Governance and participation in health

This study took place in Northern Ghana to assess the impact of male involvement in reproductive health and Family Planning (FP) services. Twelve focus group discussions were held with both male and female community members, six in communities with functional community health-based planning and services strategy (CHPS) and six for communities with less/no-functional CHPS. Fifty-nine in-depth interviews were held with other stakeholders at both district and regional levels. The results revealed a general high perception of an improved health status of children in the last ten years in the communities; however, participants reported that malnutrition was still rife in the community. The results also revealed that women still needed to get spousal approval to use contraceptives; however, the matrilineal system appears to give more autonomy to women in decision-making. The CHPS strategy was perceived as very helpful with full community participation at all levels of the implementation process. Males were more involved in FP services in communities with functioning CHPS than those without functioning CHPS. The authors argue that involving males in reproductive health issues including FP is important to attain reproductive health targets.

This report draws on the experiences and views of people living in extreme poverty and marginalisation in 107 countries. The authors distil messages from 84 participatory research studies published in the last seven years. Forty-seven of these studies are based on creative material coming from visual participatory methods. Their findings show that a development framework post-2015 will have legitimacy if it responds to the needs of all citizens, in particular those who are most marginalised and face ongoing exclusion from development processes. The framework has to incorporate shared global challenges and have national level ownership if it is to support meaningful change in the lives of people living in poverty. The authors first focus on understanding the lessons learnt from people's experiences of predominantly international development assistance, before they merge these findings with learning from the second phase of the synthesis, adding a substantive focus on national and local level policy and development planning and how relationships, and accountability between citizens and governance institutions at these levels can be strengthened through the active engagement of those most marginalised in decision-making.

This report presents the findings of a research and advocacy process that included consultative workshops with civil society organisations (CSOs) in all nine of South Africa’s provinces. The research found that the legislated ‘enabling environment’ for civil society was dysfunctional. The serious lack of current and reliable national data about the size, scope and activities of the sector negatively affects the ability of the sector and of government to support it. The sustainability and effectiveness of civil society to address poverty and equity is compromised by these problems. South African civil society sector is facing a funding crisis, which needs to be addressed on many fronts: the authors call for legislative reform and renewed work on an enabling policy environment for civil society, and for grant-making and other forms of investment in social development. International sources are now much less available, which means that local funding sources must be developed and leveraged, including private philanthropy, corporate social investment and the contributions from state-related agencies such as the National Lottery Board (NLB) and the national Development Agency (NDA). The authors urge these funding agencies to work with government leadership to commit to a cooperative process towards over-arching and systemic reform of the enabling environment for civil society. They further recommend that a cross-sectoral working group, which includes strong civil society representation, is established to plan the necessary changes.

In Turkey, Brazil and Egypt, thousands have taken to the streets to voice their anger and frustration at the lack of social and economic justice in their countries. The author of this article argues this public unrest is directly linked to the wholesale adoption of neoliberal economic policies by these countries’ governments, which has led to social inequality. He argues that, despite mainstream perceptions, free markets don't automatically regulate themselves nor do they naturally respect individual or community rights. And while the power of transnational corporations has expanded exponentially to eclipse governments of small countries, income and wealth disparities have widened. But despite the grave warnings from civil society, governments and financial institutions continue to privatise services when they should be focusing on how to make the public sector fit for purpose. Political leaders and captains of industry have subjected ordinary people to double burdens of paying taxes to the state and paying profit-adjusted higher costs for privatised services like health, education and public transport, despite these services being part of the social contract between citizens and the state.