Governance and participation in health

Public services: Transformation or stasis?
Ruiters G: Public Services Yearbook 2005/2006

Although the South African state has shifted away from uncritical promotion of neo-liberal public management, the government continues to mesh limited welfarism with market-driven reforms. It has tried to use service delivery to win political loyalty, but this strategy has largely backfired. There is growing public awareness that the current failures and inequities in access to public services can no longer be blamed on the legacy of apartheid. According to the free basic water policy applied since 2001, poor South Africans are entitled to 6,000 litres of free water per month. Yet, according to the Department of Finance’s own numbers, most poor households use 25,000 of water per month. Consequently, most such households then fall into arrears. Free basic water, often seen as a big improvement, also has unintended effects. It is a way to increase state surveillance of citizens by requiring registration and its restrictive availability is used as a disincentive for poor people to use water. If poor people use more than their basic allocation, they are heavily penalised by higher tariffs.

Putting words into action in Zambia
Dickinson C and Collins T: Compass 9, October 2009

The Strengthening the AIDS Response Zambia (STARZ) programme marked a cutting edge multisectoral approach to HIV in the region. Non-governmental sectors (including civil society and the private sector) tend to be poorly organised, and authority tends to rest with government ministries. Not all sectors have incentives or welcome being coordinated, particularly by relatively young commissions claiming the mandate to do so. Coordination can also mean different things to different groups – for some it signifies regulation and control, while for others the emphasis is on participation and information exchange and even access to resources. The main aim of this project was to support the national AIDS commission, known locally as the National AIDS Council (NAC), in coordinating a multisectoral response to the epidemic. The report notes that coordination is improved when the roles and rules of engagement for key stakeholders are understood, and where accessible coordination structures are in place to enable public, civil society and private sector representatives to work effectively with the NAC. The STARZ programme has supported important processes that have focused on improved relationships between the NAC and the civil society and private sectors – including internal coordination.

Analysing and addressing governance in sector operations
Boesen N: 2008

This guide, produced by the EuropeAid Co-operation Office, offers guidance to European Community (EC) sector specialists on how to analyse and address governance in sector operations in a more systemic and comprehensive way, without being a compulsory blueprint. It aims to strengthen understanding of governance issues at sector level. It is divided into four chapters, which provide a broad definition of governance and overall EC policy on governance, experiences in dealing with governance at sector level reasons for strengthening efforts, a focus on an overall approach in addressing sector governance, and a methodology that can guide the process of analysing governance at sector level.

Community Radio Performance Assessment System: Manual on indicators for community media
Nepali Community Radio Support Centre: 2009

Like many other developing countries with forbidding landscapes and isolated communities, radio is to be the most effective way of communication in Nepal, where the majority of population lives in villages and the half of it cannot read and write. This manual draws from both the grassroots experience of community media and from international broadcast practices. It considers the issues that are the real basis for the success of community media: public accountability, community representation, locally relevant programming, diverse funding and acknowledgement of staff, including volunteers. It covers in details many key success factors, such as participation and ownership, content, management, volunteerism and networking. It can be applied across a wide range of contexts, from policy issues to the assessment of a local station.

Health through people’s empowerment: A rights-based approach to participation
De Vos P, de Ceukelaire W, Malaise G, Pérez D, Lefèvre P and van der Stuyft P: Health and Human Rights 11(1), 2009

This paper focuses on three crucial issues when analysing human rights and health: the importance of social class in community participation, the pivotal role of power and empowerment, and the role of the state, which refers to the concepts of claim holders and duty bearers included in a rights-based approach to health. The concept of ‘health through people's empowerment’ is proposed to identify and describe the core aspects of participation and empowerment from a human rights perspective and to put forward common strategies. If marginalised groups and classes organise, they can influence power relations and pressure the state into action. Such popular pressure through organised communities and people's organizations can play an essential role in ensuring adequate government policies to address health inequities and in asserting the right to health.

Neither consolidating nor fully democratic: The evolution of African political regimes, 1999–2008
AfroBarometer: AfroBarometer Briefing Paper 67, May 2009

The twenty African countries included in the Afrobarometer include many of the most politically liberal countries on the continent, including seven countries ranked by Freedom House in 2008 as ‘free’. However, when one assesses the quality of these regimes based on popular attitudes and perceptions, one does not find any consolidated democracies among them (although Botswana comes close). In fact, some are consolidating as autocracies, but most countries are best understood as unconsolidated, hybrid regimes. They exhibit some key elements of democracy, such as regular elections and protection of core individual freedoms. But either the popular demand for democracy, or the perceived supply of democracy, or, in most cases, both, fall short of the standards of full democracy. But the trajectories of individual countries are extremely diverse, with some exhibiting sharp declines away from democratic consolidation, while others are steadily advancing.

NGOs in Zambia fear new law will hobble their activities
IRIN News: 26 August 2009

Zambian civil society fears the imminent introduction of legislation designed to regulate non-governmental organisations (NGOs) that may compromise their independence and even result in a clampdown on their operations. The new 2009 NGO Bill calls for ‘the registration and co-ordination of NGOs, to regulate the work, and the area of work, of NGOs operating in Zambia.’ If the bill becomes law, a 16-member board will be established by the community development minister to ‘receive, discuss and approve the code of conduct [of NGOs], and ... provide policy guidelines to NGOs for harmonising their activities to the national development plan of Zambia.’ NGOs will be compelled to re-register every five years and submit annual information on their activities, funders, accounts and the personal wealth of their officials – failure to comply could result in the suspension or cancellation of registration. However, civil society leaders and human rights activists fear the proposed new law could be used by government to silence critics and erode civil society.

Planning a governance assessment: A guide to approaches, costs and benefits
United Nations Development Programme (UNDP): March 2009

This guide examines the basic issues that a country or organisation should consider when developing and producing a governance assessment. It is by no means the ‘last word’, but should serve as a starting point and outline for those interested in conducting a country-led governance assessment. The paper explains the trade-offs of various approaches and methodologies in terms of quality and costs. At the same time, it provides some basic background on the technical aspects of conducting a governance assessment. The guide attempts to answer the rather complex question: how can country-led governance assessments be carried out with broad stakeholder participation at a reasonable cost, and at the same time produce meaningful results that can be used by civil society and governments alike?

African leaders challenged to meet their commitments to health
ARASA: 27 July 2009

The AIDS and Rights Alliance for Southern Africa (ARASA), a Namibia-based partnership of health and human rights groups from the Southern African region, today launched a YouTube video clip entitled ‘Lords of the Bling’, linked to a public petition that presents a ‘moral challenge’ to African leaders regarding their commitments to funding health. The clip highlights the cost of lavish expenditure and corruption among various African leaders and calculates how many people could, for equivalent sums of money, have received life-saving treatment for HIV and TB, which jointly claim almost two million African lives every year. The video clip and petition are intended to serve as an awareness-raising campaign and a platform for solidarity on holding African governments accountable for their commitments to health. ARASA is seeking sign-ons from organisations and individuals, which will be presented to leaders on International Human Rights Day in December 2009. ARASA intends to mobilise civil society around this critical issue and claim the right to health.

Commonwealth Local Government Handbook 2009
Commonwealth Local Government Forum: July 2009

This 2009 edition of the Commonwealth Local Government Handbook is a complete reference book to local government in the Commonwealth. Updated and revised, it details the systems of local government in the 53 countries of the Commonwealth, looking at how local government is structured, how elections take place, what services local government is responsible for, how local government is financed and what reforms are envisaged. The profiles are in a format that allows easy country-to-country comparison. The 2009 Handbook includes a preface by CLGF Secretary-General Carl Wright, a foreword by CLGF Chairperson Basil Morrison, and an introduction by Hubert Ingraham, Prime Minister of the Bahamas.

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