Governance and participation in health

Migration Governance and Migrant Rights in the Southern African Development Community (SADC) Attempts at Harmonization in a Disharmonious Region
Dodson B; Crush J: United Nations Research Institute for Social Development (UNRISD) Research Paper 2015–3, October 2015

This paper examines prospects for enhanced regional migration governance and protection of migrants’ rights in the Southern African Development Community (SADC). Migration in this region is substantial in scale and diverse in nature, incorporating economic, political and mixed migration flows. In addition to movements between countries within the region, migrants also come from across the African continent and even further afield. At its foundation in 1992, SADC as an institution initially embraced a vision of intra-regional free movement, but this has not become a reality. If anything, there has been a hardening of anti-migrant attitudes, not least in the principal destination country of South Africa. There have also been serious violations of migrants’ rights. Attempts at regional coordination and harmonisation of migration governance have made limited progress and continue to face formidable challenges, although recent developments at national and regional levels show some promise. In conjunction with the 2003 SADC Charter of Fundamental Social Rights and 2008 Code on Social Security, incorporation of migrants into the SADC 2014 Employment and Labour Protocol could signal a shift towards more rights-based migration governance. The paper concludes by arguing that there can be no robust rights regime, either regionally or in individual countries, without extension of labour and certain other rights to non- citizens, nor a robust regional migration regime unless it is rights-based.

One Million Signatures to Have a Clear Law on Abortion
Centre for Health Human Rights and Development (CEHURD): Uganda, September 2015

The Centre for Health Human Rights and Development(CEHURD) through the Coalition to Stop Maternal Mortality due to Unsafe Abortion, marked the Global Day of Action on Safe and Legal Abortion on the 28th of September 2015. The global trending hash tag on social media was #BustTheMyth that all messages on myths and facts on abortion were attached to while sending out to followers on social media. A petition was read in line with the theme; Because every woman and Girl Counts and a campaign to have 1 million signatures was launched. The campaign sought to have one million signatures to be presented to parliament and the Speaker of Uganda Parliament, the Rt. Hon. Rebecca Kadaga and entire legislative council, to consider having a proper and clear law on abortion. Two social media campaigns in line with the theme were launched to boost the main campaign with the hash tags; #BustTheMyth and #LetHerSpeak: Because every woman and girl counts.

World Health Organisation Executive Board meeting 138
World Health Organisation: Geneva, January 2016

The WHO Executive Board is composed of 34 members technically qualified in the field of health. Members are elected for three-year terms. The main Board meeting, at which the agenda for the forthcoming Health Assembly is agreed upon and resolutions for forwarding to the Health Assembly are adopted, is held in January, with a second shorter meeting in May, immediately after the Health Assembly, for more administrative matters. The main functions of the Board are to give effect to the decisions and policies of the Health Assembly, to advise it and generally to facilitate its work. The full set of documents under consideration at the 138th WHO Executive Board meeting are available online at the organisation's website.

Bringing stakeholders together for urban health equity: hallmarks of a compromised process
Katz A; Cheff R; O’Campo P: International Journal for Equity in Health 2015, 14(138), 2015

There is a global trend towards the use of ad hoc participation processes that seek to engage grassroots stakeholders in decisions related to municipal infrastructure, land use and services. The authors present the results of a scholarly literature review examining 14 articles detailing specific cases of these processes to contribute to the discussion regarding their utility in advancing health equity. They explore hallmarks of compromised processes, potential harms to grassroots stakeholders, and potential mitigating factors. The authors conclude that participation processes in urban areas often cut off participation following the planning phase at the point of implementation, limiting convener accountability to grassroots stakeholders, and, further, that where participation processes yield gains, these are often due to independent grassroots action. Given the emphasis on participation in health equity discourse, this study seeks to provide a real world exploration of the pitfalls and potential harms of participation processes that is relevant to health equity theory and practice.

CSO conference on Global Health and Universal Health Coverage: Dakar, February 2014 Workshop Report
Action for Global Health (AfGH); Network of West African NGO Platforms, (REPAOC): 8 December 2015

Action for Global Health (AfGH) in partnership with the Network of West African NGO Platforms, (REPAOC) convened a conference in Dakar, Senegal, 17-19th February 2014, which brought together civil society actors from 23 countries and five continents. The main purpose of the workshop was to gain clarity and consensus on what Universal Health Coverage (UHC) incorporates, building upon Civil Society Organisation’s (CSO) country experiences from a grassroots level; develop a common understanding of the strengths of the UHC concept and the pitfalls of its implementation; define a clear position on how UHC should be framed to achieve the highest attainable standard of health for all; and outline a course of action for CSO advocacy on the right to health. The meeting concluded with a declaration – Ensuring UHC is fit for contributing to the right to health – which captured the main discussion points and reflections of the CSOs present.

Regional health governance: A suggested agenda for Southern African health diplomacy
Penfold E: Global Social Policy 15(3), 278-295, 2015

Regional organisations can effectively promote regional health diplomacy and governance through engagement with regional social policy. Regional bodies make decisions about health challenges in the region, for example, the Union of South American Nations (UNASUR) and the World Health Organisation South East Asia Regional Office (WHO-SEARO). The Southern African Development Community (SADC) has a limited health presence as a regional organisation and diplomatic partner in health governance. This article identifies how SADC facilitates and coordinates health policy, arguing that SADC has the potential to promote regional health diplomacy and governance through engagement with regional social policy. The article identifies the role of global health diplomacy and niche diplomacy in health governance. The role of SADC as a regional organisation and the way it functions is then explained, focusing on how SADC engages with health issues in the region. Recommendations are made as to how SADC can play a more decisive role as a regional organisation to implement South–South management of the regional social policy, health governance and health diplomacy agenda.

20 Years Later – The Role of Art and Justice in South Africa’s Democracy
Sachs A; Justice Cameron E: African Futures, Essays, 2015

At the entrance to the Constitutional Court of South Africa stands a sculpture of a large man yoked to a cart. His burden is a human one: a man and woman who themselves are seated on the back of a fourth figure kneeling on the cart. At first glance, the sculpture resonates with the history of servitude that marked the dehumanising institution of apartheid. On closer reflection, the sculpture reveals a more complex message. The sculptor, South African artist Dumile Feni, did not create any racial differentiation between the four figures, and the man drawing the cart is the only figure large and strong enough to accomplish this task. The title of the work is History, and the four figures carry each other in a way that reflects the dependence, the interconnectedness and the tension that have always characterised human relationships. History is the first of many artworks that challenge a visitor to the Constitutional Court to reflect on South Africa’s tortured past and the country’s transition to a constitutional order. The Constitutional Court Art Collection (CCAC)[1] is both a living monument to the ideals on which South Africa’s post-apartheid Constitution is based and a reminder of the work that remains.

Communities Deliver – The critical role of communities in reaching global targets to end the AIDS epidemic
UNAIDS; Stop AIDS Alliance: 2015

There is now wide recognition that community responses must play an increasing role in addressing the HIV epidemic in the years ahead. The UNAIDS Strategic Investment Framework, published in 2011, identifies community responses as a “critical enabler” of service delivery. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has estimated that to achieve bold HIV treatment and prevention targets set in 2014, investments in community mobilisation and services must increase more than threefold between 2015 and 2020. Much of the critically important work in making progress in the response to HIV and implementing a Fast-Track approach that lies ahead—including broadening the reach of services, supporting retention in care, increasing demand, monitoring quality, advancing human rights and combatting stigma and discrimination—can only be achieved with a strong community voice and presence. This report draws on multiple sources to document the many ways in which communities are advancing the response to AIDS, and the evidence for the effectiveness of these responses. Core areas of community-based activities include advocacy, service provision, community- based research and financing; each of these areas is illustrated by examples of community- based actions.

Honouring the value of people in public health: a different kind of p-value
Bishai D; Ghaffar A; Kelley E; Kieny M: Bulletin of the World Health Organization 93, 661-662, 2015

When faced with a complex public health problem there is a natural urge to find solutions. People hire consultants, gather data, test hypotheses and examine P-values to identify risk factors: data-driven technological fixes get implemented every day. In the right situation, there is nothing wrong with solutionism – the belief that all difficulties have technical solutions. Solutionism works well for circumscribed problems involving a small number of motivated individuals, where every element of the prescribed solution can be implemented as planned. However, complex problems in public health usually have elements that defy planning, because health involves people, and people are unpredictable. Recent research has shown that integrating community participation in the planning and implementation of health reforms is a key factor in supporting health improvements. The approach has been applied in a variety of areas including: the control of infectious disease; reducing maternal deaths and improved birth outcomes; enabling better health seeking behaviours; improving quality of life by promoting healthy environments through improvements to housing, reducing crime and building social cohesion. Critical factors for achieving trust include allowing participants to see their common concerns and building strong relationships within health committees or participatory groups. There must be a commitment to sustain long-lasting relationships between the community, local health workers and managers. Technical solutions for health problems are still needed. The authors argues there is still need the familiar P-value because biological evidence is necessary, but public health practice also needs to recognize the value of people. Regardless of the political environment, the power of the state to alter health decisions inside the home has limits. Only an approach that values, honours and engages people can alter how they make decisions about their health.

PASS presents: Revolting Songs with Neo Muyanga
Muyanga N: Pan African Space Station, Chimurenga Magazine, 2015

This Pan African Space Station (PASS) broadcast recorded at the Chimurenga headquarters features Neo Muyanga, Soweto-born composer and musician living in Cape Town. Revolting Music is a survey of the songs of protest that liberated South Africa. Muyanga argues that it often comes as something of a surprise to many visitors to find that people in South Africa, sang and danced throughout the decade of the 1980’s – a period many agree was one of the most violent phases in the struggle against the system of apartheid, and yet the people sang and made art fervently during this time. These acts were not merely stratagems for fun but the songs were a part of the arsenal in the fight to secure democratic rights for all and to overthrow the government. During his recording, Neo Muyanga presents a series of anecdotes and medleys of songs of protest from the era of the 80’s – songs of his youth – juxtaposed against new songs he has composed in response to the challenges of new socio-political realities in South Africa today.

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