The role of multilateral external funding agencies in global health is a new area of research, with limited research on how these agencies differ in terms of their governance arrangements, especially in relation to transparency, inclusiveness, accountability, and responsiveness to civil society. In this paper, the authors argue that historical analysis of the origins of these agencies and their coalition formation processes can help to explain these differences. They propose an analytical approach that links the theoretical literature discussing institutional origins to path dependency and institutional theory relating to proto institutions in order to illustrate the differences in coalition formation processes that shape governance within four multilateral agencies involved in global health. Two new multilateral donor agencies that were created by a diverse coalition of state and non-state actors, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and GAVI (‘proto-institutions’), were more adaptive in strengthening their governance processes. This contrasts with two well-established multilateral external funding agencies, such as the World Bank and the Asian Development Bank, what we call Bretton Woods (BW) institutions, which were created by nation states alone; and hence, have different origins and consequently different path dependent processes.
Governance and participation in health
To inform policy makers about the feasibility of facility-based SMS interventions, this national, cross-sectional, cluster sample survey was undertaken in 2012 at 172 public health facilities in Kenya. Outpatient health workers and caregivers of sick children and adult patients were interviewed about personal ownership of mobile phones and use of SMS. The analysis included 219 health workers and 1,177 patients’ respondents (767 caregivers and 410 adult patients). All health workers possessed personal mobile phones and 98.6% used SMS. Among patients’ respondents, 61.2% owned phones and 71.4% of phone owners used SMS. The phone ownership and SMS use was similar between caregivers of sick children and adult patients. Wealthier respondents who were male, more educated, literate and living in urban area were significantly more likely to own a phone and use SMS. Mobile phone ownership and SMS use is ubiquitous among Kenyan health workers in the public sector, the researchers conclude. Some of the disparities on SMS use can be addressed through the modalities of m-Health interventions and enhanced implementation processes while further growth in mobile phone penetration is needed to reduce the ownership gap.
PHM WHO watchers developed statements on many of the 2013 World Health Assembly WHA66 agenda items. This website provides statements read out by PHM during the WHA66 and links to daily reports prepared by the PHM WHO watchers. The statements are on WHO Reform; WHO General Program of Work; Social Determinants of Health; MDG's and Post 2015 Agenda; Universal Health Coverage and the Consultative Expert Working Group on Research and Development.
The South African government plans to launch a National Recordal System (NRS) to catalogue its indigenous knowledge. According to the South African Department of Science and Technology (CSIR) benefits could include community recognition, sustainable livelihood, economic value and improved quality of life. Most of the traditional knowledge in South Africa is oral, passed down from one generation to the next, and with older generations passing away, the need to record that knowledge is urgent. Much of this knowledge is medical and is based on traditional remedies and treatments for illnesses. The NRS includes the establishment of indigenous knowledge networks, provincial Indigenous Knowledge Systems Documentation Centers (IKSDCs) and an Information Communication Technology (ICT) knowledge platform. The NRS aims to enable and maintain a secure, accessible national repository for the management, dissemination and promotion of indigenous traditional knowledge, and achieve national intellectual property objectives for the protection of indigenous traditional knowledge.
The State of Civil Society 2013 Report presents insights from over 50 civil society experts from around the world. Alongside the report, CIVICUS is publishing a draft methodology for an Enabling Environment Index (EEI) that seeks to measure how well countries around the world are doing on creating positive conditions for civil society. Amidst the challenges facing civil society, the 2013 report highlights good practices around the world and challenges on the horizon for citizens and civil society around the world, such as: rising fundamentalism threatening women's and sexual minorities rights movements; challenges to democracy in Africa, with case studies from Burkina Faso, Central African Republic, Democratic Republic of Congo and Uganda; the state of the internet and access to information; threats to writers, journalists and trade unionists; and civil society successes.
This paper is aimed at those who work as health facilitators and activists at community level, civil society organisations, government personnel and anyone else interested in the rights of ordinary citizens to participate in decisions and have access to the resources that determine the way their country’s health system functions. The paper is divided into three sections: The first focuses on how the interaction between people’s participation, knowledge and power effects the functioning of health systems. The following section pays particular attention to approaches we can use to build a more just and equitable health system. The final section concludes by asking a series of questions to provoke and deepen our thinking on ways we can overcome obstacles to achieving this goal, at both community level and as we move from the local to the global as a strategy for change. Each section blends discussion on concepts and issues with descriptions of experiences and case studies from around the globe, especially from countries in Latin America, Asia and east and southern Africa, where a wealth of material describes the impact of neoliberalism and globalisation on health systems, and attempts to build alternatives.
The Sixty-fifth World Health Assembly requested the Director-General to report, through the Executive Board at its 132nd session, to the Sixty-sixth World Health Assembly, on progress in the implementation of WHO reform, on the basis of a monitoring and implementation framework. This report provides a comprehensive overview of progress up to the end of the first quarter of 2013 in the three broad areas of WHO reform: programmes and priority-setting; governance; and management, as well as a high-level implementation plan for reform. A comprehensive, detailed and budgeted implementation plan is the basis for managing change, monitoring progress, and mobilising resources to finance the proposed reform activities. The plan and report are structured around the 12 elements of reform that were identified in the monitoring and implementation framework considered by the Sixty-fifth World Health Assembly, and include an additional element on change management. The report provides a narrative describing action taken in each area, and a status update on the outputs and key deliverables.
Non-governmental organisations and civil society organisations in Ghana are being called upon to contribute to the drafting of the country’s new local governance policy, which is intended at deepening local governance through appropriate social accountability. The new policy will consider the views of ordinary Ghanaians to clarify the status, roles and relationships between levels of government and the different actors and strengthen their participation and contribution to local governance. The Institute of Local Government Studies has received funding from the European Union to implement an action on “A Social Accountability Platform for Local Governance Performance in Ghana” with the objective to provide a harmonised approach to promoting comprehensive and coherent social accountability at the sub-national level.
The aim of this study was to assess malaria prevalence and knowledge, attitude and practice (KAP) about malaria in the ShewaRobit Town community in northeastern Ethiopia. In October and November 2011, 425 individuals were examined for malaria using thin and thick Giemsa stained blood film, and 284 of the participants were interviewed to assess their KAP about malaria. All respondents had heard of malaria. Most of the respondents (85.2%) attributed the cause of malaria to mosquito bite. However, some of the respondents (>20%) identified the causes of malaria as a lack of personal hygiene, exposure to cold weather, hunger, chewing maize stalks, body contact with a malaria patient and flies. Sleeping under mosquito nets, draining stagnant water and indoor residual spraying were the most frequently mentioned malaria preventive measures perceived and practiced by the respondents. Of the individuals examined for malaria, only 2.8% were positive for Plasmodium parasites. Although a respondents had a high level of knowledge about the cause, transmission and preventive methods of malaria, a considerable proportion of them had misconceptions about the cause and transmission of malaria, suggesting the necessity of health education to raise the community’s awareness about the disease.
In 2011, Publish What You Fund, the world’s biggest funding transparency monitoring body, ranked USAID in the bottom 36% of most transparent external funders, but by 2012 it had climbed into the top 37% . In the light of this improvement, the author of this article calls on USAID Administrator Raj Shah to commit USAID to joining the top 10% by the time he leaves his post in four years. He predicts, though, that it is more likely that “technological innovation” will continue to win out over “governance” issues like transparency in Shah’s priorities. Poverty, he argues, is a function of power imbalances as much as innovation deficits, which requires USAID’s leadership to start talking about governance, incentives and democratising “power” as much as helping people to get more and better “stuff”. Shah should explain why transparency is so important, and explicitly link transparency to making local institutions more politically accountable to their own citizens. Functioning, inclusive domestic institutions in developing countries are the indispensable foundation for innovations to take hold, the author concludes.