Governance and participation in health

Distinguishing between civil society groups is divisive and will weaken cohesion among different sectors: An interview with Lewis Mwape of the Zambia Council for Social Development
CIVICUS: 20 December 2012

If implemented, new provisions governing the registration of civil society organisations (CSOs) and non-governmental organisations (NGOs) under Zambia’s NGO Act will be extremely problematic, according to Lewis Mwape of the Zambia Council for Social Development. Under the law CSOs and NGOs must re-register every five years, creating a major administrative workload. Prior to registering, they must explicitly state their sources of funding and proposed activities, which Mwape regards as impractical. The NGO Act also greatly narrows the definitions of CSOs and NGOs, no longer recognising labour unions, faith-based organisations and professional groups. Distinguishing between civil society groups is divisive and will weaken cohesion among different sectors, says Mwape. Advocacy and human rights organisations can also be subjected to arbitrary and/or discriminatory application of the law, and the law gives the Minister too much discretionary power. Zambian civil society has initiated a campaign calling for the amendment of the law but they are facing major difficulties in accessing and mobilising the hundreds of NGOs and CSOs based in less accessible areas to engage in the campaign to re-evaluate the law.

Online Civil Society Consultation on the Global health Theme of the Post-2015 UN Agenda
Global Health South (The Alliance of Southern CS in Global Health)/CHESTRAD in partnership with Campaign 2015+ and the Call for Action on Universal Health Coverage With Support from the Health Thematic Group, Post 2015 UN Agenda: January 2013

From the 9th of December 2012 to 11th January 2013, an online consultation on global health Theme in the Post-2015 UN Agenda was conducted. Researchers targeted a total of 785 institutions across partner organisations and networks and attracted participation from over 180 organisations active across 48 countries, notably community based and regional organisations in Africa, which constituted 69.5% of all participants. A number of key messages emerged. 1. There is no strong support for one health goal framed around Universal Health Care. 2. There is a very clear emphasis given to prioritising the needs of women and children. 3. There are strong calls to broaden the focus of the goals towards health systems strengthening and away from disease- and issue-specific interventions. 4. Strong support is given to the importance of a multisectoral action for health, alongside recognition of the need to address the socio-economic determinants and the rapidly evolving economic realities between countries. 5. The health-related post-2015 development goals should take into account the context in which action will be taken, and must be founded on guiding principles that are adaptable at the national level, and flexible for local implementation. They should also be based on shared, coherent understanding that enables global level solidarity and differentiated accountable action where necessary and appropriate.

Further details: /newsletter/id/37581
Project Matchstick
HDI Youth Marketers: January 2013

In this 2012 survey, the opinions on their social conditions of 1,360 young South Africans from various backgrounds of the country were gathered. Individuals across age groups (kids, teens and young adults) from Gauteng, KwaZulu Natal and the Western Cape responded to the survey and expressed their opinions on numerous issues and attributes relevant to South African society. Generally, respondents expressed high levels of nostalgia towards the country’s previous leaders, specifically Nelson Mandela, and were critical of the current leadership. Across all the regions, crime was ranked as the country’s biggest problem, and education was cited repeatedly as being crucial to ensure the future success of young South Africans. Freedom of expression was highlighted as a key issue throughout the interviews, yet many young people felt they were not given the opportunity to be heard. Many respondents argued that relying on the government to bring about change is not good enough, and expressed a desire for youth to play a greater role.

Resilience: A Trojan horse for a new way of thinking?
De Weijer F: ECDPM Discussion Paper 139, January 2012

According to this paper, the current widespread use of the term ‘resilience’ in development circles is at risk of being diluted by current ways of thinking about change because the term has not brought about genuine change in thinking about social systems. The author argues that if the term ends up being used in a very linear manner, where change is controllable from the outside and follows a linear path, it will have failed to achieve its mission. The author calls for a break from expert-led technocratic solutions and renewed focus on human agency as the main vehicle for change. Resilience-based thinking underlines the importance of leadership and reinvents the task of the international community as supporting constructive leadership rather than designing expert solutions. For leaders, it opens up space for creative thinking and hybrid, localised solutions.

When ‘solutions of yesterday become problems of today’: crisis-ridden decision making in a complex adaptive system (CAS): the additional duty hours allowance in Ghana
Agyepong IA, Kodua A, Adjei S and Adam T: Health Policy and Planning 27 (suppl): Iv20–iv31, 27 September 2012

Implementation of policies (decisions) in the health sector is sometimes defeated by the system’s response to the policy itself. This can lead to counter-intuitive, unanticipated, or more modest effects than expected by those who designed the policy. The health sector fits the characteristics of complex adaptive systems (CAS) and complexity is at the heart of this phenomenon. Anticipating both positive and negative effects of policy decisions, understanding the interests, power and interaction between multiple actors and planning for the delayed and distal impact of policy decisions are essential for effective decision making in CAS. Failure to appreciate these elements often leads to a series of reductionist approach interventions or ‘fixes’. This in turn can initiate a series of negative feedback loops that further complicates the situation over time. In this paper, researchers use a case study of the Additional Duty Hours Allowance (ADHA) policy in Ghana to illustrate these points. Using causal loop diagrams, they unpack the intended and unintended effects of the policy and how these effects evolved over time. The overall goal is to advance our understanding of decision making in complex adaptive systems; and through this process identify some essential elements in formulating, updating and implementing health policy that can help to improve attainment of desired outcomes and minimise negative unintended effects.

Where next? US-Africa foreign relations under a second term
This is Africa: 16 January 2013

While Barack Obama’s re-election has been met with enthusiasm across Africa, the article reports that many are frustrated about a lack of delivery on past promises. Where does Africa fit into the new administration’s foreign policy? The author argues that Obama’s current rhetoric about Africa makes generalisations about common aspirations, opportunity and African potential. He asserts that future engagement with African countries may be focused on the New Alliance for Food Security and Nutrition, part of the G8 plan to boost food production in Africa by introducing large-scale, mechanised agriculture with genetically modified crops. The author poses that this is expected to impact negatively on small-scale farmers and possibly increase food insecurity.

African Civil Society Statement: Call for a ban on GM crops and food
African Centre for Biosafety: 15 November 2012

In the wake of the recent ban by Kenya on the importation of genetically modified (GM) products until proper health evaluation has been completed, African civil society in this paper is requesting the African Union (AU) discuss banning all GM products throughout the continent at the next AU summit in January 2013. Civil society represented by 400 African organisations consisting of small-scale farmers, social movements, non-governmental organisations, faith-based groups, organic producers and consumers, business people and ordinary citizens issued a statement pointing out the lack of safety data on GM foods, as well as condemning the patenting of life and privatisation of agriculture, which threatens to displace African food producer control over their production systems.

Challenges and Opportunities for HIV, AIDS and TB Budget Monitoring at Local Level in South Africa
Centre for Economic Governance and AIDS in Africa: 10 September 2012

This evaluation of the South African Budget Monitoring and Expenditure Tracking (BMET) project, which was launched in 2009, demonstrates that citizen involvement in economic governance is both possible and progressing. The project is aimed at improving the delivery, accessibility and affordability of treatment for people living with HIV and AIDS and TB. Project interventions have reached a range of targeted beneficiaries and achieved a positive impact in four key aspects. First, community engagement has stimulated community members’ interest in budget issues relating to health care provision and mobilising for improvements. Second, health workers have a better understanding of their own and their client-community needs towards enhancing facility systems. Third, citizens are empowered with skills to research and track the quality of HIV and AIDS and TB services in their community and demand answers. Finally, collaboration on resolving longstanding and complex health service delivery problems has been enhanced because citizens, organisations and health authorities have a shared, relational understanding of both the barriers to and the opportunities for change.

Civil Society Call to Action at the GAVI Partner’s Forum 2012
ACTION and the GAVI civil society constituency: 7 December 2012

ACTION and the GAVI civil society constituency have issued this statement urging the GAVI Alliance to support increased participation from civil society in its funding, strategy and governance. The GAVI Alliance is a public-private partnership that works to increase access to immunisation in developing nations. This Call to Action was presented at the GAVI Alliance Partners’ Forum in Dar es Salaam, Tanzania, where more than 600 global health leaders gathered in early December to discuss accelerating progress in global immunisation. The statement calls on GAVI to recognise the vibrant role played by civil society representatives in the Forum and their vital contributions to delivering vaccinations and care, reaching unimmunised children, as well as mobilising resources for health and immunisations. The signatories are hoping that GAVI will articulate in its next business plan how civil society contributes to each of GAVI’s strategic objectives, and will create a second seat on the GAVI Alliance Board for a civil society representative.

Civil Society Statement on the occasion of the Second Southern Africa Regional Child Rights Conference
Save the Children et al: 5 November 2012

At a meeting on 1-2 November 2012 in Johannesburg, child rights organisations from across Southern Africa brought together a number of stakeholders – including parliamentarians, government officials and various civil society organisations – to meet under the auspices of the Child Rights Network for Southern Africa (CRNSA) and to reflect on building a strong child rights movement in Southern Africa. In this statement, they call on the Southern African Development Community (SADC) to adopt a specific children’s protocol, ensuring meaningful participation of children at various levels of decision making, in particular helping each country to establish a state-funded children’s Parliament. At the same time, SADC should make state parties implement its basic minimum package of services for children, domesticate regional and international instruments that state parties have ratified and allocate and increase budgets for children at all levels while guaranteeing meticulous budget monitoring. The signatories further call on SADC governments to ensure timeous reporting to treaty bodies, especially the African Charter on the Rights and Welfare of the Child – to whom only Tanzania has reported – as well as prioritise child abuse prevention and early intervention programmes, expeditiously pass comprehensive child-related laws and policies, act as role models in championing children rights and address the contradictions arising from the existence of dual legal systems (customary law and civil law), notably in the case of harmful cultural practices.

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