This paper aims to provide insight into the practical challenges faced by parliaments and parliamentarians in addressing the issues of equity in health. It goes on to describe the attempts that have been made to address those challenges in southern Africa. A number of opportunities for parliaments to promote health equity are identified. Firstly, parliaments are in charge of their rules, which they can revise to become more efficient and effective when they commit themselves to reforms. Secondly, in the region there is a vibrant civil society that raises questions and compels parliaments to address issues.
Governance and participation in health
Parliamentary functions and reforms and their application in promoting health equity in southern Africa
Participatory approaches in the health sector
Communities are no longer seen as passive recipients of healthcare. But what does this shift in emphasis mean? What kind of relationship between communities, service providers and managers is best? A workshop held at the Institute of Development Studies in 1999 asked three questions: What does accountability mean? How can health service providers be accountable to their users? What sorts of partnership will improve accountability and effectiveness? Studies from eleven countries illustrated experiences with participatory approaches and partnerships in enhancing accountability in the health sector.
Trade policy and civil society participation
This paper examines the way that a range of development actors view and engage with the arena of trade policy, focusing in particular on the challenges encountered by civil society actors participating in that arena. The dynamics of civil society participation in the trade arena – what might be achieved, and how – are very different from those that shape civil society participation in processes labelled poverty reduction; this paper explores the differences.
Civil society contributions to pro-poor, health equity policies
CSOs at national and grassroots level, are involved in mutual support, building citizen capacities, advocating public interests and rights, meeting social needs, providing services and advocating accountability within private and public health services. What is the impact of this input on health gains and informed health action within poor communities and on equity in health? This review of the literature explores whether civil society contributes to improved provision, coverage of and access to health services in low-income communities. The paper further examines whether civil society promotes improved responsiveness of health services, or enhances advocacy for and development of policies that are pro-poor and that enhance health equity.
Decentralisation and poverty reduction: the reality in Africa
Although decentralisation is often heralded as a means to promote democracy and poverty reduction, there is little reliable evidence to prove these claims. In fact, ruling parties and ethnic elites in Africa have used decentralisation to further strengthen their own power and influence at a local level. New research argues that on its own, decentralization will not reduce poverty. Just as important are an ideological commitment to the poor and democratic accountability. Research from the Institute of Development Studies looks at the politics of local-central relations in a selected number of African states which have adopted decentralisation.
** Impact Of Participatory Mechanisms And Structures In Equity And Quality Of Health Service Delivery
Abstract of paper presented at the Equinet conference, Durban, 8-9 June 2004, by TJ Ngulube, R Loewenson, I Rusike, M Macwangi, C Njobu, A Ngwengwe, EQUINET GoVERN theme
In 2002/3 EQUINET implemented a multi-country research study to examine the impact of Health Centre Committees (HCCs) and District Health Boards (DHBs) in bringing about equity in the primary health care services in Zambia and Zimbabwe. The research work sought to examine equity from an EQUINET perspective, with emphasis that equity related work needs to define and build a more active role for important stakeholders in health, and to incorporate the power and ability people (and social groups) have to make choices over health inputs and their capacity to use these choices towards health.
Further details: /newsletter/id/30456
Community Assessment of the Socio-economic Situation in Zimbabwe: Health and Education
Civic organisations have through the monitoring Group of the National NGO Food Security Network (FOSENET) been monitoring food security in Zimbabwe since July 2002. In 2004 this monitoring has been widened to cover other social and economic conditions, recognizing the wide range of conditions influencing social and economic wellbeing. The Civic Monitoring Programme is implemented through NGOs based within districts and community based monitors. Monthly reports from all areas of the country are compiled to provide a monthly situation assessment of food security and social welfare to enhance an ethical, effective and community focussed response to the current situation. Quarterly reports such as this one complement the monthly monitoring and provide more detailed information on specific areas of social and economic conditions at community level. Queries and feedback on these reports is welcomed and should be directed to the Civic Monitoring Programme at fsmt2@mweb.co.zw This is the first round of such quarterly monitoring and continuous measures are being implemented to improve data quality and relevance, including training and peer review, so feedback is welcomed. For the full report, please contact fsmt2@mweb.co.zw.
Parliamentary Functions and Reforms and their application in promoting Health Equity
Equinet discussion paper
In response to demands by the public represented by Civil Society Organisations, Parliaments have been called upon to be more effective in carrying out their functions or representation, oversight and legislating. Beginning with the Parliament of South Africa in 1994 there has thus been a wave of Parliamentary reforms in the region with different levels of success. Parliaments have instituted changes in their committee systems and in the legislative process to allow greater participations from the public. In seeking to promote health equity and public health, legislatures, through their committees, have sought ways to engage with relevant stakeholders, and other organisations in order to broaden their knowledge base.
Health promotion through self-care and community participation
The concepts of health promotion, self-care and community participation emerged during the 1970s, primarily out of concerns about the limitation of professional health systems. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in their infancy in the developing countries. There is a window of opportunity for promoting self-care and community participation for health promotion. This article proposes elements of a programme for health promotion in the developing countries following key principles of self care and community participation.
Campaign to support women's health rights
In 1987, May 28th was proclaimed the International Day of Action for Women's Health. Health is a human right for all and, as asserted in many international human rights covenants and agreements, the right to health cannot be fulfilled if women's sexual and reproductive rights are not addressed. However, health sector reforms and privatisation of health services around the world are jeopardising women's access to health and sexual and reproductive rights. Women's Global Network for Reproductive Rights (WGNRR) invites you to support promoting women's sexual and reproductive health and rights by organising your own activity or event on the 28th of May.
Further details: /newsletter/id/30348