URL":"http://www.cris.unu.edu/fileadmin/user_upload/Policy_brief_no_7-English-v2.pdf","body":"Monitoring pro-poor health policies at the regional level can support countries and regional bodies to identify gaps in addressing poverty and health, strengthen the link between regions and member states and hold actors accountable to their commitments. The Southern African Development Community (SADC) has conducted work in understanding how poor health and poverty coincide, are mutually reinforcing, and socially-structured by gender, age, class, ethnicity and location, with health policy documents on the issues. Yet guidelines and policies have been unevenly implemented. The Poverty Reduction and Regional Integration (PRARI) project seeks to support the development of a monitoring system to measure the contribution of regional governance in the development of pro-poor health policies in collaboration with key stakeholders in the region. The paper describes the system. It builds on existing efforts in the region and focuses on policy areas such as the social determinants of health; HIV/AIDS, TB and malaria; non-communicable diseases; maternal and child health; human resources for health; pharmaceuticals; among others. Global developments such as those related to the incoming Sustainable Development Goals (SDGs) are also considered. In order for this indicator-based monitoring system to be effective and to have an impact, it is argued to require regional ownership, active participation of national and regional experts throughout the process of indicator development, implementation and evaluation and evidence that it will address health priorities for the region. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"MPhil in Inclusive Innovation","field_subtitle":"Call for Applications: Deadline 1 November 2015","URL":"http://www.gsb.uct.ac.za/s.asp?p=443","body":"The University of Cape Town (UCT) Graduate School of Business is now inviting applications to its pioneering MPhil specialising in Inclusive Innovation in 2016 \u2013 a hands-on postgraduate degree that aims to generate practical and scalable sustainable solutions to African challenges.  Inclusive innovators who take this learning journey will travel through a rigorous academic curriculum right through to practical prototyping of new business models, processes, services or products that will help create a more inclusive economy and society at large. You will work together in a \u201cliving lab\u201d environment, where expertise, life experience, passion and innovation all converge to support new possibilities and ideas. In this rich, integrative space, commercial, technological and social innovations all combine to further Africa\u2019s future. You will also be exposed to some of the most exciting thinkers and practitioners working in the field of social innovation and entrepreneurship at this time. Applicants should be passionate and creative individuals who have a postgraduate degree, work experience, and a passion for a better, more inclusive future.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Pan-African human rights defenders awards","field_subtitle":"Pan-African Human Rights Defenders Network: Nominations are presently open","URL":"https://africandefenders.org/hrd-award/","body":"Pan-African Human Rights Defenders Network (PAHRD\u2013Net) has opened a call for nominations for the 2nd Edition of human rights defenders awards. The awards will honor exceptional individuals who peacefully promote and protect universally recognized rights as stated in the Universal Declaration of Human Rights and the African Charter on Human and Peoples\u2019 Rights. Altogether six awards will be presented, one overall award and five sub-regional awards. Both individuals and organizations are eligible for the award.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Post-2015 Development Agenda: New draft out for final negotiations ","field_subtitle":"TWN:  Info Service 28 July 2015","URL":"http://tinyurl.com/ortqahs","body":"The Co-facilitators of the Post-2015 Development Agenda talks have released what could be the near-final version of the Post-2015 Development Agenda. This will set the stage for the final round of hectic negotiations at the United Nations headquarters in New York in end July.\r\nThe \u201cOutcome Document for the UN Summit to Adopt the Post 2015 Development Agenda: Draft for Adoption\u201d attempts to resolve some of the still remaining thorny issues. However, whether and how quickly the Member States agree to the final document remains to be seen. The document is likely to undergo some changes as negotiations continue, and the final document will be adopted when there is consensus among member states. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Price tag of HIV response to more than double by 2033","field_subtitle":"Schmidt H; Gostin L; Emanuel E: The Lancet, 29 June 2015","URL":"http://www.health-e.org.za/2015/06/12/price-tag-of-hiv-response-to-more-than-double-by-2033/","body":"With 3.1 million people on antiretrovirals (ARV), South Africa has the world\u2019s largest ARV programme. Sustaining it \u2013 and the HIV response \u2013 is argued to more than double in cost in the next two decades, according to new research. The research reported in this paper modelled the cost of county\u2019s HIV response and what it will take to meet ambitious international development targets adopted by the country in 2014. The research found that South Africa\u2019s HIV programme will cost about R40 billion each year by 2033 \u2013 more than double the R21 billion budgeted for the programme in the next financial year. The analysis also revealed the top 18 most cost-effective ways South Africa can tackle its epidemic. Top of the list was increasing condom distribution, medical male circumcision and mass communication campaigns promoting safer sex among teens. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Public health, universal health coverage, and Sustainable Development Goals: can they coexist?","field_subtitle":"Schmidt H; Gostin L; Emanuel E: The Lancet, June 2015","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60244-6/fulltext","body":"The UN General Assembly is currently considering proposals for Sustainable Development Goals (SDGs). SDG 3, focusing on health, specifically includes universal health coverage (UHC) among its targets. The authors argue that while UHC is timely and important, its promotion also entails substantial risks. A narrow focus on UHC could emphasise expansion of access to health-care services over equitable improvement of health outcomes through action across all relevant sectors\u2014especially public health interventions, needed to effectively address non-communicable diseases (NCDs). The challenge for policy makers is observed to be to not merely to improve clinical services, but to achieve equitable health outcome improvements through genuine integration of individual and population-level health promotion and preventative efforts with curative services. Future UHC evaluations should include assessments of the extent to which this integration is accomplished\u2014with particular attention to the distribution of benefits across groups\u2014and not, as major current work be limited to the clinical side.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Report of the Ebola Interim Assessment Panel","field_subtitle":"WHO: Geneva July 2015","URL":"http://www.who.int/csr/resources/publications/ebola/report-by-panel.pdf?ua=1","body":"This report of the assessment panel which the WHO commissioned on its response to the Ebola outbreak was meant to review the roles and responsibilities at the three levels of the organization (headquarters, regions, countries) and the WHO\u2019s actions in the course of the outbreak. The report and recommendations fall under the following three headings: the International Health Regulations (2005); WHO\u2019s health emergency response capacity; and WHO\u2019s role and cooperation with the wider health and humanitarian systems. It found Member States have largely failed to implement the core capacities, particularly under surveillance and data collection, which are required under the International Health Regulations (2005); in violation of the Regulations, nearly a quarter of WHO\u2019s Member States instituted travel bans and other additional measures not called for by WHO, which significantly interfered with international travel, causing negative political, economic and social consequences for the affected countries; and significant and unjustifiable delays occurred in the declaration of a Public Health Emergency of International Concern (PHEIC) by WHO. The Panel concluded that WHO be the lead health emergency response agency but that this requires that a number of organizational and financial issues be addressed urgently. The Panel considered that during the Ebola crisis, the engagement of the wider humanitarian system came very\r\nlate in the response. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Rising through cities? A look at Ghana","field_subtitle":"Paller J: Africa Research Institute, 9 June 2015","URL":"http://www.africaresearchinstitute.org/blog/rising-through-cities-a-look-at-ghana/","body":"A new report by the World Bank- Rising through Cities in Ghana-analyses the rapid transformation of a country whose urban population has grown from 4 million in 1984 to more than 14 million today. 51% of Ghanaians now live in cities. Over the same period annual GDP growth has averaged 5.7%, the number of industrial and service jobs has increased by 21% and the capital city, Accra, has registered a 20% reduction in poverty. In August 2014, a fiscal debt crisis forced the government to request financial assistance from the International Monetary Fund. In May 2015, Accra residents peacefully protested the failure to resolve a three-year long electric power crisis that has sapped businesses and hindered economic growth. The World Bank has presented a report with data on urban development in Ghana and this paper provides a critical analysis of the report and a link to the original publication. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"SADC Gender Protocol 2015 Barometer: Botswana","field_subtitle":"Glenwright D; Botswana Council of NGOs: Botswana Council of NGOs, Gaberone, June 2015","URL":"http://www.genderlinks.org.za/article/sadc-gender-protocol-2015-barometer-botswana-2015-06-25","body":"Botswana has made good progress against the targets of the Southern African Development Community (SADC) Protocol on Gender and Development set for 2015, according to this report. However, President Ian Khama of the Republic of Botswana said that Botswana would not sign the SADC Gender Protocol because the government considers some its time frames unrealistic, and some of its measures to have serious resource implications that the state cannot guarantee. Progress is noted in the report on the health sector, with trained personnel delivering more than 90% of births and 84% of the population living within five kilometres of a quality health facility. However, the maternal mortality rate is noted to have increased and only 44% of the population access contraception. Although Botswana has one of the world's highest HIV prevalence more than 95% of HIV-positive pregnant women access the prevention of mother-to-child transmission programme. In spite of these achievements, this report also reveals obstacles for the country on the road to gender equality, including a failure to address contradictions between formal and customary laws, with the latter discriminating against women, especially widows and divorced women. ","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"SADC holds Ministerial Meeting on Disaster Preparedness and Response","field_subtitle":"SADC: Botswana, July 2015","URL":"http://www.sadc.int/news-events/news/sadc-holds-ministerial-meeting-disaster-preparedness-and-res/","body":"'Enhancing Regional Disaster Preparedness and Response' was the theme of the first extra-ordinary Meeting of Ministers Responsible for Disaster Risk Management and Ministers of Finance, held on June 26, 2015 in Harare, Zimbabwe. The SADC Region is exposed to a wide range of hazards and disasters that frequently result in heavy loss of lives and livelihoods, displacement of large populations, disruption of economic activities, destruction of assets and loss of investment. The Hazards that affect the Region include floods, drought, snow, volcanic eruption landslides, tsunamis, tropical cyclones, storms, wild fires and earthquakes. These hazards increase the risk of shortages of water, outbreaks of diseases such as Malaria, cholera and other diarrhoeal diseases, malnutrition and stunted growth, foot and mouth diseases in animals and other negative impacts. The meeting was organised by the SADC Secretariat specifically by the Disaster Risk Reduction Unit under the auspices of the Directorate of the Organ on Politics, Defence and Security Affairs in collaboration with the Government of Zimbabwe. The Ministers directed the SADC Secretariat to develop a comprehensive regional disaster risk reduction strategy which should include regional response mechanisms and a humanitarian assistance framework. They also agreed to the establishment of a regional disaster preparedness and response fund and development of an integrated early warning system to ensure effective information dissemination on hazards faced by the region.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Technology, innovation and health equity","field_subtitle":"Fong H; Harris E: Bulletin of the World Health Organization 93 (7), July 2015","URL":"http://www.who.int/bulletin/volumes/93/7/15-155952/en/","body":"Innovative technologies have enormous potential to improve human well-being. However, technological progress does not guarantee equitable health outcomes. As advances in technology redefine the ways people, systems and information interact, resource-poor communities are often excluded. Where technological fixes have been imposed on communities, the results have included abandoned equipment, incompatible computer programs and ineffective policies. A shift in values among leadership, communities and the creators of technology is argued to be critical to implementing technology sustainably and equitably. Numerous examples are outlined where technological applications undermine equity, fairness and human rights: for example, the use of high-tech medical interventions in preference to simpler preventive measures or terminator genes that prevent the re-use of seeds for food crops. To ensure equitable outcomes, the authors note that the design and implementation of technology needs to respect ethical principles and local values. Decisions on the use of new technology should be made by local users, and implementation needs long-term commitment and local ownership. In this article, the authors discuss features of technology implementation that can promote health equity, using a range of examples from the health, agriculture and economic sectors.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Use of Evidence - Blended Learning Course","field_subtitle":"International NGO Training and Research Centre: Online course 6 October 2015 to 4 November 2015","URL":"http://www.intrac.org/events.php?action=event&id=647","body":"This course seeks to help those who lack confidence using evidence in their work and facing external or internal pressure to justify the evidence that they produce. In this course delivered online participants will have the opportunity to develop their knowledge and understanding of evidence. With a practical focus, they will learn the skills to identify sources of evidence, assess the quality of evidence, and integrate the use of evidence into their own work and organisation so that it is of high quality and can be used with confidence. At the end of the course, participants will be familiar with definitions of, and approaches to, evidence in international development and the wider implications for practitioners; be able to identify and work with existing sources of evidence, addressing relevance and purposes for different activities and audiences; be able to understand different approaches to, and have built skills in, assessing the quality of evidence; be able to plan for the use of better evidence in their work; have applied their learning and have explored the challenges and how to overcome them. During the practical component of the course, participants will apply their learning to a particular area of work where they use evidence, such as advocacy, monitoring and evaluation, or programming. The course takes place over four weeks and includes self-directed learning and one-to-one coaching tailored to the needs of the participant. It is aimed at technical staff in NGOs who need to engage with evidence in their work, for example in programme, planning, monitoring and evaluation, or advocacy. Participants will have some exposure to using research evidence through academic training or work experience, but need to gain a better understanding of core concepts.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: implications of multimorbidity for health systems in an era of health transition","field_subtitle":"Oni T; Unwin N: International Health 7(4), June 2015","URL":"http://inthealth.oxfordjournals.org/content/early/2015/06/22/inthealth.ihv040.full.pdf+html","body":"In today\u2019s globalised world, rapid urbanisation, mechanisation of the rural economy, and the activities of transnational food, drink and tobacco corporations are associated with an increased risk of chronic non-communicable diseases (NCDs). As a result, population health profiles are rapidly changing. Many low and middle income countries (LMICs) are undergoing rapid changes associated with developing high rates of NCD while concomitantly battling high levels of communicable diseases. This review synthesises evidence on the overlap and interactions between established communicable and emerging non-communicable disease epidemics in LMICs. The review focuses on HIV, TB and malaria and explores the disease-specific interactions with prevalent NCDs in LMICs. The authors highlight the complexity, bi-directionality and heterogeneity of these interactions and discuss the implications for health systems. It is argued to require breaking down barriers between departments within\r\nhealth ministries that have traditionally designed services and\r\nprograms for communicable and NCD separately and integrated multi-sectoral action addressing determinants across the life course.","php":"","field_issue_date":"2015-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"African performance on human rights","field_subtitle":"Anambo Ongoche E: Pambuzuka News 730, 10 June 2015","URL":"http://www.pambazuka.net/en/category.php/features/94929","body":"Almost two decades after adoption of the African Charter on Human and Peoples' Rights, the record of adherence to its provisions across the continent is mixed. Some countries have made notable progress, but others show persistent serious violations of human rights. African performance on human rights as spelled out in the Charter varies from one country to another. The author elaborates the situation in different countries on the continent against the rights set out in the Charter. The author concludes that Africa has a long way to go in the practice and upholding of human rights at out in the Charter. He urges that governments be made accountable to ensure that human rights are upheld.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Agenda 2063 Vision and Priorities","field_subtitle":"African Union, Addis Ababa, May 2015 ","URL":"http://agenda2063.au.int/en/documents/agenda-2063-africa-we-want-popular-version-final-edition","body":"The African Union set out its vision of An Integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in the global arena. Aiming to encourage discussion among all stakeholders, Agenda 2063 is an approach to how the continent should effectively learn from the lessons of the past, build on the progress now underway and strategically exploit all possible opportunities available in the immediate and medium term, so as to ensure positive socioeconomic transformation within the next 50 years. Agenda 2063 emphasizes the importance of Pan-Africanism, unity, self-reliance, integration and solidarity that was a highlight of the triumphs of the 20th century. It highlights the need to more effectively use African resources for the benefit of people in the continent. It raises regional political, institutional renewal and financing/resource mobilization issues, as well as the changing nature of Africa\u2019s relationships with the rest of the world. The AU is calling for input to the agenda. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"BRICS Bank could be game-changer","field_subtitle":"Klomegah K: Pambuzuka News 731, 19 June 2015","URL":"http://www.pambazuka.net/en/category.php/features/94938","body":"The July BRICS Summit ratified an agreement on the establishment of a $100 billion BRICS pool of currency reserves, according to a document published early May 2015. It is reported that the bank will invest primarily in infrastructure projects in both BRICS and non-BRICS countries. The establishment of its first regional office in Johannesburg will give access to the Africa, where infrastructure development needs are highest. The idea to set up BRICS bank was first proposed by India and that topped the agenda at the summit of the group in New Delhi in March 2012. India believes a joint bank would be in line with the growing economic power of the five-nation group. The bank could firm up the position of BRICS as a powerful player in global decision-making. India believes that a BRICS bank could, among others, issue convertible debt, which would arguably be top-rated and can be bought by central banks of all BRICS countries. BRICS countries would thus have a vessel for investment risk-sharing.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Call for applicants: Strengthening PhD programmes in African Universities ","field_subtitle":"Application deadline: 21 August 2015","URL":"http://www.codesria.org/spip.php?article2377&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) calls for applications from research laboratories and doctoral schools in African universities for the first phase of its initiative to support research in the social sciences and humanities. The objective of this initiative is to restore and/or enhance the seminar culture within research laboratories, doctoral schools in African universities, while encouraging the use of multi and interdisciplinary approaches. After a rigorous selection exercise by an international independent selection committee, selected research laboratories and doctoral schools will receive a grant of 10,000 dollars from CODESRIA, which is expected to be used for: the purchase of books and journals for the benefit of the entire academic community; a scientific seminar exposing PhD students to relevant literature, current debates, and theoretical approaches in relation to a given topic; a methodology seminar, and a scientific writing workshop. Further information can be found at the website.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Applications: PhD Applications at HEARD/UKZN, South Africa","field_subtitle":"Closing date for applications: 1 August 2015","URL":"http://tinyurl.com/qfv6kaz","body":"HEARD is calling for applications for up to four full-time PhD Research Scholarships in any of the following key areas of strategic focus Sexual and Reproductive Health; Health Systems Strengthening and Economics of Critical Enablers in HIV Programming. Award of the HEARD PhD Research Scholarship is conditional on candidates meeting the requirements for PhD registration at the University of KwaZulu-Natal, and on participating in a compulsory training component during the first year of study. The training component will be conducted over four two-week blocks during the first year of study. Candidates will produce a thesis related to one of HEARDs priority research nodes, as detailed above. The Scholarship programme emphasises the mastery of quantitative and qualitative methods for understanding policy problems and for devising, evaluating and/or implementing policy solutions. The intention of providing PhD scholarships is to produce expertly qualified graduates to advise or to be part of influential policy making organisations in Africa. During their PhD, students will be strongly encouraged to present their work at international meetings. Successful candidates will be based in Durban, South Africa, for the duration of the scholarship, with the exception of the time during which they may undertake field research elsewhere.  Applications are invited from citizens of all African countries. Female candidates and, in the case of South Africa, those from previously disadvantaged backgrounds, are especially encouraged to apply. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Case Study Brief: Health centre committees ensuring services respond to the needs of people living with HIV in Malawi","field_subtitle":"REACH Trust, TARSC: EQUINET 2015","URL":"http://www.equinetafrica.org/bibl/docs/HCC%20Malawi%20Brief%20March2015.pdf","body":"Malawi's 1994 Constitution obliges the state to provide adequate health care within the resources available, and guarantees equality in access to these health services. Community participation is a central pillar for implementing PHC in Malawi\u2019s 2011-2016 Health Sector Strategic Plan, which commits to ensuring that local communities have a voice and an opportunity to participate in issues that affect their health. This brief describes the role ad functioning of health centre advisory committees in supporting services to be responsive to the needs of people living with HIV. The committee members worked with volunteers, visiting villages with messages about prevention of vertical transmission and the services available for it.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Disability Grant: a precarious lifeline for HIV/AIDS patients in South Africa","field_subtitle":"Govender V; Fried J; Birch S; Chimbindi N; Cleary S: BMC Health Services Research 15(227), June 2015, doi:10.1186/s12913-015-0870-8","URL":"http://www.biomedcentral.com/1472-6963/15/227","body":"In South Africa, HIV/AIDS remains a major public health problem. In a context of chronic unemployment and deepening poverty, social assistance through a Disability Grant (DG) is extended to adults with HIV/AIDS who are unable to work because of a mental or physical disability. Using a mixed methods approach, the authors consider inequalities in access to the DG for patients on ART and implications of DG access for on-going access to healthcare. Data were collected in exit interviews with 1200 ART patients in two rural and two urban health sub-districts in four different South African provinces. Additionally, 17 and 18 in-depth interviews were completed with patients on ART treatment and ART providers, respectively, in three of the four sites included in the quantitative phase. Grant recipients were comparatively worse off than non-recipients in terms of employment and wealth. The regression analyses showed that the employed were significantly less likely to receive the DG than the unemployed. Also, patients who were longer on treatment and receiving concomitant treatment (i.e., ART and tuberculosis care) were more likely to receive the DG. The qualitative analyses indicated that the DG alleviated the burden of healthcare related costs for ART patients. Both patients and healthcare providers spoke of the complexity of the grants process and eligibility criteria as a barrier to accessing the grant. This impacted adversely on patient-provider relationships. These findings highlight the appropriateness of the DG for people living with HIV/AIDS. However, improved collaboration between the Departments of Social Development and Health is essential for preparing healthcare providers who are at the interface between social security and potential recipients.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Do antenatal care visits always contribute to facility-based delivery in Tanzania? A study of repeated cross-sectional data","field_subtitle":"Choe SA; Kim J; Kim S; Park Y; Kullaya SM; Kim CY: Health Policy and Planning,  June 2015, doi: 10.1093/heapol/czv054","URL":"http://heapol.oxfordjournals.org/content/early/2015/06/05/heapol.czv054.long","body":"There is a high disparity in access to perinatal care services between urban and rural areas in Tanzania. This study analysed repeated cross-sectional data from Tanzania to explore the relationship between antenatal care (ANC) visits, facility-based delivery and the reasons for home births in women who had made ANC visits. The relationship between the number of ANC visits (up to four) and facility delivery in the latest pregnancy was explored. For rural women, there was no significant relationship between the number of ANC visits and facility delivery rate. The most frequent reason for home delivery was \u2018physical distance to facility\u2019, and a significant proportion of rural women reported that they were \u2018not allowed to deliver in facility\u2019. The disconnect between ANC visits and facility delivery in rural areas may be attributable to physical, cultural or familial barriers, and quality of care in health facilities. This suggests that improving access to ANC may not be enough to motivate facility-based delivery, especially in rural areas.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Doubt, defiance, and identity: Understanding resistance to male circumcision for HIV prevention in Malawi","field_subtitle":"Parkhurst J; Chilongozi D; Hutchinson E: Social Science and Medicine 135, 15-22, 2015 ","URL":"http://www.sciencedirect.com/science/article/pii/S027795361500249X","body":"Global policy recommendations to scale up of male circumcision (MC) for HIV prevention tend to frame the procedure as a simple and efficacious public health intervention. However, there has been variable uptake of MC in countries with significant HIV epidemics. In this paper the authors present an in-depth analysis of Malawi's political resistance to MC, finding that ethnic and religious divisions dominating recent political movements aligned well with differing circumcision practices. Political resistance was further found to manifest through two key narratives: a \u2018narrative of defiance\u2019 around the need to resist 'donor manipulation', and a \u2018narrative of doubt\u2019 which seized on a piece of epidemiological evidence to refute global claims of efficacy. Further, the authors found that discussions over MC served as an additional arena through which ethnic identities and claims to power could themselves be negotiated, and therefore used to support claims of political legitimacy.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Ebola Fund Watch: Tracking For Ebola Crisis in West Africa","field_subtitle":"BudgIT; Open Society Initiative for West Africa: June 2015","URL":"http://ebolafundwatch.org/index.html","body":"This resource gathers evidence on the use of funds for the containment of the Ebola outbreak as provided by external funders. It also plans to create a narrative of cumulative experiences of how emergency funds were applied to survivors, victims, healthcare workers, institutions and other beneficiaries. It focuses on curating, tracking and demanding accountability for funds meant for Ebola virus treatment and containment across the sub region. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 173: More than a voice: invest in community representatives capacities for them to be heard","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evidence for policy and practice","field_subtitle":"Murphy L: Eldis 2015","URL":"http://www.eldis.org/go/topics/resource-guides/evidence-for-policy-and-practice#.VY8wQvlVhBd","body":"Quality assured research synthesis documents from a selected set of publishers who focus is on supporting evidence-informed decision-making on issues relevant to international development. This Guide provides access to a set of quality assured research synthesis documents specifically intended to assist evidence-informed decision-making in development policy and practice. They are selected by the Eldis team from a limited set of \"approved\" publishers who have been assessed to ensure a robust methodological approach to quality assurance. The Guide also provides a space for discussion on some of the debates on what constitutes \"evidence\", the use of different methods for quality assessment and the various approaches to impact evaluation","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Global evidence on inequities in rural health protection: New data on rural deficits in health coverage for 174 countries","field_subtitle":"Scheil-Adlung X: International Labour Office, ESS Document No. 47, Geneva, 2015","URL":"http://tinyurl.com/pza73zd","body":"While inequities in health protection are increasingly recognized as an important issue in current policy debates on universal health coverage (UHC) and in the post-2015 agenda, the rural/urban divide is largely ignored. This paper presents global estimates on rural/urban disparities in access to health-care services. The report uses proxy indicators to assess key dimensions of coverage and access involving the core principles of universality and equity. Based on the results of the estimates, policy options are discussed to close the gaps in a multi-sectoral approach addressing issues and their root causes both within and beyond the health sector. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Global health security: the wider lessons from the west African Ebola virus disease epidemic","field_subtitle":"Heymann D et al (23 co-authors): The Lancet 385 (9980),1884\u20131901, 2015","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60858-3/fulltext","body":"The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. It drew renewed attention to global health security\u2014its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? This paper describes some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed but their common goal is a more sustainable and resilient society for human health and wellbeing.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Global vaccination targets \u2018off-track\u2019 warns WHO","field_subtitle":"WHO: Geneva, April 2015","URL":"http://www.who.int/mediacentre/news/releases/2015/global-vaccination-targets/en/","body":"Progress towards global vaccination targets for 2015 is far off-track with 1 in 5 children still missing out on routine life-saving immunizations that could avert 1.5 million deaths each year from preventable diseases. WHO issued this statement calling for renewed efforts to get progress back on course in the lead-up to World Immunization Week in April 2015.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Identifying implementation bottlenecks for maternal and newborn health interventions in rural districts of the United Republic of Tanzania","field_subtitle":"Baker U; Peterson S; Marchant T; Mbaruku G; Temu S; Manzi F; Hanson C: Bulletin of World Health Organization 93, 22 April 2015, http://dx.doi.org/10.2471/BLT.14.141879","URL":"http://www.who.int/bulletin/volumes/93/6/14-141879/en/","body":"The authors aimed to estimate the effective coverage of key maternal and newborn health interventions in rural parts of the United Republic of Tanzania and to identify bottlenecks in implementation. They used data from an observational, cross-sectional study that was performed in Tandahimba and Newala districts in south-eastern United Republic of Tanzania. They investigated five key maternal and newborn health interventions: (i) syphilis screening; (ii) pre-eclampsia screening; (iii) use of a partograph to monitor labour; (iv) active management of the third stage of labour; and (v) postpartum care in a health facility. The largest bottleneck in Tandahimba was health facility readiness, which was associated with a 52% reduction in coverage. Clinical practice was another large bottleneck, with an attrition of 35%. In Newala, clinical practice was the largest bottleneck, causing an attrition of 57%. The authors provide a framework that could help operationalize measurements and track progress towards universal health coverage in all areas of health care.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"International parental migration and the psychological well-being of children in Ghana, Nigeria, and Angola","field_subtitle":"Mazzucato V; Cebotari V; Veale A; White A; Grassi M; Vivet J: Social Science and Medicine 135, 215-224, 2015","URL":"http://www.sciencedirect.com/science/article/pii/S0277953614007114","body":"When parents migrate, leaving their children in the origin country, transnational families are formed. Transnational family studies on children who are \u201cleft behind\u201d indicate that children suffer psychologically from parental migration. Many of the factors identified as affecting children's responses to parental migration however are not considered in child psychology and family sociology studies. This study aimed to bridge these areas of knowledge by quantitatively investigating the association between transnational families and children's psychological well-being. It analyzed a survey conducted in three African countries in 2010\u201311 (Ghana N = 2760; Angola N = 2243; Nigeria N = 2168) amongst pupils of secondary schools. The study compared children in transnational families to those living with their parents in their country of origin. Children's psychological well-being was measured through the Strengths and Difficulties Questionnaire. Multiple regression analyses reveal that children in transnational families fare worse than their counterparts living with both parents but not in Ghana where living conditions mediate this relationship.  Specific characteristics of transnational families and country contexts mattered: (1) changing caregivers is associated with poorer well-being in all countries; (2) which parent migrates does not make a difference in Ghana, when mothers migrate and fathers are caregivers results in poorer well-being in Nigeria, and both mother's and father's migration result in worse outcomes in Angola; (3) the kin relationship of the caregiver is not associated with poorer well-being in Ghana and Nigeria but is in Angola; (4) children with parents who migrate internationally do not show different results than children whose parents migrate nationally in Ghana and Nigeria but in Angola international parental migration is associated with poorer psychological well-being. The study showed that broader characteristics in the population rather than parental migration per se are associated with decreased levels of well-being.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Knowledge, perception and practices about malaria, climate change, livelihoods and food security among rural communities of central Tanzania ","field_subtitle":"Mayala BK; Fahey CA; Wei D; Zinga MM; Bwana VM; Mlacha T; Rumisha SF; Stanley G; Shayo EH; Mboera L: Infectious Diseases of Poverty 4(21), April 2015, doi: 10.1186/s40249-015-0052-2 ","URL":"http://www.idpjournal.com/content/pdf/s40249-015-0052-2.pdf","body":"This study determined knowledge, perceptions and practices as regards to malaria, climate change, livelihoods and food insecurity in a rural farming community in central Tanzania. Using a cross-sectional design, heads of households were interviewed on their knowledge and perceptions on malaria transmission, symptoms and prevention and knowledge and practices as regards to climate change and food security. A total of 399 individuals (mean age = 39.8 \u00b1 15.5 years) were interviewed. Nearly all (94.7%) knew that malaria is acquired through a mosquito bite. Three quarters (73%) reported that most people get sick from malaria during the rainy season. About 50% of the respondents felt that malaria had decreased during the last 10 years. The household coverage of insecticide treated mosquito nets was high (95.5%). Ninety-six percent reported to have slept under a mosquito net the previous night. Only one in four understood the official Kiswahili term (Mabadiliko ya Tabia Nchi) for climate change. However, there was a general understanding that the rain patterns have changed in the past 10 years. Sixty-two percent believed that the temperature has increased during the same period. Three quarters of the respondents reported that they had no sufficient production from their own farms to guarantee food security in their household for the year. Three quarters (73.0%) reported to having food shortages in the past five years. About half said they most often experienced severe food shortage during the rainy season. The authors concluded that farming communities in Kilosa District have little knowledge on climate change and its impact on malaria burden, but that food insecurity. They recommend integrating control of malaria and food insecurity interventions. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Malawi govt backtracks on hospital user fees","field_subtitle":"Chauwa A: Nyasa Times April 5 2015","URL":"http://www.nyasatimes.com/2015/04/06/malawi-govt-backtracks-on-hospital-user-fees/","body":"The Malawi government has said that medical services in all public health facilities will remain free. Minister of Health spokesperson Henry Chimbali told Nyasa Times that government has introduced by-pass fees [and not user fees] in referral hospitals in order to decongest the facilities. He also noted that the ministry will review the current arrangement between the Ministry and Christian Health Association of Malawi (CHAM) saying the current Memorandum of Understanding (MoU) dates back to 2002, is well overdue for review and needs to take into account some of the emerging issues that have taken place such as the passing into law of the new Act on Public Private Partnership Agreements (PPPs) which is the basis of the arrangement between the Ministry of Health and CHAM. The proposal is to work out a mechanism that will see greater access to quality health services by all Malawians especially those in rural and hard to reach areas. He also noted that the Ministry of Health seeks to establish a Health Fund to support health service delivery and widen coverage of medical insurance for those who can afford it.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Mind the Gap: House Structure and the Risk of Malaria in Uganda","field_subtitle":"Wanzirah H; Tusting LS; Arinaitwe E; Katureebe A; Maxwell K; Rek J; Bottomley C; Staedke SG; Kamya M; Dorsey G; Lindsay SW: PLOS One, January 2015, doi: 10.1371/journal.pone.0117396","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0117396","body":"Good house construction may reduce the risk of malaria by limiting the entry of mosquito vectors. The authors assessed how house design may affect mosquito house entry and malaria risk in Uganda. 100 households were enrolled in each of three sub-counties: Walukuba, Jinja district; Kihihi, Kanungu district; and Nagongera, Tororo district. CDC light trap collections of mosquitoes were done monthly in all homes. All children aged six months to ten years (n = 878) were followed prospectively for a total of 24 months to measure parasite prevalence every three months and malaria incidence. Homes were classified as modern (cement, wood or metal walls; and tiled or metal roof; and closed eaves) or traditional (all other homes). The human biting rate was lower in modern homes than in traditional homes. The odds of malaria infection were lower in modern homes across all the sub-counties, while malaria incidence was lower in modern homes in Kihihi but not in Walukuba or Nagongera. The authors concluded that house design is likely to explain some of the heterogeneity of malaria transmission in Uganda and represents a promising target for future interventions, even in highly endemic areas.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Monitoring Pro-Poor Health-Policy Success in the SADC Region","field_subtitle":"Amaya A;, Bagapi K; Choge I; De Lombaerde P: Kingah S: Kwape I; Luwabelwa M;  Mathala O:  Mhehe E: Moeti T: Mookodi L; Ngware Z; Phirinyane P:  PRARI Policy brief April 2015","URL":"http://www.open.ac.uk/socialsciences/prari/files/policy_brief_7_en.pdf","body":"In the area of health, the Southern African Development Community (SADC) has conducted important work in understanding how poor health and poverty coincide, are mutually reinforcing, and socially-structured by gender, age, class, ethnicity and location, demonstrated by the key health policy documents that have been facilitated by the secretariat. Yet the time lapse between the formulation of guidelines and policies and their implementation has at times been uneven. This brief describes the Poverty Reduction and Regional Integration indicator-based monitoring system addressing health priorities for the region, under the institutional leadership of the SADC secretariat and with the support from its Member States that are the main beneficiaries of the process.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"More than a voice: invest in community representatives capacities for them to be heard","field_subtitle":"H\u00e9l\u00e8ne Rossert, USA, Robert Bourgoing, France","body":"\r\nIn a 2015 report on the Representation and Participation of Key Populations on Country Coordinating Mechanisms (CCMs) in Swaziland, Lesotho, South Africa, Botswana, Zimbabwe and Zambia, (http://tinyurl.com/obuudjv) Aidspan noted that key population representatives (KPRs) \u201chave often in the past been seen as somewhat token CCM members\u201d and that \u201ctheir ability to contribute, and the quality of their participation in the processes of these bodies [is] unclear\u201d.\r\n\r\nWe believe indeed that building the capacity of KPRs to contribute their indispensable share to the governance of Global Fund-supported programs is a central condition for achieving the vision of ending HIV, tuberculosis and malaria as public health threats by 2030.\r\nWomen and girls, men who have sex with men, people who inject drugs, transgender people, sex workers, prisoners, refugees and migrants, people living with HIV, adolescents and young people, orphans and vulnerable children\u2026 Giving those groups a voice by opening the doors of CCMs to their representatives is a major step in the right direction. But to unleash their potential to be heard and become a trusted force for change, they need support to build essential skills and competencies.\r\n\r\nThe Global Fund and its success against AIDS, TB and malaria owe a lot to the extraordinary contributions of civil society representatives worldwide. With the new rules of engagement in the Global Fund governance systems, activists with high levels of formal education are now making room for a new generation of civil society representatives, whose level of preparedness varies considerably, as highlighted in the Aidspan report. These new arrivals must absorb a tremendous volume of information and data that is made available, at an increasing speed, about the Fund, its partners and health-related issues.\r\n\r\nA variety of toolkits, manuals, guidelines, tutorials and training workshops has already been produced around Global Fund policies and processes. But these good initiatives are scattered, developed separately, written primarily in English, sometimes in French and Spanish, and generally not designed with a focus on the specific needs of less-educated or extremely marginalized groups. Let\u2019s face it: how many KPRs have been efficiently trained through sporadic two or three-day workshops? How many have excelled basing their knowledge and understanding of program implementation through Global Fund orientation sessions? Self-education and workshops cannot by themselves be substitutes for a better structured and adapted training curriculum for KPRs.\r\n\r\nIn a 2014 study on the engagement in the funding model of key populations from 11 countries (at http://tinyurl.com/qxwuzd7), the Global Fund Board\u2019s communities delegation observed: \u201cIn cases where community representatives had received capacity building over the longer term, KPs were empowered to engage, raise concerns, challenge existing power structures and decision making processes and influence final outcomes. In cases where capacity building was lacking, KP representatives were engaged only in a tokenistic way and faced stigma during the process, labelled as incompetent and seemingly reinforcing negative preconceptions about key affected communities\u201d.\r\n\r\nKPRs have access to extended networks and an intimate knowledge of the needs and priorities of some of the most hard-to-reach communities. They bring a unique expertise that other CCM members, be they doctors, academics, government representatives or other high-level officials don\u2019t have. But to make the most of it, to enter CCM discussions confidently and influence public health decision-making in a credible way, they must learn to speak the language spoken at CCM meetings and in public health circles. They need to master the technical complexities of Global Fund procedures and be fully at ease with using the language of decision makers to represent the interests of their groups. This needs long-term capacity building.\r\n\r\nWe see four main components for such a curriculum, which could be conceived as a training-of-trainers program to reach out to members of marginalized communities in their own languages. Program management, from design to evaluation, is an area where KPRs and communities can bring true innovation, especially in monitoring and qualitative program evaluation. Good governance of their own community organizations is another essential component of their credibility. Advocacy is a third area that requires special skills, especially in the context of a complex international multistakeholder partnership. To develop and implement effective strategies that attract attention to their cause or to play constructive watchdog functions, KPRs must be able to conduct needs assessments and evaluations of service delivery systems, notably public ones.\r\n\r\nUnderlying those three areas, the importance of information literacy cannot be overstated. To keep learning, KPRs must develop essential skills to navigate their way through a vast and expanding array of information resources (websites, social media channels, mailing lists, databases, etc.). This is critical to building their networks, understanding where their priorities fit in the bigger picture, and keeping a strategic watch over the most relevant developments in their field of interest while avoiding information overload.\r\n\r\nThis may seem like a formidable challenge. The good news is that today\u2019s internet offers cheap and reliable channels to deliver certified courses in multiple languages at no cost to participants, to connect to a global and diverse audience, reaching out to distant individuals at their own pace and offering a space for networking with their peers around the world. Although face to face training will remain indispensable to provide more targeted support, open online courses can offer an extraordinary channel to deliver training to very large groups, to monitor its results and to address concerns over fake, ineffective and costly training. The KPRs\u2019 skills and knowledge gaps, as well as the technology to deliver a program that addresses them, can quite easily be figured out. For the Global Fund and its partners, it is mostly a matter of making this a priority and investing in the design and development of a curriculum for maximum impact, in a coordinated way.\r\n\r\nCommunity leaders and KPRs represent the untapped \u2018human resources\u2019 of current and future public health efforts. By pooling together different capacity building initiatives and internet possibilities, public health training for KPRs is at our grasp. Let\u2019s support their capacity to be heard, if we really hope to win the fight against disease.\r\n\r\nA longer version of this post was published in Aidspan\u2019s Global Fund Observer newsletter Issue 266 28 May 2015 http://tinyurl.com/pd7bhz3  and in R. Bourgoing\u2019s Aid Transparency blog at  http://tinyurl.com/owr4qb2 and it has been used with the authors permission.  H\u00e9l\u00e8ne Rossert is a US-based Global Fund advocate and former Vice Chair of the Global Fund Board. Robert Bourgoing is an aid transparency advocate and trainer, and former Manager of Global Fund Online Communications.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Multi-level Pro-Poor Health Governance, Statistical Information Flows, and the Role of Regional Organisations in South America and Southern Africa","field_subtitle":"Amaya A;  Kingah S: De Lombaerde, P: PRARI Working Paper 15/1, The Open University-United Nations University Institute on Comparative Regional Integration Studies, Milton Keynes, UK 2015","URL":"http://www.open.ac.uk/socialsciences/prari/files/working_paper_1_en.pdf","body":"In this paper, the authors analyse regional to national-level data flows with the use of two case studies focusing on UNASUR (Bolivia and Paraguay) and SADC (Swaziland and Zambia). Special attention is given to pro-poor health policies, those health policies that contribute to the reduction of poverty and inequities. The results demonstrate that health data is shared at various levels. This takes place to a greater extent at the global-country and regional-country levels, and to a lesser extent at the regional-global levels. There is potential for greater interaction between the global and regional levels, considering the expertise and involvement of UNASUR and SADC in health. Information flows between regional and national bodies are limited and the quality and reliability of this data is constrained by individual Member States\u2019 information systems. Having greater access to better data would greatly support Member States\u2019 focus on addressing the social determinants of health and reducing poverty in their countries. This has important implications not only for countries but to inform regional policy development in other areas. By serving as a foundation for building indicator-based monitoring tools, improving health information systems at both regional and national levels can generate better informed policies that address poverty and access to health. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"NHI far from reality but progress made in improving public health","field_subtitle":"Health E-News, 1 June 2015","URL":"http://tinyurl.com/nkxn9xj","body":"South Africa's proposed National Health Insurance (NHI) scheme, is many years away, but many of the country\u2019s 10 pilot sites are reported to be making progress. Of the 10 NHI pilot districts Health e-news investigated all \u2013 with the exception of OR Tambo in the Eastern Cape \u2013 are making reasonable progress in improving public health. The pilot districts, covering 20 percent of the population, were set up almost five years previously after Health Minister Aaron Motsoaledi announced the NHI as government policy. Negative patient experiences in public health facilities led government to concentrate on cleaning its own house before attempting any engagement of the NHI with the private sector.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Online Rational Medicines Use Course Module ","field_subtitle":" Bradley H: Schools of Public Health & Pharmacy, 2015 ","URL":"http://tinyurl.com/pm22av2","body":"This module is specifically developed to equip healthcare professionals such as pharmacists, doctors and nurses with the necessary skills to improve rational medicines use. It will be of value to members of Pharmacy and Therapeutics Committees, Masters of Public Health students and staff working in pharmacy and health departments in South Africa and other African countries. Additional online modules focusing on Pharmaceutical Public Health will be available in 2016. The module covers rational medicines use and problems associated with irrational medicine use; medicines use problems using several quantitative methods; qualitative methods to investigate prescribing behaviour and medicine use; promotion of rational medicine use including educational, managerial, economic and regulatory interventions; medicines Use evaluation and its application to programmes; essential medicines concept and the development of Standard Treatment Guidelines and Essential Medicines Lists using evidence-based decision making principles; infection control and antimicrobial resistance and pharmacy and therapeutics committees. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"PHM WHO Watch notes of  World Health Assembly May 2015","field_subtitle":"Peoples Health Movement: Global Health Watch, June 2015","URL":"http://www.ghwatch.org/sites/www.ghwatch.org/files/WHA68Notes,May2014(WHO-Watch).pdf","body":"WHO Watch is an intervention in global health governance. It provides a current account of global policy dynamics in relation to a wide and growing range of health issues. The links enable local activists to keep in touch with the global policy movements which shape the context for such local struggles. They also help to ensure that policy analysis and policy advocacy at the regional and global levels is informed by the reality of grass roots activism, both in health systems and around the conditions which shape health.  This link provides the WHO Watch notes from the World Health Assembly May 19-26 2015. It covers the discussions on 23 major items at the Assembly. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Running ahead: Food security and agricultural development","field_subtitle":"Kamau MN: Pambuzuka News 730, 10 June 2015","URL":"http://www.pambazuka.net/en/category.php/features/94931","body":"Agriculture has the potential not only to feed all of Africa\u2019s people but also to earn the continent revenues for development. There are numerous practical ways in which this can be achieved. the Comprehensive Africa Agriculture Development Programme (CAADP) is a programme of African Union, which was endorsed in Maputo in 2003 with the aim of improving and promoting agriculture across Africa calls for  countries to allocate 10% of their national income to agricultural development. Most countries have poor storage facilities and transportation systems which have led to post-harvest losses in both grains and vegetables. Maize has been affected by aflatoxin. There has been persistent price fluctuation of agricultural products which makes it almost impossible to plan for the earnings. The foreign income is minimal since most countries engage in primary exports, where the market is saturated. The author indicates that it is time Africa embraced the concept of value addition, exporting finished products will give an upper hand in the global market. Enhancing tariff barriers will make imports expensive boosting the demand for local products.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Sex and gender matter in health research: addressing health inequities in health research reporting ","field_subtitle":"Gahagan J; Gray K; Whynacht A:  International Journal for Equity in Health 2015, 14(12), 2015 ","URL":"http://www.equityhealthj.com/content/14/1/12","body":"Attention to the concepts of \u2018sex\u2019 and \u2018gender\u2019 is increasingly being recognised as contributing to better science through an augmented understanding of how these factors impact on health inequities and related health outcomes. However, the ongoing lack of conceptual clarity in how sex and gender constructs are used in both the design and reporting of health research studies remains problematic. Conceptual clarity among members of the health research community is central to ensuring the appropriate use of these concepts in a manner that can advance understanding of the sex- and gender-based health implications of the research findings. During the past twenty-five years much progress has been made in reducing both sex and gender disparities in clinical research and, to a significant albeit lesser extent, in basic science research. Why, then, does there remain a lack of uptake of sex- and gender-specific reporting of health research findings in many health research journals? This question, the authors argue, has significant health equity implications across all pillars of health research, from biomedical and clinical research, through to health systems and population health.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"State of inequality: Reproductive, maternal, newborn and child health","field_subtitle":"World Health Organisation: Global Health Observatory Data, WHO Geneva, 2015","URL":"http://www.who.int/gho/health_equity/report_2015/en/","body":"The report delivers both promising and disappointing messages about the situation in low- and middle-income countries with respect to reproductive, maternal, newborn and child health indicators. Within-country inequalities have narrowed, with a tendency for national improvements driven by faster improvements in disadvantaged subgroups. &#8232;&#8232;However, inequalities still persist in most reproductive, maternal, newborn and child health indicators. The extent of within-country inequality differed by dimension of inequality and by country, country income group and geographical region. The patterns of change in inequality over time varied by health indicator, and according to country and dimension of inequality. The report observes that while national averages and improvements over time are important indications of progress on a global level, reporting inequalities within countries shows how any progress in national averages is realized by population subgroups. Establishing goals and targets that specify a reduction in inequality encourages the orientation of policies, programmes and practices to promote health in disadvantaged subgroups. Without a dedicated focus on equity, efforts to improve health can risk perpetuating or intensifying within-country inequality, even as increases in national coverage are achieved.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Students want HIV testing in schools: a formative evaluation of the acceptability of HIV testing and counselling at schools in Gauteng and North West provinces in South Africa ","field_subtitle":"Madiba S; Mokgatle M: BMC Public Health 15(388), April 2015, doi:10.1186/s12889-015-1746-x ","URL":"http://www.biomedcentral.com/content/pdf/s12889-015-1746-x.pdf","body":"The proposal by the South African Health Ministry to implement HIV testing and counselling (HTC) at schools in 2011 generated debates about the appropriateness of such testing. However, the debate has been between the Ministries of Education and Health, with little considerations of the students. This study assessed the students\u2019 opinions and uptake of HIV testing and counselling in general, and the acceptability of the provision of HIV testing and counselling in schools. A survey was conducted among grade 10\u201312 high school students in North West and Gauteng provinces, South Africa. Seventeen high schools (nine rural and eight urban) were randomly selected for the administration of a researcher-assisted, self-administered, semi-structured questionnaire. A total of 2970 students aged 14\u201327 years participated in the study. Having multiple sexual partners, age, and gender were significantly associated with increased odds of having had a HIV test. Fear, being un-informed about HTC, and low HIV risk perceptions were the reasons for not getting tested. The acceptability of HTC at school was high (n = 2282, 76.9%) and 2129 (71.8%) were willing to be tested at school. Appropriateness, privacy, and secrecy were the main arguments for and against HTC at school. One-third had intentions to disclose their HIV status to students versus 42.5% for teachers. Stigma, discrimination and secrecy were the primary reasons students did not intend to disclose. A high acceptability of HTC and willingness to be tested at school suggest that HIV prevention programs tailored to youth have a high potential of success given the readiness of students to uptake HTC. The authors conclude that bringing HIV testing to the school setting will increase the uptake of HTC among youth and contribute towards efforts to scale up HTC in South Africa. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Surveys of measles vaccination coverage in eastern and southern Africa: a review of quality and methods used","field_subtitle":"Kaiser R; Shibeshi M; Chakauya J; Dzeka E; Masresha B; Daniel F; Shivute N: Bulletin of the World Health Organization 93(5), 285-360, 2015","URL":"http://www.worldbulletin.net/news/157999/tanzania-to-ban-clerics-ngos-for-political-views","body":"This study assessed the methods used in the evaluation of measles vaccination coverage in 2012/3 in eastern and southern Africa, identified quality concerns and made recommendations for improvement. Of the 13 reports the authors reviewed, there were weaknesses in 10 of them for ethical clearance, 9 for sample size calculation, 6 for sampling methods, 12 for training structures, 13 for supervision structures and 11 for data analysis. The authors recommend improvements in the documentation of routine and supplementary immunisation, via home-based vaccination cards or other records. They recommend that standards be developed for report templates and for the technical review of protocols and reports. This would ensure that the results of vaccination coverage surveys are accurate, comparable, reliable and valuable for programme improvement.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The ethics of health systems research: Selected guidelines and studies ","field_subtitle":"Molyneux S; Pratt B; Wassenaar D; Rogers W: Research in Gender and Ethics (RinGs) Building stronger health systems,2015","URL":"http://tinyurl.com/nu7d7jr","body":"There is a growing interest in the ethics of health systems research, and some debate about whether a specific ethical framework or set of guidance is needed. The authors provide a framework to begin to think about this, organised around eight considerations: (1) the nature of intervention; (2) types of research subjects; (3) units of intervention and observation; (4) informed consent; (5) controls and comparisons; (6) risk assessment; (7) inclusion of vulnerable groups within different contexts, and; (8) benefits of research. This is a starting place for researchers interested in health systems research ethics. The authors note several challenges to thinking about the ethics of health systems research, including the diverse range of studies and disciplines involved, the grey zone between research and non-research, and the many overlaps of issues with other types of health research. They call for more conceptual work and empirical research aimed at better understanding this topic. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The health-systems response to violence against women","field_subtitle":"Garc\u00eda-Moreno C; Hegarty K; d\u2019Oliveira A; Koziol-McLain J; Colombini M; Feder G: The Lancet 385(9977), 1567-1579, 2015","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961837-7/fulltext","body":"Health systems have a crucial role in a multisector response to violence against women. Some countries have guidelines or protocols articulating this role and health-care workers are trained in some settings, but generally system development and implementation have been slow to progress. Substantial system and behavioural barriers exist, especially in low-income and middle-income countries. Violence against women was identified as a health priority in 2013 guidelines published by WHO and the 67th World Health Assembly resolution on strengthening the role of the health system in addressing violence, particularly against women and girls. In this Series paper, we review the evidence for clinical interventions and discuss components of a comprehensive health-system approach that helps health-care providers to identify and support women subjected to intimate partner or sexual violence. Five country case studies show the diversity of contexts and pathways for development of a health system response to violence against women. Although additional research is needed, strengthening of health systems can enable providers to address violence against women, including protocols, capacity building, effective coordination between agencies, and referral networks.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Public Health Association of South Africa (PHASA) Conference","field_subtitle":"7 \u2013 9 October 2015, Durban, South Africa","URL":"http://www.phasaconference.org.za/index.html","body":"The 11th Annual Conference of the Public Health Association of South Africa takes place between 7-9 October 2015 in Durban, KwaZulu-Natal.  The conference theme is Health and Sustainable Development:  The Future. The 2015 PHASA Conference will be more interactive than previous PHASA conferences. There will be a greater media and social media presence at the 2015 PHASA Conference ensuring that research findings and key issues reach a broader audience. The target audience is policy makers, public health academics and students, health professionals, health service managers and individuals from non-governmental and community-based health organisations.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Tracing shadows: How gendered power relations shape the impacts of maternal death on living children in sub Saharan Africa","field_subtitle":"Yamin A; Bazile J; Knight L; Molla M; Maistrellis E; Leaning J: Social Science and Medicine 135, 143-150, 2015","URL":"http://www.sciencedirect.com/science/article/pii/S0277953615002713","body":"A mixed-methods study was conducted in four countries in sub-Saharan Africa to investigate the impacts of maternal death on families and children. The analysis identified gender as a fundamental driver not only of maternal, but also child health, through manifestations of gender inequity in household decision making, labour and caregiving, and social norms dictating the status of women. Focus group discussions were conducted with community members, and in depth qualitative interviews with key-informants and stakeholders, in Tanzania, Ethiopia, Malawi, and South Africa between April 2012 and October 2013. Findings highlighted that socially constructed gender roles, which define mothers as caregivers and fathers as wage earners, and which limit women's agency regarding childcare decisions, among other things, create considerable gaps when it comes to meeting child nutrition, education, and health care needs following a maternal death. Additionally, the findings show that maternal deaths have differential effects on boy and girl children, and exacerbate specific risks for girl children, including early marriage, early pregnancy, and school drop-out. The authors conclude that investment in health services interventions should be complemented by broader interventions regarding social protection, with a shifting of social norms and opportunity structures regarding gendered divisions of labour and power at household, community, and society levels.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Tracking universal health coverage: First global monitoring report","field_subtitle":"WHO; World Bank: Joint WHO/World Bank Group report, June 2015","URL":"http://tinyurl.com/oq63rzm","body":"Universal health coverage (UHC) means that all people receive the quality, essential health services they need, without being exposed to financial hardship. Moving towards UHC is a dynamic, continuous process that requires changes in response to shifting demographic, epidemiological and technological trends, as well as people\u2019s expectations. But in all cases, countries need to integrate regular monitoring of progress towards targets into their plans. In May 2014, the World Health Organization and the World Bank jointly launched a monitoring framework for UHC, based on broad consultation of experts from around the world. The framework focuses on indicators and targets for service coverage \u2013 including promotion, prevention, treatment, rehabilitation and palliation \u2013 and financial protection for all. This report is the first of its kind to measure health service coverage and financial protection to assess countries\u2019 progress towards universal health coverage. It shows that at least 400 million people do not have access to one or more essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of health spending. ","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Travel Scholarships for Scientific Conferences","field_subtitle":"Canon Foundation","URL":"http://www.cfsr.co.uk/what.htm","body":"The Canon Foundation for Scientific Research is seeking applications to provide support for scientists and academics from developing countries in the scientific and engineering fields who would like to attend local or international conferences, symposia and workshops or undertake other postgraduate study. The Foundation welcomes applications from researchers who would like to attend local or international conferences, symposia and workshops or undertake other postgraduate study. In most cases, they will meet all or part of travel, accommodation and registration costs. They also consider offering financial assistance to qualified researchers wishing to further their expertise at an internationally recognised overseas institution.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Unpaid Care Work Programme: Uganda Country Progress Report (2012\u20132014)","field_subtitle":"Nesbitt-Ahmed Z; Malinga Apila H: Institute of Development Studies Evidence Report 126, IDS Sussex, 2015","URL":"http://tinyurl.com/np76n28","body":"The Institute of Development Studies (IDS) partnered with ActionAid International (AAI) in Uganda to develop and implement an advocacy strategy to make unpaid care work more visible in public policy, as well as to integrate unpaid care issues into each country\u2019s programming. It used an action learning methodology to look at what works and does not work in making the care economy more visible. It aimed to track and capture changes in policy and practice in order to improve understanding around the uptake of evidence. This report covers the progress of the programme in Uganda over the first two and a half years of the four-year programme. The work identified that making unpaid care work more visible calls for a collective voice amongst those involved and engaging and working effectively with the media with clear messaging.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"What do community health workers have to say about their work, and how can this inform improved programme design? A case study with CHWs within Kenya","field_subtitle":"Oliver M; Geniets A; Winters N; Rega I; Mbae S: Global Health Action 8, May 2015, doi: http://dx.doi.org/10.3402/gha.v8.27168","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/27168","body":"Community health workers (CHWs) are often spoken about or for, but there is little evidence of CHWs\u2019 own characterisation of their practice. This paper addresses this issue. A case study approach was undertaken in a series of four steps. Firstly, groups of CHWs from two communities met and reported what their daily work consisted of. Secondly, individual CHWs were interviewed so that they could provide fuller, more detailed accounts of their work and experiences; in addition, community health extension workers and community health committee members were interviewed, to provide alternative perspectives. Thirdly, notes and observations were taken in community meetings and monthly meetings. The data were then analysed thematically, creating an account of how CHWs describe their own work, and the tensions and challenges that they face. CHWs\u2019 accounts of both successes and challenges involved material elements: leaky tins and dishracks evidenced successful health interventions, whilst bicycles, empty first aid kits and recruiting stretcher bearers evidenced the difficulties of resourcing and geography they are required to overcome.  CHWs described their work was as healthcare generalists, working to serve their community and to integrate it with the official health system. Their work involves referrals, monitoring, reporting and educational interactions. Whilst they face problems with resources and training, their accounts show that they respond to this in creative ways, working within established systems of community power and formal authority to achieve their goals, rather than falling into a \u2018deficit\u2019 position that requires remedial external intervention. Their work is widely appreciated, although some households do resist their interventions, and figures of authority sometimes question their manner and expertise. The material challenges that they face have both practical and community aspects, since coping with scarcity brings community members together. The authors suggest that programmes co-designed with CHWs will be easier to implement because of their relevance to their practices and experiences, whereas those that seek to use CHWs as an instrument to implement external priorities are likely to disrupt their work.","php":"","field_issue_date":"2015-07-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"2015 Drivers of Change Awards Nominations Now Open","field_subtitle":"Closing date for nominations: 31 July 2015","URL":"http://tinyurl.com/pz23r5u","body":"The 24th African Union Summit declared 2015 as \u201cThe Year of Women's Empowerment and Development towards Africa\u2019s Agenda 2063.\u201d To embrace this, the 2015 Drivers of Change Awards will recognise people driving change in women empowerment and development, gender equity, the promotion of equality and rights for women and girls. Nominations for the 2015 Drivers of Change Awards are now open!&#8232;&#8232; The website allows people to nominate individuals, businesses, civil society organisations and governments that are making a real impact in changing the lives of women and girls in southern Africa. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"3rd International Association of Social Sciences and Humanities in HIV (ASSHH) Conference, Stellenbosch, South Africa","field_subtitle":"Closing date for pre-conference registration: 19 June 2015 ","URL":"http://www.asshhconference.org","body":"The 3rd Conference of the Association for the Social Sciences and Humanities in HIV (ASSHH) will be held in South Africa. The goal is to ask the kinds of critical questions it is sometimes difficult to pose in other settings, and to contribute to new and creative ways of thinking about the HIV epidemic. The conference will critically examine the growing gap between rhetoric and reality in the national and international HIV response and will provide opportunities for wide-ranging discussion and debate on the following themes: (Re)-writing the history of AIDS: whose facts, whose visions, whose stories?, An \u2018epidemic of signification - cultural and media representations 30 years on, in the era of PrEP and \u2018universal\u2019 access, Sexual orientation and gender identity - a new or enduring battleground?, The politics of 'practice': research and practitioner perspectives on intervention and programme development, Power, politics and resistance: the demise of agency in the face of constraint, Positive nostalgia(s) and the international HIV response and Renewing social sciences and humanities research. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"9th Action Learning, Action Research (ALARA) and 13th Participatory Action Research World Congress ","field_subtitle":"4-7 November 2015, Pretoria, South Africa","URL":"http://www.alarassociation.org/pages/events/alara-world-congress-2015","body":"This World Congress is a challenge to Action Learning / Action Research practitioners to explain how they are contributing to the creation of a fairer world. The ALARA World Congress 2015 will create a space for dialogue over questions such as: How do we know we are asking the right questions to promote sustainable learning? How do we capacitate people to address the intricate interplay of social, economic, political and cultural factors that combine to preserve injustice? How do we ensure authentic collaboration between stakeholders across all levels? How do we use AL/AR to forge innovative, sustainable responses to contemporary complex challenges? How do we know we are successful in mediating sustainable change? Delegates from developing countries should register before 28 July 2015.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A luta continua","field_subtitle":"Film by Medicusmundi and Kanaki Films on Mozambiques efforts to build its public health system","URL":"http://www.medicusmundi.cat/en/a-luta-continua","body":"Since achieving independence in 1975, Mozambique is a country in constant change. In this context, governments, foundations, NGOs and companies declare noble intentions in order to improve the precarious health situation of the population. \"A Luta Continua\" (\"The Struggle Continues\") is a film that reviews the achievements, challenges and difficulties in order to build a health system for all in an increasingly unequal country where, sometimes, aid strategies do not always walk in the same direction.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Assisted dying: Avron Moss \u2013 another casualty of legal uncertainty","field_subtitle":"Thamm M: Daily Maverick, 10 March 2015","URL":"http://tinyurl.com/osjrywb","body":"In January 2015, a few days before he would feature as Applicant No 1 in a groundbreaking High Court application for the right to an assisted death, Avron Moss ended his life using medication he had smuggled into South Africa from Mexico. Diagnosed with melanoma, Moss knew when he offered to act as the applicant that it would be a race against time. This article discusses the history and legal and social implications of assisted dying for the terminally ill in South Africa.  ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Balancing the personal, local, institutional, and global: multiple case study and multidimensional scaling analysis of African experiences in addressing complexity and political economy in health research capacity strengthening","field_subtitle":"Ager A; Zarowsky C: Health Research Policy and Systems 13(5), 2015 ","URL":"http://www.health-policy-systems.com/content/13/1/5","body":"Strengthening health research capacity in low- and middle-income countries remains a major policy goal. The Health Research Capacity Strengthening (HRCS) Global Learning (HGL) program of work documented experiences of HRCS across sub-Saharan Africa. The authors reviewed findings from HGL case studies and reflective papers regarding the dynamics of HRCS. Analysis was structured with respect to common challenges in such work, identified through a multi-dimensional scaling analysis of responses from 37 participants at the concluding symposium of the program of work. Symposium participants identified 10 distinct clusters of challenges: engaging researchers, policymakers, and donors; securing trust and cooperation; finding common interest; securing long-term funding; establishing sustainable models of capacity strengthening; ensuring Southern ownership; accommodating local health system priorities and constraints; addressing disincentives for academic engagement; establishing and retaining research teams; and sustaining mentorship and institutional support. Analysis links these challenges to three key and potentially competing drivers of the political economy of health research: an enduring model of independent researchers and research leaders, the globalisation of knowledge and the linked mobility of (elite) individuals, and institutionalisation of research within universities and research centres and, increasingly, national research and development agendas. The authors identify tensions between efforts to embrace the global \u2018Community of Science\u2019 and the promotion and protection of national and institutional agendas in an unequal global health research environment. A nuanced understanding of the dynamics and implications of the uneven global health research landscape is required, along with a willingness to explore pragmatic models that seek to balance these competing drivers.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Call for submissions \u2013 Emerging Public Health Practitioner Award","field_subtitle":"Closing date: 26 June 2015","URL":"http://www.hst.org.za/news/call-submissions-emerging-public-health-practitioner-award","body":"The South African Health Review Emerging Public Health Practitioner Award is offered to South African candidates under the age of 35 to submit a chapter dealing with public health or policy in South Africa for publication in the South African Health Review. Click on link for further details.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Case Study Brief: Health centre committee involvement in local government planning for health in Zambia","field_subtitle":"LDHMT; TARSC: EQUINET brief, 2015","URL":"http://www.equinetafrica.org/bibl/docs/HCC%20Zambia%20Brief%20March2015.pdf","body":"Neighbourhood Health Committees (NHCs) have been set up in all ten provinces in Zambia and district community health offices. Their role is being strengthened across the country, and there are many examples of efforts that have been made to promote their participation in planning, budgeting and health actions. This brief outlines these initiatives and the lessons from the work.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Citizen Participation and Accountability for Sustainable Development","field_subtitle":"Shahrokh T; Franco LE; Burns D: Institute of Development Studies Rapid Response Briefing 10, 2015","URL":"http://www.ids.ac.uk/publication/citizen-participation-and-accountability-for-sustainable-development","body":"Meaningful accountability can shift power imbalances that prevent sustainable development for people living in poverty and marginalisation. Accountability consists of both the rights of citizens to make claims and demand a response, and the involvement of citizens in ensuring that related action is taken. However, for the poorest and most marginalised people accountability is often unattainable. They face multiple barriers in influencing social, political and economic decision-making processes and accessing the services they are entitled to. This briefing draws on research by the Participate initiative to highlight the key components necessary for processes of accountability to be meaningful for all.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Civil society defines the changes that must happen for delivery on UHC","field_subtitle":"Itai Rusike, Executive Director-Community Working Group on Health, Zimbabwe  ","body":"\r\nThe way a healthcare system is designed, financed and performs has consequences for inequality. User fees, for example, prevent people from accessing healthcare and push over 100 million people each year into poverty.  The 2001 Abuja Declaration committing at least 15% of their budgets to health was signed by African governments with a goal that every member of society have access to healthcare when they need it, without risk of financial ruin. Thirteen years later, less than ten countries in the Africa region have increased their national or provincial budget to at least 15%, as stipulated in the declaration. Less than 10% of African people are reported to be protected from financial risks associated with using health care, even though health care plays an important role in the still unfinished business of achieving the Millennium Development Goals. Unless health budgets are adequate to meet priority health needs, inequalities in access to health services will remain high and these goals will not be achieved for all. \r\n\r\nThe concept of universal health coverage (UHC) offers an opportunity to address these challenges.  UHC is seen as a means to deliver on the principle of Health for All that was set out more than 30 years ago in the Alma-Ata declaration. In 2005, there were calls to revitalize primary health care (PHC). The principle of universal coverage was reaffirmed in the 2008 world health report on PHC and various subsequent World Health Assembly resolutions.  In May 2012 in the World Health Assembly, WHO Director General Margaret Chan\u2019s asserted that UHC is \u201cthe single most powerful concept that public health has to offer\u201d to reduce the financial impoverishment caused by people spending on health care and to increase access to key health services. In December of that year, the United Nations General Assembly adopted a resolution on UHC, urging governments to move towards providing all people with access to affordable, quality health-care services, given the important role that health care plays in achieving international development goals.\r\n\r\nAchieving these goals is, however, first and foremost a political process. It involves a political negotiation between different interest groups in society over what services are provided, how services are allocated and who should fund them. \r\n\r\nOn this understanding civil society organisations have come together to form a network - the African Platform for Universal Health Coverage (AFP- UHC) - to remind African leaders of their duty to shape health policies so that everyone can enjoy their right to health. Civil society organisations have already contributed to increased community roles in decision-making in health; have acted as watchdogs of service delivery and demanded accountability on policy commitments. Civil society has represented and defended the rights of poor and vulnerable people. In doing so they are vital for building more equitable health systems. The organisations involved bring existing civil society organisations together in national coalitions, engaging the public and governments through a variety of tools, including stakeholder engagement, policy briefs, strategic meetings and press briefings. Member organisations have held radio talk shows in Ethiopia, workshops in Egypt, public marches in Ghana, meetings targeted at policy makers in Kenya, campaigns challenging inequalities and user fees in Malawi, television programmes and lobbying of the Prime Minister in Mali, a public march in Kampala and a UHC Day commemoration in Zimbabwe. \r\n\r\nThe AFP-UHC thus brings civil society organisations together to contribute to, support and implement policies promoting UHC, on the basis that health is a human right.  The organisations seek to bring UHC to the political agenda of African countries. The network thus seeks to support national non state organisations to advocate that UHC be achieved through people-centered, right based approaches, in a manner that guarantees people\u2019s right to health services. The network measures its value by the extent to which it is able advocate for and achieve an increase in public sector health budgets and in the political commitment towards health. These changes are seen as key to improving the lives and wellbeing of the most vulnerable people in the society, whose rights to health are usually infringed though their sustained neglect by governments.\r\n\r\nThe network expects to see governments abolish user fees, raise and spend budgets for health more equitably, increase public sector health financing, ensure that UHC is included in global and national goals post 2015 and that governments set targets and deliver on those goals. \r\n\r\nThe author is the Zimbabwe coordinator of the African Platform for Universal Health Coverage (AFP- UHC), a network of African non government organisations with a long experience working together to demand a set of measures from governments to move towards Universal Health Coverage.  Further information on the network can be found at http://www.africaforuhc.org/. Please send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Conflicts of interest and global health and nutrition governance - The illusion of robust principles","field_subtitle":"Richter J: BMJ, doi: http://dx.doi.org/10.1136/bmj.g5457, 2015","URL":"http://www.bmj.com/content/349/bmj.g5457/rr","body":"This is a response to a BMJ paper 'Do the solutions for global health lie in healthcare?' where in the run-up to the Second International Conference on Nutrition (ICN2), the author warned against downplaying the fundamental differences between the commercial interests of multinational food companies and those of public sector agencies. If public health officials do not acknowledge the divergent interests, he suggested, they risk harming their public health mission, institutional integrity and ultimately public trust. In the response, the author suggests that the current discourse ignores the problem of involving food transnational corporations in public decision-making processes, acceptance of funds and resources in the name of partnership or stakeholder engagement. The trend to increase such engagement reduces and almost eliminates public policy spaces without corporations. The author argues that that robust, comprehensive conflict of interest safeguards do not exist with respect to global food and nutrition governance. This obscures the fact that conflicts of interest are an important legal concept and that establishing conflict of interest policies are an integral part of UN agencies\u2019 duty to establish the Rule of Law.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Contributions of global health diplomacy to equitable health systems in east and southern Africa, Report of a Regional Research Workshop, 13-14 March 2015, Johannesburg South Africa","field_subtitle":"EQUINET; TARSC; CPTL: 2015","URL":"http://www.equinetafrica.org/bibl/docs/Regional%20GHD%20meeting%20report%20March2015.pdf","body":"This report presents the proceedings of a meeting held on March 13 and 14 a regional meeting was convened with objectives to i. Present and discuss the findings from the EQUINET research programme and from related research in Africa, and the implications for policy, negotiations and programmes in east and southern Africa; ii. Review methods and challenges for implementing research and analysis on global health diplomacy for policy relevance, from review of research and experience of the work; iii. Discuss and propose areas for follow up policy, action and research, within ESA and through south-south collaboration. It included senior officials involved in health from national and regional organisations, health diplomats, researchers from the EQUINET work and others working on health diplomacy and on south-south co-operation in the region and internationally.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Defend the World Health Organization from corporate takeover","field_subtitle":"People\u2019s Health Movement, 18 May 2015","URL":"http://www.phmovement.org/en/node/9980","body":"Ahead of the first meeting of the drafting group on Framework for Engagement with Non \u2013 State Actors (FENSA), Civil Society Organisations and Social Movements expressed their deep concern on perceived attempts to facilitate a corporate takeover of WHO. The joint statement signed by over 40 organisations called on WHO member states to take such time as is necessary to achieve a robust framework for engagement with non-state actors, to protect the WHO from undue influence. Further, the statement also called on member states to support the director general's proposals to increase the assessed contributions. The framework was initiated to safeguard the independence, integrity and credibility of WHO, but the organisations have a strong apprehension that the negotiations on FENSA may fundamentally alter the influence of the private sector and philanthropic foundations and NGOS sponsored by the private sector in a manner that compromises the credibility of WHO.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Determinants of access to healthcare by older persons in Uganda: a cross-sectional study","field_subtitle":"Wandera SO;  Kwagala B; Ntozi J: International Journal for Equity in Health, 14(26), 2015 ","URL":"http://www.equityhealthj.com/content/14/1/26","body":"Older persons report poor health status and greater need for healthcare. However, there is limited research on older persons\u2019 healthcare disparities in Uganda. This paper reports on factors associated with older persons\u2019 healthcare access in Uganda, using a nationally representative sample. The authors conducted secondary analysis of data from a sample of 1602 older persons who reported being sick in the last 30 days preceding the Uganda National Household Survey. They used frequency distributions for descriptive data analysis and chi-square tests to identify initial associations and fit generalised linear models (GLM) with the poisson family and the log link function, to obtain incidence risk ratios (RR) of accessing healthcare in the last 30 days, by older persons in Uganda. More than three quarters (76%) of the older persons accessed healthcare in the last 30 days. Access to healthcare in the last 30 days was reduced for older persons from poor households; and with some or with a lot of walking difficulty. Conversely, accessing healthcare in the last 30 days for older persons increased for those who earned wages and missed work due to illness for 1\u20137 and 8\u201314 days. In addition, those who reported non-communicable diseases (NCDs) such as heart disease, hypertension or diabetes were more likely to access healthcare during the last 30 days. In the Ugandan context, health need factors (self-reported NCDs, severity of illness and mobility limitations) and enabling factors (household wealth status and earning wages in particular) were the most important determinants of accessing healthcare in the last 30 days among older persons.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 172: Civil society defines the changes that must happen for delivery on UHC","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).\r\n","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Header"}},{"node":{"title":"Evidence for Informing Health Policy Development in Low- Income Countries (LICS): Perspectives of Policy Actors in Uganda","field_subtitle":"Nabyonga-Orem J; Mijumbi R: International Journal of Health Policy and Management 4(5), 285-293, 2015","URL":"http://www.ijhpm.com/article_2984_0.html","body":"Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. The authors\u2019 explored health policy actors\u2019 views regarding what evidence they deemed appropriate to guide health policy development, with 51 key informants interviewed. Different stakeholders lay emphasis on different kinds of evidence. While external funders preferred international evidence and Ministry of  Health officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Framework of engagement with non-State actors","field_subtitle":"World Health Organisation: Draft Resolution Sixty-eighth World Health Assembly A68/A/CONF./X Agenda item 11.2, May 2015","URL":"http://tinyurl.com/pxr5wba","body":"This resolution presents a Framework of Engagement with non-State actors to replace the Principles governing relations between the World Health Organization and nongovernmental organizations and Guidelines on interaction with commercial enterprises to achieve health outcomes;(1) to implement the Framework of Engagement with non-State actors; (2) to establish the register of non-State actors in time for the Sixty-ninth World Health Assembly; (3) to report on the implementation of the Framework of Engagement with non-State actors to the Executive Board at each of its January sessions under a standing agenda item, through the\r\nProgramme Budget and Administration Committee; (4) to conduct in 2018 an evaluation of the implementation of the Framework of Engagement\r\nwith non-State actors and its impact on the work of WHO with a view to submitting the results, together with any proposals for revisions of the Framework, to the Executive Board in January 2019,through the Programme Budget and Administration Committee.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Gender-responsive HIV programming for women and girls","field_subtitle":"UNAIDS: UNAIDS Geneva 2014","URL":"http://www.unaids.org/en/resources/documents/2014/genderresponsiveHIVprogramming","body":"This document guides countries on how to include a gender perspective and promote equality and human rights for women and girls in their national HIV responses, drawing upon the latest technical developments, guidelines and investment approaches. This is relevant as women and girls continue to be profoundly affected by HIV. The brief seeks to support a gender-responsive HIV response, as a first step towards the application of key tools and resources that help integrate gender considerations into concept notes, proposals, and national strategic plans.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Global evidence on inequities in rural health protection","field_subtitle":"Scheil-Adlung X; ILO: ILO ESS Paper Series, 2015","URL":"http://www.social-protection.org/gimi/gess/RessourcePDF.action?ressource.ressourceId=51297","body":"This paper presents global estimates on rural/urban disparities in access to health-care services. The report uses proxy indicators to assess key dimensions of coverage and access involving the core principles of universality and equity. Based on the results of the estimates, policy options are discussed to close the gaps in a multi-sectoral approach addressing issues and their root causes both within and beyond the health sector.  The paper presents global evidence that suggests significant differences between rural and urban populations in health coverage\r\nand access at global, regional and national levels. Based on the evidence provided, place of residence largely determines coverage and access to health care in all regions and within all countries. . Efficient and effective multisectoral policies to address the root causes of rural inequities should consider the specific living and working characteristics of rural populations. The authors argue that if not addressed, the rural/urban disparities identified in access to health care carry the potential to considerably hamper overall socio-economic development in many developing countries.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Global health security: the wider lessons from the west African Ebola virus disease epidemic","field_subtitle":"Heymann D et al: The Lancet 385 (9980),1884\u20131901, 2015","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60858-3/fulltext","body":"The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security\u2014its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including World Health Organization reform, it will be important to distil lessons learned from the Ebola outbreak. Prof. Heymann led a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for the next steps. The paper describes some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed but their common goal is a more sustainable and resilient society for human health and wellbeing. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Health workers\u2019 experiences, barriers, preferences and motivating factors in using mHealth forms in Ethiopia","field_subtitle":"Medhanyie AA, Little Am Yebyo H, Spigt M, Tadesse K, Blanco R, Dinant GJ: Human Resources for Health 13(2), 2015","URL":"http://www.human-resources-health.com/content/13/1/2","body":"Mobile health (mHealth) applications, such as innovative electronic forms on smartphones, could potentially improve the performance of health care workers and health systems in developing countries. A pretested semistructured questionnaire was used to assess health workers\u2019 experiences, barriers, preferences, and motivating factors in using mobile health forms on smartphones in the context of maternal health care in Ethiopia. Twenty-five health extension workers (HEWs) and midwives, working in 13 primary health care facilities in Tigray region, Ethiopia, participated in this study. Sixteen (69.6%) workers believed the forms were good reminders on what to do and what questions needed to be asked. Twelve (52.2%) workers said electronic forms were comprehensive and 9 (39.1%) workers saw electronic forms as learning tools. All workers preferred unrestricted use of the smartphones and believed it helped them adapt to the smartphones and electronic forms for work purposes. Identified barriers for not using electronic forms consistently included challenges related to electronic forms and smartphones and health system issues such as frequent movement of health workers. Both HEWs and midwives found the electronic forms on smartphones useful for their day-to-day maternal health care services delivery. However, tyhe authors found that sustainable use and implementation of such work tools at scale would be daunting without providing technical support to health workers, securing mobile network airtime and improving key functions of the larger health system.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Innocent lives lost and saved: the importance of blood transfusion for children in sub-Saharan Africa","field_subtitle":"Dzik WH: BMC Medicine 13(22), 2015 ","URL":"http://www.biomedcentral.com/1741-7015/13/22","body":"Severe anemia in children is a leading indication for blood transfusion worldwide. Severe anemia, defined by the World Health Organization as a hemoglobin level&#8201;","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Innovations for health: Use of appropriate technologies in Primary Health Care in Zimbabwe - Report of an assessment","field_subtitle":"Training and Research Support Centre (TARSC); CBRT: TARSC, Harare, 2015","URL":"http://www.tarsc.org/publications/documents/AppTech%20PHC%20Zim%20rep%20April2015.pdf","body":"Zimbabwe has had a notable record of innovation and use of appropriate technologies in primary health care (PHC), particularly in environmental health. These technologies are generally defined as small-scale, decentralized, people centred, labour-intensive, energy-efficient, environmentally sound, and locally controlled. This pilot assessment aimed to explore and map specific appropriate technology innovations being developed and used at community level for health in rural and urban districts of Zimbabwe. The assessment looked at the technologies, their materials, purpose and use and related issues around their development and use,  with the evidence gathered by community based researchers within three main themes (i) food safety and nutrition, (ii) water, sanitation, waste management and housing and (iii) prevention and control of diseases. The results are presented in tables, with pictures of the technologies. While noting the limited size of the sample, the results suggest the wealth of innovations and appropriate technologies that exist, and the possibilities that may be found from a more systematic and wider assessment. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"It is time to focus on the real drivers of malaria","field_subtitle":"Tarlton D: UNDP Blog, April 2015 ","URL":"http://www.undp.org/content/undp/en/home/blog/2015/4/24/It-is-time-to-focus-on-the-real-drivers-of-malaria/","body":"The author argues that eliminating malaria seems like a straightforward issue. Decades of malaria control efforts show there is more to the story. Much of the vulnerability to malaria, it turns out, is determined by human actions. The conditions in which people are born, grow, work, live, and age define to a great extent who is vulnerable to malaria and who is not. Malaria is both a result and a cause of a lack of development. The author asserts that we know that it is those countries with the lowest levels of human development that are most affected by malaria. And within populations, those living in the poorest circumstances also suffer disproportionately. This year 2015 is argued to mark a turning point in the world\u2019s response to malaria with adoption of the new global framework Action and Investment to defeat Malaria (2016-2030) that places the management of the disease as a development issue. Under this plan, countries will for the first time report their progress on incorporating non-health sector interventions into their malaria control efforts.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Keep a Strong FENSA: Safeguard WHO's Independence From Private Interests","field_subtitle":"Gopa Kumar KM; Kishore S; Reed T; Kiddell-Monroe R: Huffington Post Blog, 21 May 2015","URL":"http://www.huffingtonpost.com/kavitha-kolappa-md-mph/fensa_b_7381712.html","body":"The authors write from the 68th World Health Assembly, where a drafting group of Member States are discussing the Framework of Engagement With Non-State Actors (FENSA). This process aims to determine the rules of engagement between WHO and non-State actors (NSAs), a moniker encompassing academia, nongovernmental organizations, philanthropic foundations, and the private sector. Many from civil society view this process as a way of safeguarding WHO's independence from private interests. The authors outline the fault lines in the proposals of contentious issues. During the open-ended process, India supported including language in paragraph 44 that named specific industries WHO should exercise caution in engaging with, such as the food, beverage, alcohol, and infant formula industries. India further proposed, \"WHO's engagement will be strictly limited to assisting such industries to comply with WHO's norms and standards or guideline or policy.\" On behalf of the African group, Zimbabwe asserted that the \"framework should explicitly list the types of industries that WHO will deal cautiously with and the reasons for the cautious engagement,\" also naming alcohol, food, and beverage. Greece argued, \"strict rules should govern its [WHO] engagement with the pharmaceutical industries.\" Finland recommended a \"high level of restriction\" for engagement with industries that have \"clear interests in health policies,\" referencing non-communicable disease control. Yet these calls were rejected by Canada, Denmark, Norway, and the United States. U.S. sought to eliminate the line concerning \"other industries affecting human health\" altogether. Other issues up for debate have been secondments from the private sector, as well as restrictions and/or ceilings on financial contributions from non state actors. The authors urged member states to ensure that FENSA creates a strong enough \"fence\" to safeguard public health. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Management of severe paediatric malaria in resource-limited settings","field_subtitle":"Maitland K: BMC Medicine 13(42), 2015","URL":"http://www.biomedcentral.com/1741-7015/13/42","body":"Over 90% of the world\u2019s severe and fatal Plasmodium falciparum malaria is estimated to affect young children in sub-Sahara Africa, where it remains a common cause of hospital admission and inpatient mortality. Few children will ever be managed on high dependency or intensive care units and, therefore, rely on simple supportive treatments and parenteral anti-malarials. There has been some progress on defining best practice for antimalarial treatment with the AQUAMAT trial in 2010 showing that in artesunate-treated children, the relative risk of death was 22.5% lower than in those receiving quinine. This review highlights the spectrum of complications in African children with severe malaria, the therapeutic challenges of managing these in resource-poor settings and examines in-depth the results from clinical trials with a view to identifying the treatment priorities and a future research agenda.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Materials for Facilitators Series on Health Budgets and Monitoring Budget Implementation ","field_subtitle":"International Budget Partnership, USA","URL":"http://tinyurl.com/nfo6vud","body":"These materials are aimed at trainers and facilitators conducting workshops for people interested in using budgets as a tool to enhance advocacy and research. The series\u2019 provide guidance on how to run workshops on budget-related topics as well as relevant materials and tasks for the workshop. IBP uses an adult education approach in participatory workshops and rely on good preparation by the facilitator and strong interaction and reflection by participants. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Medicines Utilisation Research in Africa: Botswana Workshop and Symposium","field_subtitle":"27 - 29 July 2015, University of Botswana","URL":"http://muria.nmmu.ac.za/Botswana-Workshop-and-Symposium-27-29-July-2015","body":"The workshop and symposium are intended to develop and progress medicines utilization research in Africa. The workshop will cater for all personnel including those just starting research in this area and those already undertaking medicine utilization research. This will be achieved through two workshop streams (parallel sessions) and a one day symposium for researchers to present their projects and findings. Topics will depend on the content of the submitted abstracts. There will be both oral and poster presentations. Particular consideration will be given to abstracts describing current drug utilisation research and activities with ARVs.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Multisectoral Action Framework for Malaria","field_subtitle":"Roll Back Malaria Partnership; UNDP: UNDP New York, 2015","URL":"http://www.rollbackmalaria.org/files/files/about/MultisectoralApproach/Multisectoral-Action-Framework-for-Malaria.pdf","body":"This Multisectoral Action Framework for Malaria makes a clear case for re-structuring the way countries address malaria. It presents a menu of concrete, implementable processes and actions to transform malaria\r\nresponses\u2014from being a concern of the health sector only, towards a coordinated multi-pronged effort that harnesses expertise across a range of sectors and institutions. The Framework calls for action at several levels and in multiple sectors, globally and across inter- and\r\nintra-national boundaries, and by different organizations. It emphasizes complementarity, effectiveness and sustainability, and capitalizes on the potential synergies to accelerate both socio-economic development and malaria control. It involves new interventions as well as putting new life into those that already exist, and coordinates and manages these in new and innovative ways. It is a guide for policymakers and practitioners and a stimulus for innovation.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"New evidence: tax financing for UHC","field_subtitle":"Mohga Kamal-Yanni: Oxfam Global Health Check, May 2015 ","URL":"http://www.globalhealthcheck.org/?utm_source=Global%20Health%20Check&utm_campaign=2ea32101e4-Global%20Health%20Check%20email&utm_medium=email&utm_term=0_89f8d74097-2ea32101e4-12084821","body":"The Ebola crisis exposed the weaknesses of healthcare systems in low- and middle-income countries created mainly by insufficient funding. Given the global community\u2019s commitment to universal health coverage (UHC), the Ebola outbreak has prompted serious reflection among health policy decision-makers. One of the central features of this debate is financing: how can relatively poor countries find the money to pay for universal health coverage? To date, low- and middle-income countries have been growing toward UHC through social health insurance systems funded through employment. Yet, progress has been slow and uneven leaving people in the informal sector, who are the majority of the population, out was insurance schemes. Rather than seeking innovative solutions to this old problem, this blog outlines how Aaron Reeves argues that what is needed is a renewed commitment to an old solution: tax-based financing. Using data from low- and middle-income countries my colleagues and I examined the association between tax revenues and health spending. We found that tax revenue was a major statistical determinant of progress towards UHC. Each $10 per-capita increase in tax revenue was associated with an additional $1 of public health spending per capita. Whereas each $10 increase in GDP per capita was associated with an increase of $0.10. Crucially, tax revenues sit on the pathway between economic growth and health spending. In short, tax financing is an efficient way of translating economic growth into health spending. Countries with more tax revenues have also made more progress on other indicators of UHC, even after adjusting for economic activity in the country. Among tax poor countries, greater tax revenues are associated with more women being attended by a skilled healthcare worker during pregnancy and greater access to healthcare for all people.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Online directory about NGOs and other development organisations in South Africa","field_subtitle":"Prodder: SANGONeT NGO Pulse Portal ","URL":"http://www.searo.who.int/entity/healthpromotion/documents/hl_tookit/en/","body":"Information and knowledge have become critical determinants of development and the driving forces behind economic progress in today's competitive world. Access to credible information is a strategic prerequisite for the success of development projects and processes. It empowers decision-making and enables action across a wide range of development issues.  This directory highlights the activities of organisations involved in development work in South Africa. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Perinatal deaths in South Africa, 2011-2013","field_subtitle":"Statistics South Africa, April 2015","URL":"http://www.statssa.gov.za/publications/P03094/P030942013.pdf","body":"Statistics South Africa (Stats SA) has published statistics on perinatal deaths based on administrative records captured on death notification forms collected from the South African civil registration system maintained by the Department of Home Affairs. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Prevention of mother-to-child transmission of HIV in rural Uganda: Modelling effectiveness and impact of scaling-up PMTCT services","field_subtitle":"Woodward D: Glob Health Action 2015, 8 (26308), 2015","URL":"http://dx.doi.org/10.3402/gha.v8.26308","body":"The reported coverage of any antiretroviral (ARV) prophylaxis for prevention of mother-to-child transmission (PMTCT) has increased in sub-Saharan Africa in recent years, but was still only 60% in 2010, and this may be an overestimation as it does not measure completion. The PMTCT programme is complex as it builds on a cascade of sequential interventions that should take place to reduce mother-to-child transmission (MTCT) of HIV: starting with antenatal care, HIV testing, and ARVs for the woman and the baby. This study was based on a population-based cohort of pregnant women recruited in the Iganga-Mayuge Health and Demographic Surveillance Site in rural Uganda 2008\u20132010. Using modelling, it was estimated that HIV infections in children could be reduced by 28% by increasing HIV testing capacity at health facilities to ensure 100% testing among women seeking ANC. Providing ART to all women who received ARV prophylaxis would give an 18% MTCT reduction. The results highlight the urgency in scaling-up universal access to HIV testing at all ANC facilities, and the potential gains of early enrolment of all pregnant women on antiretroviral treatment for PMTCT. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Public Health Association of South Africa (PHASA) Conference","field_subtitle":"7-9 October 2015, Southern Sun Elangeni, Durban, South Africa","URL":"http://www.phasaconference.org.za","body":"The 11th Annual Conference of the Public Health Association of South Africa takes place between 7-9 October 2015 in Durban, KwaZulu-Natal. With 2015 being the target date for the achievement of the Millennium Development Goals, the conference will provide an opportunity to reflect on the challenges faced by South Africa and Africa in trying to achieve the MDGs.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Radical changes in medical education needed globally","field_subtitle":"Ebrahim S, Squires N, di Fabio J, Reed G, Bourne P, Keck W, Neusy AJ, Chalkidou K: The Lancet 3(3), 2015","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)70013-6/abstract","body":"New medical schools in Africa have developed curricula that include community and rural health components, long-term family attachments, and admission processes that are more equitable for disadvantaged students. These worthwhile innovations have been incorporated in previous reforms of medical education, but the authors ask in this paper if they are sufficient to meet the challenges of achieving universal health care. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Rural Doctors Association of South Africa (RuDASA)","field_subtitle":"23-26 September 2015, Mpumalanga, South Africa","URL":"http://www.rudasa.org.za/","body":"An annual RuDASA conference has been organised almost every year since 1996, and attracts a range of rural health professionals from all over the country. The conference is a much-anticipated, vibrant forum which combines a mixture of sessions ranging from clinical skills updates for and by a wide range of health professionals to emotive discussions and workshops on issues such as justice and equity. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons","field_subtitle":"Maggard KR, Hatwiinda S, Harris JB, Phiri W, Kr\u00fc\u00fcner A, Kaunda K, Topp SM, Kapata N, Ayles H, Chileshe C, Henostroza G, Reid SE: Bulletin of the World Health Organisation 93(2) 65-132, 2015","URL":"http://www.who.int/bulletin/volumes/93/2/14-135285/en/","body":"This study aimed to improve the Zambia Prisons Service\u2019s implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing. For both tuberculosis and HIV, the authors implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. They also established routine systems \u2013 with inmates as peer educators \u2013 for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia\u2019s prisons. In a period of 9 months, the authors screened 7638 individuals and diagnosed 409 new patients with tuberculosis. They tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments was 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive. Both tuberculosis and HIV infection are common within Zambian prisons. The authors enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. These observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Social determinants of malaria and health care seeking patterns among rice farming and pastoral communities in Kilosa District in central Tanzania ","field_subtitle":"Shayoa EH: Rumishaa SF; Mlozib M; Bwanac VM; Mayalaa BK; Malimac RC; Mlachaa T; Mboera L: Acta Tropica 144: 41-9, 2015","URL":"http://www.ncbi.nlm.nih.gov/pubmed/25596436","body":"This study was carried out to understand the role social determinants and health seeking behavior among rice farming and pastoral communities in Kilosa District in central Tanzania. The study involved four villages; two with rice farming communities while the other two with pastoral communities. In each village, heads of households or their spouses were interviewed to seek information on livelihoods activities, knowledge and practices on malaria and its preventions. A total of 471 individuals were interviewed. Only 23.5% of the respondents had adequate knowledge on malaria. Fifty-six percent of the respondents could not associate any livelihood activity with malaria transmission. Majority (79%) of the respondents believed that most of fevers were due to malaria; this was higher among the pastoral (81.7%) than rice farming communities (76.1%). Cases of fever were significantly higher in households with non-educated than educated respondents. Women experienced significantly more episodes of fever than men. Fever was reported more frequently among pastoral than rice farming communities.  Treatment seeking frequency differed by the size of the household and between rice farming and pastoral communities. In conclusion, education, sex, availability of health care facility and livelihood practices were the major social determinants that influence malaria acquisition and care seeking pattern in central Tanzania. The authors argue for an ecohealth approach to address the links of livelihoods and malaria transmission among rural farming communities.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Social Determinants of Migrant Health","field_subtitle":"Lefkowitz B; Cacari-Stone L: The Conference on Social Determinants of Migrant Health, October 2014","URL":"http://cultureofhealthequity.org/our-work/social-determinants-of-migrant-health/","body":"This conference reports on work on the integration of social determinants of health \u2013 socioeconomic and structural factors \u2013 into immigrant health research and policy. A cross-national framework was used to consider issues of place, migration and health. In addition to public health, it drew upon the fields of economics, sociology of immigration, and social epidemiology, and incorporated three theoretical frameworks: the life-course framework from social epidemiology, the \u2018push-pull\u2019 factor theories from geography and economics, and transnational theory from sociology. It built upon recent academic literature, including a Social Sciences and Medicine (SSM) supplement on immigration and health, to formulate areas where more research is needed and to recommend potentially fruitful program interventions and policy changes. It integrated work with North American Latino immigrants, Asian and South Asian immigrants, African and Afro-Caribbean immigrants, and Arab immigrants, and research linking the migration to Europe of Arab, Turks and other populations, and to the Middle East of immigrants from Africa.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Tenofovir substitution in Namibia based on an analysis of the antiretroviral dispensing database","field_subtitle":"Kalemeera F; Mengistu A; Gaeseb J: Journal of Pharmaceutical Policy and Practice 8(14), 2015 ","URL":"http://www.joppp.org/content/8/1/14","body":"In the management of HIV infection, tenofovir (TDF) is preferred to its predecessors based on its safety profile, despite some adverse reactions which warrant its substitution for some patients. This review measured the rate of TDF\u2019s substitution from January 1 2008 to November 30 2011, and compared the gender difference in these rates of substitution using dispensing records from the national antiretroviral dispensing database. No gender difference was observed and the authors indicate that further investigation is required to determine the clinical reasons for TDF\u2019s withdrawal.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The reality of task shifting in medicines management- a case study from Tanzania","field_subtitle":"Wiedenmayer K; Kapologwe N; Charles J; Chilunda F; Mapunjo S: Journal of Pharmaceutical Policy and Practice 8(13), 2015 ","URL":"http://www.joppp.org/content/8/1/13","body":"Tanzania suffers a severe shortage of pharmaceutical staff negatively affecting the provision of pharmaceutical services and access to medicines, particularly in rural areas. Task shifting has been proposed as a way to mitigate this. This study aimed to understand the context and extent of task shifting in pharmaceutical management in Dodoma Region, Tanzania. The authors explored 1) the number of trained pharmaceutical staff as compared to clinical cadres managing medicines, 2) the national establishment for staffing levels, 3) job descriptions, 4) supply management training conducted and 5) availability of medicines and adherence to Good Storage Practice in 270 public health facilities in 2011. In 95.5% of studied health facilities medicines management was done by non-pharmaceutically trained cadres, predominantly medical attendants. Task shifting was found to be a reality in the pharmaceutical sector in Tanzania occurring mainly as a coping mechanism rather than a formal response to the workforce crisis. Pharmacy-related tasks and supply management were informally shifted to clinical staff without policy guidance, explicit job descriptions, and without the necessary support through training. It was argued that implicit task shifting be recognised and formalised and job orientation, training and operational procedures be used to support non-pharmaceutical health workers to effectively manage medicine supply.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The role of civil society organisations in promoting community participation","field_subtitle":"Serunjogi F: CEHURD Newsletter, May 2015","URL":"http://www.cehurd.org/2015/05/the-role-of-civil-society-organisations-in-promoting-community-participation/","body":"In an initiative to promote the decentralizing of the health system, the government of Uganda through Ministry of Health called for an establishment of Health Unit Management Committees (HUMCs) at each government health facility as a way of empowering community members to participate in influencing health system for better service delivery. As part of an action research process, the Center for Health Human Rights and Development (CEHURD) carried out a case study on two HUMCs in Kikoolimbo health center III in Kyankwanzi district and Nyamiringa health center II Kiboga district. The purpose of this case study was to provide an understanding of the experiences of HUMCs in performing their roles and what role Civil Society can play to support them perform their roles and responsibilities as well as advancing health rights and addressing health inequities using the human rights based approach. The findings revealed that these two health unit management committees had limited knowledge of the HUMCs guidelines. The committee members were trained by CEHURD and community dialogues held to inform community members about the existence of these committees as well as their roles and responsibilities. The author noted that when communities are empowered, they can differentiate between performing and non-performing committees.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Tracking development assistance for health to fragile states, 2005\u20132011","field_subtitle":"Graves CM; Haakenstad A; Dieleman JL : Globalization and Health 2015, 11(12), 2015 ","URL":"http://www.globalizationandhealth.com/content/11/1/12","body":"Development assistance for health (DAH) has grown to more than $31.3 billion in 2013. This paper presents evidence on the degree to which countries with high concentrations of conflict, violence, inequality, debt and corruption have received health aid compared to other countries. The authors combined DAH estimates and a multidimensional fragile states index for 2005 to 2011 comparing 'fragile' versus 'stable' states. Comparing low-income countries, fragile countries received $7.22 per person while stable countries received $11.15 per person. Funders preferred funding to low-income fragile countries that have refugees or ongoing external intervention but tended to avoid funding countries perceived to have political gridlock, flawed elections, or economic decline. While external health funding to 'fragile' countries has increased since 2005, it is per person almost half as much as the DAH provided to more stable countries of comparable income levels.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Unexplained health inequality \u2013 is it unfair?","field_subtitle":"Asada Y, Hurley J, Norheim OF, Johri M: International Journal for Equity in Health 14(11), 2014","URL":"http://www.equityhealthj.com/content/14/1/11","body":"Accurate measurement of health inequities is indispensable to track progress or to identify needs for health equity policy interventions. A key empirical task is to measure the extent to which observed inequality in health \u2013 a difference in health \u2013 is inequitable. Empirically operationalising definitions of health inequity has generated an important question not considered in the conceptual literature on health inequity. Empirical analysis can explain only a portion of observed health inequality. This paper demonstrates that the treatment of unexplained inequality is not only a methodological but ethical question and that the answer to the ethical question \u2013 whether unexplained health inequality is unfair \u2013 determines the appropriate standardization method for health inequity analysis and can lead to potentially divergent estimates of health inequity. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Validating estimates of prevalence of non-communicable diseases based on household surveys: the symptomatic diagnosis study","field_subtitle":"James SL; Romero M; Ram\u00edrez-Villalobos D; G\u00f3mez S; Pierce K; Flaxman A; Serina P; Stewart A;  Murray CJL; Gakidou E; Lozano R; Hernandez B: BMC Medicine 13(15), 2015 ","URL":"http://www.biomedcentral.com/1741-7015/13/15","body":"Easy-to-collect epidemiological information is critical for the more accurate estimation of the prevalence and burden of different non-communicable diseases around the world. Current measurement is restricted by limitations in existing measurement systems in the developing world and the lack of biometry tests for non-communicable diseases. Diagnosis based on self-reported signs and symptoms (\u201cSymptomatic Diagnosis,\u201d or SD) analysed with computer-based algorithms may be a promising method for collecting timely and reliable information on non-communicable disease prevalence. This study developed and assessed the performance of a symptom-based questionnaire to estimate prevalence of non-communicable diseases in low-resource areas. The authors collected 1,379 questionnaires in Mexico from individuals who suffered from a non-communicable disease that had been diagnosed with gold standard diagnostic criteria or individuals who did not suffer from any of the 10 target conditions. To make the diagnosis of non-communicable diseases, the authors selected the Tariff method, a technique developed for verbal autopsy cause of death calculation. They assessed the performance of this instrument and analytical techniques at the individual and population levels. The questionnaire revealed that SD is a viable method for producing estimates of the prevalence of non-communicable diseases in areas with low health information infrastructure. This technology can provide higher-resolution prevalence data, more flexible data collection, and potentially individual diagnoses for certain conditions.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Why language matters: insights and challenges in applying a social determination of health approach in a North-South collaborative research program","field_subtitle":"Spiegel JM; Breilh J; Yassi A: Globalization and Health 2015, 11(9), 2015 ","URL":"http://www.globalizationandhealth.com/content/11/1/9","body":"A focus on social determinants of health provides a welcome alternative to the bio-medical illness paradigm. However, the tendency to concentrate on the influence of risk factors related to living and working conditions of individuals, rather than to more broadly examine dynamics of the social processes that affect population health, has triggered critical reaction not only from the Global North but especially from voices the Global South where there is a long history of addressing questions of health equity. In this article, the authors elaborate on how focusing instead on the language of \u201csocial determination of health\u201d has led to application of more equity-sensitive approaches to research and related policy and praxis. The authors briefly explore the epistemological and historical roots of epidemiological approaches to health and health equity that have emerged in Latin America to consider its relevance to global discourse. In this region marked by pronounced inequity, context-sensitive concepts such as \u201ccollective health\u201d and \u201ccritical epidemiology\u201d have been prominent, albeit with limited acknowledgement by the Global North. The authors illustrate attempts to apply a social determination approach (and the \u201c4 S\u201d elements of bio-Security, Sovereignty, Solidarity and Sustainability) in five projects within their research collaboration linking researchers and knowledge users in Ecuador and Canada, in diverse settings (health of healthcare workers; food systems; antibiotic resistance; vector borne disease [dengue]; and social circus with street youth). The authors argue that the language of social determinants lends itself to research that is more reductionist and beckons the development of different skills than would be applied when adopting the language of social determination. They conclude that this language leads to more direct analysis of the systemic factors that drive, promote and reinforce disparities, while at the same time directly considering the emancipatory forces capable of countering negative health impacts. It follows that \u201creverse innovation\u201d must not only recognise practical solutions being developed in low and middle income countries, but must also build on the strengths of the theoretical-methodological reasoning that has emerged in the South.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Working with marginalised communities on using data and technology in advocacy","field_subtitle":"Ganesh M; Slater D; Martini B: Beatrice Martini Blog on Tech and Tools for Justice and Rights, May 2015","URL":"http://www.harm-reduction.org/blog/working-marginalised-communities-using-data-and-technology-advocacy","body":"Mutual trust and respect, real commitment to collaboration and flexibility are all essential elements to be responsibly equipped to work with a marginalised community. And they are not even enough. The authors write in this paper about the experience of working with marginalised communities on using data and technology in advocacy as they think it could greatly help other practitioners planning to collaborate with groups struggling to get their rights honoured and their voices heard. The authors summarise advice emerging from the case study as to: listen to and learn from the community, keeping assumptions at bay; give ownership of the work to the community itself; build capacity tailored to its needs and abilities, accessibly and sustainably; provide people with the tools and methodologies that equip them to work independently on more successful initiatives in the future. ","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"World Malaria Day 2015: Invest in the Future, Defeat Malaria","field_subtitle":"Mosca D; Motus N: International Labour Organisation for Migration, April 2015","URL":"http://www.iom.int/news/world-malaria-day-2015-invest-future-defeat-malaria","body":"In 2013, there were about 198 million malaria cases in the world and an estimated 584,000 deaths from the disease. The countries endemic for malaria are also some of the poorest countries in the world. The burden of malaria on the poor, including migrants and displaced populations in these countries further fuels the cycle of poverty. IOM works with governments and partners, mostly in Africa and Asia, to ensure universal access to health care, including malaria prevention, early diagnosis, and treatment services among migrants and hard-to-reach populations. This year\u2019s theme for World Malaria Day on April 25th was 'Invest in the Future: Defeat Malaria'. It focused on reaching 2015 malaria targets in all malaria-endemic countries, as well as scaling up efforts in malaria elimination and control beyond 2015.","php":"","field_issue_date":"2015-06-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"9th Action Learning, Action Research (ALARA) and 13th Participatory Action Research World Congress, Pretoria, South Africa, 4-7 November","field_subtitle":"Final date for submission of abstracts: 12 May 2015","URL":"http://www.alarassociation.org/pages/events/alara-world-congress-2015-call-for-abstracts/alara-world-congress-2015-abstract-submission#gsuser_F","body":"The theme of this World Congress is a challenge to Action Learning / Action Research practitioners the world over, whether working in resource rich or more socio-economically challenged contexts, to explain how they are contributing to the creation of a fairer world. Abstracts should be emailed to conferencepl@gmail.com.  Abstracts should be 250 words max, typed in single space Arial 12 using the following headings as a guide:\r\nBackground: an overview of the issue under discussion, the problem the research addresses and the purpose and objective of the research\r\nMethods: the study period / setting / location, study design, study population, data collection and methods of analysis used. Results: the findings / outcome of the study. Please summarize any specific results.\r\nConclusions: the significance of findings / outcomes of the study and future implications of the results. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A narrative review of research impact assessment models and methods","field_subtitle":"Milat AJ; Bauman AE; Redman S: Health Research Policy and Systems 13(18), 18 March 2015","URL":"http://www.health-policy-systems.com/content/pdf/s12961-015-0003-1.pdf","body":"Research funding agencies continue to grapple with assessing research impact. This narrative literature review synthesized evidence on processes and conceptual models used for assessing policy and practice impacts of public health research. The review involved keyword searches of electronic databases, including MEDLINE, CINAHL, PsycINFO, EBM Reviews, and Google Scholar in July/August 2013. The review included theoretical and opinion pieces, case studies, descriptive studies, frameworks and systematic reviews describing processes, and conceptual models for assessing research impact. A total of 16 different impact assessment models were identified, with the \u2018payback model\u2019 the most frequently used conceptual framework. Typically, impacts were assessed across multiple dimensions using mixed methodologies, including publication and citation analysis, interviews with principal investigators, peer assessment, case studies, and document analysis. The vast majority of studies relied on principal investigator interviews and/or peer review to assess impacts, instead of interviewing policymakers and end-users of research. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"A Wake-up Call - Lessons from Ebola for the world's health systems","field_subtitle":"Wright S; Hanna L; Mailfert M; Gushulvili D; Kite G: Save the Children 2015","URL":"http://tinyurl.com/nshw3tz","body":"Ebola has taken a dreadful toll in the three West African countries hit by the current outbreak \u2013 Guinea, Sierra Leone and Liberia. In this report, Save the Children documents the existing weaknesses of the health services in the three main countries affected by Ebola. There is broad agreement that the Ebola crisis was not quickly contained, reversed or mitigated because national health systems in these countries were dangerously under-resourced, under-staffed and poorly equipped. The virus was able to spread, in part, due to the poor state of these health services, which were quickly overwhelmed and lacked the ability to cope with a major disease outbreak. This inability to cope with a major health emergency reflects a similar inability to cope with the daily health needs of their populations over the longer term. The authors argue that one of the most important lessons from the Ebola crisis is the need to build comprehensive health services with sufficient funding, staff and equipment, to deal with everyday problems as well as infectious\r\ndisease outbreaks. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"African ministers of finance call for increased investment to end the AIDS epidemic by 2030","field_subtitle":"UNAIDS, 1 April 2015","URL":"http://www.unaids.org/en/resources/presscentre/featurestories/2015/april/20150331_africanfinance","body":"African ministers of finance and key partners in the AIDS response meeting in Addis Ababa, Ethiopia, have called for increased national investment to end the AIDS epidemic as a public health threat by 2030. The international community has committed to meeting the 90\u201390\u201390 treatment targets, under which 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression. If the 90\u201390\u201390 targets are met by 2020, ending the AIDS epidemic a decade later is achievable.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Breaking the Rules 2014: Evidence of Violations of the International Code of Marketing of Breastmilk Substitutes and subsequent resolutions compiled from January 2011 to December 2013","field_subtitle":"International Baby Food Action Network: May 2014","URL":"http://www.babymilkaction.org/wp-content/uploads/2014/05/BTR14inbrief.pdf","body":"Breaking the Rules 2014 (BTR) is a 237-page monitoring report which describes evidence of 813 Code violations, from 81 countries, collected between Jan 2011 and Dec 2013. The Rules are the International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly resolutions (the Code), which are the yardstick to measure compliance by all companies in all countries. Following the request for clarification of \u2018inappropriate promotion\u2019 of foods for infants and young children, BTR: in Brief provides examples of marketing tactics that should not be allowed. The emphasis is on toddler milks or growing up milks (GUMs), a product which has been generating huge profits for the baby food industry over the past decade or more. The inappropriate promotions reported are Code violations. This abridged report is meant to show how the 16 largest baby food companies continue to ignore international recommendations adopted to protect infants and young children the world over so the public and investors can hold them to account.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Call for applications for CODESRIA Textbook Programme","field_subtitle":"Deadline for submission of applications: 26 August 2015","URL":"http://www.codesria.org/spip.php?article2245&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) is pleased to announce its programme for the publication of textbooks for use in African universities. The programme is aimed at making available to teachers and students textbooks that are adapted to the African context and the research and learning environment on the continent. African researchers are invited to submit their textbook manuscripts to the Council. This programme is for senior scholars with a proven track record of academic achievement and a demonstrable knowledge of the domain in which they wish to produce a textbook. In selecting proposals, the Council will lay emphasis on the value which is likely to be added by the manuscript. Proposals can be submitted by single authors or by a team of contributors. Each textbook can be organised around a discipline,  a body of disciplines, or a specific theme. The textbooks will cover the African continent, a sub-region or a specific country.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Climate for evidence informed health system policymaking in Cameroon and Uganda before and after the introduction of knowledge translation platforms: a structured review of governmental policy documents","field_subtitle":"Ongolo-Zogo P; Lavis JN; Tomson G;  Sewankambo NK: Health Research Policy and Systems 13(2), 1 January 2015 ","URL":"http://www.health-policy-systems.com/content/13/1/2","body":"There is a scarcity of empirical data on African country climates for evidence-informed health system policymaking (EIHSP) to backup the longstanding reputation that research evidence is not valued enough by health policymakers as an information input. In this paper, the authors assess whether and how changes have occurred in the climate for EIHSP before and after the establishment of two Knowledge Translation Platforms housed in government institutions in Cameroon and Uganda since 2006. The authors merged content analysis techniques and policy sciences analytical frameworks to guide this structured review of governmental policy documents geared at achieving health Millennium Development Goals. They combined i) a quantitative exploration of the usage statistics of research-related words and constructs, citations of types of evidence, and budgets allocated to research-related activities; and (ii) an interpretive exploration using a deductive thematic analysis approach to uncover changes in the institutions, interests, ideas, and external factors displaying the country climate for EIHSP. Descriptive statistics compared quantitative data across countries during the periods 2001\u20132006 and 2007\u20132012. The use of evidence syntheses to frame poverty and health problems, select strategies, or forecast the expected outcomes has remained sparse over time and across countries. The budgets for research increased over time from 28.496 to 95.467 million Euros (335%) in Cameroon and 38.064 to 58.884 million US dollars (155%) in Uganda, with most resources allocated to health sector performance monitoring and evaluation. The consistent naming of elements pertaining to the climate for EIHSP features the greater influence of external donors through policy transfer. The authors indicate that the review illustrated a conducive climate for EIHSP in Cameroon and Uganda but a persistent undervalue of evidence syntheses and recommend that global and national health stakeholders raise the profile of evidence syntheses (e.g., systematic reviews) as an information input when shaping policies and programmes.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda","field_subtitle":"Banek K; Nankabirwa J; Maiteki-Sebuguzi C; DiLiberto D;  Taaka L; Chandler C; Staedke S: Health Policy and Planning, 30(4),  2014, doi: 10.1093/heapol/czu033","URL":"http://heapol.oxfordjournals.org/content/30/4/451.full","body":"In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management of fever (HBMF) programme, to include treatment for malaria, diarrhoea and pneumonia through Integrated Community Case Management (ICCM). To understand the level of support available, and the capacity and motivation of community health workers to deliver these expanded services, the authors interviewed community medicine distributors (CMDs), who had been involved in the HBMF programme in Tororo district, shortly before ICCM was adopted. Between October 2009 and April 2010, 100 CMDs were recruited to participate by convenience sampling. The survey included questionnaires to gather information about the CMDs\u2019 work experience and to assess knowledge of fever case management, and in-depth interviews to discuss experiences as CMDs including motivation, supervision and relationships with the community. CMDs faced multiple challenges including high patient load, limited knowledge and supervision, lack of compensation, limited drugs and supplies, and unrealistic expectations of community members. CMDs described being motivated to volunteer for altruistic reasons; however, the main benefits of their work appeared related to \u2018becoming someone important\u2019, with the potential for social mobility for self and family, including building relationships with health workers. At the time of the survey, over half of CMDs felt demotivated due to limited support from communities and the health system. Community health worker programmes rely on the support of communities and health systems to operate sustainably. When this support falls short, motivation of volunteers can wane. If community interventions, in increasingly complex forms, are to become the solution to improving access to primary health care, greater attention to what motivates individuals, and ways to strengthen health system support are required.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Contributions of global health diplomacy to equitable health systems in east and southern Africa, Report of a Regional Research Workshop, 13-14 March 2015, Johannesburg South Africa","field_subtitle":"EQUINET, TARSC, CPTL; EQUINET, Harare, 2015","URL":"http://www.equinetafrica.org/bibl/docs/Regional%20GHD%20meeting%20report%20March2015.pdf","body":"This report presents the proceedings of a meeting held on March 13 and 14 a regional meeting was convened with objectives to\r\ni. Present and discuss the findings from the EQUINET research programme and from related research in Africa, and the implications for policy, negotiations and programmes in east and southern Africa;\r\nii. Review methods and challenges for implementing research and analysis on global health diplomacy for policy relevance, from review of research and experience of the work;\r\niii. Discuss and propose areas for follow up policy, action and research, within ESA and through south-south collaboration. It included senior officials involved in health from national and regional organisations, health diplomats, researchers from the EQUINET work and others working on health diplomacy and on south-south co-operation in the region and internationally. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Corporate social responsibility in global health: an exploratory study of multinational pharmaceutical firms","field_subtitle":"Droppert H; Bennett S: Globalization and Health 2015, 11(15), April 2015 ","URL":"http://www.globalizationandhealth.com/content/11/1/15","body":"As pharmaceutical firms experience increasing civil society pressure to act responsibly, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. The author\u2019s sought to understand how multinational pharmaceutical companies currently engage in CSR activities in developing countries and their motivations for doing so. They conducted a small-scale, exploratory study combining (i) in-depth review of publicly available data on pharmaceutical firms\u2019 CSR with (ii) interviews of representatives from 6 firms, purposively selected, from the highest earning pharmaceutical firms worldwide. Corporate social responsibility differed for each firm. Across the firms studied, the common CSR activities were: differential pharmaceutical pricing, strengthening developing country drug distribution infrastructure, mHealth initiatives, and targeted research and development. Primary factors that motivated CSR engagement were: reputational benefits, recruitment and employee satisfaction, better rankings in sustainability indices, entrance into new markets, long-term economic returns and improved population health. CSR strategies ranged from philanthropic donations to integrated business models. The authors indicate that the study points to the need to (i) develop clearer definitions of CSR in global health (2) strengthen indices to track CSR strategies and their public health effects in developing countries and (iii) undertake more country level studies that investigate how CSR engages with national health systems.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Determinants of immunization inequality among urban poor children: evidence from Nairobi\u2019s informal settlements","field_subtitle":"Egondi T; Oyolola M; Mutua MK; Elung\u2019ata P: International Journal for Equity in Health, 14(24), February 2015 ","URL":"http://www.equityhealthj.com/content/14/1/24","body":"Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization in 1974, major disparities still exist in immunization coverage across different population sub-groups. In Kenya, while the proportion of fully immunized children increased from 57% in 2003 to 77% in 2008\u20139 at national level and 73% in Nairobi, only 58% of children living in informal settlement areas are fully immunized. This study aimed to determine the degree and determinants of immunization inequality among the urban poor of Nairobi, using data from the Nairobi Cross-Sectional Slum Survey of 2012 on full immunization status among children aged 12\u201323 months. The wealth index was used as a measure of social economic position for inequality analysis. Immunization inequality was found to be mainly concentrated among children from poor families. Decomposition of the results suggests that 78% of this inequality is largely explained by the mother\u2019s level of education. The author suggests that efforts to reduce this inequality should aim at targeting mothers with low levels of education during immunization campaigns.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Distance decay and persistent health care disparities in South Africa","field_subtitle":"McLaren ZM; Ardington C; Leibbrandt M: BMC Health Services Research, 14(54), 2014","URL":"http://www.biomedcentral.com/1472-6963/14/541","body":"Access to health care is a particular concern given the important role of poor access in perpetuating poverty and inequality. South Africa has large racial disparities in access despite post-apartheid health policy to increase the number of health facilities, even in remote rural areas. However, even when health services are provided free of charge, monetary and time costs of travel to a local clinic may pose a significant barrier for vulnerable segments of the population, leading to overall poorer health. Using newly available health care utilization data from the first nationally representative panel survey in South Africa, together with administrative geographic data from the Department of Health, the authors use graphical and multivariate regression analysis to investigate the role of distance to the nearest facility on the likelihood of having a health consultation or an attended birth. Ninety percent of South Africans live within 7 km of the nearest public clinic, and two-thirds live less than 2 km away. However, 14% of Black African adults live more than 5 km from the nearest facility, compared to only 4% of Whites, and they are 16 percentage points less likely to report a recent health consultation  and 47 percentage points less likely to use private facilities. Racial differentials in the likelihood of having a health consultation or an attended birth persist even after controlling for confounders. The results have two policy implications: minimizing the distance that poor South Africans must travel to obtain health care and improving the quality of care provided in poorer areas will reduce inequality. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Drivers of routine immunisation coverage improvement in Africa: findings from district-level case studies","field_subtitle":"LaFond A; Kanagat N; Steinglass R; Fields R; Sequeira J; Mookherji S: Health Policy and Planning 30(3) 298-308, 2014 ","URL":"http://tinyurl.com/ndmmjnk","body":"There is limited understanding of why routine immunisation (RI) coverage improves in some settings in Africa and not in others. Using a grounded theory approach, the authors conducted in-depth case studies to understand pathways to coverage improvement by comparing immunisation programme experience in 12 districts in three countries (Ethiopia, Cameroon and Ghana). Drawing on positive deviance or assets model techniques the authors compared the experience of districts where diphtheria\u2013tetanus\u2013pertussis (DTP3)/pentavalent3 (Penta3) coverage improved with districts where DTP3/Penta3 coverage remained unchanged (or steady) over the same period, focusing on basic readiness to deliver immunisation services and drivers of coverage improvement. The results informed a model for immunisation coverage improvement that emphasises the dynamics of immunisation systems at district level. In all districts, whether improving or steady, the authors found that a set of basic RI system resources were in place from 2006 to 2010 and did not observe major differences in infrastructure. They found that the differences in coverage trends were due to factors other than basic RI system capacity or service readiness and identified six common drivers of RI coverage performance improvement\u2014four direct drivers and two enabling drivers\u2014that were present in well-performing districts and weaker or absent in steady coverage districts, and map the pathways from driver to improved supply, demand and coverage. Findings emphasise the critical role of implementation strategies and the need for locally skilled managers that are capable of tailoring strategies to specific settings and community needs. The case studies are unique in their focus on the positive drivers of change and the identification of pathways to coverage improvement, an approach that should be considered in future studies and routine assessments of district-level immunisation system performance.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"E-procurement in support of universal health coverage","field_subtitle":"Humphreys G: Bulletin of the World Health Organization, 93(3) 138-139, 2015","URL":"http://www.who.int/bulletin/volumes/93/3/15-020315/en/","body":"Kenya is gearing up for digital bidding on essential medicines\u2019 contracts, part of a wave of African countries looking at procurement to improve transparency, bring down costs and support universal health coverage. John Kabuchi, procurement manager for the Kenya Medical Supplies Authority, notes: \u201cWe are currently gearing up for full e-procurement functionality, including electronic bidding, and I am hopeful that supporting legislation will be passed before next June.\u201d Kenya hopes to make the most of new technologies and approaches, such as e-procurement, to support efforts to make essential health care more widely available.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"\r\nContact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 171: Open Letter to his Excellency Jacob Zuma ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Header"}},{"node":{"title":"Factors influencing the use of maternal healthcare services and childhood immunization in Swaziland","field_subtitle":"Tsawe M; Moto A; Netshivhera T; Ralesego L; Nyathi C; Susuman AS: International Journal for Equity in Health, 14(32), 2015 doi:10.1186/s12939-015-0162-2","URL":"http://www.equityhealthj.com/content/14/1/32","body":"This study examined the factors that influence the use of maternal healthcare services and childhood immunization in Swaziland. The study used secondary data from the Swaziland Demographic and Health Survey 2006\u201307 using univariate, bivariate and multivariate analysis. The study findings showed a high use rate of antenatal care and delivery care and a low rate of postnatal care use. The uptake of childhood immunization is high, averaging more than 80%. Factors found to be influencing the use of maternal healthcare and childhood immunization included: woman\u2019s age, parity, media exposure, maternal education, wealth quintile, and residence. Programs to educate families about the importance of maternal and child healthcare services should be implemented and should focus on: (a) age differentials in use of maternal and child health services, (b) women with higher parities, (c) women in rural areas, and (d) women from the poor quintiles. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Feasibility of establishing a biosafety level 3 tuberculosis culture laboratory of acceptable quality standards in a resource-limited setting: an experience from Uganda","field_subtitle":"Ssengooba W; Gelderbloem SJ; Mboowa G; Wajja A; Namaganda C; Musoke P; Mayanja-Kizza H; Joloba ML: Health Research Policy and Systems 13(4), 2015 ","URL":"http://www.health-policy-systems.com/content/13/1/4","body":"Despite the recent innovations in tuberculosis (TB) and multi-drug resistant TB (MDR-TB) diagnosis, culture remains vital for difficult-to-diagnose patients, baseline and end-point determination for novel vaccines and drug trials. The authors share their experience of establishing a BSL-3 culture facility in Uganda as well as 3-years performance indicators and post-TB vaccine trials (pioneer) and funding experience of sustaining such a facility. Between September 2008 and April 2009, the laboratory was set-up with financial support from external partners. After an initial procedure validation phase in parallel with the National TB Reference Laboratory and legal approvals, the laboratory registered for external quality assessment and instituted a functional quality management system. Pioneer funding ended in 2012 and the laboratory remained self-sustainable with internationally acceptable standards in both structural and biosafety requirements. With the demonstrated quality of work, the laboratory attracted more research groups and post-pioneer funding, which helped to ensure sustainability. The high skilled experts in this research laboratory provide an excellent resource for national discussion of laboratory and quality management systems.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Global malaria eradication and the importance of Plasmodium falciparum epidemiology in Africa","field_subtitle":"Snow RW: BMC Medicine 13(23), February 2015 doi:10.1186/s12916-014-0254-7","URL":"http://www.biomedcentral.com/1741-7015/13/23","body":"The global agenda for malaria has, once again, embraced the possibility of eradication. The author argues that as history has shown, there will be no single magic bullet that can be applied to every epidemiological setting. Africa has a diverse malaria ecology, lending itself to some of the highest disease burden areas of the world and a wide range of clinical epidemiological patterns making control with our current tools challenging. This commentary highlights why the epidemiology of Plasmodium falciparum malaria in Africa should not be forgotten when planning an eradication strategy, and why forgetting Africa will, according to the author, once again, be the single largest threat to any hope for global eradication.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Health in the sustainable development goals: ready for a paradigm shift?","field_subtitle":"Buse K; Hawkes S: Globalization and Health 2015, 11(13), 2015 doi:10.1186/s12992-015-0098-8","URL":"http://www.globalizationandhealth.com/content/11/1/13","body":"The Millennium Development Goals (MDGs) galvanised attention, resources and accountability on a small number of health concerns of low- and middle-income countries with unprecedented results. The international community is presently developing a set of Sustainable Development Goals as the successor framework to the MDGs. This review examines the evidence base for the current health-related proposals in relation to disease burden and the technical and political feasibility of interventions to achieve the targets. In contrast to the MDGs, the proposed health agenda aspires to be universally applicable to all countries and is broad in encompassing both communicable and non-communicable diseases as well as emerging burdens from, among other things, road traffic accidents and pollution. The authors argue that success in realising the agenda requires a paradigm shift in: 1) ensuring leadership for intersectoral coherence and coordination on the structural drivers of health; 2) shifting the focus from treatment to prevention through locally-led, politically-smart approaches to a far broader agenda; 3) identifying effective means to tackle the commercial determinants of ill-health; 4) further integrating rights-based approaches; and 5) enhancing civic engagement and ensuring accountability. The authors are concerned that neither the international nor the global health community truly appreciates the extent of the shift required to implement this health agenda which is a critical determinant of sustainable development.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Health literacy toolkit for low- and middle-income countries","field_subtitle":"Dodson S; Good S; Osborne R: WHO Regional Office for South-East Asia, 10 February 2015","URL":"http://www.searo.who.int/entity/healthpromotion/documents/hl_tookit/en/","body":"This series of information sheets introduces health literacy, its relevance to public policy, and the ways it can be used to inform the promotion of good health, the prevention and management of communicable and noncommunicable diseases, and the reduction of health inequities. It provides information and links to further resources to assist organisations and governments to incorporate health literacy responses into practice, service delivery systems, and policy. It seeks to governments, politicians and policy makers; academic institutions; public, civil society, and non-governmental organisations; and practitioners; relevant private sectors promoting health and well-being; communities, community-based organisations and social networks; WHO and other UN partners and development organisations.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Hopes dashed as HIV measure found to be useless","field_subtitle":"Kahn T: BDLive, 25 February 2015","URL":"http://tinyurl.com/kwlgls4","body":"Hopes that a South African-developed vaginal gel containing tenofovir would protect women against HIV were dashed after a major new study found that it did not work. Scientists had been optimistic that the microbicide would protect millions of women from HIV, after a phase 2 study of 900 women in KwaZulu-Natal found it reduced the risk of getting the virus by 39%. The development was hailed as a breakthrough, though the scientists who led the work were careful to emphasise that further research was needed to replicate the findings. At that stage, 11 other trials testing six other products had failed. The findings had a wide margin of error, with the efficacy of HIV protection estimated to lie between 6% and 60%. A much larger Follow-on African Consortium for Tenofovir Studies (FACTS) 001 trial was launched in 2011 to confirm its findings. The consortium scientists announced at the annual Conference on Retroviruses and Opportunistic Infections in Seattle, however, that the tenofovir-containing microbicide provided to 2,059 women aged between 18 years and 30 years did not protect them from HIV. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue","field_subtitle":"Opwora A; Waweru E;  Toda M; Noor A; Edwards T; Fegan G; Molyneux S; Goodman C: Health Policy and Planning, 30(4), 2014 doi: 10.1093/heapol/czu026","URL":"http://heapol.oxfordjournals.org/content/30/4/508.full","body":"With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups.  The authors present data on user fee implementation, revenue and expenditure from a nationally representative survey of 248 Kenyan public health centres and dispensaries in 2010. No facilities adhered fully to the user fee policy across eight tracer conditions, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities\u2019 need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Improving regulatory capacity to manage risks associated with trade agreements","field_subtitle":"Walls HL; Smith RD; Drahos P: Globalization and Health 2015, 11(14), 2015 doi:10.1186/s12992-015-0099-7","URL":"http://www.globalizationandhealth.com/content/11/1/14","body":"Modern trade negotiations have delivered a plethora of bilateral and regional preferential trade agreements (PTAs), which involve considerable risk to public health, thus placing demands on governments to strengthen administrative regulatory capacities in regard to the negotiation, implementation and on-going management of PTAs. In terms of risk management, the administrative regulatory capacity requisite for appropriate negotiation of PTAs is different to that for the implementation or on-going management of PTAs, but at all stages the capacity needed is expensive, skill-intensive and requires considerable infrastructure, which smaller and poorer states especially struggle to find. It is also a task generally underestimated. If states do not find ways to increase their capacities then PTAs are likely to become much greater drivers of health inequities. Developing countries especially struggle to find this capacity. In this article the authors set out the importance of administrative regulatory capacity and coordination to manage the risks to public health associated with PTAs, and suggest ways countries can improve their capacity.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Open Letter to his Excellency Jacob Zuma","field_subtitle":"Mia Couto,  Chairperson, Fernando Leite Couto Foundation, Mozambique","body":"\r\nWe remember you in Maputo, in the 1980s, from that time you spent as a political refugee in Mozambique. Often our paths crossed on Julius Nyerere Avenue and we would greet each other with the casual friendliness of neighbours. Often I imagined the fears that you must have felt, as a person persecuted by the apartheid regime. I imagined the nightmares you must have experienced at night when you thought of the ambushes plotted against you and against your comrades in the struggle. But I don\u2019t remember ever seeing you with a bodyguard. In fact it was we Mozambicans who acted as your bodyguards. For years we gave you more than a refuge. We offered you a house and we gave you security at the cost of our security. You cannot possibly have forgotten this generosity.\r\n\r\nWe haven\u2019t forgotten it. Perhaps more than any other neighboring country, Mozambique paid a high price for the support we gave to the liberation of South Africa. The fragile Mozambican economy was wrecked. Our territory was invaded and bombed. Mozambicans died in defence of their brothers on the other side of the border. For us, Mr President, there was no border, there was no nationality. We were all brothers in the same cause, and when apartheid fell, our festivities were the same, on either side of the border.\r\n\r\nFor centuries Mozambican migrants, miners and peasants, worked in neighbouring South Africa under conditions that were not far short of slavery. These workers helped build the South African economy. There is no wealth in your country that does not carry the contribution of those who today are coming under attack.\r\n\r\nFor all these reasons, it is not possible to imagine what is going on in your country. It is not possible to imagine that these same South African brothers have chosen us as a target for hatred and persecution. It is not possible that Mozambicans are persecuted in the streets of South Africa with the same cruelty that the apartheid police persecuted freedom fighters, inside and outside the country. The nightmare we are living is more serious than that visited upon you when you were politically persecuted. For you were the victim of a choice, of an ideal that you had embraced. But those who are persecuted in your country today are guilty merely of having a different nationality. Their only crime is that they are Mozambicans. Their only offence is that they are not South Africans.\r\n\r\nMr President, the xenophobia expressed today in South Africa is not merely a barbaric and cowardly attack against \u201cthe others\u201d. It is also aggression against South Africa itself. It is an attack against the \u201cRainbow Nation\u201d which South Africans proudly proclaimed a decade or more ago. Some South Africans are staining the name of their motherland. They are attacking the feelings of gratitude and solidarity between nations and peoples. It is sad that your country today is in the news across the world for such inhuman reasons.\r\n\r\nCertainly measures are being taken. But they are proving inadequate, and above all they have come late. The rulers of South Africa can argue everything except that they were taken by surprise. History was allowed to repeat itself. Voices were heard spreading hatred with impunity. That is why we are joining our indignation to that of our fellow Mozambicans and urging you: put an immediate end to this situation, which is a fire that can spread across the entire region, with feelings of revenge being created beyond South Africa\u2019s borders. Tough, immediate and total measures are needed which may include the mobilization of the armed forces. For, at the end of the day, it is South Africa itself which is under attack.\r\n\r\nMr President, you know, better than we do, that police actions can contain this crime but, in the current context, other preventive measures must be taken. So that these criminal events are never again repeated.\r\n\r\nFor this, it is necessary to take measures on another scale, measures that work over the long term. Measures of civic education, and of exalting the recent past in which we were so close, are urgently needed. It is necessary to recreate the feelings of solidarity between our peoples and to rescue the memory of a time of shared struggles. As artists, as makers of culture and of social values, we are available so that, together with South African artists, we can face this new challenge, in unity with the countless expressions of revulsion born within South African society. We can still transform this pain and this shame into something which expresses the nobility and dignity of our peoples and our nations. As artists and writers, we want to declare our willingness to support a spirit of neighbourliness which is born, not from geography, but from a kinship of our common soul and shared history.\r\n\r\nThis editorial is reproduced from Brittle Paper and is an open letter addressed to President Zuma, written by award-winning Mozambican novelist Mia Couto.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Our public water future: The global experience with remunicipalisation","field_subtitle":"Kishimoto S; Lobina E; Petitjean O: TNI, PSIRU, Multinationals Observatory, MSP and EPSU, 2015","URL":"http://tinyurl.com/qbf6u6g","body":"After three decades of often catastrophic results, many cities, regions and countries are closing the book on water privatisation. A quiet citizen revolution is reported to be unfolding as communities across the world reclaim control of their water services to manage this crucial resource in a democratic, equitable and ecological way. Over the last 15 years, 235 cases of water remunicipalisation have been recorded in 37 countries. More than 100 million people have been affected by this global trend, whose pace is accelerating dramatically. From Jakarta to Paris, from Germany to the United States, this book draws lessons from this vibrant movement to reclaim water services. The authors show how remunicipalisation offers opportunities for developing socially desirable, environmentally sustainable and quality water services benefiting present and future generations. The book aims to engage citizens, workers and policy-makers in the experiences, lessons and good practices for returning water to the public sector. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Our Toilets Are Dirty: Report of the Social Audit into the Janitorial Service for Communal Flush Toilets in Khayelitsha, Cape Town","field_subtitle":"Social Justice Coalition; Ndifuna Ukwazi (Dare to Know):  October 2014","URL":"http://www.opensocietyfoundations.org/voices/link-between-functioning-toilets-and-justice","body":"Millions of South Africans still lack access to basic sanitation, including at least 500 000 in Cape Town. The report found that 26 percent of the toilets in Khayelitsha\u2019s informal settlements do not work, with 15 percent of them blocked, 12 percent without water, and 6 percent without a sewage pipe. The report\u2019s key findings also showed a lack of proper worker safeguards: janitors do not have proper training, protective gear, or the required cleaning equipment, and only one in eight cleaners is inoculated against disease. By attempting to verify public service delivery and facilitating transparency and accountability, the community-led social audit approach has been successful in exposing\u2014and, over time, reducing\u2014corruption and enhancing basic services in India and Ghana, and elsewhere in the global South. In South Africa, the community used a social audit to investigate how ZAR 60 million (about US$5 million) of public resources was utilized. The audit included the residents of Khayelitsha and various partners in inspecting 528 toilets and interviewing 193 Khayelitsha residents and 31 janitors. The report calls for specific and workable government actions to rectify gaps in services that are provided by the private sector via the local municipality.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"People's March against Xenophobia: We are One","field_subtitle":"Coalition of trade unions, civil society and social movements in South Africa against Xenophobia","body":"\r\nThe attacks against foreigners in KwaZulu Natal, Johannesburg and other parts of our country are shameful. If we close our eyes, or turn away, we bring shame on ourselves. The attacks present South Africans to the world as a barbaric, violent and murderous nation. We are not. Our march will show another South Africa to ourselves and the world. We are the country of Nelson Mandela, Oliver Tambo and all people who gave their lives for freedom. In our freedom struggle we had vital help from our sisters, brothers and comrades throughout Africa and the World. In 1994 we voted for peace, not war. We have the fairest Constitution in the world - that protects ALL who live here.\r\n\r\nWe link arms with our sisters and brothers from other countries who live with us here in South Africa. We are proud our extended family transcends national borders, languages, cultures and religions - because we need each other, because we are one! We will march to celebrate our solidarity with everyone from other countries living amongst us - particularly the poor, people seeking refuge, and political and economic migrants who have come to our country to try and survive. We will march to show our deep concern and solidarity to all poor communities where chronic unemployment, inadequate housing, rising crime and bad schools have become the norm. We will march to appeal to people who live in poor communities not to resort to violence. Do not to be distracted by blaming people from other countries who are also poor. The poor of the world must unite!\r\n\r\nWe will march to expose employers who play one group of workers off against another in order to maximize their profit. They are part of the problem right across our Africa. Workers, do not to be fooled: recognize that it is only by uniting workers and communities within and across national borders that a real challenge to poverty, pay and conditions can be fought and won.\r\n\r\nInternational solidarity helped end apartheid. Likewise, we must build unity within and across our national boundaries. Our struggle against all forms of oppression continues. Authorities must listen to our pleas, and improve and protect our communities and respond positively.\r\nWe are all human beings. We must be treat one another with respect, and live our lives in dignity. It is time for all good people to come together. We are the majority. We reject division, and it is time for real change! Don't turn away. Don't make excuses. Join us! Come from your school, workplace, union, your church, your university, your business, your community. Take three hours to march for life, dignity and equality. Together, let us show the world and our countrymen and women that another South Africa exists - where solidarity defeats xenophobia!\r\n\r\nThis call was made by South Africans for a march on 23 April that involved about 30,000 people through Johannesburg, to demand an end to a recent wave of xenophobic attacks. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Public Health Association of South Africa (PHASA) Conference","field_subtitle":"7-9 October, 2015, Durban, South Africa","URL":"http://www.phasaconference.org.za","body":"With 2015 being the target date for the achievement of the Millennium Development Goals, the conference will provide an opportunity to reflect on the challenges faced by South Africa and Africa in trying to achieve the MDGs. The focus of the conference though will be on moving forward and identifying potential solutions both within and outside the health system in order to improve the health status of our population.  This is reflected in the theme of conference \u201cHealth and Sustainable Development:  The Future\u201d. The 2015 PHASA Conference will be more interactive than previous PHASA conferences. A panel debate involving politicians, civil society and academics is set to be one of the highlights of the 2015 PHASA Conference. There will be a greater media and social media presence at the 2015 PHASA Conference ensuring that research findings and key issues reach a broader audience. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Public health governance in Africa, November 12-13, 2015, Windhoek, Namibia","field_subtitle":"Application deadline: May 31, 2015","URL":"https://equinetafrica.org/grp%40codesria.sn","body":"The ongoing Ebola Virus Disease (EVD) outbreak has brought to the fore many themes that often rise to the surface in debates on public health in Africa. Many of these issues, which had come up at the height of the HIV/AIDS pandemic are being reharshed with new undertones and inflections. They include questions of global inequalities and their impact on public health in developing countries, the challenges of public healthcare provision and problems of social welfare and social security systems in developing countries and the intricacies of intra and inter-state relations in the face of healthcare challenges. Through its conference on the theme \u2018Public health governance in Africa\u2019 CODESRIA wishes to seize on opportunities for debate presented by the ongoing EVD epidemic to rekindle wider conversations about public health governance in Africa. While acknowledging the biological dimension of diseases and the systems that are (supposed to be) put in place to deal with them at a societal level, this conference will deliberately seek to insert conversations about these in broader discussions concerning economics, politics, culture and spirituality. CODESRIA invites abstracts from scholars and practitioners that are interested in participating in this conference. Authors of abstracts selected should be ready to submit full papers by 31st August 2015.\r\nAll documents should be sent by email to grp@codesria.sn. Please use the subject line \u2018Governance Research Program\u2019 when sending your email.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Public health nurse educators\u2019 conceptualisation of public health as a strategy to reduce health inequalities: a qualitative study","field_subtitle":"Mabhala MA: International Journal for Equity in Health14(14),  2015 doi:10.1186/s12939-015-0146-2","URL":"http://www.equityhealthj.com/content/14/1/14","body":"Nurses have long been identified as key contributors to strategies to reduce health inequalities. This qualitative research project explored public health nurse educators\u2019 understanding of public health as a strategy to reduce health inequalities. 26 semi-structured interviews were conducted with higher education institution-based public health nurse educators. Public health nurse educators described health inequalities as the foundation on which a public health framework should be built. Two distinct views emerged of how health inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health. Despite upstream interventions to reduce inequalities in health being proved to have more leverage than individual behavioural interventions in tackling the fundamental causes of health inequalities, some nurses have a better understanding of individual interventions than population approaches.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Safe male circumcision in Botswana: Tension between traditional practices and biomedical marketing","field_subtitle":"KKatisia M; Daniela M: Global Public Health, DOI: 10.1080/17441692.2015.1028424 April 2015","URL":"http://www.tandfonline.com/doi/pdf/10.1080/17441692.2015.1028424","body":"Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, the authors present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders, community leaders and men in the community. The authors observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organisation, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders was reported to have turned into resistance.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Setting research priorities across science, technology, and health sectors: the Tanzania experience","field_subtitle":"de Haan S, Kingamkono R, Tindamanyire N, Mshinda H, Makandi H; Tibazarwa F; Kubata B; Montorzi G: Health Research Policy and Systems 13(14), 12 March 2015","URL":"http://www.health-policy-systems.com/content/13/1/14","body":"Identifying research priorities is key to innovation and economic growth, since it informs decision makers on effectively targeting issues that have the greatest potential public benefit. The authors report here on a major cross-sectoral nationwide research priority setting effort recently carried out in Tanzania by the Tanzania Commission for Science and Technology (COSTECH) in partnership with the Council on Health Research for Development (COHRED) and the NEPAD Agency. The first of its type in the country, the process brought together stakeholders from 42 sub-sectors in science, technology, and health. The cross-sectoral research priority setting process consisted of a \u2018training-of-trainers\u2019 workshop, a demonstration workshop, and seven priority setting workshops with representatives from public and private research and development institutions, universities, non-governmental organisations, and other agencies affiliated to COSTECH. The workshops resulted in ranked listings of research priorities for each sub-sector, totalling approximately 800 priorities. This large number was significantly reduced by an expert panel in order to build a manageable instrument aligned to national development plans that could be used to guide research investments. The Tanzania experience is an instructive example of the challenges and issues to be faced in when attempting to identify research priority areas and setting a science, technology, and health research agenda in low- and middle-income countries. As countries increase their investment in research, it is essential to increase investment in research management and governance as well, to make proper use of research investments.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Sexual violence research initiative 4th international conference 2015","field_subtitle":"Stellenbosch, South Africa, 14-17 September 2015","URL":"http://www.svri.org/forum2015/","body":"The forum brings together researchers, gender activists, funders, policy makers, service providers, practitioners and survivors from around the world and will showcase innovation to end sexual violence, intimate partner violence and child abuse, and strengthen responses to survivors in low and middle income countries. The SVRI Forum is a key platform for sharing research, innovation and networking. SVRI Forum 2015 will focus debate on the following key questions: What are the intersections of different forms of gender-based and other forms of violence across the lifespan and why do they matter? What social norms are related to sexual violence and intimate partner violence, child abuse and neglect and how do we change them? How should we evaluate social norm change interventions and other forms of prevention? How can we integrate prevention and responses to violence into other sectors including health, education, social development, sports and justice sectors? If we know it works, what does it cost and how do we scale up effective programs? What works to prevent or respond to sexual violence in conflict, post conflict and humanitarian settings?","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"South Africa's new food and nutrition policy fails to address constitutional right to food","field_subtitle":"Moyo B: Pambuzuka News 716, 4 March 2015","URL":"http://www.pambazuka.net/en/category/comment/94125","body":"The author argues that the proposed food policy in South Africa shies away from confronting capital interests within the food value-chain. Apart from acknowledging that the emerging agricultural sector is in need of assistance, the policy is reported to be silent on the influence of big-business in the food system.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Strengthening the capacities health centre committees as health advocates in Zimbabwe","field_subtitle":"CWGH; TARSC; EQUINET Case study Brief, Harare  2015","URL":"http://www.equinetafrica.org/bibl/docs/HCC%20Zimbabwe%20Brief%20March2015.pdf","body":"Health Centre Committees (HCCs) in Zimbabwe have made a vital contribution to health services and community health. HCCs have supported health activities and played a role in discussing how funds including those from fee collections are used in the clinics. In 2011 training materials were developed jointly by TARSC, CWGH and MoHCC for an approximately three to four day training for HCCs on these roles using participatory tools. This case study brief outlines the training of HCC members and of community members in health literacy. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Strengthening the protection of sexual and reproductive health and rights in the African Region through human rights","field_subtitle":"Ngwena C; Durojaye E: Pretoria University Law Press, 2014","URL":"http://www.pulp.up.ac.za/pdf/2014_14/2014_14.pdf","body":"Strengthening the protection of sexual and reproductive health and rights in the African region through human rights uses rights-based frameworks seeks to address some of the serious sexual and reproductive health challenges that the African region is currently facing. The authors provide human rights approaches on how these challenges can be overcome.  Human rights issues addressed by the book include: emergency obstetric care; HIV/AIDS; adolescent sexual health and rights; early marriage; and gender-based sexual violence.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Tax Experiments in Developing Countries: A Critical Review and Reflections on Feasibility","field_subtitle":"Mascagni G: CDI Practice Paper 11, March 2015","URL":"http://www.ids.ac.uk/publication/tax-experiments-in-developing-countries-a-critical-review-and-reflections-on-feasibility","body":"This CDI Practice Paper provides a critical assessment of the literature on tax experiments to date. It examines the main conceptual, methodological and data-related challenges, and provides practical reflections on how to move forward in low- and middle-income countries where this type of research is still underdeveloped. It offers a guide for practitioners on the main challenges in quantitative research on tax compliance and on the methods used tackle them, which may be of interest for evaluation research more generally.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Prospects and Politics of Social Protection Reform in Zambia","field_subtitle":"Kuss MK: Institute of Development Studies Working Paper 453, April 2015","URL":"http://www.ids.ac.uk/publication/the-prospects-and-politics-of-social-protection-reform-in-zambia","body":"This paper analyses the prospects for social protection reform in Zambia under the \u2018pro-poor\u2019 government of the Patriotic Front (PF). The paper argues that the PF has been changing the development policy arena in ways that may modify domestic political structures providing more rights-based benefits especially for the extreme poor and vulnerable. It further argues that the persistence of the clientelistic dynamics of state-society relations and weak civil society organisations inhibit the expression of demands for formal social protection by poor people. It concludes that because the social protection reform is supply -, rather than demand-driven, its progress depends on the extent to which the government is motivated to sustain the provision of social protection in the long-run.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The SA SURE Project Stories of Change","field_subtitle":"Health Systems Trust: : SA SURE Stories of Change  1(1): January 2015 ","URL":"http://www.hst.org.za/publications/sa-sure-project-stories-change-january-2015","body":"Health System Trust announces the first edition of the SA SURE Project\u2019s Stories of Change \u2013 a quarterly publication presenting case stories that describe how SA SURE Project teams partner with Health Department personnel to apply policy in contextual practice in facilities across the country, and thus achieve sustainable responses to HIV, AIDS and TB. They share these stories to convey the beginnings of good practice: interesting experiences of how key challenges are being addressed using various tools, enterprise and connection to support service quality improvement at clinic level.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The \u201cchild size medicines\u201d concept: policy provisions in Uganda","field_subtitle":"Nsabagasani X; Ogwal-Okeng; Mbonye A; Ssengooba F; Nantanda R; Muyinda H; Holme Hansen E: Journal of Pharmaceutical Policy and Practice 8(2), 2015 doi:10.1186/s40545-015-0025-7","URL":"http://www.joppp.org/content/8/1/2","body":"In 2007, the World Health Organization (WHO) launched the \u2018make medicines child size\u2019 (MMCS) campaign by urging countries to prioritize procurement of medicines with appropriate strengths for children\u2019s age and weight and, in child-friendly formulations of rectal and flexible oral solid formulations. This study examined policy provisions for MMCS recommendations in Uganda. This was an in-depth case study of the Ugandan health policy documents to assess provisions for MMCS recommendations in respect to oral and rectal medicine formulations for malaria, pneumonia and diarrhea, the major causes of morbidity and mortality among children in Uganda- diseases that were also emphasized in the MMCS campaign. Asthma and epilepsy were included as conditions that require long term care. Schistomiasis was included as a neglected tropical disease. Content analysis was used to assess evidence of policy provisions for the MMCS recommendations. For most medicines for the selected diseases, appropriate strength for children\u2019s age and weight was addressed. However, policy documents neither referred to \u2018child size medicines\u2019 concept nor provided for flexible oral solid dosage formulations like dispersible tablets, pellets and granules- indicating limited adherence to MMCS recommendations. Some of the medicines recommended in the clinical guidelines as first line treatment for malaria and pneumonia among children were not evidence-based. The Ugandan health policy documents reflected limited adherence to the MMCS recommendations. This and failure to use evidence based medicines may result into treatment failure and or death. A revision of the current policies and guidelines to better reflect \u2018child size\u2019, child appropriate and evidence based medicines for children is recommended.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis","field_subtitle":"Topp S; Chipukuma J; Hanefeld J: Health Policy and Planning, 30(4), 2014, doi: 10.1093/heapol/czu029","URL":"http://heapol.oxfordjournals.org/content/30/4/485.full","body":"Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving understanding of the mechanisms and causal pathways influencing primary health centre performance. A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker, patient and key informant interviews; direct observation of facility operations. Structural constraints included limited resources creating challenging service environments in which work overload and stockouts were common. Health workers\u2019 frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient\u2013provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers\u2019 answerability to their employer and clients, and a lack of effective sanctions undermined supervisors\u2019 ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Understanding The Rising Powers' Contribution to the Sustainable Development Goals","field_subtitle":" Constantine J; Pontual M: Institute of Development Studies Rapid Response Briefing 9, March 2015","URL":"http://tinyurl.com/mogrvmw","body":"Rising powers such as Brazil, India and China have been criticised for their inputs in the negotiations on the post-2015 development agenda. The start of the United Nations (UN) negotiations saw high expectations for the role of these countries in shaping the Sustainable Development Goals (SDGs) that have not materialised. However, what appears to be a confrontational style of diplomacy is in fact an assertive affirmation of long-standing principles.  The G77 and China have consistently\r\ncalled for the reform of the UN Security Council, and of the Bretton Woods institutions, which resulted in International Monetary Fund reform being nominally approved in 2010 before being blocked by the United States (US) Congress. The issues defended by the Brazilian negotiators centred on poverty eradication, its relationship with inequality; sustainable production and consumption; financing and keeping climate change strictly within the UNFCCC process. Brazil is keen to avoid what it sees as the securitisation of development through the SDGs. It supports governance as a general principle guiding the SDGs, but is adamant in its refusal to consider security as a stand-alone goal. The Brazilians are prioritising the \u2018how\u2019 of the SDGs, concentrating on the means of implementation for sustainable development through data disaggregation and exploring how to reutilise the structure of the MDGs as well as Brazil\u2019s experience of participatory development in implementation. The authors argue that a more nuanced understanding of these countries\u2019 positions in the post-2015 process is required.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"UNESCO-Equatorial Guinea International Prize for Research in the Life Sciences","field_subtitle":"Closing date: 30 June 2015","URL":"http://www.ngopulse.org/opportunity/2015/04/13/unesco-equatorial-guinea-international-prize-research-life-sciences","body":"The United Nations Educational, Scientific and Cultural Organisation (UNESCO) \u2013 Equatorial Guinea International Prize for Research in the Life Sciences rewards the projects and activities of an individual, individuals, institutions, other entities or non-governmental organisations for scientific research in the life sciences, which have led to improving the quality of human life. The Prize encourages research as well as the establishment and development of networks of centres of excellence in the life sciences. Candidates shall have made significant research contribution to the life sciences to enhance the quality of human life. The prize winners, maximum three, shall be selected by the Director-General of UNESCO on the basis of the assessments and recommendations made to her by an international jury. The nomination form should be completed in English or French only, and should reach UNESCO no later than 30 June 2015. ","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"US PEPFAR abstinence and faithfulness funding had no impact on sexual behaviour in Africa","field_subtitle":"Alcorn K: aidsmap, 25 February 2015","URL":"http://www.aidsmap.com/page/2949285/","body":"Nearly US$1.3 billion spent on US-funded programmes to promote abstinence and faithfulness in sub-Saharan Africa is argued by the author of this paper to have had no significant impact on sexual behaviour in 14 countries in sub-Saharan Africa, as shown from an analysis of sexual behaviour data. The preliminary findings were presented by Nathan Lo of Stanford University School of Medicine at the Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle, USA. The Pepfar programmes aimed to delay sexual debut in order to reduce the period of high risk during adolescence, especially for girls, and to reduce partner numbers. The study investigated trends in sexual behaviour derived from national Demographic and Health Surveys in 14 PEPFAR focus countries before and after the beginning of PEPFAR funding in 2004, and compared these to a counterfactual: trends in eight other African countries \u2013 largely in West Africa \u2013 where PEPFAR funding was not determining the content of prevention campaigns. They found no significant change in PEPFAR countries relative to non-PEPFAR countries over time for any of the measures assessed, for men or women, although there was a trend towards a lower number of reported sexual partners for men in both PEPFAR and non-PEPFAR countries.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Zero Stigma, Zero Discrimination toolkit","field_subtitle":"South African National AIDS Council","URL":"http://sanac.org.za/world-aids-day-campaign-toolkit-and-guiding-messages","body":"World AIDS Day is commemorated each year on the 1st of December and is an opportunity for every community to unite in the fight against HIV, show support for people living with HIV and remember those who have died. The UNAIDS World AIDS Day theme for 2011 to 2015 is: \u201cGetting to Zero\u201d. This year, South Africa will focus on ZERO DISCRIMINATION, without losing sight of the other \u2018zeroes\u2019, Zero new HIV infections; and Zero AIDS related deaths. A group of HIV-positive people have told their stories and experiences of stigma and discrimination. These are not stories of despair and hopelessness, but stories of courage and hope, and tell of how key people in their lives helped them to overcome challenges. These stories have been captured on video, in photographs and in text. They are available free of charge on the SANAC website for civil society, the private sector, media and others to use in their World AIDS Day campaigns.","php":"","field_issue_date":"2015-05-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":" Health supply chain personnel: An integral part of the health workforce","field_subtitle":"Cometto G, Babar Z, Brown A, Hedman L, Campbell J: Journal of Pharmaceutical Policy and Practice 7 (Suppl 1), DOI:10.7196/samj.9301, 2014","URL":"http://www.joppp.org/content/pdf/2052-3211-7-S1-I1.pdf","body":"Approximately a third of the world population \u2013 and about half in the most underdeveloped settings \u2013 have been estimated to lack access to essential medicines and diagnostics. Effective supply chains are vital to deliver essential health commodities. In high-income countries the availability of medicines in the public and private sector is taken as a given: quality assurance is managed by robust national regulatory agencies; supply and distribution are increasingly privatised, with performance measured against timeliness and cost. Conversely, in many low- and middle-income countries, stock-outs of essential commodities are commonplace, with a mean availability of core medicines in the public sector ranging from 38.2% in sub-Saharan Africa to 57.7 % in Latin America and the Caribbean. Vulnerability of supply chain functions also increases the potential for the entry of counterfeit and substandard products.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"African leaders reaffirm commitment to the AIDS response and women\u2019s empowerment","field_subtitle":"UNAIDS: Geneva, February 2015 ","URL":"http://www.unaids.org/en/resources/presscentre/featurestories/2015/february/20150211_africanleaders","body":"The 24th Summit of the African Union and related events reaffirmed that Africa is committed and will remain committed to women\u2019s empowerment and to ending the AIDS epidemic by 2030. The Summit took place in Addis Ababa, Ethiopia, from 23 to 31 January 2015 under 2015 annual African Union theme of \u201cWomen empowerment and development towards Africa\u2019s Agenda 2063\u201d. This report outlines the importance of ending AIDS was particularly articulated during the gender pre-summit meeting, at which the participants noted that member states should ensure that ending the AIDS epidemic by 2030 is part of Agenda 2063 and that it has an inclusive human rights approach that leaves no one behind, including children, adolescents, women of child-bearing age and women and girls in conflict and post-conflict settings.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Between the rack and a hot place: can we reconcile poverty eradication and tackling climate change?","field_subtitle":"Woodward D: Institute of Development Studies, February 2015","URL":"https://www.youtube.com/watch?v=rFpHs0sDKug","body":"The author argues that the majority of humanity is on the rack of poverty; and a major obstacle to its eradication is the growing threat of extreme and irreversible climate change. The coexistence of a chronic crisis of serious under-consumption for most with an increasingly critical environmental crisis resulting from over-consumption in aggregate can only be explained by extreme inequality in the global distribution of income. Resolving both simultaneously, as envisaged in the Post-2015 Agenda, requires a fundamental reconsideration of the nature and objectives of economic policy, and of the global economic system. The lecture will discuss the extent and implications of global inequality, before building on a number of working hypotheses to outline an alternative model of economic development more conducive to the achievement of these two most fundamental global goals.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Call for applications for the Eighth South-South Institute on \u201cInequality and Social Justice: Perspectives from the Global South","field_subtitle":"Deadline for submission of applications: 15 April 2015","URL":"http://www.codesria.org","body":"The Latin American Council of Social Sciences (CLACSO), the Council for the Development of Social Science Research in Africa (CODESRIA) and the International Development Economic Associates (IDEAS), are pleased to announce, within the framework of the third three-year phase of the Africa/Asia/Latin America Scholarly Collaborative Program, the call for applications for participation in the Eighth South-South Institute on \u201cInequality and Social Justice: Perspectives from the Global South\u201d. The Institute will be held in Durban, South Africa, from September 11 to 18, 2015, on the back of the third World Social Science Forum (WSSF III, jointly hosted by CODESRIA, the Human Sciences Research Council of South Africa and the ISSC). The Theme of the WSSF III is: Transforming Global Relations for a Just World. Younger scholars resident in countries of the South and who are pursuing active academic careers are eligible to apply for a place in the Institute. The Tri-continental arrangement requires applicants resident in Africa to submit their applications to CODESRIA, those resident in Asia to IDEAS and those resident in Latin America to CLACSO. ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for applications: 2015 small grants programme for thesis writing","field_subtitle":"Applications 15th April, 2015","URL":"https://equinetafrica.org/The%20Council%20for%20the%20Development%20of%20Social%20Science%20Research%20in%20Africa%20%28CODESRIA%29%20is%20pleased%20to%20announce%20the%20twenty-sixth%20session%20of%20its%20Small%20Grants%20Programme%20for%20Thesis%20Writing.%20The%20grants%20serve%20as%20part%20of%20the%20Council%E2%80%99s%20contribution%20to%20the%20development%20of","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) is pleased to announce the twenty-sixth session of its Small Grants Programme for Thesis Writing. The grants serve as part of the Council\u2019s contribution to the development of the social sciences in Africa, and the continuous renewal and strengthening of research capacities in African universities, through the funding of primary research conducted by graduate and postgraduate students. Hence, candidates whose applications are successful are encouraged to use the resources provided under the grants to cover the cost of their fieldwork, the acquisition of books and documents, the processing of data which they have collected and the printing of their theses/dissertations. As the Council is strongly committed to encouraging African researchers to engage one another on a sustained basis, recipients of the small grants will also be supported to order books and journals produced by African scholarly publishers, including CODESRIA itself. They will also be encouraged to apply for participation in CODESRIA research methodology workshops.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers for a Special Issue of New Solutions: A Journal of Environmental and Occupational Health Policy on The Informal Economy","field_subtitle":"Deadline for submissions: 10 June 2015","URL":"https://equinetafrica.org/lundf%40ukzn.ac.za","body":"New Solutions seeks submissions for a special issue that will focus on the informal economy. The broad definition suggested by Women in Informal Employment: Globalising and Organising (WIEGO) will be used as a basis for this issue: \u201cthe informal sector refers to the production and employment that takes place in unincorporated small or unregistered enterprises; informal employment refers to employment without legal and social protection\u2014both inside and outside the informal sector; and the informal economy refers to all units, activities, and workers so defined and the output from them. Together, they form the broad base of the workforce and economy, both nationally and globally.\u201d (WIEGO Working Paper No. 1). Because New Solutions is a policy journal, manuscripts, including scientific papers, should include a perspective that addresses relevant policy concerns. Manuscripts are welcome for any of its journal sections, including: Scientific Solutions, Feature Articles, Movement Solutions, Documents, Voices, and Comment and Controversy. Earlier submissions are encouraged to ensure consideration.  Pre-submission inquiries may be sent to the editors.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Case studies of experiences of mechanisms for social participation in health services","field_subtitle":"Editor","body":"This month's editorial presents one of the many experiences of the mechanisms that exist at primary care level for community participation in health services and for communication between services and communities. A series of case study briefs have been produced on these experiences, highlighting their contribution to people centred health systems, but also their challenges. As noted by those working with health centre committees in the region, if the intention is to build PHC-oriented, people-centred health systems then these mechanisms need skills for activism and transformation to help build social participation and power and a range of capacities, tools and processes that support this.&#8195;The case study brief on experiences in South Africa is included in this newsletter and we will include further case study briefs in forthcoming newsletters. ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Case study brief: Communities shaping health centre committee roles and policy in Eastern Cape Province, South Africa,","field_subtitle":"QUINET; Learning Network for Health and Human rights UCT; TARSC ","URL":"http://www.equinetafrica.org/bibl/docs/HCC%20South%20Africa%20Brief%20March2015.pdf","body":"Communities in the Eastern Cape have played a role in formulating and implementing the guidance on their roles and functioning. In the Nelson Mandela Bay Health District, for example, health in 2006, a team from the Eastern Cape Provincial Department of Health invited health committee members, health service, local government, community and other local stakeholders to a meeting to contribute and to provide substance to the policy on health committees. This workshop served to frame the draft policy, which was later sent to all districts for discussion before further review and feedback by HCC representatives. The amendments made in this process were integrated into the final policy that was adopted in 2009 by the legislature in the province and published in 2010. This brief discusses this case study on the role of health centre committees as part of a series of case study briefs on the topic. ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Code4SA launch new medicines pricing app","field_subtitle":"Health-E News, February 2015","URL":"http://www.health-e.org.za/2015/02/12/health-e-news-code4sa-launch-new-medicines-pricing-app/","body":"Created by the non-profit Code4SA, this new app uses the latest single exit prices for medicines to let people see if they are paying too much for medication in South Africa. In 2004, the government introduced a single exit price mechanism for medicines to put a stop to discounts and additional levies on medicines. The mechanism now lists the maximum price for most medicines. However, dispensers may charge an additional dispensing fee depending on the price of the medicine. Using the latest single exit prices, the free app allows people to check what price they should be paying for prescriptions \u2013 and whether cheaper generics are available.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Communities shaping policy on health centre committee roles in Eastern Cape Province, South Africa","field_subtitle":"Therese Boulle, Leslie London, Zingisa Sofayiya Learning Network for Health and Human Rights, UCT","body":"\r\nSouth Africa is in a process of transforming its health system from a centralised and largely curative model to a district health system implementing primary health care and addressing the social determinants of health.  The strategies for this depend on an effective district health system, and this in turn depends in part on the role given to communities in health. But who shapes this role?\r\n\r\nPublic participation in health is covered in the country\u2019s law and policy. South Africa\u2019s 1996 Constitution provides for the right to health, health care, participation and association, and for public participation in policy-making. The 2003 National Health Act provides for participation at community level in clinic and community health centre committees. The 1988 Municipal Structures Act and the 2000 Municipal Systems Act create mechanisms within local government for communities to participate in decisions on local community developments through ward committees and local government councillors.  These frameworks for participatory democracy need follow up to realise them in practice.\r\n\r\nIn September 2014 a National Colloquium found that while many provinces have established committees, there is a lack of clarity on their roles, affecting their functioning.   The Department of Health at national level issued draft guidelines for HCCs in 2014 to address this gap. In the Eastern Cape, a policy was published in 2010 on the establishment and functioning of clinic and community health centre committees. It describes the roles, linkages, reporting and accountability of those in the committees. The policy seeks to involve communities in the planning and provision of health services, as a link between the community, health facility, and district health council and to foster co-operative governance. It sets out the community representation in the committees, drawn from women, the religious community, youth, non-government and community based organisations, traditional health practitioners and disabled people, with flexibility to include social groups relevant to the local context.  This structure, while set in policy, is only slowly being operationalized in the districts. While in some districts the HCCs may be less functional, in the Nelson Mandela Bay Health District, where additional support has been provided by the university to the fifty clinics, all the committees except one are functional.  Forums are held at sub-district and district level, as required by the policy, to monitor and support the committees and their members.\r\n\r\nCommunities in the Eastern Cape have played a role in formulating and implementing the guidance on their roles and functioning in the committees. In the Nelson Mandela Bay Health District, for example, health committees had been operating since 1996 but in a haphazard and variable manner, without guidelines for their functioning and erratic staff and management support. This frustrated members. In 2006 a team from the Eastern Cape Provincial Department of Health invited health committee members, health service, local government, community and other local stakeholders to a meeting to contribute and to provide substance to the policy on health committees.  This workshop served to frame the draft policy, which was later sent to all districts for discussion before further review and feedback by HCC representatives. The amendments made in this process were integrated into the final policy that was adopted in 2009by the legislature in the province and published in 2010. \r\n\r\nThe policy provides for three-yearly review. In 2014 a review was initiated with HCC members, in consultation with the province.  Workshops were held with the committees, facilitated by University of Cape Town.  These reviews helped to make the policy more accessible, to support understanding of roles amongst HCC members, to raise roles that had been overlooked, challenges in implementation of functions and suggestions on improvements. It demonstrated tangibly to HCC members that their voices can be heard in amending and adapting policy to improve it.  Reviewing the policy also made the HCC members clearer on how to monitor its implementation and the duties of service providers. \r\n\r\nSome issues were raised during the policy review: Greater support was urged from facility managers and local government councillors who were seen to be critical members for the functioning of committees, but inadequately involved. Communication between communities and services was observed to be weaker than set in the policy. Community members were found to distrust the complaint box process where HCCs monitor the opening of complaints boxes, recording and resolution of complaints.  The committees noted that very limited resources are made available to support their work, including for transport, communication or capacity development. The HCCs made various proposals in the review, to ensure include processes for establishing committees and re-election every three years; to formally recognise HCC members; to make the reporting obligations of facility managers clearer; to include ongoing capacity building and skills development in the policy and to proactively support opportunities to discuss and engage with local communities and give feedback on issues to communities to build confidence in the system.\r\n\r\nThe process taught lessons about how people can shape and use their policies for participation on health. HCC members feel empowered when they know policies, not only to understand their own roles and responsibilities, but to ensure that they are enforced and that service and local government personnel are accountable for their roles. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the issues raised please visit www.equinetafrica.org. ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Ebola preparedness: emergency department training modules","field_subtitle":"Centers for Disease Control and Prevention, February 2015 ","URL":"http://www.cdc.gov/vhf/ebola/healthcare-us/emergency-services/emergency-department-training.html","body":"This course is directed at emergency department staff. It is aimed at training to help emergency department staff prepare to evaluate whether or not a patient might have ebola virus disease. Staff members should use this information to follow the 3 steps within the \u201cIdentify, Isolate, and Inform\u201d strategy. Centers for Disease Control recommends that staff members screen all patients with travel histories, exposure, or clinical symptoms that might suggest the person could have ebola virus disease.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Ending female genital mutilation within a generation","field_subtitle":"Wandia M, Pambuzuka News, 713, February 2015 ","URL":"http://www.pambazuka.net/en/category/comment/93941","body":"A multi-pronged approach is needed to end female genital mutilation (FGM) in one generation. This includes prevention, protection, provision of services, partnerships and prosecutions. States must live up to their international obligations to protect women and girls. Over the last 12 months, the campaign against FGM has received renewed support from different actors committed to ending the practice. According to UNICEF, Kenya has led the way with falls in prevalence from middle-aged women to adolescent girls from 49% to 15%, albeit with an increase in the percentage of FGM performed by health personnel. 2014 also saw a significant increase in the prosecution of FGM cases globally and verdicts in a few countries. This article discusses the global challenges and successes of addressing FGM and makes recommendations towards eliminating FGM in a generation.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 170: Communities shaping policy on health centre committee roles in Eastern Cape Province, South Africa ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Header"}},{"node":{"title":"Fertility among orphans in rural Malawi: challenging common assumptions about risk and mechanisms","field_subtitle":"Kidman R, Anglewicz P: International Perspectives on Sexual and Reproductive Health 40(4), 2014 ","URL":"http://www.jstor.org/stable/pdf/10.1363/4016414.pdf","body":"Although a substantial literature suggests that orphans suffer disadvantage relative to non orphaned peers, the nature of this disadvantage and the mechanisms driving it are poorly understood. Some evidence suggests that orphans experience elevated fertility, perhaps because structural disadvantage leads them to engage in sexual risk-taking. An alternative explanation is that orphans intentionally become pregnant to achieve a sense of normality, acceptance and love. Data from the 2006 wave of the Malawi Longitudinal Study of Families and Health on 1,033 young adults aged 15\u201325 were used to examine the relationship of maternal and paternal orphanhood with sexual risk indicators and desired and actual fertility. Regression analyses were used to adjust for covariates, including social and demographic characteristics and elapsed time since parental death. Twenty-six percent of respondents had lost their father and 15% their mother. Orphanhood was not associated with sexual risk-taking. However, respondents whose mother had died in the past five years desired more children than did those whose mother was still alive (risk differences, 0.52 among women and 0.97 among men). Actual fertility was elevated among women whose father had died more than five years earlier (0.31) and among men whose mother had died in the past five years (1.06) or more than five years earlier (0.47). The elevations in desired and actual fertility among orphans are consistent with the hypothesis that orphans intentionally become pregnant. Strategies that address personal desires for parenthood may need to be part of prevention programs aimed at orphaned youth.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Free access to OUP resources for ebola world health emergency","field_subtitle":"Oxford University Press, 2015","URL":"http://www.oxfordjournals.org/en/our-journals/medicine-and-health/ebola.html","body":"In response to the outbreak of the Ebola virus in West Africa, Oxford University Press has made more than 50 articles from leading journals and online resources freely accessible to assist researchers, medical professionals, policy makers, and others working on the containment, treatment, and prevention of Ebola hemorrhagic fever. Articles are free to access worldwide until 4 January 2016.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health in all policies: training manual","field_subtitle":"World Health Organisation, February 2015","URL":"http://apps.who.int/iris/bitstream/10665/151788/1/9789241507981_eng.pdf","body":"The World Health Organisation (WHO) calls on enhanced global efforts to improve health in some of the world\u2019s poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. In order to address this and to spur up action, raise awareness and facilitate implementation of a Health in All Policies (HiAP) approach WHO has launched a Health in All Policies training manual. This manual is a training resource to increase understanding of the importance of Health in All Policies among health and other professionals. The material will form the basis of 2- and 3-day workshops, which will: build capacity to promote, implement and evaluate HiAP; encourage engagement and collaboration across sectors; facilitate the exchange of experiences and lessons learned; promote regional and global collaboration on HiAP; and promote dissemination of skills to develop training courses for trainers.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health workers\u2019 experiences, barriers, preferences and motivating factors in using mHealth forms in Ethiopia","field_subtitle":"Medhanyie AA, Little Am Yebyo H, Spigt M, Tadesse K, Blanco R, Dinant GJ: Human Resources for Health 13(2), 2015","URL":"http://www.human-resources-health.com/content/13/1/2","body":"Mobile health (mHealth) applications, such as innovative electronic forms on smartphones, could potentially improve the performance of health care workers and health systems in developing countries. However, contextual evidence on health workers\u2019 barriers and motivating factors that may influence large-scale implementation of such interfaces for health care delivery is scarce. A pretested semistructured questionnaire was used to assess health workers\u2019 experiences, barriers, preferences, and motivating factors in using mobile health forms on smartphones in the context of maternal health care in Ethiopia. Twenty-five health extension workers (HEWs) and midwives, working in 13 primary health care facilities in Tigray region, Ethiopia, participated in this study. Sixteen (69.6%) workers believed the forms were good reminders on what to do and what questions needed to be asked. Twelve (52.2%) workers said electronic forms were comprehensive and 9 (39.1%) workers saw electronic forms as learning tools. All workers preferred unrestricted use of the smartphones and believed it helped them adapt to the smartphones and electronic forms for work purposes. Identified barriers for not using electronic forms consistently include challenges related to electronic forms (for example, problem with username and password setting as reported by 5 (21.7%), smartphones (for example, smartphone froze or locked up as reported by 9 (39.1%) and health system (for example, frequent movement of health workers as reported by 19 (82.6%)). Both HEWs and midwives found the electronic forms on smartphones useful for their day-to-day maternal health care services delivery. However, sustainable use and implementation of such work tools at scale would be daunting without providing technical support to health workers, securing mobile network airtime and improving key functions of the larger health system.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity","field_subtitle":"Stasse S; Vita D; Kimfuta J; da Silveira VC; Bossyns P; Criel B: Global Health Action 8(25480), 5 January 2015, doi: 10.3402/gha.v8.25480","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307026/","body":"&nbsp;Commercialisation of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalisation of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalise the use of resources. The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Incrementum ad Absurdum: Global growth, inequality and poverty eradication in a carbon-constrained world","field_subtitle":"Woodward D: World Economic Review 4, February 2015","URL":"http://tinyurl.com/nqf8h7m","body":"The paper seeks to assess the timeframe for eradication of poverty, defined by poverty lines of $1.25 and $5 per person per day at 2005 purchasing power parity, if pre-crisis (1993-2008) patterns of income growth were maintained indefinitely, taking account of the differential performance of China. On the basis of optimistic assumptions, and implicitly assuming an indefinite continuation of potentially important pro-poor shifts in development policies during the baseline period, it finds that eradication will take at least 100 years at $1.25-a-day, and 200 years at $5-a-day. While this could in principle be brought forward by accelerating global growth, global carbon constraints raise serious doubts about the viability of this course, particularly as global GDP would need to exceed $100,000 per capita at $1.25-a-day, and $1m per capita at $5-a-day. The clear implication is that poverty eradication, even at $1.25-a-day, and especially at a poverty line which better reflects the satisfaction of basic needs, can be reconciled with global carbon constraints only by a major increase in the share of the poorest in global economic growth, far beyond what can realistically be achieved by existing instruments of development policy \u2013 that is, by effective measures to reduce global inequality.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"INVESTIGACI\u00d3N-ACCI\u00d3N PARTICIPATIVA EN SISTEMAS DE SALUD: UNA GU\u00cdA DE M\u00c9TODOS","field_subtitle":"Loewenson R; Laurell AC; Hogstedt C; D\u2019Ambruoso L; Shroff Z:  TARSC, AHPSR, WHO, IDRC Canada, EQUINET, Harare, 2014 ","URL":"http://www.equinetafrica.org/bibl/docs/Spanish%20PAR%20Reader%20March%202015%20for%20web.pdf","body":"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, rontline 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 \u2013 old and new \u2013 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 \u2018participatory action research\u2019 (PAR) and provides information on its paradigms, methods, application and use, particularly in health policy and systems. This version of the reader is in Spanish. It 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. The result of team work, the reader draws on experience and published work from all regions globally and explains:\r\n\u2022 key features of participatory action research and the history and knowledge paradigms that inform it;\r\n\u2022 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\r\n\u2022 communication, reporting, institutionalization and use of participatory action research in health systems.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Maternal mortality: a cross-sectional study in global health","field_subtitle":"Sajedinejad S, Majdzadeh R, Vedadhir A, Tabatabaei MG, Mohammad K: Globalization and Health, 4  doi:10.1186/s12992-015-0087-y,  2015","URL":"http://www.globalizationandhealth.com/content/pdf/s12992-015-0087-y.pdf","body":"Although most of maternal deaths are preventable, maternal mortality reduction programs have not been completely successful. As targeting individuals alone does not seem to be an effective strategy to reduce maternal mortality (Millennium Development Goal 5), the present study sought to reveal the role of many distant macrostructural factors affecting maternal mortality at the global level. After preparing a global dataset, 439 indicators were selected from nearly 1800 indicators based on their relevance and the application of proper inclusion and exclusion criteria. Then Pearson correlation coefficients were computed to assess the relationship between these indicators and maternal mortality. Only indicators with statistically significant correlation more than 0.2, and missing values less than 20% were maintained. Due to the high multicollinearity among the remaining indicators, after missing values analysis and imputation, factor analysis was performed with principal component analysis as the method of extraction. Ten factors were finally extracted and entered into a multiple regression analysis. The findings of this study not only consolidated the results of earlier studies about maternal mortality, but also added new evidence. Education, private sector and trade  and governance were found to be the most important macrostructural factors associated with maternal mortality. Employment and labor structure, economic policy and debt, agriculture and food production, private sector infrastructure investment, and health finance were also some other critical factors. These distal factors explained about 65% of the variability in maternal mortality between different countries. Decreasing maternal mortality requires dealing with various factors other than individual determinants including political will, reallocation of national resources (especially health resources) in the governmental sector, education, attention to the expansion of the private sector trade and improving spectrums of governance. In other words, sustainable reduction in maternal mortality (as a development indicator) will depend on long-term planning for multi-faceted development. Moreover, trade, debt, political stability, and strength of legal rights can be affected by elements outside the borders of countries and global determinants. These findings are believed to be beneficial for sustainable development in Post-2015 Development Agenda.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Morbidity and mortality of black HIV-positive patients with end-stage kidney disease receiving chronic haemodialysis in South Africa","field_subtitle":"Wearne N: South African Medical Journal 105 (2), DOI:10.7196/samj.9068 2015","URL":"http://www.samj.org.za/index.php/samj/article/view/9068","body":"South Africa (SA) has the highest prevalence of HIV/AIDS of any country in the world, which adds complexity to a health system already overwhelmed by chronic kidney disease, particularly that due to hypertension, diabetes and chronic glomerulonephritis. Renal disease is common in HIV-infected individuals. Prior to availability of ART, HIV was a death sentence for individuals with chronic kidney disease (CKD). However, since ART roll-out there is growing evidence of little difference in survival between HIV-infected patients who are receiving efficacious ART compared with the general population on dialysis. In this issue of the SAMJ, Fabian et al. demonstrate that haemodialysis in black African HIV-positive patients in the private sector in SA imparts excellent overall survival. This study contributes to the growing data reflecting good outcomes for HIV-positive patients on dialysis. However, transplantation is regarded as the best treatment option for CKD in patients without HIV, and we ask whether we should not be striving for dialysis to be the bridge to transplantation in HIV-positive patients. Also, importantly, attention needs to be geared towards prevention of CKD and slowing progression towards end-stage renal disease (ESRD). Those who provide healthcare to HIV-positive patients need to be aware of the special renal issues relevant to HIV, and the potential for evolution to ESRD.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Older people's health in sub-Saharan Africa","field_subtitle":"Aboderin I, Beard J: The Lancet 385 (9968), 2014","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61602-0.pdf","body":"Awareness is growing that the world's population is rapidly ageing. Although much of the related policy debate is about the implications for high-income countries, attention is broadening to less developed settings. Middle-income country populations, in particular, are generally ageing at a much faster rate than was the case for today's high-income countries, and the health of their older populations could be substantially worse. However, little consideration has been given to issues of old age in sub-Saharan Africa, which remains the world's poorest and youngest region.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Participatory health councils and good governance: healthy democracy in Brazil?","field_subtitle":"Saugues S, Madonko T: International Journal for Equity in Health 14:21 , 2015 ","URL":"http://www.equityhealthj.com/content/14/1/21","body":"The Brazilian Government created Participatory Health Councils (PHCs) to allow citizen participation in the public health policy process. PHCs are advisory bodies that operate at all levels of government and that bring together different societal groups to monitor Brazil\u2019s health system. Today they are present in 98% of Brazilian cities, demonstrating their popularity and thus their potential to help ensure that health policies are in line with citizen preferences. Despite their expansive reach, their real impact on health policies and health outcomes for citizens is uncertain. The authors thus ask the following question: Do PHCs offer meaningful opportunities for open participation and influence in the public health policy process? Thirty-eight semi-structured interviews with health council members were conducted. Data from these interviews were analyzed using a qualitative interpretive content analysis approach. A quantitative analysis of PHC data from the Sistema de Acompanhamento dos Conselhos de Saude (SIACS) database was also conducted to corroborate findings from the interviews. The authors learned that PHCs fall short in many of the categories of good governance. Government manipulation of the agenda and leadership of the PHCs, delays in the implementation of PHC decision making, a lack of training of council members on relevant technical issues, the largely narrow interests of council members, the lack of transparency and monitoring guidelines, a lack of government support, and a lack of inclusiveness are a few examples that highlight why PHCs are not as effective as they could be. Conclusions Although PHCs are intended to be inclusive and participatory, in practice they seem to have little impact on the health policymaking process in Brazil. PHCs will only be able to fulfil their mandate when combined with good governance. This will require a rethinking of their governance structures, processes, membership, and oversight. If change is resisted, the PHCs will remain largely limited to a good idea in theory that is disappointing in practice.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Promoting the use of climate information to achieve long-term development objectives in Sub-Saharan Africa: Results from the future climate for Africa scoping phase","field_subtitle":"Jones L, Carabine E, Roux JP, Tanner T: Climate and Development Knowledge Network, February 2015","URL":"http://tinyurl.com/o7zx2t6","body":"The impacts of climate change are currently being felt by people and communities. However, many of the most severe impacts will be felt in the decades to come. Significant barriers emerge in an effort to achieve long-term development objectives, particularly in sub-Saharan Africa, a region with low capacity to adapt to the future impacts of climate change. Factoring medium- to long-term climate information into investments and planning decisions is therefore an important component of climate-resilient development. We know little about how climate information is used in Africa to make decisions with long-term consequences, or how effective it is. We know even less about the barriers to \u2013 and opportunities for \u2013 using climate information in decision-making. How, then, should governments, businesses and donors strive for climate information to achieve Africa\u2019s long-term development objectives? The Future Climate For Africa (FCFA) programme explores these questions and seeks to challenge many of the assumptions that underlie them. To guide the programme, six case studies investigated how climate information was being used in decision-making in sub-Saharan Africa. These comprised four country case studies: Malawi, Rwanda, Zambia and a combined study of Accra, Ghana and Maputo, Mozambique; and two desk-based studies focused on long-lived infrastructure in the ports sector and the large hydropower sector. This report presents the results of the scoping phase.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Public health nurse educators\u2019 conceptualisation of public health as a strategy to reduce health inequalities: a qualitative study","field_subtitle":"Mabhala M, International Journal for Equity in Health 14(14), DOI:10.1186/s12939-015-0146-2, 2015","URL":"http://www.equityhealthj.com/content/14/1/14","body":"Nurses have long been identified as key contributors to strategies to reduce health inequalities. This raises questions about: convergence between policy makers\u2019 and nurses\u2019 understanding of how inequalities in health are created and sustained and educational preparation for the role as contributors in reducing health inequalities. This qualitative research project determined public health nurse educators\u2019 understanding of public health as a strategy to reduce health inequalities, through semi-structured interviews. Public health nurse educators described health inequalities as the foundation on which a public health framework should be built. Two distinct views emerged of how health inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health. Despite upstream interventions to reduce inequalities in health being proved to have more leverage than individual behavioural interventions in tackling the fundamental causes of health inequalities, some nurses have a better understanding of individual interventions than population approaches.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Refusal to enrol in Ghana\u2019s National Health Insurance Scheme: is affordability the problem?","field_subtitle":"Kusi A, Enemark U, Hansen KS, Asante FA; International Journal for Equity in Health 14(2), 2015","URL":"http://www.equityhealthj.com/content/14/1/2","body":"Access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households. Ghana began the implementation of a National Health Insurance Scheme (NHIS) in 2004 as a way to ensure equitable access to basic healthcare for all residents. After a decade of its implementation, national coverage is just about 34% of the national population. Affordability of the NHIS contribution is often cited by households as a major barrier to enrolment in the NHIS without any rigorous analysis of this claim. In light of the global interest in achieving universal health insurance coverage, this study seeks to examine the extent to which affordability of the NHIS contribution is a barrier to full insurance for households and a burden on their resources. The study uses data from a cross-sectional household survey involving 2,430 households from three districts in Ghana conducted between January-April, 2011. Affordability of the NHIS contribution is analysed using the household budget-based approach based on the normative definition of affordability. The burden of the NHIS contributions to households is assessed by relating the expected annual NHIS contribution to household non-food expenditure and total consumption expenditure. Households which cannot afford full insurance were identified. Results show that 66% of uninsured households and 70% of partially insured households could afford full insurance for their members. EnrolLing all household members in the NHIS would account for 5.9% of household non-food expenditure or 2.0% of total expenditure but higher for households in the first (11.4%) and second (7.0%) socio-economic quintiles. All the households (29%) identified as unable to afford full insurance were in the two lower socio-economic quintiles and had large household sizes. Non-financial factors relating to attributes of the insurer and health system problems also affect enrolment in the NHIS. Affordability of full insurance would be a burden on households with low socio-economic status and large household size. Innovative measures are needed to encourage abled households to enrol. Policy should aim at abolishing the registration fee for children, pricing insurance according to socio-economic status of households and addressing the inimical non-financial factors to increase NHIS coverage.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"South African national cancer registry: effect of withheld data from private health systems on cancer incidence estimates","field_subtitle":"Singh E, Underwood JM, Nattey C, Babb C, Sengayi M, Kellett P: The South African Medical Journal 105 (2), DOI:10.7196/samj.8858, 2015","URL":"http://www.samj.org.za/index.php/samj/article/view/8858","body":"The National Cancer Registry (NCR) was established as a pathology-based cancer reporting system. From 2005 to 2007, private health laboratories withheld cancer reports owing to concerns regarding voluntary sharing of patient data.The study aimed to estimate the impact of under-reported cancer data from private health laboratories. A linear regression analysis was conducted to project expected cancer cases for 2005 - 2007. Differences between actual and projected figures were calculated to estimate percentage under-reporting. The projected NCR case total varied from 53 407 (3.8% net increase from actual cases reported) in 2005 to 54 823 (3.7% net increase) in 2007. The projected number of reported cases from private laboratories in 2005 was 26 359 (19.7% net increase from actual cases reported), 27 012 (18.8% net increase) in 2006 and 27 666 (28.4% net increase) in 2007. While private healthcare reporting decreased by 28% from 2005 to 2007, this represented a minimal impact on overall cancer reporting (net decrease of ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Strengthening health systems in low-income countries by enhancing organisational capacities and improving institutions","field_subtitle":"Swanson RC, Atun R, Best A, Betigeri A, de Campos F, Chunharas S, Collins T, Currie G, Jan S, McCoy D, Omaswa F, Sanders D, Sundararaman T, Van Damme W: Globalization and Health 11 (5), 2015","URL":"http://www.globalizationandhealth.com/content/11/1/5","body":"This paper argues that the global health agenda tends to privilege short-term global interests at the expense of long-term capacity building within national and community health systems. The Health Systems Strengthening (HSS) movement needs to focus on developing the capacity of local organisations and the institutions that influence how such organisations interact with local and international stakeholders. While institutions can enable organisations, they too often apply requirements to follow paths that can stifle learning and development. Global health actors have recognised the importance of supporting local organisations in HSS activities. However, this recognition has yet to translate adequately into actual policies to influence funding and practice. While there is not a single approach to HSS that can be uniformly applied to all contexts, several messages emerge from the experience of successful health systems presented in this paper using case studies through a complex adaptive systems lens. Two key messages deserve special attention: the need for donors and recipient organisations to work as equal partners, and the need for strong and diffuse leadership in low-income countries. An increasingly dynamic and interdependent post-Millennium Development Goals (post-MDG) world requires new ways of working to improve global health, underpinned by a complex adaptive systems lens and approaches that build local organisational capacity.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The 9th World Congress of Developmental Origins of Health and Disease","field_subtitle":"8-11 November 2015, Cape Town, South Africa","URL":"http://www.dohad2015.org","body":"The Developmental Origins of Health and Disease (DOHaD) concept describes how during early life (conception, pregnancy, infancy and childhood) the interplay between maternal and environmental factors program (induce physiological changes) fetal and child growth and development that have long-term consequences on later health and disease risk. Timely interventions may reduce such risk in individuals and also limit its transmission to the next generation. DOHaD research has substantial implications for many transitioning African societies and for global health policy. The 9th World Congress in Cape Town, South Africa, will bring together scientists, clinical researchers, obstetricians, paediatricians, public health professionals and policy leaders from around the world. These experts will address, head-on, the many challenges that currently impact the health of mothers, babies in the womb, infants, children and adolescents, as well as explore solutions, interventions and policies to optimise health across the life of people. The 9th World Congress, the first to be held in Africa, will explore new solutions in infant and child malnutrition, and new epidemics of obesity and non-communicable diseases.   ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The complexity of resource allocation for health","field_subtitle":"Dieleman J, Haakenstad A: The Lancet 3(1), 2015","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70373-0/fulltext","body":"This research emphasises that many governments are not meeting spending goals, and in many countries the financing gaps are so great that, even if they met the spending goals, expenditure would still fall short of what is needed. Expenditure would cover only 64% of estimated future funding requirements, leaving a gap of around a third of the total US$7.9 billion needed.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The global financial crisis and access to health care in Africa","field_subtitle":"Mensah J: Africa Today 60(3), 2014","URL":"http://www.jstor.org/stable/pdf/10.2979/africatoday.60.3.35.pdf?&acceptTC=true&jpdConfirm=true","body":"Just when health care financing in Africa is expected to pick up due to perceptible improvements in many economies, including those of Ethiopia, Rwanda, and Angola, the global financial crisis gathers momentum for contagion. This paper examines how the financial crisis is undermining access to health care in Africa, and offers some suggestions to help improve the situation. The paper sees access as a multifaceted concept, imbued with various social, economic, and geographic characteristics. The study found that the revenue constrictions wrought by the ongoing financial crises (e.g., through reductions in donor funding, tourist bookings, and remittance to Africa) have affected the supply of health care services, put pressure on personal finances, and compelled many households to reduce their demand for formal health care services.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The governance and politics of urban space in the postcolonial African city","field_subtitle":"Guma PK: Research paper submitted to Third Swiss Researching Africa Days, 17-18 October 2014","URL":"https://www.academia.edu/9550465/The_Governance_and_Politics_of_Urban_Space_in_Postcolonial_African_Cities","body":"With the fading of colonial memory in postcolonial Africa, dramatic changes are emerging and are shaping urban cities in quite significant ways. Urbanisation is exploding, and large numbers of Africans are becoming town dwellers, informal settlements alike are becoming the norm rather than the exception. Urban challenges have thus become complex, hence calling for an infrastructural rethink to urban governance and development in Africa. The interest for this paper, is to explore the governance and politics of urban space in the postcolonial African city. Guma\u2019s research question, put in its most general form, asks what constitutes the governance and politics of urban space in the post-colonial African city? By taking three East African cities of Kampala, Nairobi and Dar es Salaam as his main analytical units, he focuses on: understanding urban structures and dynamics of urban governance and political frameworks and networks of survival, and exploring realities that shape urban governance within the global and neo-liberal context of post colonial Africa.  To achieve this end, he draws from comparative, qualitative and reflective exploratory fieldwork research within the realm of socio-anthropological, legal-political, and architectural-geographical investigation. ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The scramble for Africa: A continuing narrative","field_subtitle":"Oyateru T, Pambuzuka News, 713, February 2015 ","URL":"http://www.pambazuka.net/en/category/comment/93946","body":"Africa is fast becoming the go-to continent for countries wanting access to the vast and rich resources. But can the continent harness its potential, negotiate effectively and have the confidence to take charge of its own future, without allowing global financial giants to ride rough-shod over it? This article discusses the current state of investment into the region, the influence of China and America and the implications for Africans. ","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Video: Health For All Now! The 3rd People's Health Assembly","field_subtitle":"Saugues S, Madonko T, 19 February 2015","URL":"https://www.youtube.com/watch?v=Kmm5Hj0HNWA&feature=youtu.be","body":"This video is of the Third People\u2019s Health Assembly, organised by the People\u2019s Health Movement (PHM) at the University of the Western Cape, Cape Town, South Africa, 6-11 July 2012. It brought health activists, civil society, academics, communities, health professionals, networks and individuals from across the world together to analyse global health and to strategise jointly towards Health for All.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Why is cancer not a priority in South Africa?","field_subtitle":"Stefan DC: The South African Medical Journal 105 (2), 2015","URL":"http://www.samj.org.za/index.php/samj/article/view/9301","body":"Cancer is in the second position on the list of causes of death in South Africa after adding all cancers together. It is expected that cancer will lead the list in the near future. A co-ordinated effort, including a fully functional National Cancer Registry, a National Cancer Control Plan and a new cancer research approach, is argued to be required in order to reduce the burden of cancer.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"WTO least-developed countries request waiver of IP rights on pharma products","field_subtitle":"Saez C, Intellectual Property Watch, 25 February 2015","URL":"http://tinyurl.com/oe8so4g","body":"In the World Trade Organization intellectual property committee meeting in February, least-developed countries (LDCs) submitted a request to extend a waiver allowing them not to enforce intellectual property rights on pharmaceutical products that goes to 2016. The countries have extended the waiver before, but this time they are seeking to make it indefinite, until they are no longer considered LDCs are disproportionately exposed to the health risks associated with poverty, and \u201cpatent protection contributes to high costs, placing many critical treatments outside the reach of LDCs, according to a communication by the group.","php":"","field_issue_date":"2015-04-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"2015 Postdoctoral Fellowship Competition","field_subtitle":"Deadline for submissions: 15 March 2015","URL":"http://www.codesria.org/spip.php?article2276","body":"CODESRIA\u2019s postdoctoral fellowship program is meant to give scholars at different levels of their careers the resources to undertake sustained work over multiple years on a project of their choice with the goal of producing empirically grounded and theoretically innovative work that will constitute original contributions to their field of work and to the understanding of Africa in the world. In addition to a financial grant of USD 15,000 over a 15-`month period, selected scholars will be provided access to CODESRIA\u2019s library. Priority thematic areas from which the Council seeks to draw participants for its 2015 postdoctoral fellowships  relate to a range of areas relating to African youth, economic transformation, human rights, social security and social welfare systems, African arts, education and  gender analysis. Further detail on the themes and requirements for applications can be found on the website. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Access to Cancer Treatment: A study of medicine pricing issues with recommendations for improving access to cancer medication","field_subtitle":"t Hoen E: Oxfam International, 4 February 2015","URL":"http://tinyurl.com/n353osx","body":"According to the World Health Organization, cancer is one of the leading causes of death around the world, with 8.2 million deaths in 2012. More than 60 percent of the world\u2019s new cases of cancer occur in Africa, Asia, and Central and South America and these regions account for 70 percent of the world\u2019s cancer deaths. In low- and middle-income countries, expensive treatments for cancer are not widely available. Unsustainable cancer medication pricing has increasingly become a global issue, creating access challenges in low-and middle-income but also high-income countries. This report describes recent developments within the pricing of medicines for the treatment of cancer, discusses what lessons can be drawn from HIV/AIDS treatment scale-up and makes recommendations to help increase access to treatment for people with cancer.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Advancing the application of systems thinking in health: why cure crowds out prevention","field_subtitle":"Bishai D, Paina L, Li Q, Peters DH, Hyder AA: Health Research Policy and Systems 12(28), 2014","URL":"http://www.health-policy-systems.com/content/12/1/28","body":"This paper illustrates unintended consequences of apparently rational allocations to curative and preventive services, using computer modelling.  The model exhibits a \u201cspend more get less\u201d equilibrium in which higher revenue by the curative sector is used to influence government allocations away from prevention towards cure. Spending more on curing disease leads paradoxically to a higher overall disease burden of unprevented cases of other diseases. The authors suggest that this paradoxical behaviour of the model can be stopped by eliminating lobbying, eliminating fees for curative services and ring-fencing public health funding. The authors have created an artificial system as a laboratory to gain insights about the trade-offs between curative and preventive health allocations, and the effect of indicative policy interventions. The underlying dynamics of this artificial system resemble features of modern health systems where a self-perpetuating industry has grown up around disease-specific curative programs like HIV/AIDS or malaria. The model shows how the growth of curative care services can crowd both fiscal and policy space for the practice of population level prevention work, requiring dramatic interventions to overcome these trends.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Africa Forum on Inclusive Economies 2014","field_subtitle":"Rockefeller Foundation, African Development Bank, United Nations Economic Commission for Africa: December 2014","URL":"http://inclusiveeconomies2014.org/en/","body":"The Rockefeller Foundation, the African Development Bank and the United Nations Economic Commission for Africa convened in December 2014 at the Africa Forum on Inclusive Economies, a Pan African convening aimed at bringing together key thought leaders and policy makers to closely interrogate and propel forward, thinking around the theme of advancing inclusive economies. The convening aimed to focus new ideas and narratives towards the advancement of an inclusive economies approach with key African institutions and influencers and to provide a platform to further enhance thinking and critical debate on the issue of inclusive economies. Reports, videos and a blog from the convening can be found on the website. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"After Ebola: What next for West Africa\u2019s health systems?","field_subtitle":"Mcilhone M: African Brains, February 2015","URL":"http://tinyurl.com/luerxqx","body":"As rates of Ebola infection fall in Guinea, Liberia and Sierra Leone, planning has begun on how to rebuild public health systems and learn lessons from the outbreak. Nobody is declaring victory yet. But in Sierra Leone, the worst-affected country, there were 117 new confirmed cases reported in the week to 18 January, the latest statistics available, compared with 184 the previous week and 248 the week before that. Guinea halved its cases in the week to 18 January \u2013 down to 20 \u2013 and Liberia held steady at eight. The epidemic is not over until there are zero cases over two incubation periods \u2013 the equivalent of 42 days. This article discusses the role of citizen and state, external funders and local community action in addressing the epidemic. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Bring the right to health into Uganda\u2019s Constitution this year!","field_subtitle":"Moses Mulumba,  Executive Director, Center for Health, Human Rights and Development, Uganda ","body":"Uganda\u2019s Constitution has much to make our country proud\u2014including chapter four which has strong commitments to fundamental rights and freedoms, such as freedom of expression and the promise of non-discrimination.\r\n\r\nThese sacred freedoms are not always upheld or enforced\u2014but that is a matter for another day! As a first principle, the fact that these guarantees are enshrined in our Constitution shows the potential to protect, promote and defend the human rights of all people in the country. They provide the entry point for citizens from all walks of life to hold our duty bearers to account. \r\n\r\nEvery ten years we must ask: what is missing from our Constitution? What should be amended to adapt to our changing environment? In 2015, Parliament will consider proposed revisions to our Constitution. \r\n\r\nIt is this vital opportunity that motivated the Center for Health Human Rights and Development (CEHURD) and a team of partners, on World Human Rights Day, to submit a bold proposal to the Uganda Law Reform Commission \u2014that included in the revisions being considered by parliament in 2015, there should be an explicit guarantee for all citizens of the right to the highest attainable standard of physical and mental health. \r\n\r\nThose who framed our Constitution, despite their wisdom, did not expressly cater for the right to the highest attainable standard of health in its substantive articles, but rather placed it under the non binding State policies and objectives. It is now urgent for the country to correct this. \r\n\r\nWhy? Simply put: because when it comes to health, our leaders and policy makers are failing the citizens. \r\n\r\nUganda\u2019s astonishingly poor health indicators speak volumes. Unlike its neighbours, which have shown important advances, Uganda has had a stagnant rate of maternal deaths for the past decade alongside rising HIV incidence and declining condom use. Uganda has a stubborn burden of drug resistant tuberculosis and, according to the World Health Organisation 2005 report on malaria, Uganda has the world's highest malaria incidence, with 478 cases for every 1 000 people every year. This disease burden is coupled with ailing public health facilities that lack essential services like water and electricity. \r\n\r\nUnfortunately, health services have been eclipsed by rural electrification and infrastructure as political priorities for investment. Health care is seen by government as an area for charitable donation or as spending on \u2018consumption\u2019. This is extremely shortsighted. There should be no trade-off between building roads or building health services. This is a false dichotomy. We cannot develop as a country economically if our population is sick, or if families are one attack of cerebral malaria short of impoverishment! \r\n\r\nCountries that have expanded access to free, essential services have found that those investments have yielded real benefit to their citizens, including in terms of less absenteeism from work and schooling due to ill health, and increases in economic productivity at the household level. \r\n\r\nIn reality, in receiving taxes from people, government is bound by a social contract to account back to the people on how their resources are being used. \r\nThe structural adjustment programmes that liberalized and reduced public funding to social services located health in the market place and weakened this state duty. Now is the time to redeem it.  We believe that a strong constitutional norm is needed to raise the role and accountability of the state in health care and raise pressure to address the social conditions that affect our health. \r\n\r\nIncluding the right to the highest attainable standard of health as a constitutional right provides a bench mark for government, private sector and society to respect, protect, fulfil and promote it. Without a clear obligation, incontrovertibly stated in the Constitution, our policymakers will continue to look on this right as \u2018optional\u2019, not fundamental to the duties of government. \r\n\r\nOther countries, such as South Africa, Kenya and recently Zimbabwe, have taken this step to ensure clear expression of the right to health care and to the social determinants of health in their Constitutions. Their people have raised social pressure for these rights and taken up their implementation through social action and strategic litigation, to ensure that government is accountable for these obligations and to build more equitable health systems. \r\n\r\nCEHURD and partners have thus submitted a proposal to the Uganda Law Reform Commission to include in the Constitution provisions for citizens to realize the right to the highest attainable standard of health; to access basic medical and emergency treatment, reproductive health services including family planning, medicines and health information, and for people who would otherwise not be able to afford health services and commodities to access social protection to enable them to do so. \r\n\r\nHaving health as a constitutional right does not mean that people should expect to immediately be healthy, nor does it mean that our government must put in place expensive health services for which they have no resources. It means that government and public authorities should take progressive measures such as investing resources and developing and implementing policies and action plans which will lead to available and accessible health care for all in the shortest possible time, and to fair distribution of public resources for this. It also means that the public and private sector have a duty to promote public health.  \r\n\r\nIsn\u2019t it time that our politicians and leaders take this step to commit to the right to the highest attainable standard of health? Citizens will be watching closely how far government gives priority to this critical right in the current constitutional reform process, at a time of common epidemics of preventable sickness and death. Surely we cannot wait another decade to make this commitment as a country!\r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the issues raised in this op-ed please visit the CEHURD website: www.cehurd.org ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Call for Abstracts for the Prince Mahidol Award Conference 2016 \u201cPriority Setting for Universal Health Coverage\u201d","field_subtitle":"Abstract  submissions by 31 March 2015","URL":"http://pmac2016.jupinnothai.com/Data/Sites/1/media/files/pmac2016_callforabstract.pdf","body":"The Prince Mahidol Award Conference (PMAC) is an annual international conference focusing on policy-related health issues. The Conference will be held in Bangkok, Thailand, from 26 \u2013 31 January 2016. The theme for PMAC 2016 is \u201cPriority Setting for Universal Health Coverage\u201d. The objectives are to advocate and build momentum on evidence- informed priority setting and policy decisions to achieve UHC goals; to advocate for the global movement and collaborations to strengthen the priority setting of health interventions and technology in the long-term; to share knowledge, experience, and viewpoints on health-related priority setting among organisations and countries; and to build capacity of policymakers and respective stakeholders for development and introduction of contextually-relevant priority setting mechanisms in support of UHC. The abstract should contain no more than 300 words that illustrate original research, or experience from the field on the subjects which have never been presented at any international conference. All submissions should fall under three main sub-themes as follows: firstly, organising priority setting: what evidence is needed? Secondly, using priority setting evidence in making UHC decisions. Thirdly, priority setting in action: learning and sharing country experiences.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for applicants: SADC Civil Society expert","field_subtitle":"Call closes 6 March 2015","URL":"https://equinetafrica.org/Roshneen%40osisa.org.","body":"The Open Society Initiative for Southern Africa and the Southern African Trust are seeking a SADC Civil Society Expert who has extensive experience working with civil society in the SADC region to undertake a mapping and analysis of civil society in the SADC region, and contribute to the development of a Sustainability Mechanism. Interested applicants are requested to submit their applications including a cover letter detailing their understanding of the scope of the assignment, a budget, the curriculum vitae and a sample report of at least one previous assignment undertaken by the 6 March 2015 to the email address below.","php":"Further details: /newsletter/id/39335","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for papers: Informing the Establishment of the WHO Global Observatory on Health Research and Development","field_subtitle":"Submissions by 8 March 2015","URL":"http://www.who.int/healthsystems/r-d_observatory/en/","body":"WHO has announced a new Call for Papers for a peer-reviewed Journal Series on \u201cInforming the Establishment of the WHO Global Observatory on Health Research and Development\u201d. This Call is launched in association with the WHO Global Observatory on Health Research and Development (R&D) called for by WHO\u2019s Member States in the 2013 WHA Resolution 66.22, as part of a strategic work plan to promote innovation, build capacity, improve access and mobilise resources to address diseases that disproportionately affect the world\u2019s poorest countries. With this collection of papers, WHO aims to provide global stakeholders with up-to-date knowledge on methods, strategies, tools, experiences and applications to draw from when developing future investment decisions and implementation plans for new R&D. More importantly, the aim is to push the frontier for knowledge and innovation in this field by inviting new thinking, approaches, analysis and information and welcome a wide range of perspectives and disciplines relevant to understanding the availability of and funding for health R&D. Papers will be published during the course of 2015/16 in Health Research Policy and Systems.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Papers: New Solutions: A Journal of Environmental and Occuappational Health Policy Extractive Industries","field_subtitle":"Submissions by: 31 March 2015","URL":"http://www.newsolutionsjournal.com/index.php/newsolutionsournal","body":"New Solutions seeks submissions for a special issue that will focus on the extractive industries. Extractive industries are defined as processes that involve the extraction of raw materials from the natural environment to be used for consumption and include the mining of precious and other metals (e.g. gold, silver, iron, manganese, tin, asbestos and rare-earth metals, amongst others), and the extraction of energy sources such as coal, uranium, natural gas, oil sources such as oil shale and tar sands, as well as dredging and quarrying for primary materials. Because New Solutions is a policy journal, manuscripts, including scientific papers, should include a perspective that addresses relevant policy concerns. Manuscripts are welcome for any of its journal sections, including: Scientific Solutions, Feature Articles, Movement Solutions, Documents, Voices, and Comment and Controversy. The editors encourage submissions that highlight possible alternatives or solutions and examples of positive community responses and activities.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for proposals: Scaling Up Food Security and Nutrition Innovations - Canadian International Food Security Research Fund","field_subtitle":"Submissions by: 27 March 2015","URL":"http://www.idrc.ca/EN/Funding/Competitions/Pages/CompetitionDetails.aspx?CompetitionID=91","body":"International Development Research Centre and Foreign Affairs, Trade and Development Canada have announced the 2015 open call for proposals under the Canadian International Food Security Research Fund. With a strong focus on taking effective, pilot-tested innovations to a wider scale of use and application, this call will fund outstanding research-for-development projects that promise consistent and meaningful development outcomes (i.e. reaching important numbers of end-users) by testing, demonstrating and effectively scaling up models, delivery mechanisms, and approaches. This is an open, competitive call for proposals, and will fund projects submitted by strong partnerships between research, development, private sector, and other  organisations from Canada and from eligible countries.Projects are anticipated to begin in October 2015. The size of the projects funded by this call will be in range from CA$0.5 to $1.5 million. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Cartooning for Peace","field_subtitle":"Foundation of cartooning for peace, Geneva","URL":"http://www.cartooningforpeace.org/en/qui-sommes-nous/","body":"Kofi Annan, former Secretary General of the UN, said in 2006 \u201cCartoons make us laugh. Without them, our lives would be much sadder. But they are no laughing matter : They have the power to inform, and also to offend.\u201d With Plantu, French editorial cartoonist at \u201cLe Monde\u201d newspaper, he gathered together twelve of the greatest international cartoonists at the United Nations Headquarters in New York on October 16, 2006, at a symposium entitled \u201cUnlearning Intolerance\u201d. The Cartooning for Peace initiative started with this meeting. It aims to promote a better understanding and mutual respect between people of different cultures and beliefs using editorial cartoons as a universal language. Cartooning for Peace facilitates meetings of professional cartoonists of all nationalities with a wide audience, to promote exchanges on freedom of expression and recognition of the journalistic work of cartoonists. Cartooning for Peace also provides protection and legal assistance to cartoonists working in difficult environments, as well as advice and support in the exercise of their profession.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"CDRA: Planning, Monitoring, Evaluation and Learning Course","field_subtitle":"Cape Town, March and November; Johannesburg, July","URL":"http://www.ngopulse.org/event/planning-monitoring-evaluation-and-learning-course","body":"The Community Development Resource Association (CDRA), a civil society organisation, established in 1987, based in Cape Town, South Africa, is conducting courses on Planning, Monitoring, Evaluation and Learning between 9 March - 27 November 2015 in Johannesburg and Cape Town. The pressure that organisations face for external accountability leave many tasked with ticking the boxes and filling in the blanks with a sense of unease. The same questions tend to plague researchers. Does the evaluation framework represent what the project is about? Are researchers bringing learning into practice adequately? Are partners learning and growing? This five-day course is for those keen to design monitoring and evaluation processes that foster learning. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Children Health Foundation: Innovative Small Grants Program 2015","field_subtitle":"Call closes: 30 April 2015","URL":"http://www.fundsforngos.org/developing-countries-2/ghana/child-health-foundation-innovative-small-grants-program-2015/","body":"The Child Health Foundation is currently accepting letters of intent from interested health workers, investigators, or community organisations for innovative research or innovative service projects directed at improving the health of infants, children, and pregnant women. Selected individuals or groups will be notified to further send a full proposal. The Foundation has been supporting innovative approaches to adapting ORT to the health care and social situations around globe. Small innovative projects can make a major impact on child health in diverse settings, and find out the answers to some persistent health problems. The number of projects approved depends on the amount of funding available. The 2014 Innovative Small Grants have been awarded for the health and well-being of children to organisations in Tanzania, India, Kenya, Colombia, Ethiopia, Rwanda, Cambodia, and Vietnam. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa","field_subtitle":"Ashmore J, Gilson L: Human Resources for Health 13:3, 2015 ","URL":"http://www.human-resources-health.com/content/13/1/3","body":"Dual practice or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries\u2019 public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Findings suggest dual practice can impact both positively and negatively on specialists\u2019 intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a \u2018stepping stone\u2019 to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Contributions of Global Health Diplomacy to equitable health systems in east and southern Africa","field_subtitle":"EQUINET Regional research workshop, Johannesburg, South Africa March 13-14 2015","body":"This workshop is being held to discuss the evidence from research in EQUINET and related research with a particular focus on east and southern Africa (ESA) on global health diplomacy. It will present and discuss the findings from the EQUINET research programme and from related research in Africa, and the implications for policy, negotiations and programmes in east and southern Africa; review methods and challenges for implementing research and analysis on global health diplomacy for policy relevance, from review of research and experience of the work; and discuss and propose areas for follow up policy, action and research, within ESA and through south-south collaboration. The reports of the EQUINET research are on the website ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"\r\nContact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 169: Bring the right to health into Uganda\u2019s Constitution this year! ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Header"}},{"node":{"title":"Ethical considerations related to participation and partnership: an investigation of stakeholders\u2019 perceptions of an action-research project on user fee removal for the poorest in Burkina Faso","field_subtitle":"Hunt MR, Gogognon P, Ridde V: BMC Medical Ethics 15(13), February 2013","URL":": http://www.biomedcentral.com/1472-6939/15/13","body":"Healthcare user fees present an important barrier for accessing services for the poorest in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are poorest in implementing user fee removal. The authors explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research in 39 in-depth interviews in the affected community, local healthcare professionals, management committees of local health clinics, researchers and regional or national policy-makers. Using constant comparative techniques, the authors carried out an inductive thematic analysis of the collected data.  Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatisation, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships.The investigation illuminated the distinctive ethical terrain of a participatory public health action-research project. The authors indicate that careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Financing and access to health care in West Africa: empirical data, cartoons and received ideas","field_subtitle":"Queuille L, Ridde V, University of Montreal, School of Public Health: January 2015","URL":"http://www.equitesante.org/healthcare-financing-access-west-africa-empirical-satirical/","body":"The project Access to healthcare for vulnerable groups in West Africa with the Help NGO produces publications in order to make research results and knowledge more accessible. The authors have worked for 10 years on producing and applying scientific knowledge about healthcare access and financing in Africa and aim to share their observations by experimenting with using satirical cartoons as a knowledge sharing tool.  Made by the designer Glez, this series of cartoon focuses on preconceived ideas that people can have about the implementation of free health care and health insurance coverage in Sub-Saharan Africa.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Global Forum on Research and Innovation for Health, Manila, Philippines, 24-27 August 2015","field_subtitle":"Deadline for abstract submissions: 5 May 2015","URL":"http://www.forum2015.org","body":"Forum 2015 is a unique global platform to promote the role of research and innovation in creating better health, enhancing equity and stimulating development. The Forum 2015 organisers invite abstract submissions from policymakers, business and community leaders, researchers and scholars, non-profit and international organisations, and any others from various disciplines and sectors whose work addresses key concerns in research and innovation for health and development. The abstracts may be research-focused, clinical-focused, policy-focused or program-focused. The abstract should describe clearly developed-work that is evidence-based. Abstracts describing work that is in early stages of development will not be considered. At the time of the abstract submission, authors may request a poster presentation, an oral presentation, or both. The Forum 2015 will make the final decision on what type of presentation method will be awarded based on the overall program needs","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health in All Policies Training Manual  ","field_subtitle":"World Health Organisation, 2015","URL":"http://www.who.int/social_determinants/en/","body":"The WHO has launched its Health in All Policies Training Manual. The manual provides a resource for regional and country training workshops to increase understanding of HiAP by health professionals and others. WHO is developing a global plan to raise awareness among the end-users regarding this tool, and is seeking to consolidate a strong network of institutions to support responses to training requests at national and sub-national levels.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health Information Systems Program - SA 2015 International Conference","field_subtitle":"23- 25 March 2015, Bloemfontein, South Africa ","URL":"http://www.hst.org.za/events/health-information-systems-program-sa-2015-international-conference","body":"Over the last 20 years, the District Health Information System in South Africa and in many countries in Sub- Saharan Africa and Asia has evolved significantly from a paper based system to a web based system. The conference is expected to be a platform through which this evolution is explored and where best practices and lessons learned are being shared.  The conference will bring together a wide range of practitioners from health information users, systems developers, health leaders ranging from programme managers, district managers, provincial managers and health planners from South Africa and around the world. The audience will also include public health and health informatics students as well as researchers. The conference hopes to provide a platform to explore new developments, innovations and possibilities around health information systems development and information use. The conference will be preceded by 2 days of field visits to selected health facilities on 23rd and 24th March 2015 where candidates will be taken through practical aspects of the development process and where they can experience the use of the DHIS software first hand. Delegates may also wish to join the DHIS2 Academy which will be held from 13 \u2013 22 March 2015 at the same venue","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Implementing rapid testing for tuberculosis in Mozambique","field_subtitle":"Cowan J, Michel C, Manhi\u00e7a I, Monivo C, Saize D, Creswell J, Gloyd S, Micek M: Bulletin of the World Health Organisation 93(2) 65-132","URL":"http://www.who.int/bulletin/volumes/93/2/14-138560/en/","body":"In Mozambique, pulmonary tuberculosis is primarily diagnosed with sputum smear microscopy. However this method has low sensitivity, especially in people infected with human immunodeficiency virus (HIV). Patients are seldom tested for drug-resistant tuberculosis. The national tuberculosis programme and Health Alliance International introduced rapid testing of smear-negative sputum samples. Four machines were deployed in four public hospitals along with a sputum transportation system to transfer samples from selected health centres. Laboratory technicians were trained to operate the machines and clinicians taught to interpret the results. The results indicated that using rapid tests to diagnose tuberculosis is promising but logistically challenging. More affordable and durable platforms are needed. All patients diagnosed with tuberculosis need to start and complete treatment, including those who have drug resistant strains.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"National Research Forum:  Evidence for advancing Universal Health Coverage in Zimbabwe","field_subtitle":"Harare, 19th and 20th March 2015","body":"The Ministry of Health and Child Care, the National Institute of Health Research and the Training and Research Support Centre in collaboration with the Technical Working Group on Universal Health Coverage and the \u2018Rebuild programme\u2019 is holding a one and a half day National Research Forum with the THEME \u201cEvidence for advancing Universal Health Coverage (UHC) in Zimbabwe\u201d on 19th and 20th March 2015 at the Harare Holiday Inn, in Harare.  The forum will gather people from all constituencies and sectors doing or using research on any aspect of UHC in Zimbabwe, to present and share their research findings, discuss the policy implications and identify priorities for future work. The conference has four theme areas: i. Health Equity: Reducing the gap in access to and coverage of health care and of social determinants of improved health. ii. Health financing: Mobilising  financial, health worker, medicines and other  resources for health, pooling of funds,  reducing out of pocket spending  and fair allocation and effective use of health resources. iii. Widening services to meet new challenges, such as non communicable diseases, Ebola and multiple/co- morbidity. and iv. People centred approaches: partnerships in health between communities, health workers, institutions and private sector. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"ND-GAIN Global Climate Change Vulnerability and Readiness Mapping","field_subtitle":"ND-GAIN","URL":"http://index.gain.org","body":"ND-GAIN ranks 175 countries both by vulnerability and readiness to adapt to climate change. The group measures vulnerability by considering the potential impact of climate change on six areas: food, water, health, ecosystem service, human habitat and infrastructure. The readiness rank weights portions of the economy, governance and society that affect the speed and efficiency of adaptation projects.The project presents this information through a series of interactive maps and rankings. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Overcoming challenges to sustainable immunisation financing: early experiences from GAVI graduating countries","field_subtitle":"Saxenian H, Hecht R, Kaddar M, Schmitt S, Ryckman T, Cornejo S: Health Policy and Planning 30(2) 197-205","URL":"http://heapol.oxfordjournals.org/content/30/2/197.full","body":"Over the 5-year period ending in 2018, 16 countries with a combined birth cohort of over 6 million infants requiring life-saving immunizations are scheduled to transition from outside financial and technical support for a number of their essential vaccines. This support has been provided over the past decade by the GAVI Alliance. Will these 16 countries be able to continue to sustain these vaccination efforts? To address this issue, GAVI and its partners are supporting transition planning, entailing country assessments of readiness to graduate and intensive dialogue with national officials to ensure a smooth transition process. The report presents learning form a pilot and observes that the experience of countries that have already transitioned should contribute to thinking about how such transition away from external funding can be achieved in low and middle income countries. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Post-2015 and FFD3: Debates Begin, Political Lines Emerge","field_subtitle":"Adams B, Luchsinger G: Social Watch Report 2014, February 2015","URL":"http://www.socialwatch.org/node/16782","body":"2015 is a said to be pivotal year. The post\u20132015 sustainable development agenda currently being drafted is premised on the reality that the present model of development is not working, given worsening inequalities and straining planetary boundaries. All countries and peoples\u2014and the planet \u2013have the right to live with a better model, one that is inclusive and sustainable. The authors argue that an increasingly urgent imperative for change informs the two\u2013track negotiations unfolding at the United Nations from now until September. One track involves the post\u20132015 sustainable development agenda; the second focuses on financing for development, an independent process that began at the 2002 Monterrey Conference. While the two talks are separate, the issues in each are observed to be deeply interlinked, and the success of any new model to depend on the outcomes of both. The political stakes are high, but so too the authors argue are the opportunities\u2014perhaps once\u2013in\u2013a\u2013generation\u2014for genuine transformation. The article discusses the implications of these two tracks of negotiation. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Public Health Association of South Africa (PHASA) Conference","field_subtitle":"7-9 October, 2015, Durban, South Africa","URL":"http://www.phasaconference.org.za","body":"With 2015 being the target date for the achievement of the Millennium Development Goals (MDGs), the conference will provide an opportunity to reflect on the challenges faced by South Africa and Africa in trying to achieve the MDGs. The focus of the conference though will be on moving forward and identifying potential solutions both within and outside the health system in order to improve the health status of our population.  This is reflected in the theme of conference \u201cHealth and Sustainable Development:  The Future\u201d. The 2015 PHASA Conference will be more interactive than previous PHASA conferences. A panel debate involving politicians, civil society and academics is set to be one of the highlights of the 2015 PHASA Conference. There will be a greater media and social media presence at the 2015 PHASA Conference ensuring that research findings and key issues reach a broader audience. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"SA follows WHO guide on low-risk yellow fever arrivals","field_subtitle":"Maqutu A: BDlive, 4 February 2015","URL":"http://tinyurl.com/mty92vo","body":"The World Health Organisation has included some African countries on its low-risk yellow fever list, which means their citizens no longer need clearance certificates when visiting SA. Visitors from Zambia, Tanzania, Ethiopia, Eritrea, and Sao Tome and Principe would no longer be expected to produce a yellow fever certificate when entering SA. In accordance with international health regulations, SA requires a yellow fever certificate from all citizens and non-citizens over the age of one who have travelled from a yellow fever risk country or have been in transit for more than 12 hours at the airport of such a country.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Sex and gender matter in health research: addressing health inequities in health research reporting","field_subtitle":"Gahagan J, Gray K, Whynacht A: International Journal for Equity in Health 14(12), 2015","URL":"http://www.equityhealthj.com/content/14/1/12","body":"Attention to the concepts of \u2018sex\u2019 and \u2018gender\u2019 is increasingly being recognised as contributing to better science through an augmented understanding of how these factors impact on health inequities and related health outcomes. However, the ongoing lack of conceptual clarity in how sex and gender constructs are used in both the design and reporting of health research studies remains problematic. Conceptual clarity among members of the health research community is central to ensuring the appropriate use of these concepts in a manner that can advance our understanding of the sex- and gender-based health implications of our research findings. During the past twenty-five years much progress has been made in reducing both sex and gender disparities in clinical research and, to a significant albeit lesser extent, in basic science research. Why, then, does there remain a lack of uptake of sex- and gender-specific reporting of health research findings in many health research journals? This question, the authors argue, has significant health equity implications across all pillars of health research, from biomedical and clinical research, through to health systems and population health.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"The death of international development","field_subtitle":"Hickel J: Al Jazeera, 20 Nov 2014 ","URL":"http://www.aljazeera.com/indepth/opinion/2014/11/death-international-developmen-2014111991426652285.html","body":"International development is dying; people just don't buy it anymore. The West has been engaged in the project for more than six decades now, but the number of poor people in the world is growing, not shrinking, and inequality between rich and poor continues to widen instead of narrow. People know this, and they are abandoning the official story of development in droves. They no longer believe that foreign aid is some kind of silver bullet, that donating to charities will solve anything, or that Bono and Bill Gates can save the world. This crisis of confidence has become so acute that the development community is scrambling to respond. The Gates Foundation recently spearheaded a process called the Narrative Project with some of the world's biggest NGOs - Oxfam, Save the Children, One, and others. They commissioned research to figure out what people thought about development, and their findings revealed a sea change in public attitudes. People are no longer moved by depictions of the poor as pitiable, voiceless \"others\" who need to be rescued by heroic white people. The author observes that this is a racist narrative that has lost all its former currency; rather, people have come to see poverty as a matter of injustice, that poverty is created by rules that rig the economy in the interests of the rich.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The health system cost of post-abortion care in Rwanda","field_subtitle":"Vlassoff M, Musange SF, Kalisa IR, Ngabo F, Sayinzoga F, Singh S, Bankole A: Health Policy and Planning 30(2) 223-233","URL":"http://heapol.oxfordjournals.org/content/30/2/223.full","body":"Based on research conducted in 2012, the authors estimated the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalisation. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Heretic's Guide to Global Finance: Hacking the Future of Money","field_subtitle":"Scott B: Pluto Press, 10 May 2013","URL":"http://suitpossum.blogspot.co.uk/p/the-heretics-guide.html","body":"The Heretic's Guide to Global Finance: Hacking the Future of Money is a friendly guide to the complex maze of modern finance but also tells us how to utilise and subvert it for social purposes in innovative ways. It sets up a framework to illuminate the financial sector and helps the reader develop a diverse DIY toolbox to undertake their own adventures in guerilla finance and activist entrepreneurialism. Part 1 (Exploring) covers the major financial players, concepts and instruments. Part 2 (Jamming) explores innovative forms of financial activism. Part 3 (Building) showcases the growing alternative finance movement - including peer-to-peer systems, alternative currencies, and co-operative economies - and shows how people can get involved in building a democratic financial system.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Time savings \u2013 realized and potential \u2013 and fair compensation for community health workers in Kenyan health facilities: a mixed-methods approach","field_subtitle":"Sander LD, Holtzman D, Pauly M, Cohn J: Human Resources for Health 2015, 13:6 ","URL":"http://www.human-resources-health.com/content/13/1/6","body":"Sub-Saharan Africa faces a severe health worker shortage, which community health workers (CHWs) may fill. This study describes tasks shifted from clinicians to CHWs in Kenya, places monetary valuations on CHWs\u2019 efforts, and models effects of further task shifting on time demands of clinicians and CHWs. Interviews were conducted with 28 CHWs and 19 clinicians in 17 health facilities throughout Kenya. Twenty CHWs completed task diaries over a 14-day period to examine current CHW tasks and the amount of time spent performing them. A modelling exercise was conducted examining a current task-shifting example and another scenario in which additional task shifting to CHWs has occurred. CHWs worked an average of 5.3 hours per day and spent 36% of their time performing tasks shifted from clinicians. The authors estimated a monthly valuation of US$ 117 per CHW. The modelling exercise demonstrated that further task shifting would reduce the number of clinicians needed while maintaining clinic productivity by significantly increasing the number of CHWs. The authors\u2019 argue that this costing of CHW contributions raises evidence for discussion, research and planning regarding CHW compensation and programmes. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Transforming health professions\u2019 education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative","field_subtitle":"Talib ZM, Kiguli-Malwadde E, Wohltjen H, Derbew M, Mulla Y, Olaleye D, Sewankambo N: Human Resources for Health 2015, 13:1  doi:10.1186/1478-4491-13-1","URL":"http://www.human-resources-health.com/content/13/1/1","body":"African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward resources to support African medical schools. The Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning, through semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes. All of the consortia have prioritised efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilise limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalisation of collaborative activities. The consortia demonstrate a paradigm shift in the relationship between medical schools. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding has created a culture of collaboration, with positive impact reported on the quality and efficiency of health workforce training. It suggests that future funding for global health education should prioritise such south-south collaborations.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Water and power: Are public services still public?","field_subtitle":"Municipal Services Project, February 2015","URL":"https://www.youtube.com/watch?v=DNkno9Bw51E","body":"Public water and electricity are back in vogue! Yet many state-owned utilities are now undergoing \u201ccorporatization\u201d: they have legal autonomy and manage their own finances. Is this a positive development in the struggle for equitable public services? Or a slippery slope toward privatisation? This video draws from in-depth research on corporatization cases from around the world. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"When HIV is ordinary and diabetes new: Remaking suffering in a South African Township","field_subtitle":"Mendenhall E, Norris SA: Global Public Health, DOI: 10.1080/17441692.2014.998698 2015","URL":"http://www.tandfonline.com/doi/full/10.1080/17441692.2014.998698#.VOHvWUJfXFI","body":"Escalation of non-communicable diseases (NCDs) among urban South African populations disproportionately afflicted by HIV/AIDS presents not only medical challenges but also new ways in which people understand and experience sickness. In Soweto, the psychological imprints of political violence of the Apartheid era and structural violence of HIV/AIDS have shaped social and health discourses. Yet, as NCDs increasingly become part of social and biomedical discussions in South African townships, new frames for elucidating sickness are emerging. This article employs the concept of syndemic suffering to critically examine how 27 women living with Type 2 diabetes in Soweto, a township adjacent to Johannesburg known for socio-economic mobility as well as inequality, experience and understand syndemic social and health problems. For example, women described how reconstructing families and raising grandchildren after losing children to AIDS was not only socially challenging but also affected how they ate, and how they accepted and managed their diabetes. Although previously diagnosed with diabetes, women illustrated how a myriad of social and health concerns shaped sickness. Many related diabetes treatment to shared AIDS nosologies, referring to diabetes as \u2018the same\u2019 or \u2018worse\u2019. These narratives demonstrate how suffering weaves a social history where HIV becomes ordinary, and diabetes new.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Who pays for and who benefits from health care services in Uganda?","field_subtitle":"Kwesiga B, Ataguba JE, Abewe C, Kizza P, Zikusooka CM: BMC Health Services Research 15:44 February 2015","URL":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324659/","body":"Equity in health care entails payment for health services according to the capacity to pay and the receipt of benefits according to need. In Uganda, as in many African countries, although equity is extolled in government policy documents, not much is known about who pays for, and who benefits from, health services. This paper assesses both equity in the financing and distribution of health care benefits in Uganda. Data are drawn from the most recent nationally representative Uganda National Household Survey 2009/10. Equity in health financing is assessed considering the main domestic health financing sources (i.e., taxes and direct out-of-pocket payments). This is achieved using bar charts and standard concentration and Kakwani indices. Benefit incidence analysis is used to assess the distribution of health services for both public and non-public providers across socio-economic groups and the need for care. Need is assessed using limitations in functional ability while socioeconomic groups are created using per adult equivalent consumption expenditure. Overall, health financing in Uganda is marginally progressive; the rich pay more as a proportion of their income than the poor. The various taxes are more progressive than out-of-pocket payments. However, taxes are a much smaller proportion of total health sector financing compared with out-of-pocket payments. The distribution of total health sector services benefits is pro-rich. The richest quintile receives 19.2% of total benefits compared to the 17.9% received by the poorest quintile. The rich also receive a much higher share of benefits relative to their need. Benefits from public health units are pro-poor while hospital based care, in both public and non-public sectors are pro-rich. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"WHO: Members States propose guidance for engagement with non-State actors","field_subtitle":"TWN Info Service on Health Issues (Jan15/06), 2015","URL":"http://www.twn.my/title2/health.info/2015/hi150106.htm","body":"A new time line with guidance from Member States has been proposed for improving a framework on engagement with non-State actors at the World Health Organization. Discussions on the framework document prepared by the WHO Secretariat were held at the meeting of the 136th session of the WHO Executive Board (EB). During the plenary session, many countries expressed their dissatisfaction with the current draft framework and Argentina proposed a draft decision to convene a working group for deciding on the way forward. This document provides the current draft of the framework. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Zimbabwe Association of Doctors for Human Rights; Zimbabwe National Network or People living with HIV and AIDS; Training and Research Support Centre","field_subtitle":"PRA report: Community Strengthening for a People Centred Primary Health Care System: The Case of Cassa Banana Community in Zimbabwe","URL":"http://www.equinetafrica.org/bibl/docs/PRA%20Rep%20Cassa%20Banana%20Feb%202015.pdf","body":"This report documents work undertaken in Cassa Banana Community from February \u2013 July 2014. The programme aimed to use Participatory Reflection and Action (PRA) methodologies in working with members of Cassa Banana to work with a representation of community members and health providers/authorities to explore and document the health challenges faced by the Casa Banana community and to formulate actions to solve these health challenges. The project also sought to support community action in demanding accountability from the relevant duty bearers in the formulation and delivery of health services, and to strengthen community/stakeholder engagement for the provision of people-centered Primary Health Care services to the Casa Banana community.","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"\u2018Rural-proofing\u2019 policy launched","field_subtitle":"Nkosi S: Health-e News, January 2015","URL":"http://www.health-e.org.za/2015/01/30/rural-proofing-policy/","body":"Rural health advocacy groups in South Africa have developed guidelines aimed at ensuring that policy makers and government address the rural context when developing and implementing policies. The guidelines are proposed to assist government departments in taking into account rural contexts when designing programmes. The guidelines and related presentations from the launch can be accessed through the link. ","php":"","field_issue_date":"2015-03-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"2015 Elections in Africa: Africa Research Institute interactive resource page","field_subtitle":"Africa Research Institute, 15 January 2015","URL":"http://www.africaresearchinstitute.org/blog/2015-elections-africa/","body":"This page provides an election map where users can  click on highlighted countries on the map for pop-up fact boxes and links to recommended reading, a timeline where users can scroll through for a chronological view of the year\u2019s elections. There is also an area for further reading providing space to browse a variety of articles, from survey reports to ambassadorial blog posts on electoral systems and performance, by country.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"A Community Health Worker \u201clogic model\u201d: towards a theory of enhanced performance in low- and middle-income countries","field_subtitle":"Naimoli JF, Frymus DE, Wuliji T, Franco LM and Newsome MH: Human Resources for Health12(56), 2014  ","URL":"http://www.human-resources-health.com/content/12/1/56","body":"There has been a resurgence of interest in national Community Health Worker (CHW) programs in low- and middle-income countries (LMICs). A lack of strong research evidence persists, however, about the most efficient and effective strategies to ensure optimal, sustained performance of CHWs at scale. To facilitate learning and research to address this knowledge gap, the authors developed from document review and consultations a generic CHW logic model that proposes a theoretical causal pathway to improved performance. The logic model draws upon available research and expert knowledge on CHWs in LMICs. The generic CHW logic model posits that optimal CHW performance is a function of high quality CHW programming, which is reinforced, sustained, and brought to scale by robust, high-performing health and community systems, both of which mobilize inputs and put in place processes needed to fully achieve performance objectives. Multiple contextual factors can influence CHW programming, system functioning, and CHW performance.The model is argued to offer new thinking about CHWs. It places CHW performance at the center of the discussion about CHW programming, recognizes the strengths and limitations of discrete, targeted programs, and is comprehensive, reflecting the current state of both scientific and tacit knowledge about support for improving CHW performance. It offers guidance for continuous learning about what works. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Annotated bibliography of e- platforms used in participatory and peer to peer exchange and learning","field_subtitle":"Loewenson T: TARSC, EQUINET Harare, 2014","URL":"http://www.equinetafrica.org/bibl/docs/Ann%20bib%20of%20e-%20platforms%20%20Dec2014.pdf","body":"Visual and information technologies are now more diversified and widely accessible. Digital images and mapping enhance access and exchange on local realities; social media (blogs, tweets and others) provide new methods for communicating experience for collective analysis, mobile phones facilitate communication and pooling of evidence across wider social networks and mapping and crowd-sourcing technology provide systems for citizen reporting, including in poorest communities. internet based resources point to the possibilities for information technology to support peer to peer learning and participatory action research to overcome the \u2018local\u2019 nature of processes and link groups with shared interest. To support discussion on these areas this work aimed to provide an annotated description of existing internet resources that have features that may guide out thinking in developing an e platform for participatory reflection and action across similar groups in different areas.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Annotated bibliography on participatory consultations to help aid the inclusion of marginalized perspectives in setting policy agendas","field_subtitle":"Siddiqui FR: International Journal for Equity in Health 13(124), December 2014 ","URL":"http://www.equityhealthj.com/content/13/1/124","body":"This bibliography presents studies from peer-reviewed and grey literature that used consultations and other participatory strategies to capture a community\u2019s perspective of their health priorities, and of techniques used to elevate participation from the implementation phase to a more upstream phase of prioritisation, policymaking and agenda setting. It covers studies that worked with marginalised populations or sub-populations. It begins by first offering some philosophical and conceptual frameworks that link participatory interventions with inclusive policy making or agenda setting, and a rationale for prioritising marginalised populations in such an undertaking. It further looks at various participatory instruments for consultations, for reaching out to marginalised populations, and for communicating the results to policymakers. A final section presents a reflective and evaluative look at the recruitment, instruments and examples.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Attitudes of Gatekeepers Towards Adolescent Sexual and Reproductive Health in Ghana","field_subtitle":"Kumi-Kyereme A, Awusabo-Asare K, Darteh EKM: African Journal of Reproductive Health 18(3), September 2014","URL":"http://www.ajol.info/index.php/ajrh/article/view/109221","body":"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 \u2018solve\u2019 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,","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Budget Bites","field_subtitle":"Africa Health Budget Network, January 2015","URL":"http://tinyurl.com/ncfpszd","body":"The Africa Health Budget Network is a group of African and global organizations and individuals already using or wishing to use budget advocacy as a tool to improve health service delivery in Africa. The network has three strands of work and provides formal training opportunities, events and tools. The network promotes learning and sharing within the network and coordinated and focused pressure on African leaders with respect to their health financing commitments. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Call for Applications: 2015 Small Grants Programme for Thesis Writing","field_subtitle":"deadline for the receipt of applications: Wednesday 15th April, 2015. ","URL":"http://newebsite.codesria.org/spip.php?article2234&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) announces the twenty-sixth session of its Small Grants Programme for Thesis Writing. The grants serve as part of the Council\u2019s contribution to the development of the social sciences in Africa, and the continuous renewal and strengthening of research capacities in African universities, through the funding of primary research conducted by graduate and postgraduate students. Candidates whose applications are successful are encouraged to use the resources provided under the grants to cover the cost of their fieldwork, the acquisition of books and documents, the processing of data which they have collected and the printing of their theses/dissertations. As the Council is strongly committed to encouraging African researchers to engage one another on a sustained basis, recipients of the small grants will also be supported to order books and journals produced by African scholarly publishers, including CODESRIA itself. They will also be encouraged to apply for participation in CODESRIA research methodology workshops.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for Grant Applications or/and letters of interest: Selection of universities to manage TDR International Post Graduate Training Scheme (2015 to 2019)","field_subtitle":"Deadline 28 February 2015","URL":"http://www.who.int/tdr/grants/Call-Training-Institutions-grants2015.pdf?ua=1","body":"This call is for applications from universities in low- and middle-income countries (LMICs) to host and manage the TDR international post graduate training scheme on implementation research (IR). The long term goal is to strengthen capacity of disease endemic countries for identifying public health needs, develop appropriate solutions and translate them into policy and practice for improved health and wellbeing of their populations.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for papers: Towards the 8th Pan African Congress","field_subtitle":"Congress date: March 2015","URL":"http://www.pambazuka.net/en/category/announce/93608","body":"Veteran and young Pan Africanist leaders will meet to discuss Pan Africanism and a vision for Africa\u2019s future in March 2015 in Accra. Towards the 8th Congress in 2015, the Local Organising Committee is inviting papers from all Africans on the continent and the Diaspora. Some of the papers will be presented at the plenaries and working groups during the 8th Congress and the will be published as part of post Congress for knowledge building. Authors can choose to write one or two papers from a list provided or propose a topic of interests within the wider Pan African discourse. Papers can either be in French or English and will be subject to peer review. Submissions should be presented in soft copy, double spaced and not more than 3,000 words. For information on the themes please visit the link and email papers to zyeebo@gmail.com.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call of Expressions of Interest: Politics of Domestic Resource Mobilization for Social Development: Zimbabwe Case Study","field_subtitle":"Project from: 2011 to 2015","URL":"http://tinyurl.com/psw4kwp","body":"UNRISD invites expressions of interest from researchers for two further research papers for its ongoing project case study on Zimbabwe from researchers with extensive expertise on Zimbabwe, either on taxation or social policy. Two papers will be commissioned as a result of this call: The Political Economy of Taxation and Fiscal Governance in Zimbabwe and Social Policy and Social Spending in Zimbabwe.  ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community health workers programme in Luanda, Angola: an evaluation of the implementation process","field_subtitle":"Giugliani C, Duncan BB, Harzheim E, Lavor AC, Lavor MC, Machado MM, Barbosa MI, Bornstein VJ, Pontes AL and Knauth DR: Human Resources for Health 12(68), 9 December 2014","URL":"http://www.human-resources-health.com/content/12/1/68","body":"The Community Health Workers (CHWs) Programme was launched in Luanda, Angola, in 2007 as an initiative of the provincial government. The aim of this study was to assess its implementation process. This is a case study using document analysis, CHWs reports, individual interviews and focal groups. Until June 2009, the programme had placed in the community 2548 trained CHWs, providing potential coverage for 261 357 families. Analysis of qualitative data suggested an association of CHWs with improvements in maternal and child access to health care, as well as an increase in the demand for health services, generating further need to improve service capacity. Nevertheless, critical points for programme sustainability were identified. For continuity and scaling up, the programme needs medium- and long-term technical, political and financial support. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Costs of Eliminating Malaria and the Impact of the Global Fund in 34 Countries","field_subtitle":"Zelman B, Kiszewski A, Cotter C, Liu J: PLoS ONE 9(12), December 2014","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0114762","body":"This study aims to 1) assess past total and Global Fund funding to the 34 current malaria-eliminating countries, and 2) estimate their future funding needs to achieve malaria elimination and prevent reintroduction through 2030. Historical funding is assessed against trends in country-level malaria annual parasite incidences (APIs) and income per capita. Following Kizewski et al. (2007), program costs to eliminate malaria and prevent reintroduction through 2030 are estimated using a deterministic model. The cost parameters are tailored to a package of interventions aimed at malaria elimination and prevention of reintroduction.The majority of Global Fund-supported countries experiencing increases in total funding from 2005 to 2010 coincided with reductions in malaria APIs and also overall GNI per capita average annual growth. The total amount of projected funding needed for the current malaria-eliminating countries to achieve elimination and prevent reintroduction through 2030 is approximately US$8.5 billion, or about $1.84 per person at risk per year (PPY). Although external funding, particularly from the Global Fund, has been key for many malaria-eliminating countries, sustained and sufficient financing is argued to be critical for furthering global malaria elimination. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Development of Health Equity Indicators in Primary Health Care Organizations Using a Modified Delphi","field_subtitle":"Wong ST, Browne AJ, Varcoe C, Lavoie J, Fridkin A, Smye V, Godwin O, Tu D:  PLoS ONE 9(12): e114563. doi:10.1371/journal.pone.0114563","URL":"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0114563","body":"The purpose of this study was to develop a core set of indicators that could be used for measuring and monitoring the performance of primary health care organizations' capacity and strategies for enhancing equity-oriented care. Indicators were constructed based on a review of the literature and a thematic analysis of interview data with patients and staff using procedures for qualitatively derived data. Indicators were considered part of a priority set of health equity indicators if they received an overall importance rating of>8.0, on a scale of 1\u20139, where a higher score meant more importance. Seventeen indicators make up the priority set. Items were eliminated because they were rated as low importance (","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Does Ownership Matter? An Overview of Systematic Reviews of the Performance of Private For-Profit, Private Not-For-Profit and Public Healthcare Providers","field_subtitle":"Herrera CA, Rada G, Kuhn-Barrientos L, Barrios X: PLoS ONE 9(12), 1 December 2014","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093456","body":"Ownership of healthcare providers has been considered as one factor that might influence their health and healthcare related performance. The authors provide an overview of what is known about the effects on economic, administrative and health related outcomes of different types of ownership of healthcare providers -namely public, private non-for-profit (PNFP) and private for-profit (PFP)- based on the findings of systematic reviews (SR). Of the 5918 references reviewed, fifteen SR were included, but six of them were rated as having major limitations, so they weren't incorporated in the analyses. According to the nine analysed SR, ownership does seem to have an effect on health and healthcare related outcomes. In the comparison of PFP and PNFP providers, significant differences in terms of mortality of patients and payments to facilities have been found, both being higher in PFP facilities. In terms of quality and economic indicators such as efficiency, there are no conclusive results. When comparing PNFP and public providers, as well as for PFP and public providers, no clear differences were found. PFP providers seem to have worst results than their PNFP counterparts, but there are still important evidence gaps in the literature that needs to be covered, including the comparison between public and both PFP and PNFP providers. More research is needed in low and middle income countries to understand the impact on and development of healthcare delivery systems.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia","field_subtitle":"Bazant E, Sarkar S, Banda J, Kanjipite W, Reinhardt S, Shasulwe H, Mulilo JMC, Kim YM: Human Resources for Health, 13 (1), 14 January 2015 ","URL":"http://www.human-resources-health.com/content/12/1/73","body":"At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers\u2019 work environment and perceived quality of HIV-related care were assessed to complement data on provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. The intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale. The performance and quality improvement intervention implemented at Zambian Defence Forces\u2019 health facilities was associated with improvements in providers\u2019 perceptions of work environments consistent with the intervention\u2019s focus on commodities, skills acquisition, and receipt of constructive feedback.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 168: UN Special Rapporteurs Open Letter to the World Bank on the issue of human rights ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET newsletter invites submissions","field_subtitle":"EQUINET steering committee","body":"\r\nNew year greetings! The EQUINET newsletter is now in its 168th issue and has been disseminating information on health equity in east and southern Africa for seventeen years. Thanks to all who have contributed. We'd like to hear more from you! We invite readers to submit short think pieces, debate pieces and information for the newsletter relating to the diversity of health equity issues affecting east and southern Africa. Please submit oped pieces of 1000 words or less with author name and institution to admin@equinetafrica.org. We also welcome information on useful resources, published papers, conferences and research grants on health. The newsletter and EQUINET website have searchable databases of publications on health equity in east and southern Africa as a resource for those engaging in various areas of research, policy and activism in health. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Expensive medicines: ensuring objective appraisal and equitable access","field_subtitle":"Kennedy SB, Nisbett RA: Bulletin of the World Health Organization 93 (1), January 2014","URL":"http://www.who.int/bulletin/volumes/93/1/14-148924/en/","body":"In response to requests for the funding of new drugs, reimbursement agencies are re-evaluating some of the methods used in assessing these products. Many trials submitted for the regulatory review of new drugs do not provide adequate data for subsidy decisions. The authors argue that all involved in bringing medicines to market need to be explicit about the additional information required, decide how these data should be collected and assessed and the methods that should be used to set a fair price for a new drug.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Feasibility and acceptability of a bar-based sexual risk reduction intervention for bar patrons in Tshwane, South Africa","field_subtitle":"Morojele NK, Kitleli N, Ngako K, Kekwaletswe CT, Nkosi S, Fritz K, Parry CDH: SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) 11(1), 2014","URL":"http://www.ajol.info/index.php/saharaj/article/view/108570","body":"Alcohol consumption is a recognised risk factor for HIV infection. Alcohol serving establishments have been identified as appropriate venues in which to deliver HIV prevention interventions. This paper describes  experiences and lessons learnt from implementing a combined HIV prevention intervention in bar settings in one city- and one township-based bar in Tshwane, South Africa. The intervention consisted of peer-led and brief  intervention counselling sub-components. Thirty-nine bar patrons were recruited and trained, and delivered HIV  and alcohol risk reduction activities to their peers as peer interventionists. At the same time, nine counselors received training and visited the bars weekly to provide brief motivational interviewing counselling, advice, and  referrals to the patrons of the bars. The intervention was overall well received and suggests that bar patrons and servers can accept a myriad of intervention activities to reduce sexual risk behaviour within their drinking settings. However, HIV- and AIDS-related stigma hindered participation in certain intervention activities. The buy-in received from the relevant stakeholders (i.e. bar owners/managers and patrons, and the  community at large) was an important contributor to the feasibility and acceptability of the intervention.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"For Town and Country: A New Approach to Urban Planning in Kenya","field_subtitle":"Ngau P: Africa Research Institute Policy Voice Series, 5 December 2014","URL":"http://www.africaresearchinstitute.org/publications/policy-voices/urban-planning-in-kenya/","body":"Urban and regional planning is under the spotlight in Kenya. The 2009 National Housing and Population Census forecast that the percentage of Kenyans living in urban settlements will increase from 32 percent to 54 percent by 2030. Residents of Nairobi await the details of a new city master plan. The devolution of power and allocation of central resources to the 47 county governments created by the 2010 constitution is under way \u2013 a process that requires integrated development plans to be in place. In the post-independence era, urban planning was deployed as a tool for \u201cmodernisation\u201d in Kenya. But in the 1980s and 1990s modernisation was supplanted by autocracy and straitened economic circumstances. In turn, planning became a means for securing control, exclusion and further enrichment of political and economic elites redolent of the colonial era. Legislation based on outdated and inappropriate models such as the UK\u2019s 1947 Town and Country Planning Act was routinely used to carry out mass evictions and demolitions in informal settlements in Kenya. By the end of the 20th century, the planning profession had become irrelevant or discredited to all but its few beneficiaries. In this paper the author describes in detail how the Department of Urban and Regional Planning (DURP) at the University of Nairobi \u2013 and other institutions \u2013 have sought to revitalise and encourage the adoption of more progressive approaches among planning professionals. Curricula reform, research and innovation, close links with other planning schools in Africa, and working partnerships with civil society organisations in informal settlements are the bedrock of the effort to ensure that Kenya\u2019s future urban planners are equipped to manage rapid urban transformation.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Indicators for Universal Health Coverage: can Kenya comply with the proposed post-2015 monitoring recommendations?","field_subtitle":"Obare V, Brolan CE, Hill PS: International Journal for Equity in Health 13(123),  20 December 2014","URL":"http://www.equityhealthj.com/content/13/1/123","body":"Monitoring progress towards achieving Universal Health Coverage (UHC) is seen to be critical at both country and global level, and a monitoring framework for UHC was proposed by a joint WHO/World Bank discussion paper in December 2013. This study determined the feasibility of the proposed framework in Kenya. The study used the WHO/World Bank UHC monitoring framework and the Bellagio meeting report sponsored by WHO and the Rockefeller Foundation to informed the list of indicators used to determine the feasibility of the framework using published literature. Kenya has yet to establish an official policy on UHC that provides a clear mandate on the goals, targets and monitoring and evaluation of performance. The country has the capacity to reasonably report on five out of the seven proposed UHC indicators, but very limited capacity to report on the two service coverage indicators for the chronic condition and injury interventions and wider systemic challenges to meet the data requirements of the proposed UHC monitoring framework.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Leaving no one behind: an agenda for equity","field_subtitle":"Watkins K: Lancet, 384, 9961, 2248\u20132255, 2014","URL":"http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)62421-6.pdf","body":"Shortly before his death, Mahatma Gandhi offered a useful reflection that helps to cut through some of the complexity surrounding debates about equity. \u201cRecall the face of the poorest and the weakest person you may have seen and ask yourself if the step you contemplate is going to be any use to them.\u201d It\u2019s a simple but compelling guide for policy makers concerned with combating extreme inequality. Something of the same spirit underpins the report of the High Level Panel established by the UN Secretary General to make recommendations for the post-2015 development agenda. Going beyond the identification of universal goals, the report calls for \u201ca focus on the poorest and most marginalised\u201d and a commitment to \u201cleave no one behind\". This approach is argued to be in-keeping with other work on the post-2015 agenda, including the Global Sustainable Development Report. Far more than the Millennium Development Goals (MDGs)\u2014which were largely neutral on the issue of inequality\u2014the High Level Panel report includes a wide-ranging social justice agenda. If  adopted by governments and backed by national policy commitments and a new global partnership, the Panel\u2019s agenda could, the author argues,  put exclusion, inequality, and marginalisation at the centre of the post-2015 development framework.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Multinational Working Groups 2015 Competition","field_subtitle":"Deadline: February 28, 2015","URL":"http://newebsite.codesria.org/spip.php?article2244&lang=en","body":"The Council for the Development of Social Science Research in Africa (CODESRIA) invites proposals from African and Diaspora researchers for its 2015 Multinational Working Groups Competition. The Council\u2019s Multinational Working Groups Competition is for researchers to explore themes covering multiple countries. Researchers should apply as individuals with clearly-thought out projects. CODESRIA\u2019s evaluators will identify the best applications and the Council will constitute groups of 12 to 15 researchers around dominant themes. Each group constituted will be led by a CODESRIA-appointed coordinator who will oversee group activities, follow up on progress by members, facilitate the exchange of ideas among group members and help ensure quality. The Multinational Working Groups Competition provides grants of USD 5000 to each researcher over a 15-month period to facilitate the completion of already-started work. Researchers are supposed to produce an article or book chapter at the end of the grant period.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"National Research Forum:  Evidence for advancing Universal Health Coverage in Zimbabwe","field_subtitle":"19th and 20th March 2015; MoHCC, NIHR, TARSC, Harare, Zimbabwe","body":"The Ministry of Health and Child Care, the National Institute of Health Research and the Training and Research Support Centre in collaboration with the Technical Working Group on Universal Health Coverage and the \u2018Rebuild programme\u2019 is holding a one and a half day National Research Forum with the THEME \u201cEvidence for advancing Universal Health Coverage (UHC) in Zimbabwe\u201d on 19th and 20th March 2015 in Harare.  The forum aims to gather people from all constituencies and sectors doing research on any aspect of UHC in Zimbabwe, to present and share their research findings, discuss the policy implications and identify priorities for future work. Registration for the conference will open on  5th January 2015, and interested delegates are asked to email to their  name, institution, address and whether they can meet the registration fee or whether they need sponsorship for it.  ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Neglected tropical disease and emerging infectious disease: An analysis of the history, promise and constraints of two worldviews","field_subtitle":"Jackson Y, Stephenson N: Global Public Health 9(9), 2014","URL":"http://www.tandfonline.com/doi/full/10.1080/17441692.2014.941297#.VJLqecbZ6jQ","body":"Emerging infectious diseases (EIDs) and neglected tropical diseases (NTDs) are medical terms referring to a group of diseases, yet they are simultaneously socio-political constructs (EID and NTD). When viewed as such, public health interest in EID has been criticised as prioritising free market, Global North interests. This paper asks if the recent turn to NTD, which directs attention and resources to \u2018the bottom billion\u2019 of the world's population, addresses the limitations of focusing on EID. Our approach involves comparing the specific socio-political framing, or \u2018worldview\u2019 of NTD, with that of EID. We examine the distinct history, rationales, morals, political and economic tensions and loci of power entailed in each worldview. This analysis suggests that efforts to foreground NTD constitute a site where humanitarian and biomedical industry actors and actions are increasingly blurred. We examine whether the NTD worldview constitutes a break with or a new version of a free market approach to global health, and whether it reworks or solidifies paternalistic Global North\u2013South relations. We consider some of the limits of work on NTD to date, suggesting that although the NTD worldview does not escape the neo-colonial history of global health, it can actualise it under a different form.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Okayafrica\u2019s Top Films of 2014","field_subtitle":"Sefaboyake J: December 2014","URL":"http://www.okayafrica.com/news/african-films-best-of-2014/","body":"On this website Okayafrica have picked some of the finest cinema originating from the continent from 2014. Some have courted controversy for their subject matter while others have been heralded as highly imaginative celebrations of Afrofuturist landscapes from the past to the present. The projects, from rising stars and celebrated auteurs alike, come from Mauritania, Ghana, South Africa, Nigeria and Kenya include documentaries, anthology films, full-length features and shorts. They address topics as varied as excessive use of police force in a South African mining community to vignettes delving into the lives of Kenya\u2019s LGBTQI community. Each of these films (and filmmakers) are reported to push cinema boundaries in the stories they tell. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Pharmaceutical Availability across Levels of Care: Evidence from Facility Surveys in Ghana, Kenya, and Uganda","field_subtitle":"Masters SH, Burstein R, DeCenso B, Moore K, Haakenstad A, et al: PLoS ONE 9(12), 31 December 2014","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0114762","body":"In this study the authors use facility-level data from nationally representative surveys conducted in Ghana, Kenya, and Uganda in 2012 to understand pharmaceutical availability within the three countries. The authors both availability of essential medicines, as defined by the various essential medicine lists (EMLs) of each respective country, and availability of all surveyed pharmaceuticals deemed important for treatment of various high-burden diseases, including those on the EMLs. The authors find that there is heterogeneity with respect to availability across the three countries with Ghana generally having better availability than Uganda and Kenya. They found that the factors associated with stock-out vary by country, but across all countries both presence of a laboratory at the facility and of a vehicle at the facility are significantly associated with reduced stock-out. The study highlights poor availability of essential medicines across these three countries and suggest more needs to be done to strengthen the supply system so that stock remains uninterrupted.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"PhD position at the Centre for Development and Environment / University of Bern in the R4D project \"Towards food sustainability: Reshaping the coexistence of different food systems in South America and Africa","field_subtitle":"Deadline 20 February 2015","URL":"http://www.igs-north-south.ch/News%20Files/PhD%20CDE.pdf","body":"This PhD is part of a project that addresses the sustainability of food systems in Kenya and Bolivia. It is focusing on the five basic aspects of food sustainability: Food security, the right to food, poverty and inequality, environmental integrity, and social-ecological resilience. The aim of the project is to analyse different food systems according to these aspects, develop an framework for assessing \u2018food sustainability\u2019 in concrete contexts, formulate policies and discuss them in local to global policy dialogues and workshops to communicate the results. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Qualitative research synthesis for health policy analysis: what does it entail and what does it offer?","field_subtitle":"Gilson L: Health Policy Plan. 29 (Suppl 3), 11 November 2014","URL":"http://heapol.oxfordjournals.org/content/29/suppl_3/iii1.full","body":"This edition presents a set of five articles that, through synthesis of available research, seek to consolidate and develop the body of health policy analysis work in low- and middle-income countries. This work is found to be currently fragmented across geographic settings and policy issues, is more descriptive than analytic and is weakly theorized.  ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Spectre of Ebola Protectionism","field_subtitle":"Bangura Y: CODESRIA Newsletter, November 2014","URL":"http://newebsite.codesria.org/spip.php?article2220","body":"A new kind of protectionism is argued by the author to be haunting the world: the spectre of ebola protectionism. As ebola ravages the societies of the Mano River Union (MRU) states of Guinea, Liberia and Sierra Leone, the author notes that there are increasing calls from conservative politicians, right-wing groups, and sections of the media to prevent people from these states from interacting with the rest of the world. The protectionist measures range from exit and entry controls, such as temperature checks and mandatory monitoring and quarantining of travellers from MRU states, to flight bans and denial of visas to holders of MRU passports. The virus poses less of a threat to rich countries with sound public health systems than poor West African countries that have extensive links with the MRU states. The author argues that exit and non-intrusive entry controls, not flight bans and visa restrictions that Australia and Canada have imposed, may be enough to manage the few cases that are likely to pop up in rich countries.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The administrative costs of community-based health insurance: a case study of the community health fund in Tanzania","field_subtitle":"Borghi J, Makawia S, Kuwawenaruwa A: Health Policy and Planning 30 (1)19-27, December 2014","URL":"http://heapol.oxfordjournals.org/content/30/1/19.full","body":"Community-based health insurance expansion has been proposed as a financing solution for the sizable informal sector in low-income settings. However, there is limited evidence of the administrative costs of such schemes. We assessed annual facility and district-level costs of running the Community Health Fund (CHF), a voluntary health insurance scheme for the informal sector in a rural and an urban district from the same region in Tanzania. Information on resource use, CHF membership and revenue was obtained from district managers and health workers from two facilities in each district. The administrative cost per CHF member household and the cost to revenue ratio were estimated. Revenue collection was the most costly activity at facility level (78% of total costs), followed by stewardship and management (13%) and pooling of funds (10%). Stewardship and management was the main activity at district level. The administration cost per CHF member household ranged from USD 3.33 to USD 12.12 per year. The cost to revenue ratio ranged from 50% to 364%. The cost of administering the CHF was high relative to revenue generated. Similar studies from other settings should be encouraged.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Ebola epidemic: a transformative moment for global health","field_subtitle":"Hill SR, Bero L, McColl G, Roughead E: Bulletin of the World Health Organization 93 (1), January 2014","URL":"http://www.who.int/bulletin/volumes/93/1/14-151068/en/","body":"The devastating effects of the current epidemic of Ebola virus disease in western Africa have put the global health response in acute focus. The index case is believed to have been a 2-year-old child in Gu\u00e9ck\u00e9dou, Guinea, who died in December 2013. By late February 2014, Guinea, Liberia and Sierra Leone were in the midst of a full-blown and complex global health emergency. The response by multilateral and humanitarian organizations has been laudable and \u2013 at times \u2013 heroic. Much of the worst affected region is recovering from civil conflicts. This region is characterized by weak systems of government and health-care delivery, high rates of illiteracy, poverty and distrust of the government and extreme population mobility across porous, artificial boundaries. A more coordinated, strategic and proactive response is urgently needed.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The International Monetary Fund and the Ebola outbreak","field_subtitle":"Kentikelenis A, King L, McKee M, Stuckler D: The Lancet, 21 December 2014","URL":"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70377-8/fulltext","body":"In recent months, the International Monetary Fund (IMF) has announced US$430 million of funding to fight Ebola in Sierra Leone, Guinea, and Liberia. By making these funds available, the IMF aims to become part of the solution to the crisis, even if this involves a departure from its usual approach. As IMF Director Christine Lagarde said at a meeting on the outbreak, \u201cIt is good to increase the fiscal deficit when it's a matter of curing the people, of taking the precautions to actually try to contain the disease. The IMF doesn't say that very often.\u201d Yet, could it be that the IMF had contributed to the circumstances that enabled the crisis to arise in the first place? A major reason why the outbreak spread so rapidly was the weakness of health systems in the region. There were many reasons for this, including the legacy of conflict and state failure. Since 1990, the IMF has provided support to Guinea, Liberia, and Sierra Leone, for 21, 7, and 19 years, respectively, and at the time that Ebola emerged, all three countries were under IMF programmes. However, IMF lending comes with strings attached\u2014so-called \u201cconditionalities\u201d\u2014that require recipient governments to adopt policies that have been criticised for prioritising short-term economic objectives over investment in health and education. Indeed, it is not even clear that they have strengthened economic performance. Here the authors review the policies advocated by the IMF before the outbreak, and examine their effect on the three health systems.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The state of HIV sector local governance in Malawi and Zambia: Evidence from five districts","field_subtitle":"Steyn J: Commonwealth Journal of Local Governance 15, 128-140, 2014","URL":"http://epress.lib.uts.edu.au/journals/index.php/cjlg/article/view/4066/4120","body":"This paper reports on a project that aimed to improve the levels of HIV governance at the district level in Malawi and Zambia by encouraging public participation in an effort to more effective use of local resources. The methodology for this project included a barometer which assessed perceptions among key stakeholders on effectiveness, efficiency, rule of law, accountability, participation and equity at district level. The stakeholders ranged from administrators, political representatives, community-based organisations and the private sector on the supply side and citizens on the demand or beneficiary side. Communication and transparency appear to be major issues underpinning the bottlenecks and shortcomings in the HIV sector governance at the district level. Information gaps have given rise to accountability deficits and coordination deficiencies. Addressing these matters would make more effective use of resources and lessen dependence on external funding sources.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The Vaccine and Cervical Cancer Screen (VACCS) project: Acceptance of human papillomavirus vaccination in a school-based programme in two provinces of South Africa","field_subtitle":"Botha MH, Haynes van der Merwe F, Snyman LC, Dreyer G: South African Medical Journal 105(1), 28 November 2014","URL":"http://www.samj.org.za/index.php/samj/article/view/8419","body":"The incidence of cervical cancer in South Africa remains high, and the current screening programme has had limited success. New approaches to prevention and screening tactics are needed to investigate acceptance of school-based human papillomavirus (HPV) vaccination, as well as the information provided, methods of obtaining consent and assent, and completion rates achieved. Information on cervical cancer and HPV vaccination was provided to 19 primary schools in Western Cape and Gauteng provinces participating in the study. Girls with parental consent and child assent were vaccinated during school hours at their schools.  A total of 3 465 girls were invited to receive HPV vaccine, of whom 2 046 provided written parental consent as well as child assent. Sufficient vaccination was achieved in 92% of the vaccinated cohort. The implementation project demonstrated that HPV vaccination is practical and safe in SA schools. Political and community acceptance was good, and positive attitudes towards vaccination were encountered. During the study, which mimicked a governmental vaccine roll-out programme, high completion rates were achieved in spite of several challenges encountered.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Towards an integrative post-2015 sustainable development goal framework: Focusing on global justice \u2013 peace, security and basic human rights","field_subtitle":"Lueddeke GR: South Eastern European Journal of Public Health, DOI 10.12908/SEEJPH-2014-26, 2014","URL":"http://www.lebrecht-landauer.de/test/towards-an-integrative-post-2015-sustainable-development-goal-framework/","body":"The United Nations (UN) Millennium Declaration and eight Millennium Development Goals (MDGs) have been hailed as a unique achievement in international development. Although the MDGs have raised the profile of global health, particularly in low- and middle-income countries, progress has been uneven both between and within countries. A key reason suggested for this lack of progress is that the MDGs fall far short in terms of addressing the broader concept of development encapsulated in the Millennium Declaration, which includes human rights, equity, democracy, and governance.  To strengthen the likelihood of realizing the post-2015 Sustainable Development Goals (SDGs), particularly with regard to \u201cplanet and population\u201d health and well-being , UN and other decision-makers are urged to consider the adoption of an integrated SDG framework that is based on (i) a vision of global justice \u2013 underpinned by peace, security and basic human rights; (ii) the development of interdependent and interconnected strategies for each of the eleven thematic indicators identified in the UN document The World We Want; and (iii) the application of guiding principles to measure the impact of SDG strategies in terms of holism, equity, sustainability, ownership, and global obligation. While current discussions on the SDGs are making progress in a number of areas, the need for integration of these around a common global vision and purpose seems especially crucial to avoid MDG shortcomings.","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"UN Special Rapporteurs Open Letter to the World Bank on the issue of human rights","field_subtitle":"Alston  P: UN Special Rapporteur on extreme poverty and human rights, with 26 other Special Rapporteurs, 12 December 2014","body":"\r\nDear Mr. Jim Yong Kim, \r\nWe have the honor to address you in our capacities as special procedures mandate-holders of the United Nations Human Rights Council. We are writing to you with regard to the World Bank\u2019s draft Environmental and Social Framework (\u201cESF\u201d), which was released for consultation on July 30, 2014. We would like to share with you a number of concerns relating to the approach to \u2018Safeguards\u2019 reflected in the current draft ESF. \r\n\r\nAt the outset, we wish to underscore the significance of the Bank\u2019s first adoption of such standards some thirty years ago. And we commend the Bank for its continued recognition of the central importance of a carefully calibrated framework of standards to ensure that its programs to promote sustainable development, poverty elimination, environmental protection and social standards do not have a negative impact on a diverse range of important values. Most of those values represent important components of international human rights law, to which the Bank\u2019s Member States have subscribed within the framework of the United Nations. It is because the Safeguards implicate human rights so directly that we have chosen to write to you as independent human rights experts appointed by United Nations Member States to provide our inputs to the Bank\u2019s consultation process. \r\n\r\nAs the Bank seeks to revise and adapt its Safeguards approach to the challenges of the twenty-first century, we believe that it is imperative that the standards should be premised on a recognition of the central importance of respecting and promoting human rights. But there is no such provision in the current draft. Instead, by contemporary standards, the document seems to go out of its way to avoid any meaningful references to human rights and international human rights law, except for passing references in the Vision statement and Environmental and Social Standard (ESS). The Bank restricts itself to noting that its operations are, in ways that are not explained or elaborated, \u2018supportive\u2019 of human rights and that it will \u2018encourage respect for them in a manner consistent with the Bank\u2019s Articles of Agreement\u2019. As noted below, however, the convoluted and anachronistic interpretation of the Articles that has so far prevailed ensures that this is a largely empty undertaking. \r\n\r\nWhile the Bank is clearly committed to ending extreme poverty and improving the quality of life of people in developing countries, the pursuit of these worthy goals does not automatically ensure that the resulting programs and projects will promote and respect human rights. We acknowledge that it is not the Bank\u2019s role to act as an enforcer of human rights, but there are a great many other ways in which it can assist governments in meeting their own international obligations, provide support and advice on how programs and projects might be made more human rights compliant, and build knowledge and understanding of human rights into its own work. By opting not to take these steps, the Bank is setting itself apart from other international organizations and agencies which have long since recognized the importance of human rights in the context of carrying out their specialized mandates, and have also rejected the notion that human rights are somehow problematically \u2018political\u2019 in ways that the many other accepted goals of development policy are not. \r\n\r\nIn many contexts, the international community has accepted that development and human rights are interdependent and mutually reinforcing. This has been recognized, for example, in the 1993 Vienna World Conference on Human Rights, the 2000 Millennium Summit and the 2005 and 2010 World Summits. Reference might also be made to a document that is cited on the Bank\u2019s own website which is the 2003 UN Common Understanding adopted by the United Nations Development Group. The Common Understanding requires that human rights guide all development cooperation and that development cooperation \u201ccontributes to the development of the capacities of \u2018duty-bearers\u2019 to meet their obligations and/or of \u2018rights-holders\u2019 to claim their rights\u201d. It is fair to say that the vast majority of development actors, from the European Investment Bank to the United Nations Development Programme, have expressed a clear commitment to human rights in their policies, thus making the Bank an increasingly isolated outlier in this regard.\r\n\r\nThe Bank\u2019s official reluctance to engage operationally with human rights also stands in marked contrast to the lessons that its formal statements suggest it has drawn from its own experience, including through the work of the Nordic Trust Fund (\u201cNTF\u201d). The Bank acknowledges on its website and in many of its non-operational policy analyses that a focus on human rights can improve development outcomes. This is consistent with the seminal insight provided in the work of Amartya Sen, undertaken in his capacity as a Presidential Fellow at the Bank, who argued that freedoms are essential means for achieving development. There are many examples of analyses and reports by the Bank that highlight the potential or actual importance of human rights in promoting the achievement of the Bank\u2019s proclaimed goals, such as those relating to gender equality and the role of women in society.\r\n\r\nRather than seeing human rights as a means by which to facilitate the participation and empowerment of the beneficiaries of development, the Bank\u2019s proposed new Safeguards seem to view human rights in largely negative terms, as considerations that, if taken seriously, will only drive up the cost of lending rather than contributing to ensuring a positive outcome. While a 2010 report by the Bank\u2019s Independent Evaluation Group (\u201cIEG\u201d) concluded that the benefits of Safeguards outweigh their costs, the approach in the draft Safeguards seems to be driven by the desire to privilege rapid approval of loans over all else, an orientation which has long been identified as a problem for the Bank. A sense of being increasingly in competition with other lenders to secure the \u2018business\u2019 of developing country borrowers seems to be at the root of this approach. The Bank has defended its increased reluctance to engage with human rights on the basis that alternative sources of development financing are emerging, which do not require meaningful Safeguards, thus providing the latter with a significant advantage over the Bank. In our view, the failure of other lenders to require that projects they fund should respect human rights standards is not a valid reason for the World Bank to follow suit. We believe that the problems that will flow from such a race to the bottom are already becoming apparent, and it will be for us, in different contexts, to make this clear to the relevant lenders.\r\n\r\nHuman rights are not merely a matter of sound policy, but of legal obligation. As an international organization with international legal personality, and as a UN specialized agency, the Bank is bound by obligations stemming not only from its Articles of Agreement, but also from human rights obligations arising under \u2018general rules of  international law\u2019 and the UN Charter. Moreover, each of the 188 Member States of the World Bank has ratified at least one (and, in almost all cases, several) of the core international human rights treaties.16 Those States are also bound by human rights obligations stemming from other sources of international law. It is widely recognized that Member States should take their international human rights obligations into account when acting through an international organization such as the World Bank. States that borrow from the Bank also continue to be bound by their own international human rights obligations in the context of Bank-financed development projects and the Bank has a due diligence responsibility not to facilitate the violations of their human rights obligations, or to otherwise become complicit in such violations.\r\n\r\nIn the past, the Bank has often pointed to its \u2018non-political mandate\u2019 to argue that it is prohibited from, or at least restricted in, its ability to deal with human rights more directly. But the Bank\u2019s Articles of Agreement should be interpreted in the context of today\u2019s international legal order, rather than that of the mid-1940s. The Bank and its Member States are bound by both the Articles of Agreement, and by international human rights law. The provisions of the Articles can clearly be interpreted in a way that underlines their consistency with international human rights law. Since all States have long ago accepted human rights as a \u201clegitimate concern of the international community\u201d the suggestion that these remain little more than political considerations is not sustainable.\r\n\r\nOur call for the Bank to include HR within its overall program objectives does not amount to suggesting that the Bank should \u2018sanction\u2019 countries with a poor human rights record. Consistent with international law, with its own obligations and with those of its Member States, the Bank should acknowledge the relevance of human rights in its overall program objectives, as well as incorporate human rights due diligence into its risk management policies. The Bank should also avoid funding projects that would contravene the international human rights obligations of its borrowers. \r\n\r\nIn the annex, we have highlighted our particular concerns with elements of the proposed ESF. Our aim is to indicate specific means by which a human rights dimension would strengthen the Bank\u2019s new Framework and ensure its compliance with international law. As Bank President, you have repeatedly undertaken that this revision process will not result in a dilution of the human rights components of the Safeguards. We believe that honoring this promise requires a significantly different approach from that which is now being pursued and there are strong legal, policy and instrumental reasons why human rights should be given a central role in the work of the Bank. The current Safeguard Review process provides a critical opportunity for the Bank to fully integrate human rights in its policies and standards. We will be submitting this letter together with its annex to the World Bank\u2019s public consultation process and plan to issue a press release in due course. We stand available to engage further with the Bank in this process and can be reached for any comments and views on our letter. Your response will be made available in a report to be presented to the Human Rights Council for its consideration. \r\n\r\nFor further information on this open letter see www.ohchr.org/Documents/Issues/EPoverty/WorldBank.pdf","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Where Do the Rural Poor Deliver When High Coverage of Health Facility Delivery Is Achieved? Findings from a Community and Hospital Survey in Tanzania","field_subtitle":"Straneo M, Fogliati P, Azzimonti G, Mangi S, Kisika F: PLoS ONE 9(12), December 2014","URL":"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113995","body":"As part of maternal mortality reducing strategies, coverage of delivery care among sub-Saharan African rural poor will improve, with a range of facilities providing services. Whether high coverage will benefit all socio-economic groups is unknown. Iringa rural District, Southern Tanzania, with high facility delivery coverage, offers a place to address this question. Delivery services are available in first-line facilities (dispensaries, health centres) and one hospital. The authors assessed whether all socio-economic groups access the only comprehensive emergency obstetric care facility equally, and surveyed existing delivery services. Hospital population socio-demographic characteristics were compared to District population using multivariable logistic regression. Women from the hospital compared to the district population were more likely to be wealthier. Poorer women remain disadvantaged even where coverage is high, as they access lower level facilities and are under-represented where life-saving transfusions and caesarean sections are available. ","php":"","field_issue_date":"2015-02-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":" Non-Communicable Disease on the rise in Uganda; Who is to blame?","field_subtitle":"Nsereko I: CEHURD newsletter December 2014","URL":"http://www.cehurd.org/2014/12/non-communicable-disease-on-the-rise-in-uganda-who-is-to-blame/","body":"A recent survey carried out by the Center for Health, Human Rights and Development (CEHURD) with support from United Nations Development Program (UNDP) Uganda country office on the prevalence of risk factors for non communicable diseases among university students in and around Kampala found that up to 67% of the respondents did not know what NCDs were, 12% of students have used drugs, particularly Marijuana, 15% were current tobacco smokers, 9% smoked Shisha. More than 40% of the respondents were staying with parents who smoke, 10% have friends who smoke, 60% have smoked for less and 57% exposed to pro-cigarette advertisements. In areas where NCD services are available, these are often hampered by access to essential medicines.\r\nA recent visit by the author to communities of Nyenga and Najja sub-counties of Buikwe district revealed that a huge percentage of the community members find no point in visiting health facilities for early screening for NCDs. The author suggests that government strengthen existing health facilities by providing essential NCD medicines and NCD screening services for at least all health center IVs. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"A concept in flux: questioning accountability in the context of global health cooperation","field_subtitle":"Bruen C, Brigha R, Kageni A and Wafula F: Globalization and Health 10:73, 2014 ","URL":"http://www.globalizationandhealth.com/content/10/1/73","body":"Accountability in global health is a commonly invoked though less commonly questioned concept. Critically reflecting on the concept and how it is put into practice, this paper focuses on the who, what, how, and where of accountability, mapping its defining features and considering them with respect to real-world circumstances. Changing dynamics in global health cooperation - such as the emergence of new health public-private partnerships and the formal inclusion of non-state actors in policy making processes - provides the backdrop to this discussion. In mapping some defining features, accountability in global health cooperation is shown to be a complex problem not necessarily reducible to one set of actors holding another to account. Clear tensions are observed between multi-stakeholder participatory models and more traditional vertical models that prioritise accountability upwards to donors, both of which are embodied in initiatives like the Global Fund. For multi-constituency organisations, this poses challenges not only for future financing but also for future legitimacy. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"A cross-sectional ecological study of spatial scale and geographic inequality in access to drinking-water and sanitation","field_subtitle":"Yu W, Bain RES, Mansour S and Wright JA: International Journal for Equity in Health13(113): November 2014 ","URL":"http://www.equityhealthj.com/content/13/1/113","body":"Measuring inequality in access to safe drinking-water and sanitation is proposed as a component of international monitoring following the expiry of the Millennium Development Goals. This study aims to evaluate the utility of census data in measuring geographic inequality in access to drinking-water and sanitation. Spatially referenced census data were acquired for Colombia, South Africa, Egypt, and Uganda, whilst non-spatially referenced census data were acquired for Kenya. Four variants of the dissimilarity index were used to estimate geographic inequality in access to both services using large and small area units in each country through a cross-sectional, ecological study. Inequality was greatest for piped water in South Africa in 2001 and lowest for access to an improved water source in Uganda in 2008. For sanitation, inequality was greatest for those lacking any facility in Kenya in 2009 and lowest for access to an improved facility in Uganda in 2002. Although dissimilarity index values were greater for smaller area units, when study countries were ranked in terms of inequality, these ranks remained unaffected by the choice of large or small area units. International comparability was limited due to definitional and temporal differences between censuses. This five-country study suggests that patterns of inequality for broad regional units do often reflect inequality in service access at a more local scale. This implies household surveys designed to estimate province-level service coverage can provide valuable insights into geographic inequality at lower levels. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"A Primer to the Emerging Extractive Sector in Kenya: Resource Bliss, Dilemma or Curse","field_subtitle":"Oiro Omolo MW, Mwabu G: Institute of Economic Affairs, November 2014 ","URL":"http://tinyurl.com/lgs33uy","body":"In any economy, the extractive sector consists mainly of oil, gas and mining activities. Experience in countries such as Norway, Canada, Botswana and Ghana suggests that extractives can be effectively managed to contribute to sustainable economic growth. Experience, however, in other parts of the world including Nigeria, the Democratic Republic of Congo, South Sudan, and the Central African Republic suggest that extractives if not well managed can lead to conflict. Extractives in Kenya contribute approximately one per cent to gross domestic product. The sector is however emerging. In the recent past, there have been oil and more mining discoveries in Kenya. For instance, oil has been discovered in Turkana County, and there are new discoveries in the mining sectors for minerals such as titanium in Kilifi County and coal in Kitui County. In addition, Kenya is actively undertaking off shore explorations with the aim of making gas discoveries. The growing extractive sector in Kenya means that there is need to give more attention to the social and economic dynamics of the sector. For instance, when Kenya discovered oil in Turkana County in March 2012, the Government was faced with emergent issues such as environmental implications, community obligations and rights, a suitable governance framework, and effective utilisation of resources generated from the sector.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"A scoping review of training and deployment policies for human resources for health for maternal, newborn, and child health in rural Africa","field_subtitle":"Tomblin Murphy G, Goma F, MacKenzie A, Bradish S, Price S, Nzala S, Elliott Rose A, Rigby J, Muzongwe C, Chizuni N, Carey A and Hamavhwa D: Human Resources for Health 12(72), December 2014","URL":"http://www.human-resources-health.com/content/12/1/72/abstract","body":"Most African countries lack the required workforce to deliver basic health care, including care for mothers and children. This is especially acute in rural areas and has limited countries' abilities to meet maternal, newborn, and child health (MNCH) targets outlined by Millennium Development Goals 4 and 5. To address the challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such policies are limited. A scoping review was conducted to identify the type, extent, and quality of evidence that exists on workforce policies for rural MNCH in Africa. Fourteen electronic health and health education databases were searched for peer-reviewed papers specific to training and deployment policies for doctors, nurses, and midwives for rural MNCH in African countries with English, Portuguese, or French as official languages. Non-peer reviewed literature and policy documents were also identified through systematic searches of selected international organizations and government websites. There was an overall paucity of information on workforce training and deployment policies for MNCH in rural Africa. Policies focusing exclusively on training or deployment were limited; most documents focused on both training and deployment or were broader with embedded implications for workforce management or MNCH. Relevant government websites varied in functionality and in the availability of policy documents. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"AFSA open letter opposing human feeding trials involving GM banana","field_subtitle":"Alliance for Food Sovereignty in Africa: Pambazuka News issue 706 December 9 2014","URL":"http://www.pambazuka.net/en/category/advocacy/93561","body":"The Alliance for Food Sovereignty in Africa (AFSA), a Pan African platform comprising civil society networks and farmer organisations working towards food sovereignty, has submitted this Open Letter to the Bill and Melinda Gates Foundation, Dr. Wendy White from Iowa State University and the Human Institutional Review Board of Iowa State University expressing fierce opposition to the human feeding trials taking place at Iowa State University involving genetically modified (GM) bananas. The Letter is supported by more than 120 organizations from around the world. The letter states:\"This so-called \u2018Super-banana\u2019, has been genetically modified to contain extra beta-carotene, a nutrient the human body uses to produce vitamin A. Unlike current GM crops in commercial production where agronomic traits have been altered, scientists have spliced genes into the GM banana to produce substances for humans to digest (extra beta carotene). The GM banana is a whole different ballgame, raising serious concerns about the risks to African communities who would be expected to consume it. Production of vitamin A in the body is complex and not fully understood. This raises important questions including inter alia, whether high levels of beta- carotene or vitamin A may carry risks and what the nature of those risks might be. While a risk assessment is a pre-requisite for GM foods under many national jurisdictions, the need for specific and additional food safety assessment for nutritionally enhanced GM crops such as the GM banana is acknowledged by the Codex Alimentarius Commission, as genetic modifications result in a composition that may be significantly different from their conventional counterparts\".","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Board of Healthcare Funders and Government: \u2018I\u2019ll change if you\u2019ll change\u2019","field_subtitle":"Bateman C:  South African Medical Journal104(10), October 2014","URL":"http://www.ajol.info/index.php/samj/article/view/108470/98282","body":"While the South African government and private healthcare funders urged one another to make internal changes to enable faster progress towards a more equitable healthcare system, some concrete evidence of vitally needed partnership did emerge from the Board of Healthcare funders' conference held in August 2014. Government\u2019s new Essential Drugs Committee will include representatives of the private healthcare funding industry to obtain consensus on just which essential medicines should be available to patients.\r\nA blueprint on how the National Department of Health (NDoH) can partner\r\nwith the private healthcare funding sector in conducting economic evaluations of products to save both sectors time and money (and avoid\r\nlongstanding unnecessary duplication) has been drawn by NDoH. National Health Minister Dr Aaron Motsoaledi also pleaded with delegates to \u2018embrace change\u2019, warning that they would be hardest hit by the\u2018exploding\u2019 epidemic of non-communicable diseases if they failed to introduce health promotion and disease prevention measures.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Call for papers European Conference on African Studies (ECAS) 2015: Living in State Housing: Expectations, contradictions and consequences \u2013 call for panel papers","field_subtitle":"Closing Date: 9 January 2015","URL":"http://www.africaresearchinstitute.org/blog/call-for-papers-ecas/","body":"State-supported low-cost housing is a significant tool and electoral strategy across African cities, which often draws on notions of urban formality, social decency, rights, material integrity, welfare, and citizenship to underpin its aims. This session examines he contradictions of\r\nhousing urban poor people in cities where affordable and well-located\r\nspace is highly restricted, where social inequalities and tensions are\r\nrife, and where unemployment persists in shaping residents daily\r\nlives. The panel hopes to attract papers from across the continent to\r\nbuild understanding of the lived experiences of state-housing in an\r\neffort to contribute to further scholarship in this relatively\r\nneglected area. Delegates can submit paper titles and abstracts via the link on the website and will be notified by email of the acceptance or rejection of their proposal. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Can frameworks inform knowledge about health policy processes? Reviewing health policy papers on agenda setting and testing them against a specific priority-setting framework","field_subtitle":"Walt G and Gilson L: Health Policy and Planning 29 (suppl 3), June 2014","URL":"http://heapol.oxfordjournals.org/content/29/suppl_3/iii6.full","body":"This article systematically reviews a set of health policy papers on agenda setting and tests them against a specific priority-setting framework. The article applies the Shiffman and Smith framework in extracting and synthesizing data from an existing set of papers, purposively identified for their relevance and systematically reviewed. Its primary aim is to assess how far the component parts of the framework help to identify the factors that influence the agenda setting stage of the policy process at global and national levels. It seeks to advance the field and inform the development of theory in health policy by examining the extent to which the framework offers a useful approach for organizing and analysing data. Applying the framework retrospectively to the selected set of papers, it aims to explore influences on priority setting and to assess how far the framework might gain from further refinement or adaptation, if used prospectively. The article also demonstrates how framework synthesis can be used in health policy analysis research. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Can the private sector help overcome nursing shortages? ","field_subtitle":"Resyst project: LSHTM,  2013","URL":"http://resyst.lshtm.ac.uk/sites/resyst.lshtm.ac.uk/files/Private_sector_infographic.pdf","body":"The demand for nurses is growing and has not yet been met in most low and middle-income countries. In India, Kenya, South Africa and Thailand, there has been a rapid proliferation of private training institutions to increase the supply of nurses. This infogram summarises evidence from RESYST research examining the role of these private institutions, their contribution to the wider health systems, and how governments in these countries have managed the opening of markets to the private sector. Private nurse training institutions are reported to be playing an increasingly important role in producing nurses in many low and middle income countries. Governments need to ensure that graduates from both private and public institutions are of sufficient quality to meet the health needs of their populations, and that training institutions have the capacity to train more nurses. In some countries including India and Kenya, the benefits of expanding nurse production through the private sector have been hindered by high levels of international migration. A balance needs to be struck between producing nurses for export, and ensuring sufficient supply and skill-mix for domestic markets.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Data Visualisation: Africa\u2019s Hydropower Future","field_subtitle":"SciDevNet, 2014","URL":"http://www.scidev.net/global/energy/data-visualisation/africa-hydropower-future-interactive.html","body":"From Cote d\u2019Ivoire in the west to Ethiopia in the east, Africa is home to some of the world\u2019s fastest growing economies. Debates often proclaim a new era of economic boom, innovation and social opportunity for the continent. But beyond the hype, millions of people remain affected by severe poverty, and at the root of this lies a perennial problem: energy poverty. This data visualisation explores a creative way of interrogating the notion of whether hydropower could hold the key to energy access in Africa.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Deaths Ascribed to Non-Communicable Diseases among Rural Kenyan Adults Are Proportionately Increasing: Evidence from a Health and Demographic Surveillance System, 2003\u20132010","field_subtitle":"Phillips-Howard PA, Laserson KF, Amek N, Beynon CM, Angell SY, Khagayi S, Byass P, Hamel MJ, van Eijk AM, Zielinski-Gutierrez E, Slutsker L, De Cock KM, Vulule J, Odhiambo FO: PLoS ONE 9(11), November 2014","URL":"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0114010","body":"Monitoring systems require strengthening to attribute the Non communicable disease (NCD) burden and deaths in low and middle-income countries (LMICs). Data from health and demographic surveillance systems (HDSS) can contribute towards this goal. Between 2003 and 2010, 15,228 deaths in adults aged 15 years (y) and older were identified retrospectively using the HDSS census and verbal autopsy in rural western Kenya. 37% were ascribed to NCDs, 60% to communicable diseases (CDs), 3% to injuries, and ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Defining Motivational Intensity of Need for Family Planning in Africa","field_subtitle":"Kuang B, Ross J, Madsen EL: African Journal of Reproductive Health 18(3), September 2014","URL":"http://www.ajol.info/index.php/ajrh/article/view/109200","body":"This study presents a new approach to defining high and low motivation groups of contraceptive users by stated intention to use, past use, and unmet need, to determine how these groups differ in characteristics and in region of residence. Data came from 23 DHS surveys in sub-Saharan countries. The low motivation non-users, with less past use and less intention to use in the future, are more rural, less educated, and closer to poverty. When used to guide planning, unmet need should be augmented with motivation, since the two classifications do not entirely overlap. Between 10 and 17 percent of current non-users of family planning are likely highly motivated to use, but are not captured in the unmet need classification. Programme implications for these non-using groups are discussed.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Emerging Powers in Africa Project call for grant proposals","field_subtitle":"Call closing December 2014 (negotiable)","URL":"http://www.fahamu.org/resources/ResearchGrantsCall28Nov2014.pdf","body":"Fahamu\u2019s Emerging Powers Project is issuing a call for grant proposals to examine the political, economic, social and cultural impact of the emerging powers footprint in Africa. The grant is specifically related to empowering civil society actors in gaining the appropriate knowledge and developing the necessary tools to articulate an informed perspective on the emerging powers in Africa and the corresponding impact. In particular, attention should be given to the forthcoming China-Africa Forum (FOCAC), the India-Africa Forum Summit, and the South Korea-Africa development cooperation meeting that is going to take place in 2015, as well as the recent Africa-Turkey Summit that took place in November 2014. Applicants are encouraged to explore how these platforms inform Africa\u2019s relationship with emerging actors; what impact have these engagements had on Africa\u2019s relationship with these and other actors; and how African civil society actors should advance African voice. The grants are for 5000 Euro, with further details on the application procedure on the website. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 167: We are not done yet. Lets close the gap!","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Header"}},{"node":{"title":"Fertility Desires and Intentions among HIV-Positive Women during the Post-natal period in Uganda","field_subtitle":" Gutin SA, Namusoke F, Shade SB, Mirembe F: African Journal of Reproductive Health 18(3), September 2014","URL":"http://www.ajol.info/index.php/ajrh/article/view/109199","body":"This study describes the fertility intentions and discusses the potential  reproductive health needs of post-natal HIV-infected Ugandan women. HIV-infected mothers attending post-natal services in Kampala, Uganda participated in this cross-sectional study using structured interviewer  administered questionnaires. Among 403 participants, 35% desired more children. Of these, 25% wanted another child within 2 years and 75% within 3 years or more. In  multivariable analyses, believing that one\u2019s partners wanted more children was associated with the desire for future children while having more living children was negatively associated with the desire for future children. A minority of women desired future pregnancies, and most wanted to delay pregnancy for 3 years. These women are in need of family planning methods to meet stated desires to delay or end future pregnancies. Perceived partner desire for children also impacts on women\u2019s fertility intentions, highlighting the importance of engaging men during the post-natal period.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Food label reading and understanding in parts of rural and urban Zimbabwe","field_subtitle":"Chopera P, Chagwena DT, Mushonga NGT: African Health Sciences 14(3), September 2014","URL":"http://www.ajol.info/index.php/ahs/article/view/107240/97129","body":"Overweight and obesity prevalence is rapidly rising in developing countries. The reading and understanding of nutrition information on food packages has been shown to improve food choices and instill healthy eating habits in individuals. The aim of this study was to describe the prevalence of food label usage and understanding among urban and rural adults in Zimbabwe and its association with demographic and socio economic factors. A cross sectional study was conducted on 320 adults (147 urban and 173 rural) using a validated questionnaire. A high proportion (77%) of the respondents read food labels. Food label reading differed significantly by educational, employment status and locality. Only 41% of food label readers mostly understood the information on the food labels. More urban shoppers (86%) read food labels than their rural counterparts (67%). A significant number of participants (81%) indicated they would like to be educated on the meaning of food labels and 80% preferred the nutrition information on food labels to be simplified. The study found above average reported reading of nutrition information on food labels with partial understanding. The authors recommend that efforts be made to determine how all consumers could be made to understand the nutrition information on food labels and use it effectively in decision making.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Grain Revolution: Finger Millet and Livelihood Transformation in Rural Zimbabwe","field_subtitle":"Muchineripi C: Africa Research Institute Policy Voice Series, October 2013","URL":"http://www.africaresearchinstitute.org/publications/chidara-muchineripi/","body":"Food shortages are the root cause of poverty in Zimbabwe\u2019s Gutu district. Rainfall is generally low and erratic. In most places the soil is sandy and over-cultivated. High population density means that the vast majority of the district\u2019s 40,000 households are restricted to farming on small plots. By the mid-2000s the effect of an economic crisis on the government\u2019s agricultural budget and an over-reliance on growing maize, a crop that requires high rainfall, had drastically undermined food security in Gutu. Following a severe drought in 2005, the Chinyika Communities Development Project was conceived to overcome the persistent threat of food shortages \u2013 and even famine \u2013 in Gutu. The objective was to persuade farmers dependent on maize production to plant finger millet, a neglected crop that is indigenous to Zimbabwe. Finger millet is drought-resistant and better suited to semi-arid and arid areas than maize. Although its cultivation is more labour-intensive, it requires fewer expensive inputs than maize. It is also highly nutritious and can be stored for up to 25 years. By 2014 almost every household in Gutu had participated in the project. Farmers with a nucleus of finger millet production each have 3-5 years of strategic food reserves and the collective capacity to produce a surplus of up to 2,000 tons a year. Accumulated reserves of finger millet exceed 20,000 tons. Families in Gutu now have a stable, dependable supply of food. This has been achieved without any external intervention or funding. The success of the Chinyika Communities Development Project was grounded in participatory research, community engagement and local ownership. The narrative is about much more than switching from one crop to another. A stable supply of food \u2013 and behavioural change \u2013 has imbued farmers with the confidence to pursue various income-generating activities. In Gutu, finger millet has been the key to the emergence of a diversified and innovative family farming system.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"HIV in (and out of) the clinic: Biomedicine, traditional medicine and spiritual healing in Harare","field_subtitle":"O\u2019Brien S, Broom A: SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) 11(1), 14 July 2014","URL":"http://www.ajol.info/index.php/saharaj/article/view/108597","body":"Contemporary lived experiences of the human immunodeficiency virus (HIV) are shaped by clinical and cultural encounters with illness. In sub-Saharan countries such as Zimbabwe, HIV is treated in very different ways in  various therapeutic contexts including by biomedical experts, traditional medicine and faith healers. The  co-existence of such expertise raises important questions around the potencies and limits of medicalisation and alternative healing practices in promoting HIV recovery. First, in this study, drawing on in-depth qualitative  interviews with 60 people from poor urban areas in Harare, the authors explore the experiences of people living with and affected by HIV. They sought to document, interrogate and reflect on their perceptions and experiences of biomedicine in relation to traditional medicine and spiritual healing. Their accounts indicate that traditional medicine and spiritual beliefs continue to significantly influence the way in which HIV is understood, and the forms of help and care people seek. The authors observe the dramatic and overwhelmingly beneficial impact of  Antiretroviral Therapy and conclude through Zimbabwean\u2019s own stories that limitations around delivery and wider structural inequalities impede its potential. The authors explore some practical implications of the biomedical clinic (and alternative healing practices) being understood as sites of ideological and expert  contestation. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"How to make planning law work for Africa","field_subtitle":"Berrisford S: Africa Research Institute Counterpoints Series, November 2013","URL":"http://www.africaresearchinstitute.org/publications/counterpoints/planning-law-in-africa","body":"As competition for land intensifies in Africa\u2019s rapidly growing towns and cities, planning laws assume a fundamental importance. They determine how urban growth is managed and directed. In most countries outdated, inappropriate and unintegrated laws are exacerbating urban dysfunction. The reform of planning law is frequently advocated as a necessary step for better management of urbanisation in Africa. But reform initiatives consistently founder. This is inevitable, given the approaches adopted. The promotion of \u201cone-size-fits-all\u201d and \u201cmodel\u201d planning laws from outside the continent has not served Africa well. Invariably it has created further legal uncertainty and a series of unanticipated, often pernicious consequences. This paper argues that more progressive, realistic urban planning in Africa will require a radically different approach to planning law reform, essential for sustainable and equitable urban development in Africa.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"How to use Instagram for research communication","field_subtitle":"Patton B: Research to Action: 22 October 2014","URL":"http://www.researchtoaction.org/2013/10/using-instagram-for-research-communication/","body":"Instagram, the social networking service that enables its users to take pictures and videos, apply digital filters to them, and share them across Facebook, Twitter, Tumblr and Flickr, is becoming increasingly popular. A free application that can be downloaded onto mobile phones and tablets. Instagram currently has a predominantly young adult audience and is used as a tool to generate interest in campaigns.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Meeting report: The Role of Health Committees in Equitable, People-centred Health Systems in the Southern and East African Region","field_subtitle":"Mdaka K, Haricharan H, London L: Learning Network for Health and Human Rights, CEHURD, UCT and EQUINET, November 2014","URL":"http://www.equinetafrica.org/bibl/docs/HCC%20Regional%20Mtg%20Rep%20Sep2014l.pdf","body":"A two-day consultation on health committees as vehicles for community participation was held in Cape Town on September 27th and 28th 2014 prior to the 3rd Global Health Systems Research Conference. The meeting, funded by the International Development Research Council (IDRC Canada), had 38 participants from 12 countries of which nine were African countries. The meeting build on previous regional networking to share experiences of health committees as vehicles for community participation from countries across the globe. The discussion focused particularly on health committees in the African region, but benefited from considerations of experiences from other countries of the South (Guatemala and India). The discussions also reaffirmed the importance of health committees for Health System responsiveness and highlighted the importance of health committees as autonomous structures able to enhance democratic governance of health systems through monitoring and evaluation of health service performance and holding the state accountable. This applies irrespective of how services are delivered. To achieve this, it is critically important for health committees to be capacitated to fulfil this role through appropriate training, health systems design and sustainable support. Government should recognize the importance of health committees for their health systems, and invest appropriate human and financial resources to ensure functional health committees. Such investments are part of state obligations with respect to realising the Right to Health. Further, strategies must be developed to obtain buy-in of health workers, managers and policy-makers in supporting meaningful participation by health committees.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Monitoring of non-communicable diseases such as hypertension in South Africa: Challenges for the post-2015 global development agenda","field_subtitle":"Day C, Groenewald P, Laubscher R, van Schaik N, Bradshaw D: South African Medical Journal 10(104), October 2014","URL":"http://www.ajol.info/index.php/samj/article/view/108475","body":"Examining the non-communicable disease (NCD) profile for South Africa (SA) is crucial when developing health interventions that aim to reduce the burden of NCDs. The objective was to review NCD indicators in national data sources in order to describe the burden of NCDs in SA, using hypertension as an example. Age, gender, district of death and underlying cause of death data were obtained for 2008 and 2009 mortality unit records from Statistics SA and adjusted using STATA 11. Data for raised blood pressure were obtained from four national household surveys: the South African Demographic and Health Survey 1998, the Study on Global Ageing and Adult Health 2007, and the National Income Dynamics Study 2008 and 2010. The proportion of years of life lost due to NCDs was highest in the metros and least-deprived districts, with all metros (especially Mangaung) showing high age-standardised mortality rates for ischaemic heart disease, cerebrovascular disease and hypertensive disease. The prevalence of hypertension has increased since 1998. National household surveys showed a measured hypertension prevalence of over 40% in adults aged \u00ac25 years in 2010. Treatment coverage was 35.7%. Only 36.4% of hypertensive cases (on treatment) were controlled. Further work is needed if NCD monitoring is to be enhanced. Priority targets for NCDs must be integrated into national health planning processes. Surveillance requires integration into national health information systems. Within primary healthcare, a larger focus on integrated chronic care is essential.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Overcoming the Health Workforce Gap","field_subtitle":"Peoples Health Movement: Global Health Watch, November 2014 ","URL":"http://www.ghwatch.org/node/45470","body":"In this new piece, Remco van de Pas and Linda Mans, researchers in public health, draw attention to a key chapter, titled \u2018The Global Health Workforce Crisis\u2019, of the latest edition of the Alternative World Health Report, Global Health Watch 4. They argue that overcoming the health work force gap is one of the key lessons we should learn from the current Ebola outbreak.\r\nThe chapter of GHW4 discusses how 'ceilings\u2019 in the public wage bill imposed by the International Monetary Fund in Africa have contributed to migration of health workforce from the continent towards northern countries. It provides shocking numbers on the cost of health workforce training to governments in the south, and corresponding subsidy to governments in the north. The chapter also highlights that concerns of \u2018economic efficiency\u2019 threaten reducing health workers' role to undertaking selective diagnosis and treatment. It concludes that a strong health workforce, supported by public funds, is a requirement for strong, universal health systems.\r\n","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Rwanda's evolving community health worker system: a qualitative assessment of client and provider perspectives","field_subtitle":"Condo J, Mugeni C, Naughton B, Hall K, Antonia Tuazon M, Omwega A, Nwaigwe F, Drobac P, Hyder Z, Ngabo F and Binagwaho A: Human Resources for Health 12(72), December 2014","URL":"http://www.human-resources-health.com/content/12/1/71/abstract","body":"In Rwanda, which faces a significant gap in health workers, the Ministry of Health expanded its community health programme in 2007, eventually placing 4 trained CHWs in every village in the country by 2009. The aim of this study was to assess the capacity of CHWs and the factors affecting the efficiency and effectiveness of the CHW programme, as perceived by the CHWs and their beneficiaries. A cross-sectional descriptive study was conducted using focus group discussions to collect qualitative information regarding educational background, knowledge and practices of CHWs, and the benefits of community-based care as perceived by CHWs and household beneficiaries. A random sample of 108 CHWs and 36 beneficiaries was selected in 3 districts according to their food security level (low, middle and high). CHWs were found to be closely involved in the community, and widely respected by the beneficiaries. Rwanda's community performance-based financing was an incentive, but CHWs were also strongly motivated by community respect. The key challenges identified were an overwhelming workload, irregular trainings, and lack of sufficient supervision. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Save the Children South Africa: Action/2015 Campaign Coalition Coordinator","field_subtitle":"Call for applicants closes January 10 2015","URL":"http://www.ngopulse.org/opportunity/save-children-south-africa-action2015-campaign-coalition-coordinator","body":"The action/2015 Campaign Coalition Coordinator will help drive the strategic direction and delivery of the South African action/2015 coalition. This is a high-level position which will play a key role in building a broad based national action/2015 coalition and in supporting the design and delivery of the coalition\u2019s action/2015 campaign. This is a 3 month consultancy opportunity. Further information on the website.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Science and technology for development in Sub-Saharan Africa: Key topics, challenges and opportunities","field_subtitle":"Romo Ramos YJ: SciDev.Net 2014","URL":"http://www.scidev.net/filemanager/root/site_assets/docs/SubSaharan-Africa-Electronic.pdf","body":"SciDev.Net\u2019s focus groups in Sub-Saharan Africa (SSA) are part of a global programme that aims to understand regional needs and contexts for science and technology in development. The programme started in 2012 in South East Asia and the Pacific, and reports are available online at www.scidev.net/global/content/learning-series.html This report highlights the key areas of interest in for development, and barriers and gaps in the use of science and technology evidence. It also provides suggestions for how communications about science and technology can be improved.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Shooting our hard drive into space and other ways to practise responsible development data","field_subtitle":"Antin K, Byrne R, Geber T, van Geffen S, Hoffmann J, Jayaram M, Khan M, Lee T,  Weinberg F, Wilson C,  R\u00fchling B, Rahman Z, Simeoni C: 9 October 2014","URL":"http://tinyurl.com/ne3ak9n","body":"This book is offered as a first attempt to understand what responsible data means in the context of international development programming. It takes a broad view of development and also anticipates that some of the methods and lessons may have resonance for related fields and practitioners. It is intended to support thoughtful and responsible thinking as the development community grapples with relatively new social and ethical challenges stemming from data use. This book builds on a number of resources and strategies developed in academia, human rights and advocacy, but aims to focus on international development practitioners so touches primarily upon issues specifically relevant to development practitioners and intermediaries working to improve the lives and livelihoods of people.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Strategic Purchasing Factsheet","field_subtitle":"Asia Pacific Observatory on health policy and systems: October 2014","URL":"http://resyst.lshtm.ac.uk/sites/resyst.lshtm.ac.uk/files/docs/reseources/FactsheetWEB.pdf","body":"A core function of health care financing is purchasing \u2013 the process by which funds are allocated to providers to obtain health services on behalf of the population. If designed and undertaken strategically, purchasing can improve health systems performance by promoting quality, efficiency, equity and responsiveness in health service provision.  This brief discusses dimensions of purchasing in ten countries.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Surviving scarcities in Bulengo","field_subtitle":"Boneza RN: Pambazuka News 11 December 2014","URL":"http://www.pambazuka.net/en/category/features/93571","body":"In 2006, statistics showed that there were about three million internally displaced persons (IDPs) in the five Eastern provinces of Democratic Republic of Congo (DRC): The oriental Province, North Kivu, South Kivu, Maniema and Katanga. Lately, due to relative peace in the region, the number of IDPs dropped to around two million by 2013. While the number has decreased, however, this article highlights how the people still need assistance for their precarious vulnerability. The majority are elderly, children, women who were victims of sexual violence and teenage mothers affected with all sort of predicaments such famine, AIDS and other disabilities. MSF built a clinic in Bulengo to provide free health care to more than 40,000 people. MSF has conducted more than 25,000 consultations in this camp, mainly for diarrhea and respiratory infections. People are mainly sick due to poor living conditions accentuated by poor nourishment. The author argues that the UN and aid agencies should start planning longer-term assistance, and other governments should respond with the necessary funding. They should join their effort to support Doctors without Borders in providing the necessary services attached to their mandate such food, water supply, shelter distribution and hygienic installations. \r\n","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Link between Inequality and Population Health in Low and Middle Income Countries: Policy Myth or Social Reality?","field_subtitle":"Van Deurzen I, van Oorschot W, van Ingen E: PLoS ONE 9(12), 11 December 2014","URL":"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0115109","body":"An influential policy idea states that reducing inequality is beneficial for improving health in the low and middle income countries (LMICs). The study provides an empirical test of this idea: the authors utilized data collected by the Demographic and Health Surveys between 2000 and 2011 52 LMICs, and examined the relationship between household wealth inequality and two health outcomes: anemia status (of the children and their mothers) and the women' experience of child mortality. Based on multi-level analyses, the authors found that higher levels of household wealth inequality related to worse health, but this effect was strongly reduced when they took into account the level of individuals' wealth. However, even after accounting for the differences between individuals in terms of household wealth and other characteristics, in those LMICs with higher household wealth inequality more women experienced child mortality and more children were tested with anemia. This effect was partially mediated by the country's level and coverage of the health services and infrastructure. Furthermore, we found higher inequality to be related to a larger health gap between the poor and the rich in only one of the three examined samples. The paper concludes that an effective way to improve the health in the LMICs is to increase the wealth among the poor, which in turn also would lead to lower overall inequality and potential investments in public health infrastructure and services.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The State of African Cities 2014","field_subtitle":"UN Habitat, 13 March 2014 ","URL":"http://unhabitat.org/the-state-of-african-cities-2014/","body":"The African continent is currently in the midst of simultaneously unfolding and highly significant demographic, economic, technological, environmental, urban and socio-political transitions. Africa\u2019s economic performance is promising, with booming cities supporting growing middle classes and creating sizable consumer markets. But despite significant overall growth, not all of Africa performs well. The continent continues to suffer under very rapid urban growth accompanied by massive urban poverty and many other social problems. These seem to indicate that the development trajectories followed by African nations since post-independence may not be able to deliver on the aspirations of broad based human development and prosperity for all. This report, therefore, argues for a bold re-imagining of prevailing models in order to steer the ongoing transitions towards greater sustainability based on a thorough review of all available options. That is especially the case since the already daunting urban challenges in Africa are now being exacerbated by the new vulnerabilities and threats associated with climate and environmental change. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"To a peaceful, just and healthy new year","field_subtitle":"EQUINET steering committee","body":"The steering committee of the Regional Network for Equity in Health in East and Southern Africa wish all a healthy new year and renewed energy in our efforts to advance equity and social justice in health. The editorial this month shows how wide is the deficit, but also how vigorous the struggle!","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Universal health coverage and non-communicable diseases: a mutually reinforcing agenda","field_subtitle":"The NCD Alliance, October 2014","body":"This policy brief analyses the relationships between Universal Health Coverage (UHC) and Non-Communicable Diseases (NCDs). It covers the unique challenges the NCD epidemic poses to achieving UHC, and the role of UHC in strengthening the NCD response. It also explores the implications and possible position of health, NCDs and UHC in the post-2015 development agenda. The key messages from the report include: UHC is a goal that all governments should commit to. It can help focus greater attention on coverage of quality services, health equity, and guar-anteeing financial-risk protection. The NCD epidemic poses unique challenges to the three dimensions of UHC. Access and availability to essential NCD services remains unacceptably low in many LMICs; major inequalities exist in terms of NCD risk, access to services, and health outcomes; and the epidemic imposes a huge economic burden on national budgets and can push households into poverty. Attainment of UHC will be dependent on prioritising NCD prevention and control in UHC design and implementation. When achieved, UHC can provide a powerful vehicle to accelerate progress on NCD outcomes, inequalities, and socio-economic impact. Lessons learnt from the NCD response can help support pathways to UHC. These include a focus on health promotion and prevention, multi-sectoral approach-es, addressing the social determinants of health, and domestic innovative financing mechanisms (including taxation on unhealthy products). For the post-2015 development agenda to be truly transformative for health, NCDs must be recognised as a priority and UHC must be articulated as a means to achieve improved health outcomes. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Universal Health Coverage network to be launched in Africa on UHC Day","field_subtitle":"Africa Civil Society Network for Universal Health Coverage, Accra, December 2014","body":"The African Platform for Universal Health Coverage (AP-UHC) will be launched with events in 9 African countries and online during the first Global Day for Universal Health Coverage (12th December 2014). The same date, two years ago, all countries unanimously supported a resolution at the United Nations General Assembly which encouraged member states to \u201cplan or pursue the transition of their health systems towards Universal Health Coverage\u201d. AP-UHC will contribute to civil society efforts for the implementation of Universal Health Coverage policies at national, and Africa level as the practical expression of the Right to Health in Africa. The network is a result of the global effort to improve and expand healthcare delivery to every locality where everybody receives the health services they need. The network will provide adequate support to national NGOs in their advocacy, using people-centred, right-based approach, to influence governments and policy makers at regional, national and community levels to implement Universal Health Coverage policies. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Universal Health Coverage: Because nobody should have to choose between health, food and education ","field_subtitle":"Hannah Yous, Health Advocacy Officer, Oxfam France 2014","URL":"http://www.globalhealthcheck.org/?utm_source=Global%20Health%20Check&utm_campaign=cfe472c579-Global%20Health%20Check%20email&utm_medium=email&utm_term=0_89f8d74097-cfe472c579-12084821","body":"Getting sick represents a risk of falling into poverty for millions of people around the world. The cost of health care put millions of people in the position to choose between buying food, sending children to school or paying to get healthcare. Yet the author argues that this is not inevitable because solutions exist: Universal Health Coverage (UHC) makes it possible for people to access health care without sacrificing other basic needs.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Using the unmet obstetric needs indicator to map inequities in life-saving obstetric interventions at the local health care system in Kenya","field_subtitle":"Echoka E, Dubourg D, Makokha A, Kombe Y, Olsen \u00d8E, Mwangi M, Evjen-Olsen B and Byskov J: International Journal for Equity in Health 13(112), December 2014 ","URL":"http://www.equityhealthj.com/content/13/1/112","body":"Developing countries with high maternal mortality need to invest in indicators that not only provide information about how many women are dying, but also where, and what can be done to prevent these deaths. The unmet Obstetric Needs (UONs) concept provides this information. This concept was applied at district level in Kenya to assess how many women had UONs and where the women with unmet needs were located. A facility based retrospective study was conducted in 2010 in Malindi District, Kenya. Data on pregnant women who underwent a major obstetric intervention (MOI) or died in facilities that provide comprehensive Emergency Obstetric Care (EmOC) services in 2008 and 2009 were collected. The difference between the number of women who experienced life threatening obstetric complications and those who received care was quantified. The most common MOI was caesarean section, commonly indicated by Cephalopelvic Disproportion (CPD)\u2013narrow pelvis. In absolute terms, 22 (11%) women in 2008 and 12 (6%) in 2009, who required a life saving intervention failed to get it. Deficits in terms of unmet needs were identified in rural areas. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"We are not done yet. Lets close the gap!","field_subtitle":"Constance Georgina Khaendi Walyaro, Kenya","body":"\r\nThis year, as we look back upon 26 years of World Aids Days, we honour the millions of heroes and heroines who fought the good fight against AIDS but are no longer with us. We need to make sure that this day and the year that follows is about what we do to ensure that people continue living positive, productive lives, with great decency and dignity.\r\n\r\nAs a young person, I grew up hearing statistics like more than 4 young people are infected with HIV every minute and over 6 000 are newly infected every day. Over half of all new HIV infections were amongst young people in my age group. We had even been called the doomed generation, because many of us had never known a world without HIV and AIDS. AIDS had become our disease and it was feared that within a decade, we would be reduced to mere statistics.  \r\n \r\nStigma and exclusion had hindered the efforts of many young people seeking the counselling, testing, treatment and support they required to ensure that those who were not infected remained uninfected, and the infected and affected were well cared for. Many carried the virus for years without knowing.\r\n\r\nHIV changed our communities and civilizations, hacking away more than twenty years of hard gains in education, food security and socio- economic development; making our families poorer, and driving us into poverty. \r\n\r\nWhile the scale of devastation caused by the epidemic was unmatched, we also knew that we could beat it - with quality treatment and effective prevention. So we began to fight back, to reclaim our spaces through advocacy, education and awareness. We changed and reclaimed our lives, forcing the epidemic into retreat in many places.\r\n \r\nWe were not always supported. To save lives we had to successfully confront the monopolies that endorsed skewed TRIPS+ trade agreements, greatly limiting the flexibilities that were won within TRIPs in the Doha Declaration to protect public health and increase access to essential medicines. We had to confront transnational corporations  that had tried to challenge Indian law in an attempt to shut down  'the pharmacy of the developing world' - one of the largest producers of affordable generic medication. We had to claim our right to affordable and accessible quality medication.\r\n\r\nBut we are not done yet.\r\n\r\nAccording to the UNAIDS GAP Report 2014, less than 50% of the 35 million people living with HIV globally know they are HIV positive. Adolescent girls and young women in Sub-Saharan Africa account for a quarter of the new infections. Gender based discrimination, poverty, and the denial of their economic, social and cultural rights continues to drive the epidemic. We are also facing high rates of antibiotic resistance and a reduction in the effectiveness of other medicines we have struggled to access. As a result people with drug resistant diseases like MDR TB need more expensive drugs. This has put a great burden on health services that are already underfunded.\r\n \r\nWorld AIDS Day 2014 and every day after presents the opportunity for us to harness the power of social change to put people first and to close the gap. Ending the AIDS epidemic by 2030 is possible, but only if we leave no-one behind. \r\n \r\nClosing the gap means enabling all people, everywhere, to access the services they need,\r\n\u2022\tBy closing the HIV testing gap, so that the 19 million people who are unaware of their HIV-positive status can begin to get support.\r\n\u2022\tBy closing the treatment gap, so that all 35 million people living with HIV have access to life-saving medicine.\r\n\u2022\tBy closing the gap in access to medicines and care for all children living with HIV, and not just the 24% who have access today.\r\n\u2022\tBy closing the gap in power so that young women, children, people of all ages, income and cultures can be included as part of the solution.\r\n \r\nWe are not done yet. Let\u2019s close the Gap!\r\n\r\nPlease send feedback or queries on the issues raised in this oped to the EQUINET secretariat: admin@equinetafrica.org. ","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"World AIDS Day: What does HIV teach us about access to medicines for Ebola? ","field_subtitle":"Kamal-Yanni M: Oxfam UK, November 2014","URL":"http://www.globalhealthcheck.org/?p=1715","body":"In 2001, the new antiretroviral medicines had started to work miracles, bringing people from their deathbeds back to life. Yet as a Ugandan doctor truly said: \u2018the medicine is in the North but the disease is in the South\u2019. The author argues that the pharmaceutical industry was happy to sell the medicines at very high prices in rich countries while turning a blind eye to the rest of the world. It was largely thanks to a huge global mobilisation of civil society led by people living with HIV that leaders and pharmaceutical companies started to feel embarrassed about denying access to life-saving medicines to millions of people. But it was only after generic competition kicked in that access to medicines became something policymakers talked about. An offer by an Indian company to sell a cocktail of the three basic medicines for one dollar a day slashed the prices of antiretrovirals, meaning that today over 9 million people are on treatment,, including over 7 million in Africa. The profit from treatment of HIV infected people in rich country provided the necessary market that has stimulated R&D for antiretroviral medicines. This is not the case for the Ebola market, which consists of small numbers of people in poor countries. Pharmaceutical companies had no commercial incentive to enter into R&D for vaccines or medicines for Ebola \u2013 or any other haemorrhagic fever. For this reason Ebola is the other side of the coin to HIV as the intellectual property rights system allows the market to shape R&D priorities, rather than public health needs. The author argues that it is not ethical, sustainable nor safe to leave commercial interests decisions and financing for R&D for products, capable of modifying global health threats, to be dictated by the commercial interests of pharmaceutical companies.","php":"","field_issue_date":"2015-01-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"A comparative study of an NGO-sponsored CHW programme versus a ministry of health sponsored CHW programme in rural Kenya: a process evaluation","field_subtitle":"Aridi J, Chapman S, Wagah M, Negin J: Human Resources for Health 12:64, November 2014","URL":"http://www.human-resources-health.com/content/12/1/64","body":"This paper presents the results of process evaluations conducted on two different models of Community Health Worker (CHW) programme delivery in adjacent rural communities in in Gem District of Western Kenya. One model was implemented by the Millennium Villages Project (MVP), and the other model was implemented in partnership with the Ministry of Health (MoH) as part of Kenya\u2019s National CHW programme. Both the MVP and national CHW programmes faced challenges in implementation. Due to better flexibility, resources and scope for rapid innovation on the ground, the MVP model was able to introduce a number of innovations that aimed to strengthen CHW management, supervision and improve CHW responsiveness. Many of these innovations proved very effective in smoothing programme operations, but programme adherence still faced a number of challenges with respects to ensuring that CHW coverage was adequate, visitation frequency was sufficient and services were delivered with the same consistency over time by all CHWs. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Acceptability of conditions in a community-led cash transfer programme for orphaned and vulnerable children in Zimbabwe","field_subtitle":"Skovdal M, Robertson L, Mushati P, Dumba L, Sherr L, Nyamukapa C, Gregson S: Health Policy and Planning 29(7): 809-817, September 2013","URL":"http://heapol.oxfordjournals.org/content/29/7/809.full?sid=d5222603-d239-4350-a366-7ed6329eac62","body":"Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash transfers is an issue of controversy. This article sets out to investigate the overall buy-in of conditions by different stakeholders and to identify pathways that contribute to an acceptability of conditions. The article draws on data from a cluster-randomized trial of a community-led cash transfer programme in Manicaland, eastern Zimbabwe. The study found a significant and widespread acceptance of conditions primarily because they were seen as fair and a proxy for good parenting or guardianship. In a socio-economic context where child grants are not considered a citizen entitlement, community members and cash transfer recipients valued the conditions associated with these grants. The community members interpreted the fulfilment of the conditions as a proxy for achievement and merit, enabling them to participate rather than sit back as passive recipients of aid. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success","field_subtitle":"Rodney AM, Hill PS: International Journal for Equity in Health (13) 72, 10 October 2014","URL":"http://www.equityhealthj.com/content/13/1/72","body":"Equity should be implicit within universal health coverage (UHC) however, emerging evidence is showing that without adequate focus on measurement of equity, vulnerable populations may continue to receive inadequate or inferior health care. This narrative review aims to: (i) elucidate how equity is contextualised and measured within UHC, and (ii) describe tools, resources and lessons which will assist decision makers to plan and implement UHC programmes which ensure equity for all. Eighteen journal articles consisting mostly of secondary analysis of country data and qualitative case studies in the form of commentaries/reviews, and 13 items of grey literature, consisting largely of reports from working groups and expert meetings focusing on defining, understanding and measuring inequity in UHC (including recent drafts of global/country monitoring frameworks) were included. The literature advocates for progressive universalism addressing monetary and non-monetary barriers to access and strengthening existing health systems. This however relies on countries being effectively able to identify and reach disadvantaged populations and estimate unmet need. Recently published resources contextualise equity as a measurable component of UHC and propose several useful indicators and frameworks. Country case-studies also provide useful lessons and recommendations for planning and implementing equitable UHC which will assist other countries to consider their own requirements for UHC monitoring and evaluation.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Agricultural Export Restrictions and the WTO: What Options do Policy-Makers Have for Promoting Food Security?","field_subtitle":"Anania G: Bridges news, November 2014","URL":"http://www.ictsd.org/sites/default/files/research/2013/11/agricultural-export-restrictions-and-the-wto-what-options-do-policy-makers.pdf","body":"Agricultural export restrictions have been seen by many as worsening food price volatility, and pushing up world prices, to the detriment of poor consumers in developing countries. At the same time, others have argued that these measures can help safeguard domestic food security, support government revenues and help countries add value to farm exports. This paper examines the likely trade, food security and development implications of various options for disciplining agricultural export restrictions. The paper seeks to provide policy-makers, negotiators and other policy actors with an impartial, evidence-based analysis of the likely trade, food security and development implications of various options for disciplining agricultural export restrictions.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Call for Applications: Teen and Young Adult Reading Groups","field_subtitle":"Closing date: 12 December 2014","URL":"http://www.ngopulse.org/opportunity/call-applications-teen-and-young-adult-reading-groups","body":"FunDza aims to get youth reading and writing for pleasure. The organisation creates, collects and shares stories that ignite the imagination of youth from under-resourced communities. FunDza is calling for applications from reading groups to apply to join its 'Popularising reading' programme. The programme is designed to support reading groups for teens and young adults, especially in South Africa.  Small organisations and reading groups are also welcome to apply.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Call for conference session papers: Private sector and Universal Health Coverage: Examining evidence and de-constructing rhetoric","field_subtitle":"Closing date: 15th January 2015","URL":"https://equinetafrica.org/mkamalyanni%40oxfam.org.uk","body":"The international Conference on Public Policy is being held 1st to 4th July 2015 in Milan Italy and will include a session on \"Private sector and Universal Health Coverage: Examining evidence and de-constructing rhetoric\". The conference aims to support exchanges between researchers on public policy from all over the world and registration opens 1st January 2015. The specific session aim seeks to discuss evidence on the scope and effectiveness of the commercial sector (and the paradigm of public private partnerships) in  achieving Universal Health Coverage in low and middle income countries. The organisers invite abstracts for papers reporting findings of empirical research to critically examine role of private sector, scope of public-private interactions, and their implications for the UHC agenda. Abstracts should outline original research/ reviews and methodologies suitable for examining private sector engagement in health care systems. Commentaries/ Opinion pieces will NOT be accepted. Abstracts should include title, authors and affiliations (please * presenting author), abstract text (500 words); keywords (up to 5); a statement listing any research funders or other sources of financial support which have contributed to the work presented and declaration of potential conflict of interest. For further details please contact Oxfam UK.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Cervical Cancer Screening among University Students in South Africa: A Theory Based Study","field_subtitle":"Hoque ME, Ghuman S, Coopoosmay R, Van Hal G: PLoS ONE 9(11), 11 November 2014","URL":"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0111557","body":"Cervical cancer is a serious public health problem in South Africa. Even though the screening is free in health facilities in South Africa, the Pap smear uptake is very low. The objective of the study is to investigate the knowledge and beliefs of female university students in South Africa. A cross sectional study was conducted among university women in South Africa to elicit information about knowledge and beliefs, and screening history.  A total of 440 students completed the questionnaire. Regarding cervical cancer, 55.2%  had ever heard about it. Results indicated that only 15% of the students who had ever had sex and had heard about cervical cancer had taken a Pap test. Pearson correlation analysis showed that cervical cancer knowledge had a significantly negative relationship with barriers to cervical cancer screening. Susceptibility and seriousness score were significantly moderately correlated with benefit and motivation score as well as barrier score. Self-efficacy score also had a moderate correlation with benefit and motivation score. Students who had had a Pap test showed a significantly lower score in barriers to being screened compared to students who had not had a Pap test. This study showed that educated women in South Africa lack complete information on cervical cancer. Students who had had a Pap test had significantly lower barriers to cervical cancer screening than those students who had not had a Pap test.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Challenging the negative discourse on human rights in Africa","field_subtitle":"Kasambala T: SAIIA Policy Briefing No 104, September 2014","URL":"http://www.eldis.org/go/topics/resource-guides/gender&id=69533&type=Document#.VEzSekvZ5FI","body":"The recent proliferation of non-governmental organisations (NGOs) and independent media across Africa is argued by the author to be an important positive development. They are said to play an essential role by investigating government policy, exposing corruption and human rights violations, advocating for the rights of minorities and vulner-able communities, and providing social services. However the continent\u2019s leaders reject what they see as an imposition of \u2018Western\u2019 ideas of human rights. This policy briefing highlights the shift in human rights discourse among African leaders towards more anti-imperialist rhetoric and the placing of African traditions above human rights. It provides examples of how local civil society organisations (CSOs) are challenging this view in the face of increasing government attacks. CSOs are argued to be crucial to positive transformation and the universal protection and promotion of human rights, and the author proposes that more needs to be done to protect human rights and create an enabling environment for CSOs.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Changing the talk and the walk: Challenges for a different practice in health systems research","field_subtitle":"Amit Sengupta, Associate Global Co-ordinator, Peoples Health Movement","body":"The Health Systems Research Symposium in Cape Town was an experience to savour. It was particularly refreshing in shifting away from the rather restricted vision of the earlier symposia in Montreux and Beijing. Opening it to debates on \u2018people centered health systems\u2019 raised the opportunity to move from the confines of the restricting, dominant neoliberal concept of Universal Health Coverage (UHC) that has circumscribed the discourse in the earlier symposia, with its focus on a narrow and preconceived template of issues, largely informed by the language of health financing and insurance. In contrast, this year\u2019s symposium promoted a public health language of care (not just coverage) and of solidarity, equity, gender justice and rights.\r\n\r\nSeveral speakers, especially in the plenaries, articulated the profound impact different dimensions of power and power relations are having on health systems. In the Peoples Health Movement, we see this as an important and extremely positive sign of our collective intent to confront and challenge these power relations. Several presentations talked about the role of social movements in building, safeguarding, nurturing and expanding health systems that are truly people centered. \r\n\r\nThere is, however, a gap between our rhetoric and our praxis. We need to integrate concerns about power and an articulation of the role of popular mobilization and of social movements in challenging power relations that undermine health into the priorities and practice of the research community. Here we have a gap, with too little practical translation of these concerns into research priorities and practice. Existing power structures play a hegemonic role in influencing research \u2013using their financial clout and exercising dominance in the domain of ideas. Unless we are able to change this, our work will continue to be informed by a hegemonic discourse that legitimates injustice and inequity. This is a challenge for young researchers, to be bold and innovative in questioning the dominant paradigm of the current research system.\r\n\r\nWe need to build on the deliberations of the symposium to change our current practice, in all stages of the research cycle. Health research should name and interrogate the practices of those who perpetuate inequity at a grand scale by their cynical use of power. There is robust evidence on this that is waiting to be mined.  It was heartening to see evidence in the symposium that there is now a growing interest in participatory research that places people at the center of research systems and not just as passive \u2018beneficiaries\u2019 of the outcomes of research. A research community that views research as a tool for change must give attention to the role of civil society and of social movements in catalyzing and driving sustainable change. Civil society is often seen as an afterthought in the research cycle. It is brought in late to legitimize often deceptive or limited evidence that maintains the status quo. Civil society in general and social movements in particular should, in contrast, have a meaningful and decisive counter-hegemonic role to drive an alternative research practice that can propel change, including research that is conceived of and driven by civil society. We need, for example, to develop work that examines the role social movements play in shaping, nurturing and advancing health systems that are solidarity based and sustained by the public. \r\n\r\nIn the symposium, there was talk of bringing to the foreground the \u2018shadow reports\u2019 that are produced by civil society at key forums. Surely we should walk the extra mile and view such shadow reports as the real reports? They present the popular concerns and aspirations and mainstream the voices of the unheard majority. Civil society thus has a task to produce evidence in such reports that is people driven, robust and that challenges the conventional wisdom replicated in the often glossier versions produced by multilateral organisations and well-heeled private foundations. The Peoples Health Movements\u2019 Global Health Watch is one effort at taking up this challenge.\r\n\r\nThe long shadow of the current Ebola epidemic reminded all of us at the symposium about all that we have failed to do. It has directed our attention to the collective failure of public health and health research to harness evidence and action to promote public services - publicly owned, nurtured and conceived by the people.  Health systems that are in the public domain are failing in many regions of the world, in spite of evidence that they are the main life-line for poor, marginalized and voiceless people. They are failing because of deliberate acts of commission that are bringing down, brick by brick, the edifice of public systems. They are failing because evidence that favours nurturing solidarity based public systems has been disregarded. Instead evidence has been used in a selective fashion to promote the notion that market based systems in healthcare delivery are superior. The Ebola epidemic was preventable, in part if overwhelming evidence on building public health systems had not been brushed aside. As a health research community we need to accept part responsibility for the current failure, in our not being vocal enough in the pursuit and use of good evidence.\r\n\r\nAs we look towards the next symposium due to take place in 2016, can we at least make partial amends for what we have failed to do?  Can we collectively raise our evidence and voice to call for public health systems, built around solidarity and justice, rather than the current dominant model of spliced and diced healthcare delivery, designed for trade in the market? \r\n\r\nThese reflections are drawn from remarks made by the author at the closing session of the 2014 Global Symposium in Health Systems Research 30 September \u2013 3 October 2014. For further information on the issues raised see the PHM website at http://www.phmovement.org/","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Citizens call to action on a petition on Ebola","field_subtitle":"Mahta Ba A: August 2014","URL":"http://www.gopetition.com/petitions/ebola-stop-quarantine-of-entire-countries.html","body":"A petition has been launched by Africans calling for concerted in the struggle to contain the Ebola epidemic in West Africa. It suggests three affirmative actions and rejects isolationist measures. Sign on to the petition is invited. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey","field_subtitle":"Kruk M, Kujawski S, Mbaruku G, Ramsey K, Moyo W, Freedman L: Health Policy and Planning, 1 October 2014","URL":"http://heapol.oxfordjournals.org/content/early/2014/09/21/heapol.czu079.abstract?sid=7891f724-3983-4ce9-8638-1aa1e4337a34","body":"Although qualitative studies have raised attention to humiliating treatment of women during labour and delivery, there are no reliable estimates of the prevalence of disrespectful and abusive treatment in health facilities. The authors measured the frequency of reported abusive experiences during facility childbirth in eight health facilities in Tanzania and examined associated factors. The study was conducted in rural northeastern Tanzania, using a structured questionnaire. A total of 1779 women participated in the exit survey and 593 were re-interviewed at home. Between 19% and 28% of women in eight facilities in northeastern Tanzania experienced disrespectful and/or abusive treatment from health providers during childbirth. This is argued by the author to be a health system crisis that requires urgent solutions both to ensure women\u2019s right to dignity in health care and to improve effective utilization of facilities for childbirth in order to reduce maternal mortality. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 166: Changing the talk and the walk: Challenges for a different practice in health systems research","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Header"}},{"node":{"title":"Even It Up Campaign","field_subtitle":"Oxfam International","URL":"https://act.oxfam.org/international/even","body":"Oxfam has launched a global campaign to end extreme inequality, with campaigns in 37 countries uniting behind the call for a more equal world. Extreme inequality is argued to be threatening to undo much of the progress made over the past 20 years in tackling poverty. It is not inevitable. It is the consequence of economic and political choices. The campaign invites people to play a critical role and provides a pack of content, including \u2018sharegraphics\u2019 to share on social media platforms. From targeting big corporations whose tax dodging activities help deny developing countries billions in revenue, to demanding policies that can close the gender gap, the campaign invites people to play a key role in amplifying the call to even it up and raise extreme inequality to the top of government\u2019s agendas.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Exploring the Ethics of Health Systems Research","field_subtitle":"Health Systems Global Thematic Working Group on Health Systems Research Ethics, November 2014","URL":"http://www.healthsystemsglobal.org/GetInvolved/Webinar.aspx","body":"Health systems research is increasingly being funded by international donors and conducted in low and middle-income countries but little conceptual work has been done to clarify the field\u2019s ethical dimensions. This is problematic because health systems research has distinctive features relative to clinical research that may restrict the applicability of existing ethical guidance. This webinar asks: What makes health systems research different from clinical research? What are the key ethical issues in externally-funded health systems research in low and middle-income countries? And do they deserve special consideration in, for example, project design and ethics review? The moderated discussion covers the features of health systems research and examples of what it entails in practice, distinctive ethical issues that arise during the conduct of such research and challenges faced by ethics review committees when considering health systems research projects.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Gendering peasant movements, gendering food sovereignty","field_subtitle":"Bell B: Pambazuka News, 207, 12 November 2014","URL":"http://www.pambazuka.net/en/category/comment/93352","body":"A problem peasant women face is invisibility in the feminist and women\u2019s movements. A second problem is the weakness with which the food sovereignty concept has dealt with the challenges of feminism. Latin America has assumed the struggle for food sovereignty as an alternative to the neoliberal economic model. Food sovereignty is based on the conviction that each people has the right to make decisions about its own food systems: about its own eating habits; about its production, marketing, distribution, exchange, and sharing; and about keeping food and seeds in the public sphere. This interview report presents the views from a feminist point of view on how people make decisions, who decides how power is organised and how to turn food sovereignty into a tool to strengthen and empower peasant women. \r\n","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Global Health Watch 4","field_subtitle":"Peoples Health Movement: Zed books, November 2014","URL":"http://www.ghwatch.org/ghw4","body":"With the world still battling the Ebola outbreak, the evidence of a clear link between the inability of affected countries to deal with the crisis and the collapse of public health systems is becoming stronger. Extreme poverty in the affected region, engendered by neo-liberal policies, further created the conditions for the rapid spread of the epidemic.  This is the context that informs the contents of the 2014 Global Health Watch (GHW) report that was released in November. With contributions from more than 80 experts from across the globe, GHW4 addresses key issues in the health sector. Through its five sections, it covers diverse issues related to health systems and the range of social, economic, political and environmental determinants of health. GHW4 locates decisions and choices that impact on health in the structure of global power relations and economic governance and is complemented by the ' Watching' section that scrutinises global processes and institutions. The final section on 'Alternatives, Action and Change', documents inspiring stories of struggles and actions for change.  ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Health Inequalities and Social Determinants  of Aboriginal Peoples\u2019 Health","field_subtitle":"Reading CL, Wien F: National Collaborating Centre for Aboriginal Health, 2009","URL":"http://www.nccah-ccnsa.ca/docs/social%20determinates/nccah-loppie-wien_report.pdf","body":"This paper uses available data to describe health inequalities experienced by diverse  Aboriginal peoples in Canada. Its method is useful for those working on indigenous people's health in other regions. The data are organized around social determinants of health across the life course and provide evidence that not only demonstrates important health  disparities within Aboriginal groups and compared to non-Aboriginal people, but also links social determinants, at proximal, intermediate and distal levels, to health inequalities. The Integrated Life Course and Social Determinants Model of Aboriginal Health is introduced as a promising conceptual framework for understanding the relationships between social determinants and various health dimensions, as well as examining potential trajectories of health across the life course. Data from diverse and often limited literature is provided to support claims made by the authors of this paper and others about health disparities among Aboriginal peoples and the degree to which inequalities in the social determinants of health act as barriers to addressing health disparities. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Health labour market policies in support of universal health coverage: a comprehensive analysis in four African countries","field_subtitle":"Sousa A, Scheffler R, Koyi G, Ngah Ngah S, Abu-Agla A, M\u2019kiambati H, Nyoni J: Human Resources for Health 12(55), 26 September 2014","URL":"http://www.human-resources-health.com/content/12/1/55","body":"Progress toward universal health coverage in many low- and middle-income countries is hindered by the lack of an adequate health workforce that can deliver quality services accessible to the entire population. The authors used a health labour market framework to investigate the key indicators of the dynamics of the health labour market in Cameroon, Kenya, Sudan, and Zambia, and identified the main policies implemented in these countries in the past ten years to address shortages and maldistribution of health workers. Despite increased availability of health workers in the four countries, major shortages and maldistribution persist. Several factors aggravate these problems, including migration, an aging workforce, and imbalances in skill mix composition. In this paper, the authors provide new evidence to inform decision-making for health workforce planning and analysis in low- and middle-income countries. Partial health workforce policies are not sufficient to address these issues. It is argued top be crucial to perform a comprehensive analysis in order to understand the dynamics of the health labour market and develop effective polices to address health workforce shortages and maldistribution as part of efforts to attain universal health coverage.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"How people-centred health systems can reach the grassroots: experiences implementing community-level quality improvement in rural Tanzania and Uganda","field_subtitle":"Tancred T, Mandu R, Hanson C, Okuga M, Manzi F, Peterson S, Schellenberg J, Waiswa P, Marchant T, The EQUIP Study Team: Health Policy and Planning, 1 October 2014","URL":"http://heapol.oxfordjournals.org/content/early/2014/09/21/heapol.czu070.abstract?sid=7891f724-3983-4ce9-8638-1aa1e4337a34","body":"Quality improvement (QI) methods engage stakeholders in identifying problems, creating strategies called change ideas to address those problems, testing those change ideas and scaling them up where successful. These methods have rarely been used at the community level in low-income country settings. Here the authors share experiences from rural Tanzania and Uganda, where QI was applied as part of the Expanded Quality Management Using Information Power (EQUIP) intervention with the aim of improving maternal and newborn health. Village volunteers were taught how to generate change ideas to improve health-seeking behaviours and home-based maternal and newborn care practices. Interaction was encouraged between communities and health staff. The study aims to describe experiences implementing EQUIP\u2019s QI approach at the community level. A mixed methods process evaluation of community-level QI was conducted in Tanzania and a feasibility study in Uganda. The authors outlined how village volunteers were trained in and applied QI techniques and examined the interaction between village volunteers and health facilities, and in Tanzania, the interaction with the wider community also. There was some evidence of changing social norms around maternal and newborn health, which EQUIP helped to reinforce. Community-level QI is a participatory research approach that engaged volunteers in Tanzania and Uganda, putting them in a central position within local health systems to increase health-seeking behaviours and improve preventative maternal and newborn health practices.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Hunger Map 2014","field_subtitle":"World Food Programme: November 2014","URL":"http://www.wfp.org/content/hunger-map-2014","body":"From Africa and Asia to Latin America and the Near East, there are 805 million people in the world who do not get enough food to lead a normal, active life. The World Food Programmae downloadable Hunger Map provides information that maps the distribution of food insecurity globally.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Inequality in South Africa","field_subtitle":"Keeton G: Sangnet Pulse, 3 November 2014","URL":"http://www.ngopulse.org/article/inequality-south-africa","body":"South Africa remains one of the most unequal societies in the world. In its third South Africa Economic Update in 2012, the World Bank pointed out that the potential for economic growth has been held back by industrial concentration, skills shortages, labour market rigidities and chronically low savings and investment rates. The bank further stated that the economic growth has also been highly uneven in distribution and this continues to perpetuate inequality and economic exclusion. Despite this, the country is making some strides in tackling the socioeconomic ills faced by its poor majority. In this paper the author week\u2019s writes that economic growth usually leads to increasing levels of inequality in developing countries. He notes, however, that as economies develop, larger portions of their populations move from agriculture into other sectors of the economy and their skills base expand to a point where inequality falls. He warns that there are no quick and easy solutions to South Africa\u2019s inequality problem, adding that without substantive improvements in the human capital of the poor, income inequality will remain unacceptably wide.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Inequities in accessibility to and utilisation of maternal health services in Ghana after user-fee exemption: a descriptive study","field_subtitle":"Ganle JK, Parker M, Fitzpatrick R, Otupiri E: International Journal for Equity in Health13(89), 1 November 2014","URL":"http://equityhealthj.com/content/13/1/89/abstract","body":"Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. This study examined the extent to which maternal health services are used in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services.. The authors analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. The findings raise questions about the potential equity and distributional benefits of Ghana\u2019s user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to maternal health services in Ghana. Ensuring equity in access will require moving beyond user-fee exemption to addressing wider issues of supply and demand factors and the social determinants of health, including redistributing healthcare resources and services, and redressing the positional vulnerability of women in their communities.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Intimate Partner Violence after Disclosure of HIV Test Results among Pregnant Women in Harare, Zimbabwe","field_subtitle":"Shamu S, Zarowsky C, Shefer T, Temmerman M, Abrahams N: PLoS ONE 9(10), October 2014","URL":"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0109447","body":"HIV status disclosure is a central strategy in HIV prevention and treatment but in high prevalence settings women test disproportionately and most often during pregnancy. This study reports intimate partner violence (IPV) following disclosure of HIV test results by pregnant women. The study demonstrated the interconnectedness of IPV, HIV status and its disclosure with IPV which was a common experience post disclosure of both an HIV positive and HIV negative result. The authors argue that health services must give attention to the gendered nature and consequences of HIV disclosure such as enskilling women on how to determine and respond to the risks associated with disclosure. Efforts to involve men in antenatal care must also be strengthened.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Investing for the Few: The IFC\u2019s Health in Africa initiative","field_subtitle":"Marriott A, Hamer J, Oxfam International, September 2014","URL":"http://www.oxfam.ca/our-work/publications/investing-for-the-few","body":"The authors argue that the World Bank Group should focus on supporting African governments to expand publicly provided healthcare \u2013 a proven way to save millions of lives worldwide and to drive down inequality. The International Finance Corporation (IFC)\u2019s Health in Africa initiative is argued to be at odds with the World Bank Group\u2019s welcome commitment to universal and equitable health coverage and to shared prosperity. The $1bn initiative, which promotes private sector healthcare delivery, is reported to be extremely unlikely to deliver better health outcomes for poor people, and the IFC is noted to fail to measure the extent to which Health in Africa impacts on people living in poverty. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"MRC/DFID African Research Leader scheme ","field_subtitle":"Applications Close 27 November 2014, 16:00 GMT","URL":"http://www.mrc.ac.uk/funding/browse/mrc-dfid-african-research-leader-scheme-2014-15/","body":"The UK Medical Research Council and the UK Department for International Development announce a further call for proposals for the prestigious African Research Leader awards. The MRC/ DFID jointly funded scheme aims to strengthen research leadership across sub-Saharan Africa (SSA) by attracting and retaining exceptionally talented individuals who will lead high quality programmes of research on key global health issues pertinent to SSA.  The African Research Leader (ARL) should be supported by an enthusiastic local research environment and by a strong linkage with a UK partner.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"NGOs Call for Ban of Liquor Sachets in Malawi","field_subtitle":"Sangonet Pulse, 4 November 2014","URL":"http://www.ngopulse.org/newsflash/ngos-call-ban-liquor-sachets-malawi","body":"Several non-governmental organisations (NGOs) in Malawi and consumer watchdogs have demanded a total ban on the sale of liquor spirit sachets, which they blame for fueling alcohol abuse among the youth. Consumers Association of Malawi executive director, John Kapito, states that, \u201cMalawians are poor, so the most attractive recreational drug they can afford is liquor in sachets. Sadly, these sell at less the cost of a lottery ticket.\u201d Liquor sold in small sachets was first outlawed in the Southern African country in May of 2013, but the move was appealed by manufacturers and since then, liquor sachet sales have risen, resulting in more youth becoming dependent on alcohol \u2013 and some dying after taking too many on an empty stomach","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Participatory action research in people centred health systems International Workshop Report","field_subtitle":"EQUINET, TARSC, ALAMES: Cape Town, South Africa, 4 October 2014","URL":"http://www.equinetafrica.org/bibl/docs/EQUINET%20ALAMES%20PAR%20workshop%20rep%204%20October2014%20lfs.pdf","body":"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 Asociaci\u00f3n 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. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Primary care priorities in addressing health equity: summary of the WONCA 2013 health equity workshop","field_subtitle":"Shadmi E, Wong W,  Kinder K,  Heath I, Kidd M: Int Jo for Equity in Health 13;104, November 2014  ","URL":"http://www.equityhealthj.com/content/13/1/104","body":"Research consistently shows that gaps in health and health care persist, and are even widening. While the strength of a country\u2019s primary health care system and its primary care attributes significantly improves populations\u2019 health and reduces inequity (differences in health and health care that are unfair and unjust), many areas, such as inequity reduction through the provision of health promotion and preventive services, are not explicitly addressed by general practice. Substantiating the role of primary care in reducing inequity as well as establishing educational training pro-grams geared towards health inequity reduction and improvement of the health and health care of underserved populations are needed. This paper summarizes the work performed at the World World Organization of National Colleges and Academies of Family Medicine 2013 Meetings\u2019 Health Equity Workshop which aimed to explore how a better understanding of health inequities could enable primary care providers /general practitioners (GPs) to adopt strategies that could improve health outcomes through the delivery of primary health care. It explored the development of a health equity curriculum and opened a discussion on the future and potential impact of health equity training among GPs. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Reflections on the 3rd Global Symposium on Health Systems Research ","field_subtitle":"Sharmila Mhatre, IDRC Canada","body":"\r\nThe final session of what was without a doubt one of the best symposiums in health lent itself to reflection on four days of sessions that sparked debate and hopefully action on people centred health systems. As a funder of health systems research in low and middle income countries for over a decade, International Development Research Centre has supported the Health Systems Research Symposium from its birth, with an aspiration that be one of the processes that contribute to  access to health and health care for all. \r\n\r\nSo what were the key messages that I heard and have taken home.\r\nProfessor Thandika Mkandawire began by articulating that we need health systems to be democratic, social, inclusive and to contribute to development.  At the same time Prof Irene Agyepong reminded us of a Nigerian proverb that a \u201cgoat that belongs to the whole village belongs to nobody - this is how health systems can be described, but we must not let it go that way.\u201d \r\nSo as a funder I ask myself whether I will stick to, as one panelist said \u201cthe politics of the achievable\u201d? My answer is no, as it would not do justice to the energy, excellence and commitment that I witnessed from participants over the course of the last three days and more importantly it would not do justice to the people who have no access to health or do not have a voice. \r\n\r\nI\u2019ve organised what I have heard into: the \u201cnot to dos\u201d, the \u201cmust dos\u201d, and the \u201chow to do\u201d.\r\n\r\nAs a \u2018not to do\u2019 Rene Loewenson reminded us that by simply putting people in the middle does not make it a people centred health system. \r\n\r\nSo what must we do? In terms of how we do people centred health system research, the knowledge that matters is the knowledge that facilitates change, as we were reminded by Kumanan Rasanathan. As Nancy Edwards suggested we must move from gold standards to platinum standards of methods. In  practice this means, quoting several people from the conference:\r\n\u2022\tFirstly, that people\u2019s knowledge and role in the production, analysis and interpretation is a critical driver of people centred health systems. It means that  people are in control and researchers are the facilitators of the process.\r\n\u2022\tSecondly, making data work for people rather than have people work for data. In one session someone spoke about \u201cchasing data to fit with multiple donors\u2019 agendas\u201d. We need to incorporate multiple types of evidence and to bring in other practices and methods.\r\n\u2022\tThirdly, while strengthening capacities are key, we cannot assume that none exist. We should recognise that capacity strengthening goes beyond training to actually shifting power, as noted by Aku Kwamie.\r\n\r\nAs a further \u2018not to do\u2019 Gita Sen reminded us that we cannot confuse the PC of People Centred with the PC of Political Correctness. We must break divides of race, gender, class, caste, culture or language and come together. This was illustrated eloquently despite the English language barrier by Lina Roso Polomo, a researcher from Mexico, as she explained how international guidelines do not always recognise the cultural diversity of our countries.\r\n\r\nSo if accountability is brought in by people, then as Kausar Khan eloquently relayed, the \u2018must do\u2019s\u2019 include duties for us to reduce ethnic and racial divides as we facilitate, mobilise, fund, engage and catalyse people-centred health systems. It cannot be \u2018us\u2019 and \u2018them\u2019 as Martin McKee reminded us.  At the conference I saw reflected in the program the silos being reduced as \u2018systems\u2019 sessions starting to integrate with \u2018disease\u2019 sessions, and discussions moved to bridge social movements with think tanks.  Inclusion and integration are key. After all, as Lucy Gilson said on the first day of the symposium, the challenge that we must squarely address is governance. \r\n\r\nThroughout the conference there was concern about the double-edged sword of Ebola, that has served this community with deep and significant challenges. The West African Health Organisation is demonstrating commitment to work with all of us to address Ebola and the system failures that it has starkly uncovered. WHO, UNICEF and European funders are advancing initiatives that address both basic science and health systems but as a global community we must do more and USAID and the World Bank called a number of meetings throughout the symposium to discuss this.   \r\n\r\nMoving from the \u2018not to dos\u2019 and the \u2018must dos\u2019 to the \u2018how to do\u2019, the wisdom of the Emerging Leaders (young researchers) is the take home lesson for all of us here. They said that to change mindsets we need to see, talk about and deal with the gorilla in the room.  To make an impact we need to take the time to stop and reflect, with others that are like minded and also with those who are not. Lastly they told us that in each of us we have the capacity to lead as we bridge divides to build collective ownership of health systems that - quoting Sheik, Ranson and Gilson from the Health Policy and Planning Supplement on the Science and Practice of People-Centred Health Systems - truly \u201cserve people and society\u201d.\r\n\r\nThese reflections are drawn from remarks made by the author at the closing session of the 2014 Global Symposium in Health Systems Research 30 September \u2013 3 October 2014. For further information on the global symposium visit http://hsr2014.healthsystemsresearch.org/ ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Ten best resources for conducting financing and benefit incidence analysis in resource-poor settings","field_subtitle":"Wiseman V,  Asante A,  Price J, Hayen A, Irava W,  Martins J, Guinness L,  Jan S: Health Policy and Planning: 24 September 2014","URL":"http://heapol.oxfordjournals.org/content/early/2014/09/24/heapol.czu108.full?sid=b6c6a9dd-6217-47c6-b38f-5ea6790ef17a","body":"Many low- and middle-income countries are seeking to reform their health financing systems to move towards universal coverage. This typically means that financing is based on people\u2019s ability to pay while, for service use, benefits are based on the need for health care. Financing incidence analysis (FIA) and benefit incidence analysis (BIA) are two popular tools used to assess equity in health systems financing and service use. FIA studies examine who pays for the health sector and how these contributions are distributed according to socioeconomic status (SES). BIA determines who benefits from health care spending, with recipients ranked by their relative SES. In this article, the authors identify 10 resources to assist researchers and policy makers seeking to undertake or interpret findings from financing and benefit incidence analyses in the health sector. The article pays particular attention to the data requirements, computations, methodological challenges and country level experiences with these types of analyses.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The Global One Health Paradigm: Challenges and Opportunities for Tackling Infectious Diseases at the Human, Animal, and Environment Interface in Low-Resource Settings","field_subtitle":"Gebreyes WA, Dupouy-Camet J, Newport MJ, Oliveira CJB, Schlesinger LS, et al: PLoS Negl Trop Dis 8(11), 13 November 2014","URL":"http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0003257","body":"Zoonotic infectious diseases have been an important concern to humankind for more than 10,000 years. Today, approximately 75% of newly emerging infectious diseases (EIDs) are zoonoses that result from various anthropogenic, genetic, ecologic, socioeconomic, and climatic factors. These interrelated driving forces make it difficult to predict and to prevent zoonotic EIDs. Although significant improvements in environmental and medical surveillance, clinical diagnostic methods, and medical practices have been achieved in the recent years, zoonotic EIDs remain a major global concern, and such threats are expanding, especially in less developed regions. The current Ebola epidemic in West Africa is an extreme stark reminder of the role animal reservoirs play in public health and reinforces the urgent need for globally operationalizing a One Health approach. The complex nature of zoonotic diseases and the limited resources in developing countries areargued by the authors to be a reminder of the need for implementation of Global One Health in low- resource settings is crucial. This review highlights advances in key zoonotic disease areas and the One Health capacity needs.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The Impact of Text Message Reminders on Adherence to Antimalarial Treatment in Northern Ghana: A Randomized Trial","field_subtitle":"Raifman JRG, Lanthorn HE, Rokicki S, Fink G: PLoS ONE 9;10, October 2014","URL":"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0109032","body":"Low rates of adherence to artemisinin-based combination therapy (ACT) regimens increase the risk of treatment failure and may lead to drug resistance, threatening the sustainability of current anti-malarial efforts. The authors assessed the impact of text message reminders on adherence to ACT regimens. Health workers at hospitals, clinics, pharmacies, and other stationary ACT distributors in Tamale, Ghana provided flyers advertising free mobile health information to individuals receiving malaria treatment. The messaging system automatically randomized self-enrolled individuals to the control group or the treatment group with equal probability; those in the treatment group were further randomly assigned to receive a simple text message reminder or the simple reminder plus an additional statement about adherence in 12-hour intervals. The main outcome was self-reported adherence based on follow-up interviews occurring three days after treatment initiation. The authors estimated the impact of the messages on treatment completion using logistic regression. The results of this study suggest that a simple text message reminder can increase adherence to antimalarial treatment and that additional information included in messages does not have a significant impact on completion of ACT treatment. Further research is needed to develop the most effective text message content and frequency.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"The prevalence and determinants of catastrophic health expenditures attributable to non-communicable diseases in low- and middle-income countries: a methodological commentary","field_subtitle":"Goryakin Y,  Suhrcke M: International Journal for Equity in Health 13(107), November 2014","URL":"http://www.equityhealthj.com/content/13/1/107","body":"Non-communicable diseases (NCDs) have been spreading fast in low and middle income countries and may also impose a substantial economic cost. One way in which NCDs might impact people\u2019s economic well-being may be via the out-of-pocket expenditures required to cover treatment and other costs associated with suffering from an NCD. In this commentary, the authors identify and discuss the methodological challenges related to cross-country comparison of-out-of-pocket and catastrophic out-of-pocket health care expenditures, attributable to NCDs, focussing on low and middle income countries. There is evidence of substantial cost burden placed by NCDs on patients living in low and middle income countries, with most of it being heavily concentrated among low socioeconomic status groups. However, a large variation in definition of COOPE between studies prevents cross-country comparison. In addition, as most studies tend to be observational, causal inferences are often not possible. This is further complicated by the cross-sectional nature of studies, small sample sizes, and/or limited duration of follow-up of patients. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Think Tank Initiative\u2019s Policy Engagement and Communications Program \u2014 Anglophone Africa: A toolkit for researchers and communications officers","field_subtitle":"Results for Development Institute, CommsConsult, Anglophone Africa PEC program team: September 2014","URL":"http://www.researchtoaction.org/live/wp-content/uploads/2014/11/TTIPEC-E-Manual.pdf","body":"In July 2013, 13 think tanks in Ethiopia, Ghana, Kenya, Nigeria, Tanzania, and Uganda embarked on a mission to strengthen their Policy Engagement and Communications (PEC) capacity. Over the course of 15 months, the think tanks worked with a mentor to diagnose their capacity needs and develop a PEC workplan to strengthen their knowledge and capacity. Work included designing and refining communciation strategies, engaging peers and external stakeholders, and leveraging tools to sharpen their strategic messaging and outreach. The work resulted in the creation of new tools, skillsets, and shared lessons and strategies. This toolkit is a collection of the knowledge generated over the course of the work. It is intended to help the 13 think tanks - and many others - continue excelling and improving in their PEC abilities. It contains guiding principles, tips and suggested approaches to help better plan, package, disseminate and evaluate PEC strategies. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Training resources on sexual and reproductive health","field_subtitle":"Rights-Oriented Research & Education Network in and Reproductive Health, November 2014","URL":"http://rorenetwork.net","body":"The Rights-Oriented Research & Education Network in Sexual & Reproductive Health (SRH) aims to generate transformative and robust evidence for policies and programmes on SRH. RORE is involved in determining new indicators and domains of data to identify rights-realization/gender equality related influences on SRH issues (e.g. on reasons for not using services) and exploratory cross-regional research to evolve concepts from the perspective of those affected. Education and training activities of the Network aim to build capacity in research from a gender and human rights perspective on sexual and reproductive health. RORE provides educational materials, training and mentoring focused on gender and human rights based SRH research and online courses with lectures focused on promoting research with a gender and rights perspective for SRH.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Transitioning from the Informal to the Formal Economy - In the Interests of Workers in the Informal Economy","field_subtitle":"WIEGO Network Platform: November 2014","URL":"http://wiego.org/sites/wiego.org/files/resources/files/WIEGO-Platform-ILO-2014.pdf","body":"This report was developed from a platform was developed in a series of regional workshops held in Argentina, Peru, South Africa, and Thailand. Hosted by WIEGO and local partners, the workshops used a participatory approach to gather feedback and insight from representatives of domestic workers, home-based workers, street vendors, waste pickers, and others. \r\nThe platform sets out common core needs and demands for informal workers around economic, social and labour rights, voice and bargaining power, legal identity and standing, and social protection. For all informal workers, it is argued that formalization must offer benefits and protections \u2013 not simply impose the costs of becoming formal. It must restore the universal rights from which workers in the informal economy have been marginalized by the neo-liberal model of governance over the past 40 years. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Video: Learning more about ethics in health systems research, Kenya","field_subtitle":"Kemri Wellcome Trust, Kenya, November 2014","URL":"http://resyst.lshtm.ac.uk/resources/video-learning-more-about-ethics-health-systems-research-kenya","body":"In this video researchers from Kemri Wellcome Trust in Kenya outline some of the ethical dilemmas that they encounter in their day to day lives. RinGs is a project and learning platform that aims to support researchers on understanding and integrating gender and ethics into their work.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Workshop report: Politicizing African urban ecologies: Enabling radical geographical research practices for African scholars","field_subtitle":"Duminy J: University of Pretoria, South Africa, November 2014","URL":"http://antipodefoundation.org/international-workshop-awards/201314-recipients/iwa-1314-lawhon/","body":"The term \u201curban political describes a critical approach to studying cities across a number of areas, from environmental issues (such as climate change, air pollution, and nature conservation) to urban flows (such as sanitation and electricity provision). Many scholars believe that there is a need for a more explicitly political approach to these topics that draws attention to who wins and who loses as cities change, as well as to how urbanization as a process is shaped by power relations. These ideas informed the Urban Political Ecology in African Cities Workshop, Pretoria South Africa held in September 2014, organized by the Situated Ecologies collective (SUPE). The report presents discussions on options for scholars and residents in cities of Africa and the global South to integrate power relations in their work on urban change.","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Zinduka is a call to East Africans to wake up","field_subtitle":"Odhiambo T: Pambazuka News, 702, 11 November 2014","URL":"http://www.pambazuka.net/en/category/comment/93363","body":"The word \u2018Zinduka\u2019 means re-awaken or stir up in Kiswahili \u2013 more or less like \u2018pambazuka\u2019. In Kirundi it simply means wake up. It is a call to prepare to work; to do something for the day. The Zinduka Festival that was held in Arusha, Tanzania, between 6 and 8 November was a call on ordinary East Africans to wake up, to be alert about the slow pace by politicians in integrating the region. Zinduka \u2013 sponsored by the akibaUhaki and other regional partners and hosted at the Sheikh Amri Abeid Stadium \u2013 was meant to celebrate the common people\u2019s efforts and intensify those efforts to bring the different communities together. The theme was: People\u2019s Voices, Sustainable Development, through Arts, Culture and Conversations. The author argues that Kiswahili can be a key driver of regional integration but that it will need massive efforts to systemize or standardize this lingua franca; integrate it in businesses, schools, offices and in their spiritual and personal life. ","php":"","field_issue_date":"2014-12-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"#WorldvsBank protests the World Bank Doing Business Rankings","field_subtitle":"Our land, our business; October 2014","URL":"http://ourlandourbusiness.org/#home","body":"On October 10, the World Bank met for its Annual General Meeting in Washington DC. Around the world, in 12 cities, people came out to protest against the Bank\u2019s Doing Business rankings. 'WorldvsBank', a global campaign asked the Bank to dump the Doing Business Rankings that only serve big business. The World Bank\u2019s Doing Business ranking gives points to countries when they act in favor of the \u201cease of doing business.\u201d This is argued by the campaign to smooth the way for corporations\u2019 activity by, for instance, cutting administrative procedures, lowering corporate taxes, removing environmental and social regulations, or lowering trade barriers. The ranking system is also argued to encourage land reforms that tend to make land just a marketable commodity, easily accessible to wealthy corporations, in process neglecting human rights, the protection of workers, and the sustainable use of natural resources.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"2015 African Doctoral Dissertation Research Fellowships","field_subtitle":"","URL":"http://aphrc.org/blog/african-doctoral-dissertation-research-fellowships-2015-call/","body":"The African Population and Health Research Center (APHRC), in partnership with the International development Research Centre (IDRC), is pleased to announce the eighth call for applications for the African Doctoral Dissertation Research Fellowships (ADDRF). The ADDRF Fellowship Program seeks to facilitate more rigorous engagement of doctoral students in research, strengthen their research skills, and provide them an opportunity for timely completion of their doctoral training. The Program targets doctoral students with strong commitment to a career in training and/or research. The overall goal of the ADDRF Program is to support the training and retention of highly-skilled, locally-trained scholars in research and academic positions across the region. The ADDRF will award about 20 fellowships in 2015. These fellowships will be awarded to doctoral students who are within two years of completing their thesis at an African university and whose dissertation topics focus on health systems. The fellowship will primarily support research (including data collection and/or analysis). Funds will not be used to support coursework. Applicants must be citizens or permanent residents of a sub-Saharan African country. For further details and application procedures see the website. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"A World That Counts","field_subtitle":"UN Data Revolution Group, 24 October 2014","URL":"http://www.undatarevolution.org/report/","body":"This is the draft report of the UN Secretary General\u2019s Expert Advisory group on the data revolution for sustainable development. This report is not about how to create a data revolution \u2013 it is argued to be already happening \u2013 but how to mobilise it for sustainable development. In the first section the authors describe what the data revolution is, and the opportunities and pitfalls it presents. The second section highlights the current state of data, and the kind of world the authors  foresee if the promise of the revolution is realised. Finally, the third section provides a \u201cvision\u201d of a possible world of data in 2030, and some recommendations for how to achieve it. The authors believe that governments, and governments acting together through the UN, have a crucial role to play. This report offers options for using the data revolution not only to monitor progress towards sustainable development goals, but also to accelerate their achievement.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Amref Health Africa International Conference ","field_subtitle":"November 24th - 26th 2014, Nairobi, Kenya","URL":"http://www.ahaic.org/","body":"From November 24th - 26th 2014, Amref Health Africa in partnership with the World Health Organization will be holding its first international conference themed \u2018From Evidence to Action: Lasting Health Change for Africa\u2019 in Nairobi, Kenya . The three day conference will focus on exchange of scientific results and debates on strategic ideas and application of knowledge to inform health care financing, human resources for health, community systems strengthening and the post 2015 health agenda. It brings together leaders, players and partners in African health development and advocacy. It provides a forum for discussions on how Africa can influence the global health agenda to improve health and health rights on the continent. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Antiretroviral Therapy for Refugees and Internally Displaced Persons: A Call for Equity","field_subtitle":"Mendelsohn JB, Spiegel P, Schilperoord M, Cornier N, Ross DA: PLoS Med 11(6), 10 June 2014","URL":"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001643","body":"Available evidence suggests that refugees and internally displaced persons (IDPs) in stable settings can sustain high levels of adherence and viral suppression. Moral, legal, and public health principles and recent evidence strongly suggest that refugees and IDPs should have equitable access to HIV treatment and support. Exclusion of refugees and IDPs from HIV National Strategic Plans suggests that they may not be included in future national funding proposals to major funders. Levels of viral suppression among refugees and nationals documented in a stable refugee camp suggest that some settings require more intensive support for all population groups. Detailed recommendations are provided for refugees and IDPs accessing antiretroviral therapy in stable settings.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"British Chevening Scholarships For International Students","field_subtitle":"Applications Close 15 November 2014, 23:59 GMT.","URL":"http://www.chevening.org/news/view?id=195&x%5B0%5D=news%20/list","body":"Chevening Scholarships are the UK government\u2019s global scholarship\r\nprogramme, funded by the Foreign and Commonwealth Office (FCO) and partner organisations. The programme makes awards to outstanding scholars with leadership potential from around the world to study postgraduate courses at universities in the UK. The programme provides full or part funding for full-time courses at postgraduate level, normally a one-year Master\u2019s degree, in any subject and at any UK university.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Citizens making things happen","field_subtitle":"Risha Chande, Twaweza, Tanzania","body":"\r\nSeven out of ten Tanzanians think that have no say in what Government does. Yet seven out of ten Tanzanians also think that voting is their only means of influence over Government. This may sound contradictory, but at core, they both reflect the same sentiment. Aside from the choices they make during elections, citizens do not feel that they influence government decision-making or activity. They appear to have little trust that formal institutions or local government officials will address their issues, and formal political institutions seem to play minimal roles in people\u2019s lives. Nine out of ten people report that they have not interacted with their member of parliament in the last year, half have not interacted with their street or village chairman to raise issues and only one in seven citizens are members of any political party. \r\n\r\nThese findings were released by Twaweza in a research brief titled Citizens making things happen: are citizens active and can they hold government to account? The brief is based on data from Twaweza\u2019s Sauti za Wananchi, Africa\u2019s first nationally representative mobile phone survey that interviews households across Mainland Tanzania. \r\n\r\nSauti za Wananchi, (http://www.twaweza.org/uploads/files/Sauti-za-Wananchi-English.pdf)  was initiated by Twaweza as a response to the concern that policy makers make decisions for the whole country, but with poor information on the experiences and realities of a large majority of citizens and on whether their policies are working on the ground across different places. It provides timely, low cost and reliable data and is a nationally representative barometer of the reality reported by Tanzanians. In 2014, together with our partners, we expect to conduct 20 survey rounds, and use widespread dissemination and intensive media outreach to share the findings, especially with policy actors, to shine a light on citizens\u2019 experiences and views.\r\n\r\nSo how are people taking up their concerns? Despite the apparently low levels of interaction with formal channels uncovered by Sauti za Wananchi, 6 out of 10 citizens report that they made joint or collective complaints to officials in their community in the last 12 months, sometimes repeating the same complaint. Common complaints ranged from seeking improvements in local public services, to teacher absenteeism and access to clean and safe water. Just over a quarter of people reported raising complaints about the absence of drugs at local facilities, generally complaining several times in the past year.\r\n\r\nWhen it comes to raising issues within the community, Sauti za Wananchi found that people are fairly vocal about problems they face. Eight out of ten citizens raise their issues in the groups they belong to, and three out of ten have called in to a radio station or complained to a friend.  In contrast, people are much less likely to walk out of a discussion, attend a demonstration or protest or to refuse to pay tax, and far less report that they would or use force to achieve a political cause.  \r\n\r\nCommunity groups thus play a more significant role in people\u2019s lives. Seven  out of ten Tanzanians belong to one, often religious groups, but also savings and loans groups. Community solidarity appears to be high: almost all citizens believe that if an unforeseen incident, such as house fire, occurred, their community would get together to help. The same confidence doesn\u2019t extend beyond immediate communities, and when asked whether they trust people generally, nine out of ten people felt that you had to be very careful with others.  Citizens also strongly feel that they can rely on themselves to get things done. Seven out of ten citizens respond positively to statements about their own ability to overcome challenges, find solutions to their problems and accomplish their own goals.  \r\n\r\nPeople also contribute collectively to their services: Seven out of ten citizens directly contribute to constructing or maintaining public facilities, most giving money and the rest contributing time. While the level of tax collection is low, people are in one way or another contributing to the running of government. However these collections are not well regulated. The lack of transparency and checks and balances mean that contributions may not be collected fairly or used productively. In fact, four out of ten of those who contributed to local facilities say they were forced to do so, eroding public trust. \r\n\r\nSauti za Wananchi  paints an interesting picture of the experience of Tanzanians. Rakesh Rajani, Head of Twaweza at the time, summed it up:  \u201cTanzanians are active members of community groups and undertake collective action to complain to officials in their community. They also feel that they are able to tackle obstacles and make things happen in their own lives but express feelings of powerlessness when it comes to their influence over government. Thus far citizens have shied away from the more emphatic and vocal forms of citizen agency such as tax refusal, protests or walk outs. However significant service delivery challenges remain in all major sectors. If the Government does not become more responsive to this softer engagement, we may see citizens become more aggressive in the future.\u201d\r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the evidence, issues and processes raised in this op-ed please visit Twaweza at www.twaweza.org   and read the full report at http://www.twaweza.org/uploads/files/CitizenAgency-EN-FINAL.pdf ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Community participation in formulating the post-2015 health and development goal agenda: reflections of a multi-country research collaboration","field_subtitle":"Brolan CE, Hussain S, Friedman E, Ruano AL, Mulumba M, Rusike I, Beiersmann C, Hill PS: International Journal for Equity in Health, 13:66, 2014","URL":"http://www.equityhealthj.com/content/13/1/66","body":"Global discussion on the post-2015 development goals, to replace the Millennium Development Goals when they expire on 31 December 2015, is well underway. While the Millennium Development Goals focused on redressing extreme poverty and its antecedents for people living in developing countries, the post-2015 agenda seeks to redress inequity worldwide, regardless of a country\u2019s development status. Furthermore, to rectify the UN\u2019s top-down approach toward the Millennium Development Goals\u2019 formulation, widespread negotiations are underway that seek to include the voices of people and communities from around the globe to ground each post-2015 development goal. This reflexive commentary, therefore, reports on the early methodological challenges the Go4Health research project experienced in its engagement with communities in nine countries in 2013. Led by four research hubs in Uganda, Bangladesh, Australia and Guatemala, the purpose of this engagement has been to ascertain a \u2018snapshot\u2019 of the health needs and priorities of socially excluded populations particularly from the Global South. This is to inform Go4Health\u2019s advice to the European Commission on the post-2015 global goals for health and new governance frameworks. Five methodological challenges were subsequently identified from reflecting on the multidisciplinary, multiregional team\u2019s research practices so far: meanings and parameters around qualitative participatory research; representation of marginalization; generalizability of research findings; ethical research in project time frames; and issues related to informed consent. Strategies to overcome these methodological hurdles are also examined. The findings from the consultations represent the extraordinary diversity of marginal human experience requiring contextual analysis for universal framing of the post-2015 agenda. Unsurprisingly, methodological challenges will, and did, arise. We conclude by advocating for a discourse to emerge not only critically examining how and whose voices are being obtained at the community-level to inform the post-2015 health and development goal agenda, but also how these voices are being translated and integrated into post-2015 decision-making at national and global levels. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Deadly economic violence of the big banks","field_subtitle":"Burger V: Pambazuka News, Issue 699, October 2014","URL":"http://www.pambazuka.net/en/category/comment/93210","body":"The author highlights through a case study the pattern of reckless lending, high interest rates that, over time, significantly inflate the sum of the original loan, strong-arm debt recovery tactics such as threats of legal action and telephone harassment, that is argued in this article to be cases of 'economic violence'. She describes how the extreme distress induced by these practices was manifested in 2012, when thousands of desperate, poorly paid, over-indebted Marikana mineworkers, while striking for a R12 500 per month living wage, refused to back down and chose to face bullets to escape the suffocating squeeze of the omashonisa (money lenders). The article proposes that debt for an increasing number of South Africans has literally become life threatening, and that there is as yet no meaningful challenge to it.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Did Ebola emerge in West Africa by a policy-driven phase change in agroecology? Ebola\u2019s social context","field_subtitle":"Wallace R G, Gilbert M, Wallace R, Pittiglio C, Mattioli R, Kock R: Environment and Planning A:46, 2014","URL":"http://www.envplan.com/openaccess/a4712com.pdf","body":"The ongoing outbreak of human Ebola virus in West Africa, the largest and most extensive recorded, began in forest villages across four districts in southeastern Guinea as early as December 2013. The authors argue that the shifts in land use in Guin\u00e9e foresti\u00e8re where the virus originated are also connected to government policies promoting neoliberal structural adjustment that, alongside divesting public health infrastructure, opened domestic food production to global capital with Ebola\u2019s latest spillover arising due to massive expansion in the land allocated to corporate production of oil palm, taking over farmland, and bringing a a variety of disturbance-associated fruit bats attracted to oil palm plantations into more direct contact with informal pickers and contract farmers. Deforestation, including from oil palm planting, changes foraging behavior of the bat and expands interfaces among bats, humans and livestock. The authors suggest that deforestation, de-development, population mobility, peri-urbanization, cycle migration, and an inadequate health system that failed to recognize and isolate cases may have contributed, and that the the present outbreak signals the need to characterise the ecosystems on which humanity must routinely be reminded it depends. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Does the distribution of healthcare utilization match needs in Africa?","field_subtitle":"Bonfrer I, van de Poel E, Grimm M, Van Doorslaer E: Health Policy and Planning 29(7): 921-937, 10 October 2013","URL":"http://www.ncbi.nlm.nih.gov/pubmed/24115777","body":"An equitable distribution of healthcare use, distributed according to people\u2019s needs instead of ability to pay, is an important goal featuring on many health policy agendas worldwide. However, relatively little is known about the extent to which this principle is violated across socio-economic groups in Sub-Saharan Africa (SSA).  The authors ex-amine cross-country comparative micro-data from 18 SSA countries and find that considerable inequalities in healthcare use exist and vary across countries. For almost all countries studied, healthcare utilization is considerably higher among the rich. When decomposing these inequalities wealth is found to be the single most important driver. In 12 of the 18 countries wealth is responsible for more than half of total inequality in the use of care, and in 8 countries wealth even explains more of the inequality than need, education, employment, marital status and urbanicity together. For the richer countries, notably Mauritius, Namibia, South Africa and Swaziland, the contribution of wealth is typical-ly less important. As the bulk of inequality is not related to need for care and poor people use less care because they do not have the ability to pay, healthcare utilization in these countries is to a large extent unfairly distributed. The weak average relationship between need for and use of health care and the potential reporting heterogeneity in self-reported health across socio-economic groups imply that the findings are likely to even underestimate actual inequities in health care. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 165: Citizens making things happen ","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Policy Brief 39: Enhancing local medicine production in east and Southern Africa","field_subtitle":"SEATINI, CEHURD, TARSC, CPTL: EQUINET Harare September 2014","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20GHD%20Meds%20polbrief39%202014.pdf","body":"This brief outlines the factors that affect medicines production in East and Southern Africa, drawing on the African Union, Southern Africa Development Community (SADC) and East African Community (EAC) pharmaceutical plans. It identifies the barriers to local production as: lack of supportive policies, capital and skills constraints, gaps in regulatory framework, small market size and weak research and development capacities. It highlights, from case study work in selected countries in East and Southern Africa the potential opportunities for strengthening local medicine production. In the brief we propose that African countries strengthen domestic capacities, co-operation between domestic private and public sectors within ESA countries, and regional co-operation across ESA countries to address bottlenecks. Some areas such as infrastructure development and training may be important groundwork for others, such as technology transfer and research and development. South-south cooperation in medicines production can play a role in this but it cannot be assumed. Negotiations on south-south arrangements should look not only at the immediate production investment, but at strengthening capacities for research and development, for regulation, medicines price and quality monitoring, prequalification, infrastructure and human resource development.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Equity-Oriented Monitoring in the Context of Universal Health Coverage","field_subtitle":"Hosseinpoor AR, Bergen N, Koller T, Prasad A, Schlotheuber A, et al.: PLoS Med 11(9), 22 September 2014","URL":"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001727","body":"Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, the authors recommend forming subgroups as quintiles, and for urban/rural inequality the authors recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. The authors recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Examining the links between community participation and health outcomes: a review of the literature","field_subtitle":"Rifkin S: Health Policy and Planning 29, suppl 2 ii98-ii106, 2014","URL":"http://heapol.oxfordjournals.org/content/29/suppl_2/ii98.full.pdf+html","body":"As a key principle of Primary Health Care (PHC) and Health Systems Reform, community participation has a prominent place in the current global dialogue. Participation is not only promoted in the context of provision and utilization of health services. Advocates also highlight participation as a key factor in the wider context of the importance of social determinants of health and health as a human right. However, the evidence that directly links community participation to improved health status is not strong. Its absence continues to be a barrier for governments, funding agencies and health professionals to promote community participation. The purpose of this article is to review research seeking to link community participation with improved health status outcomes programmes. It updates a review undertaken by the author in 2009. The search includes published articles in the English language and examines the evidence of in the context of health care delivery including services and promotion where health professionals have defined the community\u2019s role. The results show that in most studies community participation is defined as the intervention seeking to identify a direct causal link between participation and improved health status modeled on Randomized Control studies (RCT). The majority of studies show it is not possible to examine the link because there is no standard definition of \u2018community\u2019 and \u2018participation\u2019. Where links are found, they are situation-specific and are unpredictable and not generalizable. In the discussion, an alternative research framework is proposed arguing that community participation is better understood as a process. Once concrete interventions are identified (i.e. improved birth outcomes) then the processes producing improved health status outcomes can be examined. These processes may include and can lead to community uptake, ownership and sustainability for health improvements. However, more research is needed to ensure their validity.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Forum 2015: People at the center of research and innovation for health","field_subtitle":"25-27 August 2015, Manila, Philippines","URL":"http://blog.cohred.org/67/forum-2015-people-at-the-center-of-research-and-innovation-for-health?utm_source=newsletter&utm_medium=e-mail&utm_campaign=post3","body":"The Global Forum for Research and Innovation for Health is the successor of the Global Forum for Health Research that merged with the Council on Health Research for Development (COHRED) in 2011. Forum 2015, as it will be abbreviated, will provide an opportunity for everyone interested in pursuing global health, equity and development to meet, exchange information, find partners, design solutions and set research and innovation agendas - nationally, regionally and globally.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Free State\u2019s Community Health Workers\u2019 Case Postponed to 29 January 2015","field_subtitle":"Sangonet pulse: October 14 2014","URL":"http://www.ngopulse.org/press-release/free-state-s-community-health-workers-case-postponed-29-january-2015","body":"Over a hundred community health workers (CHW)\u2019s  and the members of the Treatment Action Campaign  appeared at the Bloemfontein Magistrate\u2019s Court today, regarding their criminal charges following their arrest at a peaceful vigil on 10 July 2014. The 129 community health care worker\u2019s case was postponed to the 29th of January 2015. The South African Police Services (SAPS) arrested the CHW\u2019s in the early hours of the 10th of July, during a peaceful vigil through which they were protesting the crumbling state of the public health system in Free State, their poor conditions of employment, and the 15 June\u2019s autocratic decision of the MEC for Health in the Free State department of Health, Benny Malakoane to effectively terminate their employment without warning. The postponement is meant for the prosecution to provide the CHW\u2019s the evidence against them and for the CHW\u2019s to make representations to the National Director of Public Prosecutions, Mxolisi Nxasana, that the charges should be unconditionally withdrawn.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Glimmers of hope on the Ebola front","field_subtitle":"Fleck F: Bull World Health Organ;92:704\u2013705, 2014","URL":"http://www.who.int/bulletin/volumes/92/10/14-031014.pdf","body":"Daniel Bausch - interviewed in this paper- has been assisting with patient care during the current Ebola virus disease outbreak in western Africa and \u2013 as part of a WHO-led international collaboration \u2013 is exploring the possible use of experimental therapies and vaccines. He explains in this paper why this outbreak is different. He notes that the outbreak response had outstripped the available resources. Although personnel were deployed he says \"we are all late and it has gotten out of control. It\u2019s too simplistic to lay the blame on one group. There has been a lot of finger pointing at WHO, no one is immune to criticism, but WHO has suffered a loss of personnel and resources. So it\u2019s not only about what we should have done at any particular time, but the whole foundation for an international public health response that has been eroded by the global economic downturn\". He further observes that the scale and public profile of this outbreak means that potential vaccines and therapies that were stalled are now being pushed through clinical trials. He argues that if vaccines and drugs are provided in the not too distant future, the problem will change and people will start knocking on the door demanding prevention and treatment, so this is a public health strategy as well, but stemming the outbreak will still depend primarily on the classic strategy of case identification, with isolation and treatment, and contact tracing.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Global Health Watch 4: An Alternative World Health Report","field_subtitle":"Coming November 13 2014","URL":"http://www.ghwatch.org","body":"The Global Health Watch is widely perceived as the definitive voice for an alternative discourse on health. It integrates rigorous analysis, alternative proposals and stories of struggles and change to present a compelling case for the imperative to work for a radical transformation of the way we approach actions and policies on health. It is designed to question present policies on health and to propose alternatives. GHW4 is a collaborative effort by activists and academics from across the world, and has been coordinated the People\u2019s Health Movement, Asociacion Latinoamericana de Medicina Social, Health Action International, Third World Network and Medact. This edition of the GHW will be available in November 2014 and PHM invite people to consider launching the GHW4 from December 2014. For this purpose \u2018launch kits\u2019 will be available by early November 2014.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Health Committees as vehicles for community participation","field_subtitle":"Statement from the Regional Consultation 27 & 28 September 2014","body":"Participants at the Regional Meeting on Health Committees co-hosted by the Learning Network for Health and Human Rights, the Centre for Health, Human Right and Development (CEHURD) and the Network on Equity in Health in East and Southern Africa (EQUINET), 27-28 September 2014, Cape Town developed the statement from the meeting committing themselves to strengthen regional learning networks between countries of the south for advancing health committees as vehicles for community participation and calling on governments to recognise and incorporate health committees into their health systems in ways that maintain their roles as autonomous agents for democratic governance; WHO to provide guidance on inclusion of Health Committees in Health Systems Governance; and for discussions on updating the WHO Building Blocks approach to recognise the role of collective community action through Health Committees when inserting notions of public and patient engagement.","php":"Further details: /newsletter/id/39173","field_issue_date":"2014-11-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Heroes dressed in white","field_subtitle":"Hern\u00e1ndez LM: Pambazuka October 2914","URL":"http://www.pambazuka.net/en/category/features/93128","body":"Cuba recently sent a medical team of 165 internationalist collaborators, consisting of 63 doctors and 102 nurses from across the country, with more than 15 years practical experience and of which 81 % had served on previous international missions. They went to Sierra Leone to support efforts to contain the Ebola outbreak. It is a mission they made clear were happy to undertake that goes to the heart of Cuba\u2019s people-to-people solidarity. The author argues that is affirms that Cuba doesn\u2019t give what it has left over, but its most precious commodity: its sons, its heroes in white coats.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"IDRC Fellowship at the Center for Global Development","field_subtitle":"Application deadline: 30 November 2014","URL":"http://www.cgdev.org/page/idrc-fellowships","body":"The Center for Global Development (CGD), an independent Washington-based think tank, invites applications from scholars from developing countries for a one-year visiting fellows program sponsored by Canada\u2019s International Development Research Centre (IDRC).","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"In the shadowlands of global health: Observations from health workers in Kenya","field_subtitle":"Prince RL, Otieno  P: Global Public Health, 9(8):927-945, September 2014","URL":"http://www.tandfonline.com/doi/full/10.1080/17441692.2014.941897","body":"This paper draws on ethnographic research conducted in HIV clinics and in a public hospital to examine how health workers experience and reflect upon the juxtaposition of 'global' medicine with 'local' medicine. We show that health workers face an uneven playing field. High-prestige jobs are available in HIV research and treatment, funded by donors, while other diseases and health issues receive less attention. Outside HIV clinics, patient's access to medicines and laboratory tests is expensive, and diagnostic equipment is unreliable. Clinicians must tailor their decisions about treatment to the available medical technologies, medicines and resources. How do health workers reflect on working in these environments and how do their experiences influence professional ambitions and commitments? The need to improvise in the face of inadequate diagnostic tools and unreliable facilities was stressful for all health workers. Added to this stress was the degree to which health workers had to attend to patient poverty. While staff within HIV/AIDS clinics also faced these issues, hospital staff often found them overwhelming as they were confronted daily and relentlessly with the moral dilemma of how to deal with patients who could not afford treatment. In this situation, the strain of being forced to practice medicine that was only \u2018good enough\u2019 was a source of stress and frustration. Among interns, the moral complexity of their situation added to their uneasy positioning as young professionals struggling to gain a sense of professional identity and competence. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Innovative Financing Mechanisms: Potential Sources of Financing the WHO Tobacco Convention","field_subtitle":"Ko Sy D, Syam N, Vel\u00e1squez  G: South Centre Research Paper No. 54, September 2014","URL":"http://www.southcentre.int/wp-content/uploads/2014/09/RP54_Innovative-Financing-Mechanisms-rev_EN.pdf","body":"This research paper is produced as part of the South Centre\u2019s research on expanding fiscal policies for global and national tobacco control. The objective of this research is to identify innovative solutions to fill the funding gaps in the implementation of the WHO Framework Convention on Tobacco Control (FCTC). Ideas and mechanisms for generating additional funding may be spawned from a review of the popular forms of non-traditional financing mechanisms that have been aimed at mobilizing resources for developmental programmes. The General Assessment section for each innovative financing idea in the paper reflects lessons learned and best practices that provide the reader with some framework when evaluating an innovative financing mechanism. Some are more  administratively feasible than others but in all cases, political feasibility is a critical element. A deeper understanding of the political concerns would surface and can possibly be addressed only if the ideas are allowed to be debated on, and sufficient space to explore is provided in the appropriate forum. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"International Civil society Week: Citizen action, People power","field_subtitle":"Civicus: 19-25 November, Johannesburg, South Africa","URL":"http://civicus.org/ICSW/","body":"To celebrate South Africa's 20th anniversary of freedom and democracy, CIVICUS and its partners will gather change makers from around the world at the University of Witwatersrand in Johannesburg for International Civil Society Week from 19-25 November 2014. International Civil Society Week 2014 will involve a diverse, multi-stakeholder partnership that seeks to tackle the world\u2019s most pressing challenges. Under the banner of Citizen Action, People Power, the week long series of events will gather global thinkers, innovation leaders and influential organisations.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Journal Of Health Diplomacy: Call For Papers on Africa, Health And Diplomacy","field_subtitle":"Call Closes: 30 November 2014","URL":"https://journals.carleton.ca/jhd/index.php/journal","body":"The Journal of Health Diplomacy (JHD) is now receiving manuscripts for its third issue, titled: Africa, health and diplomacy. This issue is broadly concerned with the theory and practice of health diplomacy of African states, as a co-operation with the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The issue will include invited and submitted manuscripts. To be considered for the latter, please submit your proposed manuscript to irwin@sipri.org by 30 November 2014. Manuscripts submitted to JHD will undergo a peer-review process, with referees selected for their particular knowledge/experience on the topic of the manuscript. In light of this, we ask authors to ensure that their identity is not revealed directly or indirectly on any page. Manuscripts that are being considered for publication elsewhere, or that have been previously published must not be submitted to the journal. A complete set of author guidelines is available on the journal website. JHD welcomes contributions from all academic disciplines, including international relations, political science, anthropology, sociology, history and geography. We are also interested in interdisciplinary perspectives that cross the boundaries between different theoretical fields and represent novel understandings of health diplomacy.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"LDCs and TRIPS: Overcoming challenges, seeking solutions","field_subtitle":"Bridges Africa editorial team: Bridges, 3; 8 October 2014","URL":"http://www.ictsd.org/bridges-news/bridges-africa/news/ldcs-and-trips-overcoming-challenges-seeking-solutions","body":"The Bridges Africa editorial team features various analyses that take a closer and fresh look at the unique challenges facing least developed countries in the context of the trade-innovation nexus. The dynamics underpinning the IPR and public policy debate are often epitomised by the topic of the protection of patented drugs by LDCs. In 2001, the latter obtained a separate waiver to implement TRIPS provisions on pharmaceutical products until January 2016. Should LDCs seek the renewal of this waiver before it expires, or does the general extension for the TRIPS Agreement until July 2021 already allow for exemptions from patent protection motivated by public health concerns? These and related questions are addressed in this edition.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Medical Humanities: Call for applications for 3 year doctoral fellowships","field_subtitle":"Closing date for applications: 15 December 2014","URL":"http://wiser.wits.ac.za/event/medical-humanities-doctoral-fellowships","body":"","php":"Further details: /newsletter/id/39143","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Monitoring and Evaluating Progress towards Universal Health Coverage in South Africa","field_subtitle":"Ataguba JE, Day C, McIntyre D: PLoS Med 11(9), 22 September 2014","URL":"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001686","body":"The South African health system is tiered with the minority of the population using private health services and the majority relying mainly on tax-funded health services.  South Africa (SA) bears a quadruple burden of disease com-prising tuberculosis, HIV and AIDS, high levels of maternal and child mortality, injuries, and non-communicable dis-eases. The burden of these diseases falls most heavily on the poor.  In 2007 the SA government committed itself to implementing National Health Insurance (NHI) in order to move the country toward universal health coverage (UHC).  This paper, as part of a series of case studies commissioned by the World Health Organization (WHO) to develop ap-propriate measures of UHC, provides a case study of SA\u2019s current situation in relation to UHC using the WHO-proposed indicator framework.  Drawing on different national data sources, the paper shows that disparities exist in the proposed indicators in the SA context.  The paper notes that the framework may be more appropriate for monitoring progress towards UHC over time, rather than as a tool for evaluating a country\u2019s status relative to UHC goals at a single point in time. This paper also points to the need to have UHC-related \u2018benchmarks\u2019 against which to compare country data. Further, the proposed indicators by themselves do not provide clear insights into health system reforms required to promote UHC; there is need for a more detailed system-level analysis.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Monitoring Progress towards Universal Health Coverage at Country and Global Levels","field_subtitle":"Boerma T, Eozenou P, Evans D, Evans T, Kieny MP, Wagstaff A: PLoS Med 11(9), 22 September 2014 ","URL":"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001731","body":"This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards Universal health coverage (UHC). The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Negotiating markets for health: an exploration of physicians\u2019 engagement in dual practice in three African capital cities","field_subtitle":"Russo G, McPake B, Fronteira I, Ferrinho P: Health Policy and Planning 29 (6): 774 - 783, 26 September 2013","URL":"http://heapol.oxfordjournals.org/content/29/6/774.full?sid=b6c6a9dd-6217-47c6-b38f-5ea6790ef17a","body":"Scarce evidence exists on the features, determinants and implications of physicians\u2019 dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities, Cape Verde, Maputo and Guinea Bissau, and the respective markets for physician services, with the objective of understanding the influence of local determinants on the practice. Forty-eight semi-structured qualitative interviews were conducted in the three cities to understand features of the practice and the respective markets. A survey was carried out in a sample of 331 physi-cians to explore their characteristics and decisions to work in public and private sectors. Descriptive analysis and infer-ential statistics were employed to explore differences in physicians\u2019 engagement in dual practice across the three loca-tions. Different forms of dual practice were found to exist in the three cities, with public physicians engaging in private practice outside but also inside public facilities, in regulated as well as unregulated ways. Thirty-four per cent of the respondents indicated that they worked in public practice only, and 11% that they engaged exclusively in private prac-tice. The remaining 55% indicated that they engaged in some form of dual practice, 31% \u2018outside\u2019 public facilities, 8% \u2018inside\u2019 and 16% both \u2018outside\u2019 and \u2018inside\u2019. Local health system governance and the structure of the markets for phy-sician services were linked to the forms of dual practice found in each location, and to their prevalence. The authors analysis suggests that physicians\u2019 decisions to engage in dual practice are influenced by supply and demand factors, but also by how clearly separated public and private markets are. Where it is possible to provide little-regulated services within public infrastructure, less incentive seems to exist to engage in the formal private sector, with equity and effi-ciency implications for service provision. The study shows the value of analysing health markets to understand physi-cians\u2019 engagement in professional activities, and contributes to an evidence base for its regulation.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"One week course on Tax Justice ","field_subtitle":"MS Training Centre for Development Cooperation: 24-28 November 2014, Arusha, Tanzania","URL":"http://www.mstcdc.or.tz/application/tax-justice-campaign.","body":"MS-TCDC is conducting a one-week course on Tax Justice Campaign from 24-28 November 2014 in Arusha, Tanzania. The overall objective of the course is to enable participants to appreciate the importance of taxation and revenue collection in relation to social change. They will also understand taxation form a development view point, and acquire skill to mobilise and support efforts to demand utilisation of funds from tax for poverty elimination. The course is aimed at practitioners working in CSOs, government and other development agencies engaged in governance and accountability work.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Perceptions and experiences of access to public healthcare by people with disabilities and older people in Uganda","field_subtitle":"Mulumba M, Nantaba J, Brolan CE, Ruano AL, Brooker K,  Hammonds R: International Journal for Equity in Health, 13:76, 2014","URL":"http://www.equityhealthj.com/content/13/1/76","body":"A global discussion regarding how to renew the Millennium Development Goals (MDGs) is underway and it is in this context that the Goals and Governance for Global Health (Go4Health) research consortium conducted consultations with marginalized communities in Asia, Latin America, the Pacific and Africa as a way to include their voices in world\u2019s new development agenda. The goal of this paper is to present the findings of the consultations carried out in Uganda with two groups within low-resource settings: older people and people living with disabilities. This qualitative study used focus group discussions and key informant interviews with older people in Uganda\u2019s Kamwenge district, and with persons with disabilities from the Gulu region. Thematic analysis was performed and emerging categories and themes identified and presented in the findings. Our findings show that a sense of community marginalization is present within both older persons and persons living with disabilities. These groups report experiencing political sidelining, discrimination and inequitable access to health services. This is seen as the key reason for their poor health. Clinical services were found to be of low quality with little or no access to facilities, trained personnel, and drugs and there are no rehabilitative or mental health services available. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Poverty Reduction and Regional Integration: A comparative analysis of SADC and UNASUR health policies (PRARI) ","field_subtitle":"Open University, FLASCO, SAIIA, UNU-CRIS: ","URL":"http://www.open.ac.uk/socialsciences/prari/index.php","body":"The Open University and Southampton University, South African SAIIA FLACSO-Argentina and UNU-CRIS are currently involved in the Poverty Reduction and Regional Integration (PRARI) project, a two year project studying what regional institutional practices and methods of regional policy formation are conducive to the emergence of embedded pro-poor health strategies, and what can national, regional and international actors do to promote these, particularly in South America and Southern Africa. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Public-Private Partnerships, Financial Extraction and the Growing Wealth Gap","field_subtitle":"Hildyard N: Manchester Business School, Centre for Research on Socio-Cultural Change (CRESC), July 2014","URL":"http://www.thecornerhouse.org.uk/sites/thecornerhouse.org.uk/files/PPPs%20-%20Financial%20Extraction%20-%20Wealth%20Gap%20minus%20photos.pdf","body":"This presentation looks at Public-Private Partnerships (PPPs) in infrastructure through the lens of inequality, as wealth becomes concentrated in fewer and fewer hands and as the gap between rich and poor widens globally, regionally and within countries. PPPs are now used in more than 134 developing countries, are on the rise in the aftermath of the 2008 global financial crisis, and have moved from physical infrastructure into the provision of \u201csocial infrastructure,\u201d such as schools, hospitals and health services. For the private sector, a PPP project needs to provide a stable, guaranteed income stream. Projects are devised to create multiple avenues for a flow of money that is transformed into private profit through loans, derivatives, shares, securitised income streams, and contract sales that anyone can buy and sell. The author argues that a PPP project enables millions of dollars worth of ancillary trading, mainly for the purpose of hedging risks. The choice of what infrastructure to build is thus argued to be heavily influenced by what serves the long-term profit-making interests of the private sector \u2013 and the state or public sector becomes more and more aligned with the interests of infrastructure investors and private companies. PPPs are thus reported to be not about building and providing public services but about constructing the subsidies, fiscal incentives, capital markets, regulatory regimes and other support systems necessary to transform \u201cinfrastructure\u201d into an asset class that yields above average returns of 13-25%.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Ten best resources for conducting financing and benefit incidence analysis in resource-poor settings","field_subtitle":"Wiseman V,  Asante A,  Price J, Hayen A, Irava W,  Martins J, Guinness L,  Jan S: Health Policy and Planning: 24 September 2014","URL":"http://heapol.oxfordjournals.org/content/early/2014/09/24/heapol.czu108.full?sid=b6c6a9dd-6217-47c6-b38f-5ea6790ef17a","body":"Many low- and middle-income countries are seeking to reform their health financing systems to move towards universal coverage. This typically means that financing is based on people\u2019s ability to pay while, for service use, bene-fits are based on the need for health care. Financing incidence analysis (FIA) and benefit incidence analysis (BIA) are two popular tools used to assess equity in health systems financing and service use. FIA studies examine who pays for the health sector and how these contributions are distributed according to socioeconomic status (SES). BIA determines who benefits from health care spending, with recipients ranked by their relative SES. In this article, the authors identify 10 resources to assist researchers and policy makers seeking to undertake or interpret findings from financing and benefit incidence analyses in the health sector. The article pays particular attention to the data requirements, computations, methodological challenges and country level experiences with these types of analyses.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The HIV/AIDS epidemic in South Africa: Convergence with tuberculosis, socioecological vulnerability, and climate change patterns","field_subtitle":"Abayomi A, Cowan MN: South African Medical Journal104(8):583, 9 July 2014","URL":"http://www.samj.org.za/index.php/samj/article/view/8645","body":"Recent assessment reports suggest that climate change patterns are threatening social and ecological vulnerability and resilience, with the strong potential of negatively affecting human health. Persons living with HIV/AIDS (PLWHA) have weakened physiological responses and are immunologically vulnerable to pathogens and stressors in their environment, putting them at a health disadvantage in climate-based rising temperatures, water scarcity, air pollution, potential water- and vector-borne disease outbreaks, and habitat redistributions. These climatic aberrations may lead to increased surface drying and decreased availability of arable land, threatening food/nutrition security and sanitary water practices. Coupled with HIV/AIDS, climate change threatens ecological biodiversity via a larger-scale socio-economic recourse to natural resources. Corresponding human and environmental activity shape conditions conducive to exacerbating high rates of HIV/AIDS. In South Africa, this epidemic is forming a \u2018syndemic\u2019 with tuberculosis (TB), which has come to include multidrug-resistant TB (MDR-TB) and extremely drug-resistant TB (XDR-TB) strains. Be-cause of high convergence rates, one epidemic cannot be addressed without understanding the other. Concurrent climate change mitigation and adaptation strategies are becoming increasingly important to curb changes that negatively affect the biospheres on which civilisation is ultimately dependent \u2013 from an agricultural, a developmental, and especially a health standpoint. Mitigation strategies such as reducing carbon emissions are essential, but may be only partially effective in slowing the rate of surface warming. However, global climate assessments assert that these are not sufficient to halt climate change patterns. Regionally specific climate research, socioecologically sustainable industrialisation paths for developing countries, and adoption of health system strengthening strategies are therefore vital.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The naked class politics of Ebola","field_subtitle":"Robb J: Pambazuka, Issue 699, September 2014","URL":"http://www.pambazuka.net/en/category/comment/93212","body":"Ebola is also an epidemic, and the causes and conditions of the epidemic are social, economic, and political rather than natural. Outside of these social and economic conditions, the disease would have been contained or even eliminated long before now. The three countries at the centre of the Ebola epidemic are among the most impoverished in the world. The author argues that the permanent legacy of centuries of uninterrupted plunder is chronic and widespread malnutrition, dirt roads, poor or non-existent sanitation, unreliable or non-existent electric power, and one doctor per 100,000 inhabitants. These are the conditions in which an Ebola outbreak becomes an epidemic. For several months after the existence of Ebola was confirmed in the three countries of West Africa, it did not, the author argues, threaten the extraction of wealth from the region, and the first actions were to withdraw many volunteers including those working in health and to suspend flights. As cases were diagnosed in the USA and Europe, the response is reported to have been isolationist, with media spreading fear and speculation. Aid increased, but with limited personnel, except from Cuba. The author argues that West African health workers and volunteers are the ones who have carried out the socially necessary tasks of caring for patients, collecting and burying bodies, and educating the population in prevention and containment measures, despite inadequate safety equipment, serious threats to their own health, inadequate pay, and despite sometimes being ostracised in their own communities. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The Right to Dream","field_subtitle":"Eduardo Galeano: March 2011","URL":"http://thinkloud65.wordpress.com/2011/03/31/the-right-to-dream-%E2%80%93-a-utopia-according-to-eduardo-galeano/","body":"In 1948 and again in 1976, the United Nations proclaimed long lists of human rights, but the immense majority of humanity enjoys only the rights to see, hear and remain silent. Eduardo Galeano in this poem posits that suppose we start by exercising the never-proclaimed right to dream? Suppose we rave a bit? He asks us to set our sights beyond the abominations of today to divine another possible world. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The right to health: what model for Latin America?","field_subtitle":"Heredia N, Laurell AC, Feo O, Noronha J, Gonz\u00e1lez-Guzm\u00e1n R, Torres-Tovar M: The Lancet, Early Online Publication, 16 October 2014","URL":"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61493-8/fulltext#article_upsell","body":"The drive for Universal Health Coverage is currently very intense. Everybody seems to agree on this objective. However, the term is argued to be ambiguous term and in Latin America two different notions\r\nare used. One refers to forms of health insurance, be they voluntary or compulsory and public or private, and in variable combinations. The other refers to a single public health system\u2014ie, a unified tax-funded health system as an obligation of the state. The authors argue that it is critical to distinguish between these two notions and to set uniform criteria of analysis to compare their achievements. In this context, these are: population and medical coverage in their categories of universal or segmented access and use of service and possible barriers; origin and management of health funds; type of providers; health expenditure, public and private; distribution of costs and amount of out-of-pocket expenditure; impact on public health actions and health conditions; and equity, popular participation, and transparency. Taken together, these reveal the extent to which the right to health, a widely held social value, is attained. The authors analyse the largely pluralist health insurance in Latin America and argue that it does not grant the right to health, understood as equal access to the necessary services for equal need. By contrast with the intrinsic restrictions of universal health insurance, the problems of the single public health system are identified as operational. Where implemented in Latin America, while they have problems to resolve, these unified publicly funded systems are argued to be 'on their way to grant the right to health'.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The Sub-Saharan Media Landscape - Then, Now and in the Future","field_subtitle":"Balancing Act: August 2014","URL":"http://www.balancingact-africa.com/sites/balancingact-africa.com/files/products/1.%20SSA%20Media%20Landscape.pdf","body":"Focus groups, one-to-one interviewees and surveys in Ghana, Senegal and\r\nTanzania, Nigeria. Ethiopia and South Africa provided the evidence cited in this research report. They were asked what had changed most about media and communications in the last five years. Two responses were common to all those who took part: the greater amount of media available and the presence of the Internet. These key changes have created haves and the have-nots. On almost every media measure, those living in rural Africa are at a disadvantage to their urban counterparts. The research found that over five years Facebook has grown from practically no users in Sub-Saharan Africa to become the most widely used social media platform, and the number of Africans who own or have access to mobile phones, computers, laptops, smartphones and tablets has grown considerably. Based on trends the authors predict that smartphone use will grow to between 10-20% of the population depending on the country, as will phones with internet access. While the current pattern of mobile phone use in the countries in focus has largely been voice and SMS, the numbers accessing the internet and social media is projected to grow over the next five years to between 10-25% of the population depending on the country. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"To legislate or not to legislate? A comparison of the UK and South African approaches to the development and implementation of salt reduction programs ","field_subtitle":"Charlton K, Webster J, Kowal P: Nutrients 6(9), 3672-3695, 2014 ","URL":"http://www.mdpi.com/2072-6643/6/9/3672","body":"The World Health Organization promotes salt reduction as a best-buy strategy to reduce chronic diseases, and Member States have agreed to a 30% reduction target in mean population salt intake by 2025. Whilst the UK has made the most progress on salt reduction, South Africa was the first country to pass legislation for salt levels in a range of processed foods. This paper compares the process of developing salt reduction strategies in both countries and highlights lessons for other countries. Like the UK, the benefits of salt reduction were being debated in South Africa long before it became a policy priority. Whilst salt reduction was gaining a higher profile internationally, undoubtedly, local research to produce context-specific, domestic costs and outcome indicators for South Africa was crucial in influencing the decision to legislate. In the UK, strong government leadership and extensive advocacy activities initiated in the early 2000s have helped drive the voluntary uptake of salt targets by the food industry. It is too early to say which strategy will be most effective regarding reductions in population-level blood pressure. Robust monitoring and transparent mechanisms for holding the industry accountable will be key to continued progress in each of the countries.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Treatment of Infections in Young Infants in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis of Frontline Health Worker Diagnosis and Antibiotic Access","field_subtitle":"Lee AC, Chandran A, Herbert HK, Kozuki N, Markell P, et al.: PLoS Med 11(10), 14 October 2014","URL":"http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001741","body":"Inadequate illness recognition and access to antibiotics contribute to high case fatality from infections in young infants (","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"UN Rapporteur on right to health calls for review of investment treaties","field_subtitle":"Gopakumar K: TWN Info Service on Health Issues, October 2014 ","URL":"http://www.twn.my/title2/health.info/2014/hi141002.htm","body":"Investment treaties should be reviewed to ensure that States have the right to make changes in their laws and policies to further human rights regardless of the impact of such changes on investors\u2019 rights. This recommendation came from the Special Rapporteur on Right to Health, Mr. Anand Grover in his last report to the UN General Assembly (UNGA).  The report notes that nearly 40 countries have already began renegotiation of international investment treaties. The Grover report calls for an international treaty to hold transnational corporations (TNCs) accountable for their violations on human rights. The report presents the current state of play with regard to the accountability of TNCs with regard to human rights violations. Two other sub-sections discuss the shortcomings of international investment treaties and the investor -state dispute settlement mechanism.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"WHO\u2019s antibiotic resistance draft action plan soft on critical issues ","field_subtitle":"Gopakumar KM: TWN Info Service on Intellectual Property Issues 16 October 2014","URL":"http://www.twn.my/title2/intellectual_property/info.service/2014/ip141008.htm","body":"The 67th World Health Assembly (WHA) in May 2014 mandated the WHO Secretariat \u201cto develop a draft global action plan to combat antimicrobial resistance, including antibiotic resistance, which addresses the need to ensure that all countries, especially low and middle income countries. The Global Action Plan (GAP) is to be submitted to the 68th WHA through the 136th Session of the Executive Board meeting which will take place on 26 January to 3 February 2015 in Geneva. The author argues that the draft GAP fails to provide bold solutions especially where the pharmaceutical transnational corporations (TNCs) and their home countries have vested interests. The areas where the plan is argued to raise concern are:  on the mechanism to ensure access to antimicrobial medicines at affordable prices, including local production capabilities of antimicrobial medicines and diagnostics, technology transfer and public procurement. Another major area of strategic silence is the research and development (R&D) of new AMR medicines including antibiotics and diagnostics. Other important omissions are the explicit mention of promotion of rational use of antimicrobial medicines and the management of conflict of interests.","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Why passion has a place at a health systems symposium: reflections on Cape Town 2014","field_subtitle":"Balabanova D, Lazarus J: Health System Global, October 2014","URL":"http://www.healthsystemsglobal.org/GetInvolved/Blog/TabId/155/PostId/33/why-passion-has-a-place-at-a-health-systems-symposium-reflections-on-cape-town-2014.aspx","body":"Passion. It is not a word that is used often in the health systems discourse, and it may be the last word that people outside of health systems circles would associate with our work. But, the authors argue in this blog, passion is what emerged throughout the recent Third Global Symposium on Health Systems Research in Cape Town, South Africa. Across two jam-packed days of satellite events and another three days of conference sessions, the 1,700 participants from 92 countries collectively made the symposium into a unique teaching, learning and networking opportunity. Whether people approach health systems from the realms of academia, policy-making, civil society or elsewhere, they are excited about the potential for the levers of various forms of health systems to be triggered in ways that will make the world a healthier and more equitable place. Being able to share that excitement with other people is an invaluable and invigorating experience. In early 2015, the leadership of Health Systems Global is likely to develop concrete strategies and initiatives to foster a more diverse membership base and encourage representation of more regions and countries in the global health systems discourse. ","php":"","field_issue_date":"2014-11-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":" Transforming the development agenda requires more, not less, attention to human rights","field_subtitle":"Saiz I, Balakrishnan R: Center for Economic and Social Rights, Open Global Rights 15 September 2014","URL":"http://cesr.org/article.php?id=1646","body":"The UN General Assembly later this month will begin negotiations over the content of the Sustainable Development Goals (SDGs), to succeed the Millennium Development Goals (MDGs) in 2015. The draft SDGs contain very few explicit references to human rights, and are conspicuously silent on their role as a universal normative framework for sustainable development. This article explores how human rights advocates should navigate these contentious issues over the coming year. Three key shifts in strategy are presented as necessary to turn the tables on the stale geo-political dynamics that threaten to undermine the SDGs as an endeavour that is truly transformative and human rights-centred. Firstly, human rights advocates need to underscore the extraterritorial obligations of wealthier states to respect and protect human rights beyond their borders, and to cooperate internationally in their fulfilment. Secondly, advocates must counter the corporate influence on the post-2015 process with a much stronger push for  corporate accountability. Thirdly, the human rights community must build more effective platforms and alliances with development, social justice and environmental movements to amplify the human rights voice in these debates, avoiding the fragmentation and issue-specific silos that have characterized advocacy to date.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"A local vision of climate adaptation: Participatory urban planning in Mozambique","field_subtitle":"Cast\u00e1n Broto V, Boyd E and Ensor J:  Climate and Development Knowledge Network, May 2014","URL":"http://dspace.africaportal.org/jspui/bitstream/123456789/34376/1/CDKN_InsideStory-Mozambique_Final20-05-14_WEB.pdf?1","body":"With an estimated population of 1.1 million, Maputo is the most densely populated city in Mozambique. The city is sharply divided into two areas: \u2019the cement city\u2019, or the old colonial centre with paved roads and high-rise buildings, and the bairros \u2013 largely underserved, congested areas that house the majority of the city\u2019s population. Situated on the Indian Ocean, the city is highly vulnerable to climate change impacts such as cyclones, flooding and sea level rise. Poverty and inequality, which are concentrated in the bairros, further exacerbate climate change vulnerabilities in the city. Chamanculo C is one such bairro where vulnerabilities have become evident during recent flood events. Responding to the urgent need to address urban deprivation, the municipality is currently implementing a neighbourhood upgrading programme in a participatory manner in Chamanculo C. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Access to institutional delivery care and reasons for home delivery in three districts of Tanzania","field_subtitle":"Exavery A, Kant\u00e9 AM, Njozi M, Tani K, Doctor HV, Hingora A and Phillips JF: International Journal for Equity in Health (13) 48, 2014","URL":"http://www.equityhealthj.com/content/13/1/48","body":"This study assesses facilitators and barriers to institutional delivery in three districts of Tanzania. Data was drawn from a cross-sectional survey of random households on health behaviours and service utilization patterns among women and children aged less than 5 years. The survey was conducted in 2011 in Rufiji, Kilombero, and Ulanga districts of Tanzania, using a closed-ended questionnaire. This analysis focuses on 915 women of reproductive age who had given birth in the two years prior to the survey. Chi-square test was used to test for associations in the bivariate analysis and multivariate logistic regression was used to examine factors that influence institutional delivery. Overall, 74.5% of the 915 women delivered at health facilities in the two years prior to the survey. Multivariate analysis showed that the better the quality of antenatal care (ANC) the higher the odds of institutional delivery. Similarly, better socioeconomic status was associated with an increase in the odds of institutional delivery. Women of Sukuma ethnic background were less likely to deliver at health facilities than others. Presence of couple discussion on family planning matters was associated with higher odds of institutional delivery. Institutional delivery in Rufiji, Kilombero, and Ulanga district of Tanzania is relatively high and significantly dependent on the quality of ANC, better socioeconomic status as well as between-partner communication about family planning. Therefore, improving the quality of ANC, socioeconomic empowerment as well as promoting and supporting inter-spousal discussion on family planning matters is likely to enhance institutional delivery. Programs should also target women from the Sukuma ethnic group towards universal access to institutional delivery care in the study area.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"African activists meet in Johannesburg to demand more transparent health budgets","field_subtitle":"Africa Health Budget Network: Johannesburg, South Africa, July 2014","URL":"http://www.mamaye.org/en/blog/african-activists-meet-johannesburg-demand-more-transparent-health-budgets","body":"African civil society organizations have called for greater accountability and transparency from African leaders regarding the use of public funds for the survival of mothers and babies. This call to action marks the launch of an African-led network demanding better use of existing funds for African women and children\u2019s health as well as a greater share of African national budgets allocated to mothers and babies\u2019 survival. While most African government have already made commitments about improving the health of their population, including through greater spending, it is difficult to check whether they are keeping their promises if the budget is not publicly available or if the information in the budget is not clearly presented. The members of the Africa Health Budget Network have compiled a scorecard[1] showing how open African Governments are about their health spending. Out of the 26 African countries profiled, only one, South Africa, is reported to be sufficiently transparent.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"British Chevening Scholarships for International Students","field_subtitle":"Applications Close 15 November 2014, 23:59 GMT.","URL":"http://www.chevening.org/news/view?id=195&x%5B0%5D=news%20/list","body":"Chevening Scholarships are the UK government\u2019s global scholarship programme, funded by the Foreign and Commonwealth Office (FCO) and partner organisations. The programme makes awards to outstanding scholars with leadership potential from around the world to study postgraduate courses at universities in the UK. The programme provides full or part funding for full-time courses at postgraduate level, normally a one-year Master\u2019s degree, in any subject and at any UK university","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Colloquium on lone mothers, social security and dignity in South Africa","field_subtitle":"Neves D, Noble M, Ntshongwana P and Wright G: Conference and seminar papers, June 2014","URL":"http://children.pan.org.za/node/9547","body":"In South Africa lone mothers of working age are only entitled to social assistance for themselves if they are disabled. A means-tested Child Support Grant is payable on behalf of their children but, though important, it is small in amount and is not intended to contribute to the caregiver's living expenses. In the context of South Africa\u2019s Constitution which declares that \u2018everyone has the right to have their dignity respected and protected\u2019 and that access to social security is to be progressively realised, this project explored the meaning of dignity in lone mothers' lives and the extent to which social security protects or erodes their dignity.  The themed reports of the project cover the definition of lone motherhood in South Africa, the impact of poverty and inequality on lone mothers in South Africa and social security and the dignity of lone mothers in South Africa.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Ebola and Global Health Governance: Time for the Reckoning ","field_subtitle":"Fidler D: Chatham House Expert briefing, 22 September 2014","URL":"http://www.chathamhouse.org/expert/comment/15811?dm_i=1TYE%2C2TSAW%2CBM8UKZ%2CA9I1N%2C1","body":"The author writes that the suffering inflicted by the Ebola outbreak - and the ineffective reactions to it - reveals a massive failure of global health governance. States and international organizations are scrambling, from the Security Council to the streets of Monrovia, to triage the damage to social order and human dignity from the outbreak of Ebola in West Africa. It remains to be seen whether scaled-up responses can control the epidemic. But, he argues, there awaits another reckoning\u2014the challenge of identifying what went wrong, where mistakes were made, why we ended up in crisis and how to ensure a similar failure does not happen again. He proposes that the UN Security Council should establish an independent investigation into the outbreak and the international community\u2019s responses. The investigation should probe what happened from the local level to the office of the director-general of the World Health Organization. It should gather information on when and how other actors in global health\u2014countries, regional organizations, NGOs and airlines and other corporations\u2014responded. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Ebola: Recovery of Americans sharpens divisions in global health","field_subtitle":"Ndika AC: Pambazuka News, Issue 693, 11 September 2014 ","URL":"http://www.pambazuka.net/en/category/features/92866","body":"In August ZMAPP, an untested serum-based therapy in humans, was successfully administered to two American health workers infected with the Ebola virus, who were later declared free from the virus. The public announcement raised hopes for a new front in the fight against the ravaging epidemic. Besides the ethical and equity challenges present in distributing the limited quantity of the experimental therapies, the remarkable survival and first-rate quality of treatments provided to the American patients, as well as the water-tight public health containment measures employed, paint in a very stark manner the contours of divisions in global health, which were already widening before Ebola and have been worsen by the outbreak. The authors argue that an emergency-only response by African countries and the international community would fail to bridge those divisions that will continue in future to manufacture new and remerging epidemics like Ebola at an alarming rate as well as with frightening impact on a global scale. Africa\u2019s endemic diseases like Ebola affect mostly its bottom millions. As such, the patients do not form a viable consumer base enough to motivate pharmaceutical industry to invest in innovative drugs and treatments for them. The WHO has put together a list of 17 neglected poverty-related diseases (NTDs). According to one study, of the about 1,393 new chemical entities introduced between 1975 and 1999, only 16 targeted NTDs. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 164: When will we get better control over access to medicines?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Header"}},{"node":{"title":"EQUINET Satellite Session: New resources and opportunities for participatory research in health systems: areas of focus for Health systems Global","field_subtitle":"GSHSR Cape Town 30 September 1200-1400","body":"EQUINET, COPASAH and Rotterdam Global Health Initiative Erasmus University, for the participatory cluster in the SHaPeS TWG for Health Systems Global is hosting a satellite workshop at the GSHSR on \u201dNew resources and opportunities for participatory research in health systems: areas of focus for Health systems Global\u201d on Tuesday, 30 September from 12.00 \u2013 14.00. We welcome all interested in this work! The satellite session will be convened by the three organisations in the participatory cluster of the SHaPeS Technical working Group in HSR global. It will present and discuss with delegates interested in the cluster the issues, resources and capacities for the field and how these could be developed through the TWG, and will make available work we have done to date, particularly through EQUINET and COPASAH. It will review the experience of using participatory action research, (PAR), community monitoring and innovations in social media in transforming local health systems, the challenges faced and the areas for future participatory work in HSR. It will launch the EQUINET, AHPSR and IDRC methods reader on participatory action research and web tools from COPASAH. The session will identify field building inputs in terms of the resources, capacity building, methods and opportunities that need to be taken forward by the participatory cluster of the SHaPeS Technical Working Group and the people who are interested in playing a role in the different areas of work. Contact admin@equinetafrica.org with GSHSR SATELLITE in the subject line for further detail or to let us know of your participation.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET Three day skills workshop on participatory action research","field_subtitle":"4-6 October 2014, Cape Town","URL":"http://www.equinetafrica.org/more.php?id=62_0_1_0_M6","body":"A three day skills workshop on PARTICIPATORY ACTION RESEARCH IN PEOPLE CENTRED HEALTH SYSTEMS is being hosted by EQUINET. It will include a one day workshop on 4 October hosted hosted by TARSC and the Regional Network for Equity in Health in east and southern Africa (EQUINET) and Asociaci\u00f3n Latinoamericana de Medicina Social (ALAMES), following the Global Symposium on Health Systems Research (30th Sept\u20133rd October). The workshop will be held to deepen the discussion on the use of participatory action research in health policy and people centred health systems, including in acting on the social determinants of health. The workshops aim to deepen capacities in the use of participatory action research (PAR) particularly on\r\n\u2022 Experiences and learning of the pra4equity network in using PAR and future work of the pra4equity network\r\n\u2022 Knowledge and research paradigms and how they are reflected in the features and process of PAR \r\n\u2022 Applying the theory and process of PAR in practice: Methods and tools for PAR; issues in and experiences of implementation \r\n\u2022 Meta-analysis across sites and use of new technologies in PAR\r\n\u2022 Ethical issues in PAR, and \r\n\u2022 Documenting and reporting PAR\r\nIt will draw on and distribute the Reader on Participatory Action Research in Health system developed by EQUINET with the Alliance for Health Policy and Systems Research and IDRC Canada.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Equity in utilisation of antiretroviral therapy for HIV-infected people in South Africa: a systematic review","field_subtitle":"Tromp N, Michels C, Mikkelsen E, Hontelez J, Baltussen R: International Journal for Equity in Health (13) 60, August 2014","URL":"http://www.equityhealthj.com/content/pdf/s12939-014-0060-z.pdf","body":"About half a million people in South Africa are deprived of antiretroviral therapy (ART), and there is little systematic knowledge on who they are ? e.g. by severity of disease, sex, or socio-economic status (SES). The authors performed a systematic review to determine the current quantitative evidence on equity in utilisation of ART among HIV-infected people in South Africa. The authors conducted a literature search based on the Cochrane guidelines. The authors considered ART utilisation inequitable for a certain criterion (e.g. sex) if between groups (e.g. men versus women) significant differences were reported in ART initiation/adherence on that criterion. Twelve studies met the inclusion criteria. For sex, 2 out of 10 studies that investigated this criterion found that men are less likely than women to utilise ART, while the other 8 found no differences. For age, 4 out of 8 studies found inequities and reported less utilisation for younger people. For area of living, 3 out of 4 studies showed that those living in rural areas or certain provinces have less access and 2 out of 6 studies looking at SES found that people with lower SES have less access. One study which looked at the marital status found that those who are married are less likely to utilise ART. For severity of disease, 5 out of 6 studies used more than one outcome measure for disease stage and reported within their study contradicting results. One of the studies reported inconclusive findings for ethnicity and no study had looked at religion and sexual orientation. The authors suggest that men, young people, those living in certain provinces or rural areas, people who are unemployed or with a low educational level, and those being unmarried have less access to ART. As studies stem from different contexts and use different methods conclusions should be taken with caution.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Global Health Watch 4","field_subtitle":"Peoples Health Movement, Publishing on 13 November 2014","URL":"http://www.ghwatch.org/","body":"The Global Health Watch integrates rigorous analysis, alternative proposals and stories of struggles and change to present a compelling case for the imperative to work for a radical transformation of the way we approach actions and policies on health. It is designed to question present policies on health and to propose alternatives. Find out more by visiting: www.ghwatch.org. GHW4 is a collaborative effort by activists and academics from across the world, and has been coordinated the People\u2019s Health Movement, Asociaci\u00f3n Latinoamericana de Medicina Social, Health Action International, Third World Network and Medact. This edition of the GHW, published by ZED Books, will be available from 13 November 2014. PHM request you to disseminate the evidence and analysis in GHW4 and invite you to consider launching the GHW4 in your region, starting from December 2014. For this purpose \u2018launch kits\u2019 will be available by early November 2014 and PHM will send 10 to 20 books for each event. For more information contact asengupta@phmovement.org.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Joint Global Research Programme: Women\u2019s and children's health","field_subtitle":"Closing date: 21 October 2014 16:00pm","URL":"http://www.mrc.ac.uk/documents/pdf/handbook-for-applicants-and-grant-holders/","body":"The Medical Research Council (MRC) in the UK and the Department of Biotechnology (DBT)opens in new window in India in collaboration with Department of International Development (DFID)opens in new window are pleased to announce a joint call to fund Global Health Research which will bring together researchers from the UK, India and Low Income Countries. This call for collaborative proposals will require applicants based in India, Low Income Countries and the UK to work together in partnership within cross national teams on research projects. Bids must include at least one institution from each of India, UK and a LIC. For more information please visit the website.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Last month we lost a champion for health justice: A luta continua Thomas Deve","field_subtitle":"EQUINET Steering Committee","body":"Thomas Deve, a member of the EQUINET steering committee, passed away on Sunday 7th September. The diversity of people who have written tributes show how widely he connected from local to global level. He brought a personal connect to people and struggles across the continent and critical analysis and debate to our network. He was a researcher, a policy analyst, a band manager, a teacher, a thinker, an activist and much more. We bid him a reluctant farewell and Thomas, our struggle to reclaim the resources for health will continue.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Mobile health for non-communicable diseases in Sub-Saharan Africa: a systematic review of the literature and strategic framework for research","field_subtitle":"Bloomfield GS,  Vedanthan R,  Vasudevan L, Kithei A,  Were M and Velazquez EJ: Globalization and Health (10)49, 2014","URL":"http://www.globalizationandhealth.com/content/10/1/49","body":"Mobile health (mHealth) approaches for non-communicable disease (NCD) care seem particularly applicable to sub-Saharan Africa given the penetration of mobile phones in the region. The evidence to support its implementation has not been critically reviewed. The authors systematically searched databases and grey literature for studies reported between 1992 and 2012 published in English or with an English abstract available.  mHealth for NCDs in sub-Saharan Africa appears feasible for follow-up and retention of patients, can support peer support networks, and uses a variety of mHealth modalities. Whether mHealth is associated with any adverse effect has not been systematically studied. Only a small number of mHealth strategies for NCDs have been studied in sub-Saharan Africa. There is insufficient evidence to support the effectiveness of mHealth for NCD care in sub-Saharan Africa. The authors present a framework for cataloging evidence on mHealth strategies that incorporates health system challenges and stages of NCD care. This framework can guide approaches to fill evidence gaps in this area.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Open access: academic publishing and its implications for knowledge equity in Kenya","field_subtitle":"Matheka D, Nderitu J, Mutonga D, Otiti M, Siegel K and Demaio A: Globalization and Health (10)26, 2014","URL":"http://www.globalizationandhealth.com/content/10/1/26","body":"Traditional, subscription-based scientific publishing has its limitations: often, articles are inaccessible to the majority of researchers in low- and middle-income countries (LMICs), where journal subscriptions or one-time access fees are cost-prohibitive. Open access (OA) publishing, in which journals provide online access to articles free of charge, breaks this barrier and allows unrestricted access to scientific and scholarly information to researchers all over the globe. At the same time, one major limitation to OA is a high publishing cost that is placed on authors. Following recent developments to OA publishing policies in the UK and even LMICs, this article highlights the current status and future challenges of OA in Africa. The authors place particular emphasis on Kenya, where multidisciplinary efforts to improve access have been established. They note that these efforts in Kenya can be further strengthened and potentially replicated in other African countries, with the goal of elevating the visibility of African research and improving access for African researchers to global research, and, ultimately, bring social and economic benefits to the region. The authors (1) offer recommendations for overcoming the challenges of implementing OA in Africa and (2) call for urgent action by African governments to follow the suit of high-income countries like the UK and Australia, mandating OA for publicly-funded research in their region and supporting future research into how OA might bring social and economic benefits to Africa","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Participatory action research in health systems: a methods reader","field_subtitle":"Loewenson R, Laurell AC, Hogstedt C, D\u2019Ambruoso L, Shroff Z: TARSC, AHPSR, WHO, IDRC Canada, EQUINET, Harare, 2014 ","URL":"http://www.equinetafrica.org/bibl/docs/PAR%20leaflet%20HR.pdf","body":"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 \u2013 old and new \u2013 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 \u2018participatory action research\u2019 (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:\r\n\u2022 key features of participatory action research and the history and knowledge paradigms that inform it;\r\n\u2022 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\r\n\u2022 communication, reporting, institutionalization and use of participatory action research in health systems. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Raising her Voice","field_subtitle":"Oxfam: September 2014","URL":"http://policy-practice.oxfam.org.uk/our-work/citizen-states/raising-her-voice","body":"All around the world women's voices are absent from the many places and spaces in which the decisions that affect their everyday lives are made. Oxfam aims to change this by strengthening the way in which women's individual and collective voices influence decisions about services, investments, policies and legal frameworks so that worldwide, those in power, from village leaders to politicians and law-makers, become more accountable to them.From 2008-2013, the global Raising Her Voice programme, supported projects in 17 countries to enable over 1 million women to take part in, shape and monitor the decisions that most affect their lives. Although formal funding for RHV ended in March 2013, Oxfam is continuing to work on women's political rights and empowerment worldwide. This website provides case studies and videos on the work from African countries. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Reclaiming public health through community-based monitoring: The case of Maharashtra, India","field_subtitle":"Shukla A, Saha Sinha S and SATHI: Municipal Services Project, September 2014","URL":"http://tinyurl.com/p623yg5","body":"Community-based monitoring and planning (CBMP) of health services in Maharashtra state, India represents an innovative participatory approach to improving accountability and healthcare delivery. Supported by diverse stories of change, the paper shows how this process created various forums and spaces for dialogue and led to systematic data collection on health indicators that point to greater accessibility and quality of services at village as well as primary health centre levels. The authors ask whether this experience could inform \u2018communitization\u2019 of health services in diverse contexts, as an alternative to privatization and as a means to enhancing the \u2018publicness\u2019 of health services.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Regional Consultation on Health Committees \u2013 Vehicles for realising the right to health and strengthening health systems","field_subtitle":"Cape Town 27-28 September 2014","URL":"http://www.equinetafrica.org/","body":"The Learning Network for Health and Human Rights, in conjunction with the Network on Equity in Health in East and Southern Africa (EQUINET) will be holding a 2-day regional consultation on the role of Health Committees in Equitable, People-centred Health Systems in the Southern and East African region as a satellite meeting linked to the 3rd Global Symposium on Health Systems Research.  The regional consultation will take place in Cape Town on Sat 27th and Sun 28th of September 2014 at the University of Cape Town and is funded by a grant from the International Development Research Council. The meeting has been called to share experiences from the southern and east Africa region of community participation in health systems governance through health committees. The focus of the consultation is on health committees as a strategy for realising the right to health and strengthening health systems. The consultation will build on previous meetings by the different partners in Kampala, Kiboga and Harare over the past 4 years. The target participants are those who have experience of working with health committees and community participation structures. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Secure Grants from the Elizabeth Taylor AIDS Foundation","field_subtitle":"Deadline: 31 December 2014","URL":"http://tinyurl.com/pfs8mxo","body":"The Elizabeth Taylor AIDS Foundation accepts grant applications from all the HIV/AIDS communities worldwide. Organizations working in the sector of HIV/AIDS are required to send a statement of need along with the proposed program description and the organizations\u2019 capacity to implement the proposed program.The Elizabeth Taylor AIDS Foundation supports two kinds of organizations, Those: 1.Delivering direct care and services to people living with HIV/AIDS and 2.Providing education to the public regarding the AIDS virus and the prevention of AIDS. For further information visit the website. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"The BRICS: Yash Tandon asks tough questions \u2013 which we all need to ponder","field_subtitle":"Bond P: Pambuzuka News 682, 11 June 2014","URL":"http://www.pambazuka.org/en/category/features/92085","body":"Patrick Bond addresses questions raised by Yash Tandon in regards to the role of the BRICS in Africa and in the current configuration of the neoliberal international capitalist order. The challenge is for critics of BRICS to strategise with the world\u2019s progressive forces to build a genuine anti-imperialist movement.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"The effects of health worker motivation and job satisfaction on turnover intention in Ghana: a cross-sectional study","field_subtitle":"","URL":"http://www.human-resources-health.com/content/12/1/43","body":"Motivation and job satisfaction have been identified as key factors for health worker retention and turnover in low- and middle-income countries. District health managers in decentralised health systems usually have a broadened 'decision space' that enables them to positively influence health worker motivation and job satisfaction, which in turn impacts on retention and performance at district-level. The study explored the effects of motivation and job satisfaction on turnover intention and how motivation and satisfaction can be improved by district health managers in order to increase retention of health workers. The authors conducted a cross-sectional survey in three districts of the Eastern Region in Ghana and interviewed 256 health workers from several staff categories (doctors, nursing professionals, allied health workers and pharmacists) on their intentions to leave their current health facilities as well as their perceptions on various aspects of motivation and job satisfaction. The effects of motivation and job satisfaction on turnover intention were explored through logistic regression analysis. Overall, 69% of the respondents reported to have turnover intentions. Motivation and job satisfaction were significantly associated with turnover intention and higher levels of both reduced the risk of health workers having this intention. The dimensions of motivation and job satisfaction significantly associated with turnover intention included career development, workload,  management, organisational commitment and burnout. The authors\u2019 findings indicate that effective human resource management practices at district level influence health worker motivation and job satisfaction, thereby reducing the likelihood for turnover.  Therefore, they argue that it is worth strengthening human resource management skills at district level and supporting district health managers to implement retention strategies.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The end of AIDS: Possibility or pipe dream? A tale of transitions ","field_subtitle":"Whiteside A and Strauss M: African Journal of AIDS Research (2) 13, 101\u2013108, 2014","URL":"http://www.ajol.info/index.php/ajar/article/view/105499","body":"Globally, in the last 20 years health has improved. In this generally optimistic setting HIV and AIDS accounts for the fastest growing burden of disease. The data show the bulk of this is experienced in Southern Africa. In this region, HIV and AIDS (and tuberculosis [TB]) peaks among young adults. Women carry the greater proportion of infections and provided most of the care. South Africa has the dubious distinction of having the largest number of people living with HIV in the world, 6.4 million. HIV began spreading from about 1990 and today the prevalence among antenatal clinic attendees is 29.5%. A similar situation exists in other nations of the region. It is an expensive disease, requiring more resources than are available, and it is slipping off the global agenda, both in terms of attention and international funding. Those halcyon days of the decade from 2000 to 2010 are over. This paper explores the concept of three transition points: economic, epidemiological and programmatic. The first two have been developed and written about by others. The authors add a third transition point, namely programmatic, argue this is an important concept, and show how it can become a powerful tool in the response to the epidemic. The economic transition point assesses HIV incidence and mortality of people infected with HIV. Until the number of newly infected people falls below the number of deaths of people living with HIV, the demand for treatment and costs will increase. This is a concern for the health sector, finance ministry and all working in the field of HIV. Once an economic transition occurs the treatment future is predictable and the number of people living with HIV and AIDS decreases. This paper plots two more lines. These are the number of new people from the HIV infected pool initiated on treatment and the number of people from the HIV infected pool requiring treatment. This introduces new transition points on the graph. The first when the number of people initiated on treatment exceeds the number of people needing treatment. The second when the number initiated on treatment exceeds the new infections. That is the theory. When applying South African data from the ASSA2008 model, the authors were able to plot transition points marking progress in the national response. They argue these concepts can and should be applied to any country or HIV epidemic.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"The IFC\u2019s Health in Africa initiative is failing to reach the poor","field_subtitle":"Mohga Kamal-Yanni: Global Health Check, Sep 10th, 2014","URL":"http://www.globalhealthcheck.org/?utm_source=Global%20Health%20Check&utm_campaign=34b2836be9-Global%20Health%20Check%20email&utm_medium=email&utm_term=0_89f8d74097-34b2836be9-12084821","body":"Health In Africa is a $1 billion investment project launched by the IFC in 2008, which aimed to \u2018catalyze sustained improvements in access to quality health-related goods and services in Africa [and] financial protection against the impoverishing effects of illness\u2019, through harnessing the potential of the private health sector. Specifically, it sought to improve access to capital for private health companies, and to help governments incorporate the private sector into their overall health care system. Health In Africa would do this through three mechanisms: an equity vehicle, a debt facility, and technical assistance.  Perhaps of most importance, the initiative would make extra efforts to \u2018improve the availability of health care to Africa\u2019s poor and rural population\u2019. The author reports that Oxfam\u2019s assessment of the sporadic investment information available finds that far from delivering health care for the poorest, Health In Africa has favoured high-end urban hospitals, many of which explicitly target a country\u2019s wealthy and expatriate populations.  The initiative\u2019s biggest investment to date has been in South Africa\u2019s second largest private hospital group Life Healthcare. This $93 million endowment no doubt supported the company in its subsequent expansion, but there is no evidence it has used this investment to expand access to health care for the 85% of South Africans without health insurance. Oxfam has called on the IFC to cease all Health In Africa investments until a robust, transparent and accountable framework is put in place to ensure that the initiative is pro-poor, and geared towards meeting unmet need. In addition, it calls on the World Bank Group to conduct a full review of the IFC\u2019s operations and impact to date in the health sector in low- and middle-income countries, to investigate how they are aligned with, and are accountable to, the overarching goals of the World Bank Group: to end extreme poverty and promote shared prosperity.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"The IPCC's Fifth Assessment Report What's in it for Africa?","field_subtitle":"Inter-governmental Panel on Climate Change, Climate and Development Knowledge Network, 2014","URL":"http://dspace.africaportal.org/jspui/bitstream/123456789/34489/1/J1731_CDKN_FifthAssesmentReport_WEB.pdf?1","body":"The Fifth Assessment Report of the Inter-governmental Panel on Climate Change (IPCC) finds, beyond reasonable doubt, that the Earth\u2019s climate is warming. Climate change will have widespread impacts on African society and Africans\u2019 interaction with the natural environment. Since the 1950s, the rate of global warming has been unprecedented compared to previous decades and millennia. The Fifth Assessment Report presents a long list of changes that scientists have observed around the world. Since the mid-19th century, the average increase in the temperature of the Earth\u2019s surface has been 0.85 degrees Centigrade(\u00b0C). Sea levels have risen faster than at any time during the previous two millennia. In many regions, including Africa, changing rainfall or melting snow and ice are altering freshwater systems, affecting the quantity and quality of water available. The IPCC finds that there is 95% scientific certainty that human activity, by increasing concentrations of greenhouse gases in the atmosphere, has been the dominant cause of the observed warming since the mid-20th century. The impacts of climate change will affect food security, water availability and human health in Africa significantly. Given the interdependence between countries in today\u2019s world, the impacts of climate change on resources or commodities in one place will have far-reaching effects on prices, supply chains, trade, investment and political relations in other places. Thus, climate change will progressively threaten economic growth and human security.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"The Open Budget Survey ","field_subtitle":"International Budget Partnership: September 2014","URL":"http://survey.internationalbudget.org/#home","body":"The Open Budget Survey is a comprehensive analysis and survey that evaluates whether governments give the public access to budget information and opportunities to participate in the budget process at the national level. The Survey also assesses the capacity and independence of formal oversight institutions. The IBP works with civil society partners in 100 countries to collect evidence. To easily measure the commitment to transparency, IBP created the Open Budget Index from the Survey. The Open Budget Index allows for comparisons among countries and across years. the website provides a 2014 calculator to predict the outcome of the next survey and see where transparency can improve.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"The State of Food Insecurity in the World 2014","field_subtitle":"Food and Agriculture Organisation: New York, September 2014","URL":"http://www.fao.org/publications/sofi","body":"The 2014 edition of  The State of Food Insecurity in the World was released this month. SOFI 2014 presents updated estimates of undernourishment and progress towards the Millennium Development Goal (MDG) and World Food Summit (WFS) hunger targets. The 2014 report also presents further insights into the suite of food security indicators introduced in 2013 and analyses in greater depth the dimensions of food security \u2013 availability, access, stability and utilization.  In addition, the 2014 report examines the diverse experiences of seven countries, with a specific focus on the enabling environment for food security and nutrition that reflects commitment and capacities across four dimensions: policies, programmes and legal frameworks; mobilization of human and financial resources; coordination mechanisms and partnerships; and evidence-based decision-making. ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Universal Health Protection: Progress to date and the way forward","field_subtitle":"Social protection Department, International Labour Office: ILO Geneva September 2014","URL":"http://www.ilo.org/gimi/gess/ShowRessource.action?ressource.ressourceId=46598","body":"This paper proposes policy options based on ILO research and experiences that aim at universal coverage and equitable access to health care. The policy options discussed focus on ensuring the human rights to social security and health and on the rights-based approaches underpinning the need for equity and poverty alleviation. This paper also provides insights into aspects of implementation and related challenges. It includes an overview of ILO concepts, definitions and strategic approaches to achieving socially inclusive and sustainable progress and highlights recent global trends.","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?","field_subtitle":"Mbaruku GM, Larson E, Kimweri A and Kruk ME: Human Resources for Health (12)38: August 2014","URL":"http://www.human-resources-health.com/content/12/1/38","body":"In countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers' satisfaction can help determine where resources should be focused. Although there is a growing body of research assessing health worker satisfaction in hospitals, less is known about health worker satisfaction in rural, primary health clinics. This study explores the workplace satisfaction of health workers in primary health clinics in rural Tanzania. Overall, 70 health workers in rural Tanzania participated in a self-administered job satisfaction survey. Results showed that 73.9% of health workers strongly agreed that they were satisfied with their job; however, only 11.6% strongly agreed that they were satisfied with their level of pay and 2.9% with the availability of equipment and supplies. Two categories of factors emerged from the PCA: the tools and infrastructure to provide care, and supportive interpersonal environment. Nurses and medical attendants (compared to clinical officers) and older health workers had higher satisfaction scale ratings. Two dimensions of health workers' work environment, namely infrastructure and supportive interpersonal work environment, explained much of the variation in satisfaction among rural Tanzanian health workers in primary health clinics. Health workers were generally more satisfied with supportive interpersonal relationships than with the infrastructure. Human resource policies should, it is argued, consider how to improve these two aspects of work as a means for improving health worker morale and potentially rural attrition","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"When will we get better control over access to medicines?","field_subtitle":"Rangarirai Machemedze, SEATINI","body":"\r\nAt the recent 2014 International AIDS Conference we heard that 35 million people are living with HIV, but 55% haven\u2019t been tested. Under the 2013 WHO guidelines, UNAIDS reported in 2013 that the HIV treatment coverage in low and middle-income countries represented only 34% of the 28.6 million people eligible in 2013. Medicines for malaria, pneumonia and other common conditions don\u2019t reach many low income communities and there are new challenges in ensuring the long term treatment for chronic conditions. \r\n\r\n\tAccess to medicines continues to be a major preoccupation in African health systems.  Beyond the unequal distribution of access to essential medicines globally and within countries, resistance to anti-malarials, antibiotics, and treatments for TB and other conditions can worsen the problem. The new medicines developed are frequently more expensive and may also require more stringent supervision to ensure they are properly used. For example in the 2014 AIDS Conference it was noted that there is a 10 fold price increase from first to second line treatment, and the World Health Organization (WHO) reported in 2012 that the 450 000 new cases of multidrug-resistant tuberculosis (MDR-TB) longer and more expensive treatment.  These medicines are often imported, at a cost that consume a large share of health budgets. Countries in east and southern Africa (ESA) often draw on support from external funders to meet these costs.  \r\n\t\r\nThis rising challenge, coupled with high levels of dependency on external producers and funders makes ESA countries very externally dependent when it comes to medicines. This, and the potential contribution that pharmaceutical manufacture could make to economies and trade within the continent, especially given the rich natural resources for medicines, prompted the African Union and its sub regions in east and southern Africa to come up with plans to enhance local pharmaceutical production. African Ministers of Finance, Planning and Economic Development in Nigeria in March 2014 noted: \u201cThere is growing consensus that strengthening the local production of essential medicines is a priority, along with advancing industrial development and moving the continent towards sustainability of treatment programmes for HIV, tuberculosis and malaria, and improving access to safe and effective medicines to treat a broad range of communicable and non-communicable diseases.\u201d   \r\n\r\nThe Pharmaceutical Manufacturing Plan for Africa (PMPA), the Southern Africa Development Community (SADC) Pharmaceutical Business Plan 2007-2013 and the East African Community (EAC) Regional Pharmaceutical Manufacturing Plan of Action 2012-2016 all propose policy measures to create the conditions for and support local production, as one, albeit not the only way to strengthen access to medicines. \r\n\r\nThe same plans are also rather clear about the obstacles that have to be overcome to achieve this, including in terms of ensuring adequate legal provisions, improved and reliable energy, transport and other infrastructure, technology, skills and research and development capacities to enable and sustain production and finance capital. The same 2014 conference of African Ministers of Finance, Planning and Economic Development cited above noted in its statement: \u201cThe challenges the pharmaceutical industry faces in upgrading facilities and production practices in Africa include the requirement for large capital investments and the need for experts, specially trained workers, increased regulatory oversight and regulatory harmonisation at the regional and continental levels in order to create bigger markets.\u201d  \r\n\r\nIn research that we carried out in 2013 and 2014, we found signs of progress in overcoming these obstacles, but also many challenges. Kenya, Uganda and Zimbabwe, for example, produce medicines that are not only consumed in their own countries, but are exported to other countries in the region. Some of the factors that appear to support this include the presence of a sound regulatory framework for the pharmaceutical sector, partnerships with other countries bringing investments in manufacturing and in capacities for it (such as in Uganda), local skills and research and development institutions that can support the technology for local production. Further, existing practice points to the critical importance of regional trade as a way of ensuring adequately sized markets to provide a return on investments. These are examples in practice of measures that are articulated in the regional plans. \r\n\r\nHowever, we also found that while many countries have national pharmaceutical policies that articulate such goals, they also depend on policy in other areas, such as energy and infrastructure, and that there is a gap between policies and their implementation.\r\n\r\nThe implementation gap is evident in a number of areas. One is in the extent to which governments are supporting local production with tax and other incentives to create a conducive investment, business and trade environment. For example there could be stronger measures to exempt duty and value added tax (VAT) on imported pharmaceutical raw materials and packaging materials to stimulate local production and reduced corporate tax rates, investment tax credits and other incentives for companies to set up production.  Yet sometimes we find that the opposite is in place.  For example in Zimbabwe imported drugs were in 2000 exempted from duty and VAT, while the raw materials and packaging needed for local manufacturing attracted duties of up to 40% and VAT of 15%. This increases the cost of locally produced drugs, especially when other countries are not placing these high charges on their producers, making imports cheaper than locally produced medicines. This doesn\u2019t make sense given the policy intentions and we should at least level the playing field and avoid tariff structures that promote de-industrialisation!\r\n\r\nThere is also a gap in the dialogue that should be going on between governments, pharmaceutical companies and training institutions on what capacities, skills and personnel are needed for the pharmaceutical industry and how these can be attracted and developed, including through schemes to attract and retain appropriate personnel in the public service and in countries. \r\n\r\nWhile there is an emerging interest in south-south partnership agreements on some of these areas, it is equally important that attention be given to implementing the regional plans, to use memberships of Common Market for Eastern and Southern Africa, the Southern African Development and the East African Community to negotiate for a tripartite Free Trade Area between the three blocs to widen markets for medicines and to strengthen regional interactions on the technology, infrastructure, capacities, research and development and capital needed for pharmaceutical production.\r\n\r\nIn a continent with such high health need and demand for treatment, surely we need to not only be asking when we will get better access to medicines, but when we will get better control over access to medicines?\r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the issues raised in this op-ed please visit www.equinetafrica.org ","php":"","field_issue_date":"2014-10-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"10th Public Health Association of South Africa","field_subtitle":"Polokwane, South Africa, 3-6 September 2014","URL":"http://www.phasaconference.org.za","body":"The 10th anniversary of the Public Health Association of South Africa (PHASA) conference will be celebrated with the hosting of the conference in Polokwane (Limpopo) from 3 to 6 September 2014.The theme for the 2014 conference is \u2018Dignity, rights and quality: towards a health care revolution\u2019. An invitation is extended to all our members, stake holders,  policy makers, public health academics and students, health professionals, health service managers and individuals from non-governmental and community-based health organisations. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"14th Association for Health Information and Libraries in Africa Congress","field_subtitle":"Dar es Salaam, Tanzania, 20-24 October 2014","URL":"http://www.ahila-tz.org/","body":"The Association for Health Information and Libraries in Africa (AHILA) will hold its 14th Biennial Congress in Dar es Salaam, Tanzania. AHILA was founded in 1984 with the aim of improving provision of up-to-date and relevant health information; encourage professional development of health librarians; promote information resource sharing in Africa and exchange of experiences as well as promoting the development and standardization and exchange of health databases in Africa. The main theme of the 14th AHILA Congress is: ICTs, access to health information and knowledge: building strong knowledge societies for sustainable development in Africa. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"2014 Durban International Film Festival Winners","field_subtitle":"","URL":"http://www.okayafrica.com/news/cinemafrique-african-film-tv-news-august-7/5/","body":"The 35th Edition of the Durban International Film Festival came to a close last week with an awards ceremony that saw the unveiling of the fest\u2019s new statuette, the Golden Giraffe. Of particular note, Rehad Desai\u2018s Marikana documentary Miners Shot Down was awarded \u201cSouth Africa\u2019s Best Documentary Film.\u201d The film uses the point of view of the Marikana miners as it follows the strike from day one. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Africa: Time to reclaim class opportunities","field_subtitle":"Nicolson G: Daily Maverick, 20 August 2014","URL":"http://www.dailymaverick.co.za/article/2014-08-20-africa-time-to-reclaim-class-opportunities/#.U_n9tl9waUk","body":"Narratives of \u201cthe hopeless continent\u201d and \u201cAfrica rising\u201d, pumped by the West, woven into its knowledge with nostalgic pop culture, rubber-stamped by media and financial institutions, are observed by the author to be false propaganda. A study by Standard Bank titled \u201cUnderstanding Africa\u2019s Middle Class\u201d, notes African Development Bank\u2019s (AfDB) claims that by 2010, 350 million people or 34% were middle-class in Africa, up from 27% in 1990. Examining 11 countries, chosen for, among other things, scale of population, growth and economy- Angola, Ethiopia, Ghana, Kenya, Mozambique, Nigeria, South Sudan, Sudan, Tanzania, Uganda and Zambia- the Standard Bank report noted that since 2000 the collective GDP of the 11 measured economies has grown tenfold from US$120 billion to today\u2019s level of over US$1 trillion, with a growth in the middle class of 230% in the period. While East Africa is lagging behind in pushing low-income earners to the middle, the region is argued to offer the most interesting findings in the report, with a broad upward shift within the low-income band as households shift from deeply marginalised into less poor categories. Africa\u2019s growing middle class may be driving the rising narratives, but the upward movement of low-income groups is argued to be where the most economic potential will be realised. It\u2019s also these groups that will have the largest impact on political and social development. They\u2019re the groups in the majority, the ones with the largest votes and the largest claim to the need for improved living conditions.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Assessing equity in the geographical distribution of community pharmacies in South Africa in preparation for a national health insurance scheme","field_subtitle":"Ward K, Sanders D, Leng H, Pollock A: Bulletin of the World Health Organization 92:482-489; 2014","URL":"http://www.who.int/bulletin/volumes/92/7/13-130005/en/","body":"The green paper for the national health insurance scheme in South Africa has identified private community pharmacies as potential access points for medicines, in combination with public clinics. This study examined changes in the ownership and geographical distribution of community pharmacies between 1994 and 2012 using routine national data. The authors summed community pharmacies and public clinics to assess their combined provincial distribution patterns against a South African benchmark of one clinic per 10000 residents. The study shows that monitoring trends in the distribution of community pharmacies is feasible. It shows that the increase in the number of community pharmacies has not kept pace with population growth and there are differences between urban and rural provinces and between the most and least deprived districts. Although corporations have seen substantial growth, this has not resulted in improved density ratios or equity in distribution. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya","field_subtitle":"Kihuba E, Gathara D, Mwinga S, Mulaku M, Kosgei R, Mogoa W, Nyamai R, English M: Global Health Action, 7, July 2014. ","URL":"http://www.globalhealthaction.net/index.php/gha/article/view/24859","body":"Hospital management information systems (HMIS) is a key component of national health information systems (HIS), and actions required of hospital management to support information generation in Kenya are articulated in specific policy documents. The authors evaluated core functions of data generation and reporting within hospitals in Kenya to facilitate interpretation of national reports and to provide guidance on key areas requiring improvement to support data use in decision making. Study findings indicated that the HMIS does not deliver quality data. Significant constraints exist in data quality assurance, supervisory support, data infrastructure in respect to information and communications technology application, human resources, financial resources, and integration.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"Back to the future: what would the post-2015 global development goals look like if we replicated methods used to construct the Millennium Development Goals?","field_subtitle":"Brolan CE, Lee S, Kim D and Hill PS: Globalization and Health (10)19, 3 April 2014","URL":"http://www.globalizationandhealth.com/content/10/1/19","body":"The Millennium Development Goals (MDGs) were \u2018top-down\u2019 goals formulated by policy elites drawing from targets within United Nations (UN) summits and conferences in the 1990s. Contemporary processes shaping the new post-2015 development agenda are more collaborative and participatory, markedly different to the pre-MDG era. This study examines what would the outcome be if a methodology similar to that used for the MDGs were applied to the formulation of the post-2015 development goals (Post-2015DGs), identifying those targets arising from UN summits and conferences since the declaration of the MDGs, and aggregating them into goals. The UN Department of Economic and Social Affairs (DESA) list of major UN summits and conferences from 2001 to 2012 was utilised to examine targets. The DESA list was chosen due to the agency\u2019s core mission to promote development for all. Targets meeting MDG criteria of clarity, conciseness and measurability were selected and clustered into broad goals based on processes outlined by Hulme and Vandemoortele. The Post-2015DGs that were identified were formatted into language congruent with the MDGs to assist in the comparative analysis, and then further compared to the 12 illustrative goals offered by the UN High-Level Panel of Eminent Persons on the Post-2015 Development (High-Level Panel) Agenda\u2019s May 2013 report. Ten Post-2015DGs were identified. Six goals expressly overlapped with the current MDGs and four new goals were identified. Health featured prominently in the MDG agenda, and continues to feature strongly in four of the 10 Post-2015DGs. However the Post-2015DGs reposition health within umbrella agendas relating to women, children and the ageing. Six of the 10 Post-2015DGs incorporate the right to health agenda, emphasising both the standing and interconnection of the health agenda in DESA\u2019s summits and conferences under review. Two Post-2015DGs have been extended into six separate goals by the High-Level Panel, and it is these goals that are clearly linked to sustainable development diaspora. This study exposes the evolving political agendas underplaying the current post-2015 process, as targets from DESA\u2019s 22 major UN summits and conferences from 2001 to 2012 are not wholly mirrored in the HLP\u2019s 12 goals.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"British Chevening Scholarships for International Students","field_subtitle":"Applications close 15 November 2014, 23:59 GMT.","URL":"http://www.chevening.org/news/view?id=195&x%5B0%5D=news/list","body":"Chevening Scholarships are the UK government\u2019s global scholarship programme, funded by the Foreign and Commonwealth Office (FCO) and partner organisations. The programme makes awards to outstanding scholars with leadership potential from around the world to study postgraduate courses at universities in the UK. The programme provides full or part funding for full-time courses at postgraduate level, normally a one-year Master\u2019s degree, in any subject and at any UK university.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Community-Based Interventions for the Prevention and Control of Infectious Diseases of Poverty","field_subtitle":"Sommerfeld J, Zhou X (eds):  Infectious diseases of Poverty, 31 July 2014","URL":"http://www.idpjournal.com/SERIES/CBI","body":"Effective and simple interventions and tools exist that can be used to either prevent, treat or rehabilitate patients suffering from infectious diseases of poverty (IDoP). The delivery of these interventions and tools to the affected populations, however, has proven difficult due to weak public health systems in many disease-endemic countries. Disease control and public health programmes are increasingly advocating community-based delivery strategies and interventions. These depend, to a large degree, on trained community health workers whose performance in various areas of health care such as maternal and child health has been the subject of rigorous recent systematic reviews. Community-based delivery platforms are increasingly being proposed not only to ensure sustainability and combat co-infections, but also to build capacity for integration of NTDs with existing malaria, tuberculosis, and HIV/AIDS programs for which more sophisticated healthcare delivery systems already exist. This thematic series of eight papers provides an overview on infectious diseases of poverty and integrated community-based interventions, describes the analytical framework and the methodology used to guide the systematic reviews, reports findings for the effectiveness of community-based interventions for the prevention and control of helminthic NTDs, non-helminthic NTDs, malaria, HIV/AIDS and tuberculosis and proposes a way forward. While previous reviews focus on process and effectiveness of integrated community-based interventions under real life field conditions, this series of papers evaluates the efficacy of such interventions with respect to disease or prevention outcomes.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"Controversial policy to regulate doctors on hold","field_subtitle":"Gonzalez L: Health-e News, 31 July 2014. ","URL":"http://www.health-e.org.za/2014/07/31/controversial-policy-regulate-doctors-hold/","body":"In late May, President Jacob Zuma South Africa signed into law long-dormant sections of the National Health Act that would give the Director General of Health the power to deny doctors operating licenses depending on where in the country the medical professional wished to operate, or open or expand a practice. Following this, doctors would have had to apply to the Department of Health for a \u201ccertificate of need,\u201d or permission to work in an area, by 1 April 2016. SAMA, the South African Dental Association, and the specialist body, the South African Private Practitioners Forum have all vocally opposed Certificates of Need and were considering Constitutional Court litigation against the department over the matter. The Department of Health has, however, decided to shelve plans to regulate where doctors could practice \u2013 at least temporarily. Department of Health spokesperson Joe Maila stated that the intention is not to redraft the Act but to allow parties sufficient time to draft and engage with regulations before the act takes effect. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Cultivating unemployment: Can agriculture create jobs in South Africa?","field_subtitle":"Neves D: Institute for Poverty, Land and Agrarian Studies: 20 March 2014 ","URL":"https://www.youtube.com/watch?feature=player_embedded&v=qM9xcJrs7-c","body":"Cultivating Unemployment takes a hard look at the realities of rural economies in South Africa and begins to grapple with the policy implications of these realities. The video shows the challenges and difficulties involved in creating rural economies that can multiply benefits for rural dwellers.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to admin@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to admin@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact admin@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 163: When it comes to transforming health systems, who counts?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Header"}},{"node":{"title":"Getting Treatment and Care to the Last Mile: Analyzing the Health Surveillance Assistant Cadre in Malawi","field_subtitle":"Martiniuk A, Smith S, Deveridge A, Berman J, Negin J, Mwambene N, Chingaipe E: Africa Initiative Discussion Paper 10, 23 2014","URL":"http://www.africaportal.org/articles/2014/01/23/getting-treatment-and-care-last-mile-analyzing-health-surveillance-assistant","body":"As low- and middle-income countries face continued shortages of human resources for health and the double burden of infectious and chronic diseases, there is renewed international interest in the potential for community health workers to take on a growing role in strengthening health systems. Health surveillance assistants (HSAs) \u2014 as the community health cadre in Zomba District, Malawi is known \u2014 play a vital role by connecting the community with the formal health care sector. The latest research from the Africa Initiative provides a situational analysis of the HSA cadre and its contribution to the delivery of health services in Malawi. The authors\u2019 findings show that HSAs face numerous challenges related to training, as well as challenges in defining their roles and those of their supervisors. They conclude with recommendations to improve HSA training and policy, with the ultimate goal of improving the effectiveness of this cadre of worker, and improving the health of the population.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"International Drug Price Indicator Guide","field_subtitle":"Management Sciences for Health: Boston, 2014","URL":"http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=DMP&language=english","body":"The International Drug Price Indicator Guide contains a spectrum of prices from pharmaceutical suppliers, international development organizations, and government agencies. The Guide aims to make price information more widely available in order to improve procurement of medicines of assured quality for the lowest possible price. Comparative price information is important for getting the best price, and this is an essential reference for anyone involved in the procurement of pharmaceuticals. Management Sciences for Health (MSH) has published the International Drug Price Indicator Guide since 1986 and updates it annually.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Introducing the Open and Collaborative Science in Development Network ","field_subtitle":"Open and Collaborative Science in Development Network, July 2014","URL":"http://ocsdnet.org/","body":"The Open and Collaborative Science in Development Network (OCSDNet) announces the launch of the network and a public Call for Concept Notes on case studies that explore the linkages between Open Science and development initiatives. Open and Collaborative Science (OCS) is a set of ideas and practices that aims to change the traditional culture of research by making the production and dissemination of scientific knowledge inclusive and publicly accessible. Open approaches to science include increased sharing of research plans and data, participatory citizen science, distributed \u201ccrowdsourced\u201d forms of data collection, and innovative models of large or small scale scientific collaborations, enabled by networked technologies. While principles of openness and collaboration are recognized as critical for development, they remain to be realized. Moreover, there is limited awareness about the benefits and practices of OCS in the Global South.  If the global scientific community understands how scientific knowledge can be effectively made more open and inclusive, then researchers and research-users in the Global South and North can work to ensure that scientific knowledge informs development efforts. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Journal of Health Diplomacy (call for papers on Africa, health and diplomacy","field_subtitle":"Call closes: 3 November 2014","URL":"https://journals.carleton.ca/jhd/index.php/journal","body":"The Journal of Health Diplomacy (JHD) is now receiving manuscripts for its third issue, titled: Africa, health and diplomacy. This issue is broadly concerned with the theory and practice of health diplomacy of African states, as a co-operation with the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The issue will include invited and submitted manuscripts.  To be considered for the latter, please submit your proposed manuscript to mark.pearcey@carleton.ca by 3 November 2014.  Manuscripts submitted to JHD will undergo a peer-review process, with referees selected for their particular knowledge/experience on the topic of the manuscript. In light of this, we ask authors to ensure that their identity is not revealed directly or indirectly on any page. Manuscripts that are being considered for publication elsewhere, or that have been previously published must not be submitted to the journal. A complete set of author guidelines is available on the journal website. JHD welcomes contributions from all academic disciplines, including international relations, political science, anthropology, sociology, history and geography. We are also interested in interdisciplinary perspectives that cross the boundaries between different theoretical fields and represent novel understandings of health diplomacy.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"New and old global health actors: effectiveness vs. legitimacy?","field_subtitle":"van Shaik L, van de Pas R: Clingendael, 1-66, July 2014","URL":"http://www.clingendael.nl/publication/new-and-old-global-health-actors-effectiveness-vs-legitimacy","body":"The democratic legitimacy of transnational arrangements for global health is contested. The traditional United Nations\u2019 body for health, the World Health Organization (WHO), is subject to severe criticism regarding its focus, effectiveness, and independence from country specific, and private sector interests. It is confronted by budget cuts and a fundamental reorganization. Other major actors, such as the Global Alliance for Vaccines and Immunization (GAVI), Global Fund and the Bill and Melinda Gates Foundation (hereafter The Gates), make significant contributions to international health projects, but they can be criticized for not being representative and accountable. The global health landscape in general has become an intransparent patchwork of organizations and interests, where objectives of public health, development, economy, security, and foreign policy dominate to various degrees, and sometimes clash. This paper discusses the principal arrangements for transnational governance in the area of global health, and analyses their democratic legitimacy using five different prisms: (1) representation; (2)accountability; (3) transparency; (4) effectiveness; and (5) deliberation.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Opportunities and Challenges in Tanzania\u2019s Sugar Industry: Lessons for SAGCOT and the New Alliance","field_subtitle":"Sulle E, Smalley R and Malale L: Institute for Poverty, Land and Agrarian Studies, Future Agricultures, Policy Brief 76, 1 August 2014","URL":"http://www.plaas.org.za/sites/default/files/publications-pdf/Policy_Brief_076.pdf","body":"Sugarcane outgrower schemes are central to several policy and donor strategies for driving agricultural growth and reducing poverty, including the Southern Agricultural Growth Corridor project in Tanzania (SAGCOT). But field research into the outgrower component of Kilombero Sugar Company, Tanzania\u2019s largest and best regarded sugar producer, demonstrates a pressing need for change. Sugarcane production in Kilombero has had benefits for farming households as well as the local and national economy. However, unsustainable expansion and governance issues in the outgrower scheme have created new risks. There are pressures on food security as a result of a decline in land for food crops, and on incomes, particularly when outgrowers\u2019 cane remains unharvested and farmers\u2019 payments are delayed. These problems have been aggravated by the importation of foreign sugar into the country. For this industry to provide its maximum benefits to the economy and to the household, a policy, legal and institutional framework is needed that provides greater efficiency, accountability and transparency, as well as greater security for all participating stakeholders. There are lessons for the sugar industry, as well as donors and investors of ongoing and future agribusiness developments in Tanzania.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Pilot-testing service-based planning for health care in rural Zambia","field_subtitle":"Goma F, Murphy G, Libetwa M et al: BMC Health Services Research 14(Suppl 1):S7, 2014 ","URL":"http://www.biomedcentral.com/1472-6963/14/S1/S7","body":"The objective of the study was to demonstrate the effectiveness of service-based human resources for health (HRH) planning through its adaptation in two rural Zambian districts, Gwembe and Chibombo. The health conditions causing the greatest mortality and morbidity in each district were identified using administrative data and consultations with community health committees and health workers. The number and type of health care services required to address these conditions were estimated based on their population sizes, incidence and prevalence of each condition, and desired levels of service. The capacity of each district\u2019s health workers to provide these services was estimated using a survey of health workers (n=44) that assessed the availability of their specific competencies. The primary health conditions identified in the two districts were HIV/AIDS in Gwembe and malaria in Chibombo. Although the competencies of the existing health workforces in these two mostly aligned with these conditions, some substantial gaps were found between the services the workforce can provide and the services their populations need. The largest gaps identified in both districts were: performing laboratory testing and interpreting results, performing diagnostic imaging and interpreting results, taking and interpreting a patient\u2019s medical history, performing a physical examination, identifying and diagnosing the illness in question, and assessing eligibility for antiretroviral treatment. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Policy brief 36: Increasing African agency in the design of Performance Based Financing ","field_subtitle":"U Sheffield, et al: EQUINET, Harare, July 2014","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20Polbrief%2036%20Gov.pdf","body":"Billions of dollars are channelled each year to African governments by external funders, from global institutions such as the World Bank and Global Fund to support health systems. Much of the money is provided in the form of \u201cPerformance Based financing\u201d (PBF) schemes. In 2013/4 we reviewed the decision making on and design of these PBF schemes, including through interviews with officials in Africa and at Africa regional and global levels. This brief explains what PBF schemes are and the reasons for their popularity. It presents the positive and negative features of and views expressed on PBF. It presents a set of questions national authorities should take into account when negotiating any PBF type scheme within health systems and makes recommendations for African officials who wish to improve the design and implementation of PBF schemes to support national health system goals. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Policy Brief 37: Health Centre Committees as a vehicle for social participation in health systems in east and southern Africa","field_subtitle":"TARSC with CWGH, Medico: EQUINET  Harare June 2014","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20Polbrief%2037%20HCC%202014.pdf","body":"The adoption of primary health care (PHC) in all east and Southern African(ESA) countries means that public participation is central to the design and implementation of health systems. One mechanism for this is through Health Centre Committees (HCCs) that involve representatives of communities and primary-care level health workers in planning, implementing and monitoring health services and activities. Known by different names in different countries, they are a common mechanism for communities to ensure that health systems access and use resources to address their needs and are responsive and accountable to them. They have been found to have a positive impact on health outcomes. This brief presents information and experiences from document review and from the exchanges of people working with HCCs in ESA countries at a 2014 EQUINET regional meeting on how HCCs are functioning in the region. It presents proposals for improving their functioning and impact.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Policy Brief 38: Taking the WHO Global code of Practice on the International Recruitment of health Personnel in Africa from bottom drawer to negotiating table","field_subtitle":"U Limpopo, ECSA, ACHEST, TARSC: EQUINET, Harare, July 2014","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20Polbrief%2038%20Code%202014.pdf","body":"ESA countries face many challenges in the absolute shortages, maldistribution, low production and poor utilisation of their health workforces. The World Health Organisation (WHO) Global Code of Practice on the International Recruitment of Health Personnel (the \u201cCode\u201d) was unanimously adopted by the World Health Assembly in May 2010 to address recruitment and migration of health workers. However, its implementation has shown limited progress in east and southern Africa, according to a study in the EQUINET Research programme on global health diplomacy. Health worker migration is not seen to be the scale of problem it was a decade ago in the region. While concerns from the region were mostly included in the Code,the demand for \u201cmutuality of benefit\u201d and \u201ccompensation\u201d were not. This was interpreted by some stakeholders to mean that the Code did not fully accommodate African interests. Implementation of the Code is reported to be impeded by lack of champions; of resources for implementation; by weak functional data (systems) on mobility of health personnel, and by limited domestication and dissemination of the Code in ESA countries. This brief presents opportunities to use the Code in negotiating bilateral agreements and suggests ways of strengthening its implementation.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"Rape of bodies, rape of resources, rape of a nation","field_subtitle":"Mayanja N: Pambazuka News, 691; 14 August 2014","URL":"http://www.pambazuka.org/en/category/comment/92824","body":"The author argues that the situation in DRC illustrates the deficiency of global ethics, selfishness and the longstanding failure to value the lives of the African people. Tackling the DRC\u2019s impasse requires a comprehensive approach and involvement of national, regional, continental and international communities. The author argues that the DRC is embroiled in a geo-political and economic strategic battle in the search for scarce resources that are abundant in Congo. It is the paradox of the resource curse. It is hardly remembered that sustainable extraction of the minerals would benefit global interests longer and the rain forests in the DRC are vital to curbing climate change. Tackling the DRC\u2019s impasse is argued to require a comprehensive approach and involvement of national, regional, continental and international actors, coupled with continued research to inform policies and praxis. Equally, varied strategies designed from local cultures, African philosophy and interdisciplinary academic views are vital. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Reflections on AIDS 2014 \u2013 Stepping up the Pace and Leaving No one Behind ","field_subtitle":"Burford G: CAFOD August 2014","URL":"http://www.globalhealthcheck.org/?p=1637","body":"This commentary was written on the International AIDS Conference in Melbourne 20-25 July 2012, the 20th gathering of the largest regular conference of any health or development issue, bringing together politicians, scientists, epidemiologists, practitioners, policy makers, the private sector and communities of people living with and affected by HIV. There is uniqueness in this fight against HIV in that it is a social movement, pulling people together and putting people at the forefront of the response to sustain efforts on addressing HIV. The theme of the 2014 conference was \u2018Stepping up the Pace,\u2019 and the author comments that we must redouble our efforts on areas like stigma and discrimination, which after 30 years is still increasing in some regions. 'We have the tools; we need to step up the pace.\u2019 Today, there are 15 million people on treatment, yet there are still alarming challenges that must be tackled in order to even contemplate an AIDS free generation. Statistics from 2013 show there were 1.5 million HIV deaths, 2.1 million new infections and 35 million people living with HIV. Of the 35 million people living with HIV, 55% (19 million) don\u2019t know they have the virus. They haven\u2019t been tested and if they don\u2019t find this out, they will die. The conference highlighted many reasons as to why people do not access or drop out of treatment. The author argues that people must not become those tired advocates beating the same drum, but come back from the conference championing the successes of work over the last 30 years and enter a phase of renewed energy to step up the pace and most importantly leave no one behind.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Roundtable discussion: what is the future role of the private sector in health?","field_subtitle":"Stallworthy G, Boahene K, Ohiri K, Pamba A and Knezovich J: Globalization and Health (10) 55, 2014","URL":"http://www.globalizationandhealth.com/content/10/1/55","body":"The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage. This roundtable discussion offered perspectives from a range of stakeholders \u2013 a health funder, a representative from an implementing organisation, a national-level policy-maker, and an expert working in a large multi-national company \u2013 on what the future may hold for the private sector in health. The health funder argued that the discussion about the future role of the private sector has been bogged down in language. He argued for a \u2018both/and\u2019 approach rather than an \u2018either/or\u2019 when it comes to talking about health service provision in low- and middle-income countries. An implementer of health insurance in sub-Saharan Africa examined the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term. Thirdly, a special advisor working in the federal government of Nigeria noted that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or be left behind. Finally, a representative from a multi-national pharmaceutical corporation gave an overview of global shifts that are creating opportunities for the private sector in health markets. No community member views were provided. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"SADC-EU EPA negotiations to be concluded","field_subtitle":"Bridges Africa: 22 July 2014","URL":"http://www.ictsd.org/bridges-news/bridges-africa/news/sadc-eu-epa-negotiations-to-be-concluded","body":"Chief negotiators of the Southern African Development Community (SADC) have \"initialled\" the Economic Partnership Agreement (EPA) with the European Union during a joint negotiation session in Pretoria, South Africa on 15 July.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Social Determinants of Health Equity ","field_subtitle":"Marmot M, Allen J:    American Journal of Public Health: 104, S4, S517-S519, September 2014","URL":"http://ajph.aphapublications.org/doi/full/10.2105/AJPH.2014.302200","body":"This supplement explores social determinants of equity in health and highlights differences by socioeconomic status and geographic location, among others. The paper highlights that to reduce health inequalities requires action to reduce socioeconomic and other inequalities. There are other factors that influence health, but these are outweighed by the overwhelming impact of social and economic factors\u2014the material, social, political, and cultural conditions that shape our lives and our behaviours. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Southern African states to collaborate on Ebola","field_subtitle":"Makholwa A: BusinessDay live, 7 August 2014","URL":"http://www.bdlive.co.za/national/health/2014/08/07/southern-african-states-to-collaborate-on-ebola","body":"HEALTH ministers in the Southern African Development Community (SADC) have agreed to collaborate in the event of an outbreak of Ebola in the region. The ministers held an extra ordinary meeting in Johannesburg in August to plan a coherent response should the Ebola outbreak in West Africa spread to other regions of the continent as feared. There has not been a reported case of Ebola in the SADC region but there is a risk. People travel frequently between Southern and West African countries. Among other things, the SADC ministers agreed to organise cross-border consultations to facilitate the exchange of information, and to strengthen surveillance of the virus. They agreed to commit additional financial resources, but proposed a regional fund for emergency situations as a long-term solution. South Africa was chosen as the centre of excellence in Ebola laboratory diagnosis in the region. It is expected to help with the training of health professionals treating infected individuals.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Supporting middle-cadre health care workers in Malawi: Lessons learned during implementation of the PALM PLUS package","field_subtitle":"Sodhi S, Banda H, Kathyola D, et al: BMC Health Services Research 14(Suppl 1):S8, 2014  ","URL":"http://www.biomedcentral.com/1472-6963/14/S1/S8","body":"The government of Malawi is committed to the rollout of antiretroviral treatment in Malawi in the public health sector; however one of the primary challenges has been the shortage of trained health care workers. The Practical Approach to Lung Health Plus HIV/AIDS in Malawi (PALM PLUS) package is an innovative guideline and training intervention that supports primary care middle-cadre health care workers to provide front-line integrated primary care. The purpose of this paper is to describe the lessons learned in implementing the PALM PLUS package. A clinical tool, based on algorithm- and symptom-based guidelines was adapted to the Malawian context. An accompanying training program based on educational outreach principles was developed and a cascade training approach was used for implementation of the PALM PLUS package in 30 health centres, targeting clinical officers, medical assistants, and nurses. Lessons learned were identified during program implementation through engagement with collaborating partners and program participants and review of program evaluation findings. Key lessons learned for successful program implementation of the PALM PLUS package include the importance of building networks for peer-based support, ensuring adequate training capacity, making linkages with continuing professional development accreditation and providing modest in-service training budgets. The main limiting factors to implementation were turnover of staff and desire for financial training allowances. ","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Systematic review of facility-based sexual and reproductive health services for female sex workers in Africa","field_subtitle":"Dhana A, Luchters S, Moore L, Lafort Y, Roy A, Scorgie F and Chersich M: Globalization and Health (10)46, 2014","URL":"http://www.globalizationandhealth.com/content/10/1/46","body":"Several biological, behavioural, and structural risk factors place female sex workers (FSWs) at heightened risk of HIV, sexually transmitted infections (STIs), and other adverse sexual and reproductive health (SRH) outcomes. FSW projects in many settings have demonstrated effective ways of altering this risk, improving the health and wellbeing of these women. Yet the optimum delivery model of FSW projects in Africa is unclear. This systematic review describes intervention packages, service-delivery models, and extent of government involvement in these services in Africa. The authors located 149 articles, which described 54 projects. Most were localised and small-scale; focused on research activities (rather than on large-scale service delivery); operated with little coordination, either nationally or regionally; and had scanty government support (instead a range of international donors generally funded services). Almost all sites only addressed HIV prevention and STIs. Most services distributed male condoms, but only 10% provided female condoms. HIV services mainly encompassed HIV counselling and testing; few offered HIV care and treatment such as CD4 testing or antiretroviral therapy (ART). While STI services were more comprehensive, periodic presumptive treatment was only provided in 11 instances. Services often ignored broader SRH needs such as family planning, cervical cancer screening, and gender-based violence services. Sex work programmes in Africa have limited coverage and a narrow scope of services and are poorly coordinated with broader HIV and SRH services. To improve FSWs\u2019 health and reduce onward HIV transmission, access to ART needs to be addressed urgently. Nevertheless, HIV prevention should remain the mainstay of services. Service delivery models that integrate broader SRH services and address structural risk factors are much needed. Government-led FSW services of high quality and scale would markedly reduce SRH vulnerabilities of FSWs in Africa.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"The accountability for reasonableness approach to guide priority setting in health systems within limited resources - findings from action research at district level in Kenya, Tanzania, and Zambia","field_subtitle":"Byskov J, Marchal B, Maluka S, Zulu J, Bukachi S, Hurtig A, Blystad A, Kamuzora P, Michelo C, Nyandieka L, Ndawi B, Bloch P, Olsen \u00d8: Health Research Policy and Systems 12:49, 2014","URL":"http://www.health-policy-systems.com/content/12/1/49","body":"Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions: relevance, publicity, appeals, and enforcement, which facilitate agreement on priority-setting decisions and gain support for their implementation. This intervention study applied an action research methodology to assess implementation of AFR in one district in Kenya, Tanzania, and Zambia, respectively. The assessments focused on selected disease, program, and managerial areas. The values underlying the AFR approach were in all three districts well-aligned with general values expressed by both service providers and community representatives. There was some variation in the interpretations and actual use of the AFR in the decision-making processes in the three districts, and its effect ranged from an increase in awareness of the importance of fairness to a broadened engagement of health team members and other stakeholders in priority setting and other decision-making processes. District stakeholders were able to take greater charge of closing the gap between nationally set planning on one hand and the local realities and demands of the served communities on the other within the limited resources at hand. This study provided arguments for the continued application and further assessment of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"The men\u2019s health gap: men must be included in the global health equity agenda","field_subtitle":"Baker P, Dworkin S, Tong S, Banks I, Shand T, Yamey G: Bulletin of the World Health Organization 2014;92:618-620","URL":"http://www.who.int/bulletin/volumes/92/8/13-132795/en/","body":"In most parts of the world, health outcomes among boys and men continue to be substantially worse than among girls and women, yet this gender-based disparity in health has received little national, regional or global acknowledgement or attention from health policy-makers or health-care providers. Including both women and men in efforts to reduce gender inequalities in health as part of the post-2015 sustainable development agenda would improve everyone\u2019s health and well-being. This paper notes that three types of intervention targeting men have emerged in recent years \u2013 outreach, partnership and gender transformation \u2013 and there is now evidence to support all three approaches. The authors argue that global, regional and national health and development agencies could certainly learn from the success of civil society groups in promoting policies that target men. For example, the South African non-profit organization Sonke Gender Justice successfully pushed the government to add interventions targeting men within South Africa\u2019s national HIV strategic plan. Closing the men\u2019s health gap, it is argued, can benefit men, women and their children.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"The promise and limitations of cash transfer programs for HIV prevention","field_subtitle":"Fieno J and Leclerc-Madlala S: African Journal of AIDS Research (2) 13, 153\u2013160, 2014","URL":"http://www.ajol.info/index.php/ajar/article/view/105525","body":"This article examines elements of a successful cash transfer program from Latin America and discusses challenges inherent in scaling-up such programs. The authors attempt a cost simulation of a cash transfer program for HIV prevention in South Africa comparing its cost and relative effectiveness \u2013 in number of HIV infections averted \u2013 against other prevention interventions. If a cash transfer program were to be taken to scale, the intervention would not have a substantial effect on decreasing the force of the epidemic in middle- and low-income countries. The integration of cash transfer programs into other sectors and linking them to a broader objective such as girls\u2019 educational attainment is argued by the authors as one way of addressing doubts raised by the authors regarding their value for HIV prevention.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"The Social, Economic and Environmental Implications of Diamond Mining in Chiadzwa","field_subtitle":"Chimonyo G, Mungure S, Scott P: Centre for Research and Development, 2014","URL":"http://www.crdzim.com/Implications%20of%20diamond%20mining%20in%20Chiadzwa%20pdf.pdf","body":"This report documents the progression of events in Chiadzwa Zimbabwe in terms of diamond mining and trading, the socio-economic and environmental impacts and the conflict between authorities, (government agencies) and the local communities. The project had as its objective to inform the degree of adherence to the doctrine of 'Permanent Sovereignty over Natural Resources'. The intrusion of mining in Chiadzwa is argued to have displaced the cultural and social mosaic while privatising the commons and subjecting the villagers to several risks and harms with minimal benefits. The existence of clandestine networks is reported to have made an underhand diamond economy \r\ninjurious to the prospective diamond-anchored economic resurgence, limiting the benefit sharing arrangements. The authors argue that the extractive nature of the diamond industry should be accompanied with appropriate observance of environmental laws, appropriate corporate social responsibility and transparent accountability by all stakeholders.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Third Global Symposium on Health Systems Research","field_subtitle":"Cape Town International Convention Centre, South Africa, 30 September to 3 October 2014","URL":"http://hsr2014.healthsystemsresearch.org/","body":"The Third Global Symposium on Health Systems Research which will be held in Cape Town, South Africa, from 30 September to 3 October 2014 with pre-Symposium satellite sessions on 29 and 30 September. The theme of the symposium is the science and practice of people-centred health systems, chosen to enable participants to address current and critical concerns of relevance across countries in all parts of the world. Researchers, policy-makers, funders, implementers and other stakeholders, from all regions and all socio-economic levels, will work together on the challenge of how to make health systems more responsive to the needs of individuals, families and communities. Participation is encouraged from experts and newcomers to the broad field of health systems research.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"UN working group agrees to proposed sustainable development goals","field_subtitle":"Bridges Africa: 24 July 2014","URL":"http://www.ictsd.org/bridges-news/bridges-africa/news/un-working-group-agrees-to-proposed-sustainable-development-goals?utm_content=rloewenson%40healthnet.zw&utm_source=VerticalResponse&utm_medium=Email&utm_term=UN%20working%20group%20agrees%20to%20propos","body":"The UN working group charged with outlining a proposed set of sustainable development goals (SDGs) adopted an outcome document on Saturday. The recommended goals will now be sent to the UN General Assembly for consideration as part of the discussions around the post-2015 development agenda. The final 23-page document maintains the 17 goals outlined in a revised \u201czero draft\u201d \u2013 released by the working group\u2019s co-chairs in early July to serve as a basis for this final meeting \u2013 with 169 targets. Sixty-two of these can be classed as \u201cmeans of implementation,\u201d (MoI) or the methods to achieve each goal. During the closing plenary on Saturday morning, the working group co-chairs said that while they were happy with their efforts in steering participants towards an outcome document, they recognised the final product was not flawless. Another year of discussion is likely as the UN General Assembly reflects upon the proposed goals. The document does not yet contain indicators for measuring progress towards each goal and target, which was part of the working group\u2019s original mandate. The eventual addition of indicators at a later stage may prove a useful opportunity to clarify some of the proposed targets and further work will likely be undertaken in this area.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Utilization of health care services in rural and urban areas: A determinant factor in planning and managing health care delivery systems","field_subtitle":"Oladipo JA: African Health Sciences (2)14: 322-333","URL":"http://www.ajol.info/index.php/ahs/article/view/104225/94316","body":"Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilisation of health services; similarity between rural and urban areas; and major explanatory variables for utilisation. A four-stage model of service utilisation was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analysed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilisation. Planning of different categories of health care facilities in different locations should be based on utilisation rates while proper management of established facilities should aim to improve health seeking behaviour of people.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"When it comes to transforming health systems, who counts?","field_subtitle":"Rene Loewenson, Training and Research Support Centre","body":"\r\nOur health systems are sites of constant change and struggle. In east and southern Africa national health services centred on comprehensive primary health care (PHC) have been \u2018reorganised\u2019 through waves of liberalisation, privatisation, disease focused verticalisation, performance based financing and many other reforms. People have come to services to find new rules for what is free and what is charged, for what medicines and supplies are present and what is not, and community health activities and workers have appeared, disappeared and appeared again. \r\n\r\nThe drive for a universal national health service was embedded in national liberation struggles. The PHC approach was a global concept that resonated strongly with popular expectations of what post independent health systems should look like. Many of the subsequent changes have emerged as waves of international reform, increasingly influenced by global level actors. When we ask people in participatory sessions to form a human sculpture of how their health systems are organised around a patient visiting for care, the sculpture most commonly has health workers, managers and others looking upwards to the next level to get the resources and attention they need to solve problems, (most looking away from the patient), usually with the person representing a powerful but distant global funder elevated in both power and stature on a chair in a far corner of the room. \r\n\r\nWhile these may be caricatures, they raise the question- when it comes to changes in health systems, who counts? Whose views, expectations, ideas, evidence, numbers, analysis and knowledge is used to generate change? \r\n\r\nThis matters because health is \u2018a state of mental, physical and social wellbeing and not just the absence of disease\u2019, because health outcomes reflect conditions that are socially created, and health systems are thus social institutions, built out of and influencing society. The explosion of knowledge on the biomedical basis of disease and on risk factors in public health has informed massive advances in survival. It has, however, weakly addressed and often ignored the social context and determinants of health and the social nature of health systems. As a consequence we face persistent and sometimes widening inequality in health and in access to services, rising levels of multiple morbidity and chronic conditions, epidemic resurgence and antibiotic resistance, amongst other challenges. \r\n\r\nThe problem does not lie in the extraordinary scientific innovation and creativity that lay behind these medical advances. The problem lies in one form of knowledge subjugating others, excluding and disempowering others from the creative processes that transform society, a mistake akin to suggesting that the trunk of the elephant is the whole elephant.  \r\n\r\nThat knowledge as socially constructed is not a new concept. This understanding has been central to social sciences and to cultural, anticolonial, gender and indigenous struggles. With the failure to implement what is known, in health sciences it has led to increased attention to fields such as health systems and policy research, where rather than absolute prescriptions, there is a quest to better understand \u2018what works where and for whom\u2019.  \r\n\r\nThis wider lens will generate a better understanding of context in health sciences. Will it also overcome a tendency for ordinary people to be the last to know the waves of reforms transforming their health systems?  Freire argued decades ago that meaningful social transformation, including of health systems, can only occur with the deep involvement of the people affected. The incubation of the PHC approach, the efforts to build national health services across diverse countries, the refusal to allow health care to be commodified, the gains in access to improved living and working conditions have all been a product of social and political action. \r\n\r\nThis type of action does not grow out of knowledge and perspective built in distant corridors.  In the last century activist scientists such as Orlando Fals Borda in Latin America pointed to a different understanding of science, one that seeks to not only understand the world but to transform it, and, as importantly, one in which knowledge is built from lived experience and from the learning and self-awareness that grows from action. Participatory action research (PAR) has developed in different forms as a method for such science. It overcomes the separation between subject and object. 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 using action and change as a means to new knowledge. A new methods reader on \u2018Participatory action research in health systems\u2019 produced by EQUINET  and TARSC with Alliance for Health Policy and Systems Research and IDRC Canada that can be obtained on the EQUINET website in end September details the principles and methods of PAR, its challenges and the many ways and levels at which it is being used. \r\n\r\nIn different parts of the world, PAR has built a more direct link between theory building and practice in health systems.  Workers and unions have used PAR to expose and organise for change in working conditions that are harmful to their health. Young people in high and low income countries have used it to raise visibility of and engage with authorities on harmful community environments.  Indigenous communities have used it to negotiate the organisation of their health care. It has been used in continuous processes in local authorities in shaping PHC, learning from cycles of transformation. \r\n\r\nThe practice of PAR flags that change is not itself a problem in health systems in east and southern Africa. It is rather a problem when the knowledge used to guide this change does not draw on the experience, knowledge and wisdom of those directly involved, through methods that build their power to inform, learn from and shape that change. \r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the issues raised in this op-ed please read Participatory action research in health systems: a methods reader, available on the EQUINET website www.equinetafrica.org from end September 2014","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"WTO\u2019s least developed countries submit collective request on services waiver","field_subtitle":"Bridges Africa, 25 July 2014","URL":"http://www.ictsd.org/bridges-news/bridges-africa/news/wto%E2%80%99s-least-developed-countries-submit-collective-request-on?utm_content=rloewenson%40healthnet.zw&utm_source=VerticalResponse&utm_medium=Email&utm_term=WTO%26rsquo%3Bs%20least%20developed%20co","body":"In July the WTO\u2019s poorest members, known as the Least Developed Country (LDC) Group, submitted a collective request regarding the preferential treatment they would like to see for their services and service suppliers. The move comes seven months after the global trade body\u2019s ministerial conference in Bali, Indonesia, where members agreed to take steps for bringing this \u201cservices waiver\u201d into operation. The LDC services waiver, as it is referred to in trade circles, was initially an outcome of the 2011 WTO Ministerial Conference, held in Geneva, Switzerland. However, in the two years that followed, no preferences had been requested by LDCs or granted to them, prompting WTO members to reconsider ways to use the services waiver. As a result, at the WTO\u2019s subsequent ministerial conference in Bali, Indonesia last December, members agreed to initiate a process aimed at promoting the \u201cexpeditious and effective operationalisation\u201d of the LDC services waiver. Over the next six months, WTO members will engage in consultations with the LDC Group in order to respond to the collective request at the high-level meeting. The LDCs have reserved the right to modify the request\u2019s terms ahead of the event.","php":"","field_issue_date":"2014-09-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"10th Public Health Association of South Africa, ","field_subtitle":"Protea Ranch Resort, Polokwane, South Africa, 3-6 September 2014","URL":"http://www.phasaconference.org.za","body":"The 10th anniversary of the Public Health Association of South Africa (PHASA) conference will be celebrated with the hosting of the conference in Polokwane (Limpopo) from 3 to 6 September 2014. The workshops will take place on the 3rd, the actual conference on the 4th and 5th, and the student symposium on the 6th of September. The theme for the 2014 conference is \u2018Dignity, rights and quality: towards a health care revolution\u2019. An invitation is extended to all our members, stake holders,  policy makers, public health academics and students, health professionals, health service managers and individuals from non-governmental and community-based health organisations.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Aid and its implications for governance","field_subtitle":"Soko KB: Pambazuka News, 3 July 2014","URL":"http://www.pambazuka.org/en/category/comment/92349","body":"Malawi is one of the most aid dependent countries in the world. When one considers the work that is done by international NGOs, however, or by them through local surrogates, it is argued that there is no aspect of life in Malawi that has escaped external funding. With July 6, 2014 a day 50 years to the day when Malawi became an independent state the author argues that it\u2019s important to accentuate the discussion on aid in Malawi and its implications for Malawi. the author argues that a heavy reliance on external funding means that foreigners, not the citizens, are in charge of the country\u2019s governance.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Call for proposals: The role of non-state providers in strengthening health systems towards Universal Health Coverage","field_subtitle":"Call Closes August 5 2014","URL":"http://www.ahpsrproposalsubmission.org","body":"The Alliance for Health Policy and Systems Research in collaboration with the WHO Department of Service Delivery and Safety, Canada\u2019s International Development Research Centre and the Rockefeller Foundation, is launching a new research program focused on the role of non-state providers in strengthening health systems towards the achievement of Universal Health Coverage. Research funded under this call must contribute to answering the research question: What are the factors that have enabled or hindered interventions by governments to engage non-state providers in strengthening health systems towards the achievement of Universal Health Coverage and what are the reasons for it? Between 8-12 proposals will be awarded amounts of up to US$ 120,000 depending on the context in which the study is taking place. The Principal Investigator must be a researcher in an institution based in a low or middle income country. further detail and application procedures can be found on the website for the call. ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Cape Town Conference 2014: Putting Public in Public Services.","field_subtitle":"Municipal Services Project, July 2014","URL":"https://www.youtube.com/playlist?list=PLkv7HYFP012KbOTC4n1jBxNFcqTPqaHse","body":"Presenters' insights and experiences with progressive public services inspired and energized the 150+ people who came from across South Africa and around the world for this three-day event last April. All panel presentations and plenary talks recorded by students from the University of the Western Cape are available online. ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Contribution of Noncommunicable Diseases to Medical Admissions of Elderly Adults in Africa: A Prospective, Cross-Sectional Study in Nigeria, Sudan, and Tanzania.","field_subtitle":" Akinyemi RO1, Izzeldin IM, Dotchin C, Gray WK, Adeniji O, Seidi OA, Mwakisambwe JJ, Mhina CJ, Mutesi F, Msechu HZ, Mteta KA, Ahmed MA, Hamid SH, Abuelgasim NA, Mohamed SA, Mohamed AY, et al: J Am Geriatr Soc. July 2014","URL":"http://www.ncbi.nlm.nih.gov/pubmed/25041242","body":"The authors describe the nature of geriatric medical admissions to teaching hospitals in three countries in Africa (Nigeria, Sudan, Tanzania) and compare them with data from the United Kingdom. They included all people aged 60 and older urgently medically admitted from March 1 to August 31, 2012. Data were collected regarding age, sex, date of admission, length of stay, diagnoses, medication, date of discharge or death, and discharge. In Africa, noncommunicable diseases (NCDs) accounted for 81.0% (n = 708) of admissions (n = 874), and tuberculosis, malaria, and the human immunodeficiency virus and acquired immunodeficiency syndrome accounted for 4.6% (n = 40). Cerebrovascular accident (n = 224, 25.6%) was the most common reason for admission, followed by cardiac or circulatory dysfunction (n = 150, 17.2%). Rates of hypertension were remarkably similar in the United Kingdom (45.8%) and Africa (40.2%).In the elderly population, the predicted increased burden of NCDs on health services in Africa appears to have occurred. Greater awareness and some reallocation of resources toward NCDs may be required if the burden of such diseases is to be reduced.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Equitable health services"}},{"node":{"title":"EQUINET Discussion paper 102: African participation and partnership in performance-based financing: A case study in global health policy","field_subtitle":" Barnes A; Brown G; Harman S; Papamichail A; Banda P; Hayes R; Muliamba C : EQUINET, Harare, June 2014","URL":"http://www.equinetafrica.org/bibl/docs/EQ%20GHD%20PBF%20Diss102.pdf","body":"Participation is a key policy concept in global health, and relates to the ability of stakeholders to engage with and shape health policy at four intersecting levels: local, national, regional and global. Such engagement remains the key normative aim behind debates about furthering more equitable health diplomacy and has, as a result, been increasingly integrated into the agenda of global agencies, including the Global Fund to Fight AIDS, TB and Malaria and the World Bank. This report forms part of a research programme led by EQUINET focusing on the participation of African actors in global health diplomacy. The report focuses on the participation of African actors in global health governance. In an attempt to better understand the spaces and places within which participation can occur, and particularly the ways in which global actors such as the Global Fund and the World Bank provide such opportunities, the research explored the following questions: \u2022 How do the Global Fund and World Bank provide spaces for participation in global health governance processes? \u2022 To what extent can African actors nationally and regionally extend their agency within these participatory spaces? \u2022 What role does the World Health Organisation (WHO) and its own governance play in the interface between African actors and the Global Fund and World Bank?","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Latest Equinet Updates"}},{"node":{"title":"EQUINET News","field_subtitle":"","body":"Contact EQUINET at admin@equinetafrica.org and visit our website at www.equinetafrica.org \r\nWebsite: http://www.equinetafrica.org/newsletter \r\n\r\nSUBMITTING NEWS: Please send materials for inclusion in the EQUINET NEWS to editor@equinetafrica.org Please forward this to others. \r\n\r\nSUBSCRIBE: The Newsletter comes out monthly and is delivered to subscribers by e-mail. Subscription is free. To subscribe, visit http://www.equinetafrica.org or send an email to info@equinetafrica.org \r\n\r\nThis newsletter is produced under the principles of 'fair use'. We strive to attribute sources by providing direct links to authors and websites. When full text is submitted to us and no website is provided, we make the text available as provided. The views expressed in this newsletter, including the signed editorials, do not necessarily represent those of EQUINET or the institutions in its steering committee. While we make every effort to ensure that all facts and figures quoted by authors are accurate, EQUINET and its steering committee institutions cannot be held responsible for any inaccuracies contained in any articles. Please contact editor@equinetafrica.org immediately regarding any issues arising.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Footer"}},{"node":{"title":"EQUINET Newsletter 162: How far does performance based financing tick the box of national ownership?","field_subtitle":"","body":"EQUINET NEWS IS THE ELECTRONIC MAILING LIST OF THE NETWORK FOR EQUITY IN HEALTH IN EAST AND SOUTHERN AFRICA (EQUINET)\r\n\r\nhttp://www.equinetafrica.org/\r\n\r\nEQUINET NEWS is designed to keep you informed about materials on equity and health in east and southern Africa, focusing primarily on EQUINET's principal themes. It includes news about EQUINET activities, policy debates or theme work to keep you updated on work taking place. Further information on EQUINET activities is available from the EQUINET secretariat at Training and Research Support Centre (TARSC) (email: admin@equinetafrica.org).","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Header"}},{"node":{"title":"Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya","field_subtitle":"Ojakaa D, Olango S, Jarvis J: Human Resources for Health, 12:33, 6 June 2014. ","URL":"http://www.human-resources-health.com/content/12/1/33/abstract","body":"This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi.  A cross-sectional cluster sample design was used to select 59 health facilities that yielded interviews with 404 health care workers, grouped into 10 different types of service providers. Data were collected in November 2011 using structured questionnaires and a Focus Group Discussion guide. Findings were analyzed using bivariate and multivariate methods of the associations and determinants of health worker motivation and retention. The levels of education and gender factors were lowest in Turkana with female HCWs representing only 30% of the workers against a national average of 53%. A smaller proportion of HCWs in Turkana feel that they have adequate training for their jobs. Overall, 13% of the HCWs indicated that they had changed their job in the last 12 months and 20% indicated that they could leave their current job within the next two years. In terms of work environment, inadequate access to electricity, equipment, transport, housing, and the physical state of the health facility were cited as most critical, particularly in Turkana. The working environment is rated as better in private facilities. Adequate training, job security, salary, supervisor support, and manageable workload were identified as critical satisfaction factors. Family health care, salary, and terminal benefits were rated as important There are distinct motivational and retention factors that affect HCWs in the three regions. Findings and policy implications from this study point to a set of recommendations to be implemented at national and county levels. These include gender mainstreaming, development of appropriate retention schemes, competitive compensation packages, strategies for career growth, establishment of a model HRH community, and the conduct of a discrete choice experiment. ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"Faith-based health services as an alternative to privatization?  A Ugandan case study","field_subtitle":"Dambisya YM, Manenzhe M, Kibwika-Muyinda A: Municipal Services Project Occasional Paper July 2014","URL":"http://www.municipalservicesproject.org/publication/faith-based-health-services-alternative-privatization-ugandan-case-study","body":"This study examines the delivery of health services by faith-based organizations (FBOs) as a possible alternative to privatization in Uganda, where they have been servicing communities since the mid-19th century. Their facilities focus on primary care and operate in rural, under-serviced areas where they provide access to care without discrimination on the basis of religion or ethnic group, charging affordable user fees while also treating those who cannot pay. The sector presently contributes to more than a quarter of all health services in the country, including the training of health professionals. Based on literature reviews and more than 30 key informant interviews, this research finds that FBOs promote solidarity through multi-stakeholder engagement and through cross-subsidization using mechanisms such as community health financing schemes that protect patients from catastrophic health expenditure. It analyzes how this \u2018private not-for-profit\u2019 sector fosters the development of a strong quasi-public ethos in service delivery, especially at the primary level of the Ugandan health system, posing a challenge to western liberal ideas about how the state and religion interface. ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Public-Private Mix"}},{"node":{"title":"Fine print of the food wars","field_subtitle":"Shiva V: Pambazuka News, 688, 24 July 2014","URL":"http://www.pambazuka.org/en/category/features/92591","body":"Creating \u201cownership\u201d of seed through patents and intellectual property rights and imposing it globally through the World Trade Organisation, the author argues that the biotech industry has established a monopoly empire over seed and food. The author argues that the biotech industry is denying citizens the right to safe food and attempting to dismantle national laws on biosafety across Africa. The author argues that the public relations machinery of the biotech industry undermines counterarguments to GMOs by unfounded attacks on scientists. However she also points to growing citizens\u2019 outrage, and to sovereign countries rejecting the industrial monopoly over food systems. ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Fulfilling the Health Agenda for Women and Children: The 2014 Report","field_subtitle":"Countdown to 2015: Geneva June 2014","URL":"http://www.countdown2015mnch.org/reports-and-articles/2014-report","body":"The 2014 Report, Fulfilling the Health Agenda for Women and Children, was released exactly 18 months to the day from the deadline for the Millennium Development Goals at the end of 2015. Like previous Countdown reports, it includes an updated, detailed profile for each of the 75 Countdown countries, which together account for more than 95% of the global burden of maternal, newborn and child death. The report shows that progress has been impressive in some areas, but it also highlights the vast areas of unfinished business that must be prioritized in the post-2015 framework. The 2014 Report also provides an assessment of the state of the data to support evidence-based decisions in women's and children's health, and describes elements of the Countdown process that might inform ongoing efforts to hold the world to account for progress. It concludes by laying out concrete action steps that can be taken now to ensure continued progress for women and children in the years ahead.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Monitoring equity and research policy"}},{"node":{"title":"GMOs and food sovereignty: Which way Africa?","field_subtitle":"Makori H: Pambazuka news, 688, 24 July 2014","URL":"http://www.pambazuka.org/en/category/features/92594","body":"African governments are under intense pressure from within but also from big agribusiness and Western governments to embrace genetically modified organisms (GMOs). Throughout Africa, GMOs - organisms that have been biologically modified to incorporate genes with desired traits - are now being touted as a major solution to hunger and mass poverty. Supporters of biotechnology, like Kenyan-born Harvard scholar Prof Calestous Juma, believe that with GMOs Africa, which has 60 per cent of all the arable land, will be able to feed not just its people but the world. The author argues that governments must resist all forms of arm-twisting and food colonialism and make their biotechnology choices based on the facts. There are three basic concerns about GMOs. First, the science is at best inconclusive regarding the safety of genetically engineered organisms on human health and the environment. The second concern is about food sovereignty. Opponents are convinced that the campaign for GMOs is part of the neoliberal agenda to place agricultural production in the hands of a few corporate giants through seed patents and deny small farmers control of production. Finally, the author argues that the GMOs crusade distorts the debate about food security and poverty alleviation. The problems afflicting small farmers are argued to have very little to do with technology, and almost everything to do with unequal access to land, water, affordable inputs, markets and other resources.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"Honest Accounts? The true story of Africa\u2019s billion dollar losses","field_subtitle":"Health Poverty Action et al: July 2014","URL":"http://tinyurl.com/nkq5m46","body":"The rest of the world takes from Africa much more than the continent receives. Almost $60 billion more. $192 billion flows out of Africa each year. This report outlines the range of different flows draining out of Africa, as well as the costs imposed on the continent as a result of climate change and explores the reasons for this. Curbing illicit financial flows is argued to demand greater transparency and accountability in the global financial system. This would involve clamping down on shell corporations; improved disclosure of beneficial owners of companies; stricter company\r\nreporting regulations on sales, profits and taxes; and exchanging tax information across borders. Instead of talking about \u2018good governance in Africa\u2019 the authors argue that Northern countries must take the lead to reduce the mass extraction of African capital that embeds poverty and inequality, including revenue leakages from extractive industries and fairer trade practices between African countries and MNCs.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Health equity in economic and trade policies"}},{"node":{"title":"How far does performance based financing tick the box of national ownership?","field_subtitle":"Amy Barnes, Garrett Wallace Brown, University of Sheffield and Sophie Harman, Queen Mary University","body":"\r\nThe roll out of Performance-based financing (PBF) in east and southern Africa is now widespread. Yet a recent study found cause for concern with this often \u2018taken-for granted\u2019 financing mechanism. As a result, there is a need to better understand and debate how PBF reinforces or contradicts other measures being used to build and strengthen universal health systems. \r\n\r\nPerformance-based financing has become increasingly popular in global health financing. It involves the transfer of money or goods based on implementation of a measurable action or achievement of a predetermined performance target. It is seen to increase accountability to both external funders and national stakeholders, by tracking of how money is spent. Having clear targets is argued to strengthen health systems by providing a way of assessing what programs are efficiently delivering \u2018value for money\u2019 and by rewarding good practice. Its proponents argue that external funders, generally large contributors to African heath systems, should transfer funds based on performance to achieve these gains.\r\n\r\nIn the past year we carried out research examining PBF in South Africa, Tanzania and Zambia, and with regional and global institutions (more fully reported in EQUINET discussion paper 102 at http://tinyurl.com/nudgky3). This work raised questions about how PBF affects the strength and equity of health systems, and what latitude African actors have to \u2018reframe\u2019 PBF mechanisms to address their concerns. \r\n\r\nCertainly a majority of the African actors had a positive perception of PBF and its ability to strengthen health systems, a perception also evident in the general literature pertaining to PBF. In particular, evidence suggests that Africa actors believe that PBF is useful in curbing corruption, in incentivizing targeted health outputs, and in increasing accountability mechanisms. These benefits, where they have occurred, have generated support for and ownership of the approach.  \r\n\r\nNevertheless, at the same time there were many concerns regarding the practice of PBF. Questions were raised about how performance criteria are selected and how far national input was factored into the design of PBF, a key principle in the Paris Declaration. We found that the space for genuine participation in the design of PBF was narrow, usually limited to high level personnel in national systems, and that it was affected by factors such as how much of the public budget is externally funded. Lower dependency on external funding appeared to give countries greater possibilities of setting their own targets and resisting funding conditions that potentially conflict with national strategic plans. We found, for example, that South Africa, with less than 10% of its health budget externally funded, had greater latitude to negotiate and resist unfavourable conditions. We also found that this ability to \u2018push-back\u2019 was less available in Tanzania and Zambia, where external funding contributes up to half of the health budget. Some African actors in health ministries and in service provision expressed weariness about the external conditions demanded by funders, and called for a more decisive national voice. As one senior African health official suggested, \u2018when PBF is the result of national ownership then it has excellent potential to be a mechanism for change\u2026 however, if it is not, then it will certainly be doomed to\u2026not deliver on its promises.\u2019\r\n\r\nWe found that while there is great enthusiasm for monitoring and rewarding outcomes, in practice this needs substantive investment in health information systems.  We found, as others have, that information systems lack the reliability, capacities and support to analyse and use evidence to evaluate performance. Unless this is recognized and addressed, use of performance indicators can cause weaker services (with poorer capacities to manage information) to do worse, reducing their PBF \u2018score\u2019 rating and thus restricting their funding. This causes considerable concern, since these services are usually the ones that are in more marginalized areas of highest need. In addition, many of the African actors we interviewed complained that the reporting systems required by funders are cumbersome, time-consuming and add considerable overhead costs. External funders, particularly the Global Fund, were reported to change reporting requirements and \u2018goal posts\u2019 mid-stream, without sufficient notification or technical assistance, leading to confusion and delays in programme reporting and roll out. \r\n\r\nFurthermore, external auditing mechanisms were often found to be \u2018not fit-for-purpose\u2019, implemented by auditors with little health knowledge or understanding of the recipient country, with inadequate communication between auditors and recipients.. Audit processes were found to be inflexible on target satisfaction. For example, Local Fund Agents (LFA) of the Global Fund were reported to often refuse to answer recipient\u2019s questions during report writing, to refuse to discuss reporting problems during the audit, or to allow the final LFA evaluations to be seen by recipients. This was argued to damage partnership and national input to PBF conditionalities.\r\n\r\nMoreover, many African actors that we interviewed assumed the merits of PBF, without being able to refer to strong evidence to support this view.  There is also a growing weariness about PBFs ability to \u2018be all things to all people\u2019 and an urge to have a more realistic national assessment of PBF as being one of many financing measures available.\r\n\r\nWhere PBF is seemingly most successful is in cases where there is a strong sense of national ownership and multi-sectoral partnership. PBF has had positive impacts where robust information systems exist, so that future targets can be based on valid data, where performance monitoring is possible, and where evaluations can be made reliably.  It is seemingly most successful when targeted on tightly focused health interventions, like payment per patient seen, and not on broad whole-of-system targets, where it is difficult to isolate and track individual variables. A better understanding of the positive features can contribute to health system strengthening. \r\n\r\nHowever our study also found evidence of negative consequences that can weaken national health systems. Reaching PBF targets can sometimes compromise quality of care, vertical PBF schemes can create \u2018health silos\u2019 that are not always fully integrated into comprehensive primary health care, and PBF schemes are often not well embedded into a sustainable long-term health strategy.  \r\n\r\nThese are issues that partners can identify, negotiate on and attempt to resolve. So our findings on the weaknesses of partnerships and genuine national leadership of the PBF agenda \u2013 as raised in this editorial and detailed in the full report- are crucial issues to be discussed and debated; to build better partnerships between global and African institutions and to design better systems for strengthening African health systems.  As one senior health official commented, \u2018we should be accountable for the money we receive and we should try to get as much value for money as possible... this is the non-debated part of PBF and a reason why it is so popular\u2026 but exactly how to best generate value for money is still open for discussion and for PBF to work effectively it will be important to get its processes right and to then generate agreement by all those who have to deliver these processes.\u2019\r\n\r\nPlease send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the issues raised in this op-ed please read the full report on the EQUINET website and visit www.equinetafrica.org ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Editorial"}},{"node":{"title":"Human Development Report 2014: Sustaining Human Progress: Reducing Vulnerabilities and Building Resilience","field_subtitle":"United Nations Development Programme: New York, July 2014","URL":"http://hdr.undp.org/en/content/human-development-report-2014","body":"The 2014 Human Development Report\u2014 Sustaining Progress: Reducing Vulnerabilities and Building Resilience\u2014looks at two concepts which are both interconnected and immensely important to securing human development progress. As successive Human Development Reports (HDRs) have shown, most people in most countries have been doing steadily better in human development. Advances in technology, education and incomes hold ever-greater promise for longer, healthier, more secure lives. But there is also a widespread sense of precariousness in the world today\u2014in livelihoods, in personal security, in the environment and in global politics. High achievements on critical aspects of human development, such as health and nutrition, can quickly be undermined by a natural disaster or economic slump. Theft and assault can leave people physically and psychologically impoverished. Corruption and unresponsive state institutions can leave those in need of assistance without recourse. Based on analysis of the available evidence, the Report makes a number of important recommendations for achieving a world which addresses vulnerabilities and builds resilience to future shocks. It calls for universal access to basic social services, especially health and education; stronger social protection, including unemployment insurance and pensions; and a commitment to full employment, recognizing that the value of employment extends far beyond the income it generates. It examines the importance of responsive and fair institutions and increased social cohesion for building community-level resilience and for reducing the potential for conflict to break out.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"ICYMI: Ten Things You Should Know From AIDS 2014","field_subtitle":"Lewis S: AIDS Free World 25 July 2014","URL":"http://aidsfreeworld.org/Publications-Multimedia/Articles/AIDS-2014.aspx?utm_source=Newsletter%20Peer%20List&utm_campaign=19378ebab0-Week%20in%20Review%2041%20-%20July%2025%202014&utm_medium=email&utm_term=0_349f52eb1e-19378ebab0-65516937&goal=0_349f52eb1e-19378ebab0-65516","body":"The author lists ten things raised at the 2014 Global AIDS conference in Melbourne Australia, listing backwards from 10 to 1: 10. There may be fewer people living with HIV than we thought. 9. Decriminalizing commercial sex work could significantly decrease new HIV infections among sex workers. 8. Ninety is the new zero. For years now, we\u2019ve been hearing a chorus of \u2018zero new HIV infections, zero HIV-related discrimination, and zero AIDS-related deaths.\u2019 But this week, UNAIDS changed course, promising to have 90% of all people with HIV aware of their status, 90% of people on treatment, and 90% of those on treatment with lasting viral suppression by the year 2020. 7. Women using injectable hormonal contraceptives are at greater risk of contracting HIV, but WHO isn\u2019t planning to inform women before they choose birth control methods. 6. UNAIDS is still leaving out one of the most at-risk groups of all: women. 5. Children and adolescents are dying at an alarming rate. 4. There is a huge shortfall in funding for harm reduction. 3. HIV-positive women are being pressured to undergo sterilization by health workers. 2. Undetectable viral loads.Calling it \u201cthe closest thing we have to a cure for HIV,\u201d activists issued a challenge this week to bring viral loads to undetectable levels by 2020. and 1. Funding for activists is drying up, and with it, the voices to spur governments and agencies to action. Section27's Mark Heywood issued a cri de coeur to delegates of AIDS 2014, lamenting that \"AIDS is fast becoming just another disease of the poor, criminalised and marginalised...just another manifestation of global complacency about poverty and inequality.\"","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Equity and HIV/AIDS"}},{"node":{"title":"Implementing Global Fund programs: a survey of opinions and experiences of the Principal Recipients across 69 countries","field_subtitle":"Wafula F, Marwa C, McCoy D: Globalization and Health 10(15): 24 March 2014","URL":"http://www.globalizationandhealth.com/content/10/1/15","body":"Principal Recipients (PRs) receive money from the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) to manage and implement programs. However, little research has gone into understanding their opinions and experiences. This survey set out to describe these, thereby providing a baseline against which changes in PR opinions and experiences can be assessed as the recently introduced new funding model is rolled out. An internet based questionnaire was administered to 315 PRs. A total of 115 responded from 69 countries in Africa, Asia, Eastern Europe and Latin America. The study was conducted between September and December 2012. Three quarters of PRs thought the progress update and disbursement request (PU/DR) system was a useful method of reporting grant progress. However, most felt that the grant negotiation processes were complicated, and that the grant rating system did not reflect performance. While nearly all PRs were happy with the work being done by sub-Recipients (92%) and Fund Portfolio Managers (86%), fewer were happy with the Office of the Inspector General (OIG). Non-government PRs were generally less happy with the OIG\u2019s work compared to government PRs. Most PRs thought the Global Fund\u2019s Voluntary Pooled Procurement system made procurement easier. However, only 29% said the system should be made compulsory. When asked which aspects of the Global Fund\u2019s operations needed improvement, most PRs said that the Fund should re-define and clarify the roles of different actors, minimize staff turnover at its Secretariat, and shorten the grant application and approval processes. All these are currently being addressed, either directly or indirectly, under a new funding model. Vigorous assessments should nonetheless follow the roll-out of the new model to ensure the areas that are most likely to affect PR performance realize sustained improvement. Opinions and experiences with the Global Fund were varied, with PRs having good communication with Fund Portfolio Managers and sub-Recipients, but being unhappy with the grant negotiation and grant rating systems. Recommendations included simplifying grant processes, finding performance assessment methods that look beyond numbers, and employing Local Fund Agents who understand public health aspects of programs.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Momentum builds to achieve more Millennium Development Goals by end of 2015: UN report","field_subtitle":"United Nations: New York, 7 July 2014","URL":"http://www.un.org/millenniumgoals/pdf/MDGReport2014_PR_Global_English.pdf","body":"With many MDG targets already met on reducing poverty, increasing access to improved drinking water sources, improving the lives of slum dwellers and achieving gender parity in primary school, The Millennium Development Goals Report 2014, says many more targets are within reach by their 2015 target date. If trends continue, the world will surpass MDG targets on malaria, tuberculosis and access to HIV treatment, and the hunger target looks within reach. Other targets, such as access to technologies, reduction of average tariffs, debt relief, and growing political participation by women, show great progress. The MDG report is based on comprehensive official statistics and provides the most up-to-date summary of all Goals and their targets at global and regional levels, with additional national statistics available online. Results show that concentrated efforts to achieve MDG targets by national governments, the international community, civil society and the private sector are working to lift people out of extreme poverty and improve their futures. It notes that much greater effort and investment will be needed to alter inadequate sanitation facilities. High dropout rates remain a barrier to universal primary education. Despite considerable advancements in recent years, the report says reliable statistics for monitoring development remain inadequate in many countries, but better statistical reporting on the MDGs has led to real results.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Equity in Health"}},{"node":{"title":"Nonprofit Sustainability is the Responsibility of Leadership","field_subtitle":"Brown A: Sangonet pulse July 14 2014","URL":"http://tinyurl.com/ou9bdpq","body":"In this article, the author shares few tips on sustainability, leadership and everything that could help NPOs to sustain their development interventions  Money in the bank does not necessarily mean that an organisation will be sustainable. The author argues that a strong sense of being mission-driven, measuring impact and sharing results is what leaders of charities and nonprofit organisations (NPOs) should strive to embed into the consciousness of everyone involved in the organisation, this is how an organisation can shift the status quo from fretting over money to creating future plans.  Using the seven dimensions for nonprofit sustainability as a guideline, leaders can embrace these characteristics for determining board competencies and delegation of duties for oversight, good governance and quality performance that will ensure continuity. The seven dimensions encompass the following; legal good standing and compliance; organisational capacity and expertise to do the work; financial viability of the organisation; advocacy for the work undertaken that will make a difference; quality and professionalism of service provision; stable infrastructure and building of a brand that portrays a positive public image.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Nurses association creates ethics commission ","field_subtitle":"ANGOP, Lubango, Angola 13 May 2014","URL":"http://www.portalangop.co.ao/angola/en_us/noticias/saude/2014/4/20/Nurses-association-creates-ethics-commission,6f0b5bc5-3c0a-4fc0-bf16-d8b8ff29ff16.html","body":"The Angola National Nurses Association in Lubango, southern Huila Province, created an Ethics Commission with a view to making the services rendered in this sector more humanised. The spokesman of ANEA, Rufino Kulamba, who was speaking at the International Nurses Day commemorations, said that the commission will be tasked with supervising the nursing activity. He stressed that the idea is to make professionals in this area have a better and better relationship with patients, as well as bring about professional improvements in this sector. He also explained that the commission will facilitate the filing of complaints against nurses who violate the principles of professional ethics. ","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Values, Policies and Rights"}},{"node":{"title":"Online course: Gender and Health Systems Strengthening","field_subtitle":"Constance Newman: CapacityPlus, IntraHealth International, July 2014","URL":"http://www.globalhealthlearning.org/course/gender-and-health-systems-strengthening","body":"The Global Health Learning Centre offers an online course By the end of the course, the learner will understand how health systems components interact with each other, how gender plays a role in each health systems component, and how to address these gender issues in health systems strengthening activities in order to improve health and social outcomes. This course examines gender considerations for each of six health systems components described in the World Health Organization's health systems components and ways to promote gender equality and women\u2019s empowerment in health systems strengthening interventions so that health systems better meet the health needs of women, men, girls, and boys. Each section of the course first discusses and illustrates gender issues that affect a particular health system component and then proposes solutions to address these issues and strengthen health systems. The course considers some of the gender norms that drive health behavior, health decision making, and the provision and utilization of health care. It highlights programmatic examples that illustrate aspects of gender equality and women's empowerment in health systems strengthening.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Useful Resources"}},{"node":{"title":"Performance-based Incentives in Mozambique: A Situational Analysis","field_subtitle":"Connor, C, Cumbi A, Borem P, Beith A, Eichler R, Charles J: Abt Associates Bethesda, MD: Health, 2011","URL":"http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=26&cad=rja&uact=8&ved=0CD4QFjAFOBQ&url=http%3A//www.healthsystems2020.org/files/2799_file_Performance_based_Incentives_in_MozambiqueA_Situational_Analysis.pdf&ei=jObSU7L6L8nhOqaV","body":"This report presents the findings of USAID\u2019s Health Systems 20/20 Project assessment of local interest in and capacity to implement PBIs. PBIs are reported to be legally and culturally feasible. Given the low level of health spending, limited population coverage, and estimates of unmet need in\r\nMozambique, the authors argue that PBIs should be designed to improve system efficiency but not be expected to reduce spending in absolute terms. Local stakeholders are repirted to be open to the PBI concept, citing CDC, USAID, and World Bank being ready to support introducing PBIs in Mozambique; however, some authorities and health worker staff express concerns about sustainability and equity of paying for performance.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Performance-based Incentives to Improve Health Status of Mothers and Newborns: What Does the Evidence Show?","field_subtitle":"Rena Eichler, Koki Agarwal, Askew I, Iriarte E, Morgan L, Watson J: Journal of Health, Population and Nutrition; 31:4: December 2013","URL":"http://www.jhpn.net/index.php/jhpn/article/view/2358","body":"Performance-based incentives (PBIs) aim to counteract weak providers\u2019 performance in health systems of many developing countries by providing rewards that are directly linked to better health outcomes for mothers and their newborns. Translating funding into better health requires many actions by a large number of people. The actions span from community to the national level. While different forms of PBIs are being implemented in a number of countries to improve health outcomes, there has not been a systematic review of the evidence of their impact on the health of mothers and newborns. This paper analyzes and synthesizes the available evidence from published studies on the impact of supply-side PBIs on the quantity and quality of health services for mothers and newborns. This paper reviews evidence from published and grey literature that spans PBI for public-sector facilities, PBI in social insurance reforms, and PBI in NGO contracting. Some initiatives focus on safe deliveries, and others reward a broader package of results that include deliveries. The Evidence Review Team that focused on supply-side incentives for the US Government Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives, reviewed published research reports and papers and added studies from additional grey literature that were deemed relevant. After collecting and reviewing 17 documents, nine studies were included in this review, three of which used before-after designs; four included comparison or control groups; one applied econometric methods to a five-year time series; and one reported results from a large-scale impact evaluation with randomly-assigned intervention and control facilities. The available evidence suggests that incentives that reward providers for institutional deliveries result in an increase in the number of institutional deliveries. There is some evidence that the content of antenatal care can improve with PBI. We found no direct evidence on the impact of PBI on neonatal health services or on mortality of mothers and newborns, although intention of the study was not to document impact on mortality. A number of studies describe approaches to rewarding quality as well as increases in the quantities of services provided, although how quality is defined and monitored is not always clear. Because incentives exist in all health systems, considering how to align the incentives of the many health workers and their supervisors so that they focus efforts on achieving health goals for mothers and newborns is critical if the health system is to perform more effectively and efficiently. A wide range of PBI models is being developed and tested, and there is still much to learn about what works best. Future studies should include a larger focus on rewarding quality and measuring its impact. Finally, more qualitative research to better understand PBI implementation and how various incentive models function in different settings is needed to help practitioners refine and improve their programmes.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Resource allocation and health financing"}},{"node":{"title":"Pre-GSHSR meeting organised by the Emerging Voices for Global Health 2014: Cape Town, September 29, 2014 ","field_subtitle":"University of the Western Cape , Call closes 15 September 2014","URL":"https://equinetafrica.org/ev2014_general%40uwc.ac.za","body":"This Pre-conference is organised by the Emerging Voices for Global Health 2014. The programme showcases oral and poster presentations from 'Emerging Voices' (EV) who are young promising researchers from across the globe. \r\nThe EV's aim to bring a fresh perspective on People-Centred Health Systems and other Health Systems Research themes at the Pre-conference.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Jobs and Announcements"}},{"node":{"title":"Somalia Briefing: Threats to food security & remittances","field_subtitle":"Africa Research Institute: Sound cloud July 2014","URL":"https://soundcloud.com/africaresearchinstitute/somalia-briefing","body":"This is a recording of ARI's 'Somalia Briefing' panel discussion, which took place on July 14 2014. The event focused on food security, remittances and the links between the two. Speakers were: Degan Ali, Executive Director of Adeso; Abdirashid Duale, CEO of Dahabshiil and Sara Pantuliano, Director, Humanitarian Policy Group, ODI. The event was organised by Africa Research Institute in partnership with ODI and Adeso.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Statelessness = invisibility in West Africa","field_subtitle":"IRIN: 15 July 2014","URL":"http://www.irinnews.org/report/100348/statelessness-invisibility-in-west-africa","body":"At least 750,000 people are stateless in West Africa, according to the UN Refugee Agency (UNHCR), which is calling for governments to do more to give or restore the nationality of stateless individuals, and improve national laws to prevent statelessness.  Many in the region are both stateless and refugees, said Emmanuelle Mitte, senior protection officer on statelessness with UNHCR in Dakar, but the overwhelming majority of stateless persons in West Africa are stateless within their own country, lacking proof of the criteria required to guarantee their nationality.  Statelessness can block people\u2019s ability to access health care, education or any form of social security. In the case of children who are separated from their families during emergencies, the lack of official documentation makes it much harder to reunite them, says the UN Children\u2019s Fund (UNICEF). Lack of official identification documents can mean a child enters into marriage, the labour market, or is conscripted into the armed forces, before the legal age. Statelessness can also render people void of protection from abuse. Denied the right to work or move, they risk moving into the invisible underclass, said UNHCR\u2019s West Africa protection officer, Kavita Brahmbhatt, who gave the example of a group of stranded non-documented Sierra Leonean migrants living in the slums of Liberia\u2019s capital, Monrovia, selling charcoal as they were too poor to do anything else, and too scared to return home for fear of being punished. \u201cThey became a member of Monrovia\u2019s underclass,\u201d she said.  \u201cBirth registration is more than just a right. It\u2019s how societies first recognize and acknowledge a child\u2019s identity and existence,\u201d said Geeta Rao Gupta, UNICEF deputy executive director in a late 2013 communique launching the report Every Child\u2019s Birth Right: Inequities and trends in birth registration.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Governance and participation in health"}},{"node":{"title":"Successful sodium regulation in South Africa","field_subtitle":"Hofman K: WHO  Afro, 2013","URL":"http://www.afro.who.int/en/clusters-a-programmes/hpr/social-a-economic-determinants-of-health/case-studies/country-experiences-rio/4085-successful-sodium-regulation-in-south-africa-.html","body":"Hypertension is neither unique nor novel to South Africa (SA), but the legislative actions undertaken by the South African government reflect a new approach to addressing this growing burden. Research has shown that a significant portion of hypertension is linked to sodium consumption, and a major proportion of sodium consumption in SA comes from bread--part of the staple diet. Aware of the burden of hypertension and the high levels of sodium in processed foods, Minister of Health Aaron Motsoaledi and the National Department of Health (NDOH) spearheaded legislative action to regulate sodium in food products at the manufacturing level. Based on the mixed results of voluntary regulation in other countries, the NDOH decided to initiate mandatory regulation to effectively curb sodium consumption. Answers to a questionnaire distributed to food industry members showed that about half of the groups who answered preferred to have regulated rather than voluntary sodium, because they believed this could even the playing field. The government devoted a significant amount of time and effort to understanding the industry's concerns, many of which were considered in negotiations. Years of South African research and inter-sectoral interactions between government,  academia, and industry culminated in successfully signed regulations. Even with this first successful step, the hypertension problem is far from solved. This report concludes with a discussion on plausible recommendations that calls for international collaboration across the African continent, in order to further address the growing prevalence of hypertension.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Poverty and health"}},{"node":{"title":"Task-shifting and prioritization: A situational analysis examining the role and experiences of community health workers in Malawi","field_subtitle":"Smith S, Deveridge A, Berman J, Negin J, Mwambene N, Chingaipe E, Puchalski-Ritchie L, Martiniuk A: Human Resources for Health 12:24, 2014","URL":"http://www.human-resources-health.com/content/12/1/24","body":"The objective of this study was to understand the performed versus documented roles of the HSAs, to examine how tasks were prioritized, and to understand HSAs\u2019 perspectives on their roles and responsibilities. A situational analysis of the HSA cadre and its contribution to the delivery of health services in Zomba district, Malawi was conducted. Focus groups and interviews were conducted with 70 HSAs. Observations of three HSAs performing duties and work diaries from five HSAs were collected. Lastly, six policy-maker and seven HSA supervisor interviews and a document review were used to further understand the cadre\u2019s role and to triangulate collected data.  HSAs performed a variety of tasks in addition to those outlined in the job description resulting in issues of overloading, specialization and competing demands existing in the context of task-shifting and prioritization. Not all HSAs were resistant to the expansion of their role despite role confusion and HSAs feeling they lacked adequate training, remuneration and supervision. HSAs also said that increasing workload was making completing their primary duties challenging. Considerations for policy-makers include the division of roles of HSAs in prevention versus curative care; community versus centre-based activities; and the potential specialization of HSAs. This study provides insights into HSAs\u2019 perceptions of their work, their expanding role and their willingness to change the scope of their practice. There are clear decision points for policy-makers regarding future direction in policy and planning in order to maximize the cadre\u2019s effectiveness in addressing the country\u2019s health priorities.","php":"","field_issue_date":"2014-08-01","field_equinet":"","category":"Human Resources"}},{"node":{"title":"The Promise of Community-Based Participatory Research for Health Equity: A Conceptual Model for Bridging Evidence With Policy","field_subtitle":"Cacari-Stone L, Wallerstein N, Garcia AP, and Minkler M: Am J Public Health. Published online ahead of print e1\u2013e9, July 17 2014","URL":"http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.301961","body":"Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particula