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.
Governance and participation in health
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.
In this paper, the author analyses governance gaps in healthcare systems in sub-Saharan Africa and how they could be overcome, with a particular focus on the areas of budget and resource management, individual provider performance, health facility performance and corruption. She attributes poor governance to the effects of a range of factors. Budget leaks, which refer to the discrepancy between the authorised health budget and the amount of funds received by intended recipients such as frontline providers, undermine service provision, as do high levels of health worker absenteeism. Job purchasing, which refers to payments made by job-seekers in exchange for employment in the public sector, a practice that often bypasses appointing on merit, is another common practice, which results in poor quality staff. On the financial side, chronic underfunding of health facilities and corruption at management levels are the other dimensions of poor governance in the health sector. The author urges governments and external funders to not only focus on the input and outputs, but also to ensure that these resources are used effectively to ensure maximum impact on health outcomes.
What did South African AIDS activists contribute, politically, to early international advocacy for free HIV medicines for the world's poor? Mandisa Mbali demonstrates that South Africa's Treatment Action Campaign (TAC) gave moral legitimacy to the international movement, which enabled it to effectively push for new models of global health diplomacy and governance. The TAC rapidly acquired moral credibility, she argues, because of its leaders' anti-apartheid political backgrounds, its successful human rights-based litigation and its effective popularisation of AIDS-related science. The country's arresting democratic transition in 1994 enabled South African activists to form transnational alliances. Its new Constitution provided novel opportunities for legal activism, such as the TAC's advocacy against multinational pharmaceutical companies for blocking access to affordable generics and the South African government when it failed to provided antiretrovirals. Mbali's history of the TAC sheds light on its evolution into an influential force for global health justice.
The Millennium Declaration of 2000 contains a comprehensive vision of development underpinned by human rights, and is the source document of the Millennium Development Goals (MDGs). However, in 2001, when the MDGs were formulated, influential voices were able to convince the international community that democratic freedoms could be relegated in favour of progress on economic indicators. But the neglect of these freedoms has come at a cost, the author argues, as evidenced by the Arab Spring, which showed that development must be about both freedom from fear and freedom from want. People need good standards of living where their basic needs are met but they also need civil and political freedoms to have a say in the decisions that affect their lives and to ensure that the benefits of development are evenly spread. The author calls on global and national decision-makers to reread the promises made by world leaders in the Millennium Declaration on freedom, equality, solidarity, tolerance, respect for nature and shared responsibility. He argues that it is time to put people at the centre of development and ditch the business as usual approach if we are to address impending and interlinked economic, social, political, environmental and humanitarian crises.
As debate intensifies on the future of the post-2015 sustainable development agenda, participating organisations in Beyond 2015 came together to develop this joint position paper to advance the concept of just governance. Just governance in the post-2015 era would first require a reconception of sustainable development goals not as needs and services but as rights accessible to all. Just governance likewise implies that the framework that replaces the Millennium Development Goals must include an explicit focus on equality and equity across all development goals, geared towards ensuring that those who are most marginalised participate in the benefits of development. Finally, just governance implies accountable governance for all relevant actors at all levels, based on a clear mandate regarding who is responsible for what post-2015 commitments.
To further accelerate progress in the run-up to the Millennium Development Goal (MDG) deadline in 2015, and to ensure sustained progress beyond this date, civil society argues in this report that openness – especially transparency, accountability and public participation – must be at the heart of the post-2015 development framework. They call on the High-level Panel of Eminent Persons (HLP) to pioneer a high-impact agenda through a series of concrete recommendations to the UN Secretary-General. The recommendations should be guided by the promotion of: (1) an open process for soliciting and responding to the priorities and concerns of the world’s poorest people; (2) open, comprehensive and timely reporting on investments and outcomes in pursuit of the agreed development goals and targets, along with enhanced opportunities for citizen participation; and (3) the establishment of open data platforms to ensure that progress can be transparently tracked, lessons can be learned on a real-time basis and all stakeholders can be held accountable.
At the final meeting of the United Nations Thematic Consultation on Governance and the Post-2015 Framework, held in Johannesburg at the end of February 2013, participants argued that human rights and accountability must be placed at the heart of governance at the national and global levels. A high point of the meeting was the address by High Level Panel member Graça Machel, who spoke of the panel´s commitment to ensuring that issues of governance, human rights and inequality were central to the new post-2015 framework. There was wide consensus at the meeting that weak and unaccountable governance, including at the global level, is one of the key issues that must be addressed in a future framework, and that democratic governance must be predicated on respect for the full range of human rights. Ultimately, it will be up to the international community to decide the parameters of the successor framework when it gathers for the Millennium Development Goal Review Summit in New York in September 2013. In this article, the author calls on global civil society to promote rights-based governance in the run up to this important event, which is likely to prove pivotal for the future of international development.
At the end of the Eleventh CIVICUS World Assembly, held in September 2012, the various recommendations made by delegates were analysed and distilled into 15 key commitments for civil society to implement as it seeks to work more effectively to promote equity and to challenge and change the rules of engagement between citizens, the state and other holders of power. Some of these commitments call for greater networking and smarter partnerships between formal civil society organisations and new social movements and social media technologies. The significance of encouraging local and voluntary participation, maintaining community connections and addressing marginalisation was highlighted. Other commitments argued for work within an equity and human rights based framework that includes sustainability and demands accountability to citizens, not external funders. Civil society also needs to be less dependent on governments and seek alternative financing models, like social and crowd-sourced funding. The commitments further call for civil society organisations (CSOs) to be innovative, strategic and have an assets-based approach, develop a better understanding of private sector involvement as well as develop CSO capacities for negotiation and analysis of power.