Governance and participation in health

The roles of educators in mitigating the impact of the HIV/AIDS pandemic on the education system in South Africa
Higher Education HIV/AIDS Programme: December 2009

The purpose of this study was to determine the roles of educators in mitigating the impact of the HIV and AIDS pandemic, and to ascertain the skills and knowledge required by them to play such roles effectively. The study gathered data from 3,678 survey respondents to a questionnaire. Qualitative fieldwork showed that levels of concern among educators were polarised with respect to HIV and AIDS pandemic, ranging from lack of concern and denial of its importance to extreme concern and a strong sense of ethical responsibility to mitigate its impact. However, most respondents displayed a very high level of concern regarding the pandemic. They pointed to an urgent need for training and resources for future roles. The study made four recommendations. It urged for a resolution to South Africa's current strategic dilemma, namely whether to prescribe approaches to mitigating the impact of the pandemic or allow individuals and institutions to develop their own responses. It also called for curriculum interventions that meet the challenges of the pandemic, differentiated interventions that enable educators to meet the challenges of the pandemic and more time to develop appropriate resources and support, including training.

Youth participation in development: A guide for development agencies and policy makers
Students Partnership Worldwide and DFID–CSO Youth Working Group: March 2010

This guide explores a number of different themes related to youth participation in development: governance, voice and accountability, post-conflict transition and livelihoods, and sexual and reproductive health. In the sexual and reproductive health section, several examples of youth-focused health initiatives from Uganda are discussed, such as Uganda's National Development Plan and the Youth Empowerment Programme. Another health initiative, Young, Empowered and Healthy (Yeah) is a sexual health campaign for and by young people in Uganda was launched in 2004 under the auspices of the Uganda AIDS Commission and uses radio and other media to reach youth.

Cholera prevention programme in Malawi a beacon of success
Ngozo C: Inter Press Service News Agency, 23 February 2010

Mkanda, in central Malawi, is presented as a successful example of cholera control through the Community-Led Total Sanitation (CLTS) approach, with a fall from fourteen to zero cholera cases in a year. The article does not give adequate evidence to attribute the cause of the decline, but toilet availability and community awareness both improved in the year.

Conditional cash transfers: A ‘pathway to women’s empowerment’? Do cash transfers continue poor women’s second-class citizenship status?
Molyneux M: Pathways of Women's Empowerment RPC, 2008

Conditional cash transfers (CCTs) provide mothers of school-age children in extreme poverty with a cash subsidy conditional on their children's attendance at school and health clinics. This paper assesses the evidence for the claim that these programmes empower women. It finds that, although CCTs are designed to target the extremely poor and the particularly vulnerable, they operate under a highly selective definition of social need, and these programmes privilege and target some needs over others even at household level, reinforcing social/gender inequalities within the family itself. Highly unequal gender relations were found to be central in the functioning of such programmes. The paper argues that cash transfers should be part of a broader effort to improve and strengthen the social sector while attending to the urgent needs of the most deprived. If they signal a move in the direction of residualist welfare policies designed as compensation for exclusionary economic development, then they represent a more worrying trend. If cash transfers are to enhance the life chances of seriously disadvantaged populations, their design needs to take into account the household as a whole, so that the needs of all members are met.

Participatory Learning and Action 60: Community-based adaptation to climate change
International Institute for Environment and Development, 2009

The articles in this issue on participatory learning and action focus on the recent approaches to adaptation to climate change utilising the priorities, knowledge and capacities of local people. Community-based adaptation (CBA) draws on participatory approaches and methods developed in both disaster risk reduction and community development work and sectoral-specific approaches. The emphasis now leans to policy processes and institutionalisation, issues of difference and power, assessing the quality and understanding the impact of participation, rather than promoting participation. Participatory Learning and Action reflects these developments and recognises the importance of analysing and overcoming power differentials which work to exclude the marginalised. This issue is divided into three sections: reflections on participatory processes and practice in community-based adaptation to climate change; participatory tool-based case studies; and participatory tools, with step-by-step descriptions of how to use them. The report also presents two important tools: communication maps, which help participants to understand communication patterns and relationships, and a tool called Rivers of Life, where participants reflect on personal experiences that have motivated them in their personal lives.

Strong ministries for strong health systems
Omaswa F and Boufford JI: African Center for Global Health and Social Transformation (ACHEST) and the New York Academy of Medicine: January 2010

This study and report were commissioned by the Rockefeller Foundation to explore the feasibility of establishing a support mechanism for ministers and ministries of health especially in the poorest countries, as part of the Foundation’s Transforming Health Systems initiative. Based on data from minister and stakeholder interviews and supporting research and consultation activities, this report offers seven action items geared toward building a systematic and sustained program of support for health ministries. Recommendations and proposals provided address: capacity assessment tools; leveraging existing management development resources; mapping country networks of expertise; regional networks to support health systems stewardship and governance; knowledge networks to support ministers of health; executive leadership development; and advocacy for strengthening health ministries. Collective action on these proposals is needed to strengthen health ministries and enhance the leadership capabilities of ministers.

European Parliament resolution of 20 January 2010 on the second revision of the ACP-EC Partnership Agreement (Cotonou Agreement)
European Parliament: 20 January 2010

The European Parliament in considering the second review of the Cotonou Agreement between European and African and Caribbean states, deplored the fact that the Parliament, the ACP-EU Joint Parliamentary Assembly (JPA), national parliaments of the ACP (African, Caribbean and Pacific) States and civil society organisations and non-state actors were not involved in the decision-making process that led to the identification of areas and articles of the Cotonou Agreement for revision and to the establishment of the negotiating mandates adopted by the Council of the European Union (EU) and the ACP Council of Ministers. This omission was argued to affect the transparency and credibility of the revision process and to alienate EU and ACP populations from their governments and institutions. The Parliament stressed the need to consolidate the political dimension of the Cotonou Agreement, particularly in respect of the commitment of the parties to implement the obligations stemming from the Rome Statute of the International Criminal Court. The European Parliament called on the Commission, the EU and the ACP Council to take into account the principles and results of the International Aid Transparency Initiative, and to launch a debate, involving also non state actors, on the future of ACP-EU relations post-2020.

Is the EU's governance 'good'?: An assessment of EU governance in its partnership with ACP States
Slocum-Bradley N and Bradley A: United Nations University’s Comparative Regional Integration Studies (UNU-CRIS), February 2010

Distinguishing between ‘(good) governance’ as a process and an outcome, this paper examines both the processes and outcomes of governance in the context of the European Union’s (EU) relationship with African, Caribbean and Pacific (ACP) States within the period of the Cotonou Agreement (CA). It discusses and assesses a variety of governance mechanisms, including the European Commission’s use of the governance concept, economic partnership agreements (EPAs), manifestations of partner preferences, the revision of the CA, and Fisheries Partnership Agreements. Specific examples of the wielding of each mechanism are assessed based upon two criteria: the extent to which the wielding of the mechanism by the EU is a manifestation of ‘good governance’, and the extent to which the EU’s wielding of the mechanism has resulted, or is likely to result, in the sustainable development of and reduction of poverty in ACP countries. The examples are chosen to illustrate contradictions between rhetoric and practice and the consequential negative (actual and potential) impact upon development in ACP States. The final section offers suggestions for improving the EU’s governance processes and their outcomes for development.

Small change: Why business won’t save the world
Edwards M: January 2010

In this book the author cautions against promises of the market as a means to meeting the challenges of social change. The author proposes that real change will come when business acts more like civil society, not the other way around, as business by its very nature is not equipped to attack the root causes of poverty, inequality, violence, and discrimination. Achieving fundamental social transformation requires a different set of operating values – cooperation rather than competition, collective action more than individual effort, and patient, long-term support for systemic solutions over immediate results. He argues that people give their money and time to social change organisations to serve a cause, not a balanced quarterly spreadsheet. With a vested interest in the status quo, all business can promise are valuable but limited advances: small change, in comparison to the more sweeping transformation that can be brought about by social action.

The challenge of accountability for development agencies within their own countries and before their peers: A comparative study
Vielajus M, Hudson A, Jonsson L and Neu D: Organisation for Economic Cooperation and Development, December 2009

This study proposes to sketch out an overview of the challenge of accountability within donor countries, and includes a few innovative initiatives set up by these countries to reinforce the demand for accountability, as well as to advance the production of ‘accountable’ information and diversify the tools for disseminating agencies’ action and for opening the debate. It aims to find the thread linking services provided by different agencies, to understand how they interface and what their limitations are. The study poses and attempts to answer the following questions: What is the ‘accountability demand’ currently levelled at development agencies? How can the tools for producing and disseminating information be ‘grown’ so as to meet the mounting accountability objective? How can the agencies’ accountability targets and tools be broadened to better answer the needs for information and dialogue of the stakeholders and the public at large?

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