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.
Governance and participation in health
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.
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.