Governance and participation in health

Progress report on Students' Health Advocacy Project
Guma M: HEPS Uganda, 17 August 2011

The Students’ Health Advocacy Project (SHAP) is a community outreach programme of HEPS-Uganda, a health consumers' organisation advocating for health rights and responsibilities that is also a member of the EQUINET network. SHAP targets schools in Rubaga Division to make the students aware of their health rights and responsibilities. This has been going on since 2010. So far, SHAP activities have been conducted in a few schools and for some schools a follow up has been made from the previous outreach made to them, specifically Bright Angels College. The new members of the health club in this school showed great interest in the activities carried out by SHAP and HEPS Uganda. The two organisations are currently refining the programme to make it more focused on raising students’ awareness of their basic health rights. The SHAP team is also working on expanding its activities to various schools in Rubaga and this has been effected through delivering letters so that dates can be scheduled for SHAP to take their presentations to the targeted schools.

A global co-ordinating platform for non-communicable diseases
Nishtar S and Jané-Llopis E: Journal of Health Communication 16(Suppl 2): 201-205, 14 September 2011

There is a long history of advocacy to place non-communicable diseases higher on the global public health agenda. Although attempts have been made and action is well under way, there is still no co-ordinating mechanism that helps identify action, tracks progress, and stimulates multistakeholder collaboration while preventing duplication of efforts. The September 2011 United Nations High Level Meeting on Non-Communicable Diseases and the call by all parties for more efficient responses to the growing problems of non-communicable diseases presents a unique opportunity to create an institutional mechanism that incentivises coordination. The authors argue that an apex coordinating arrangement would allow efficient global information exchange, mapping existing gaps in action, and identifying and catalysing collaboration across sectors and regions of the world.

Global health diplomacy: A way forward in international affairs
Report of the Inaugural Conference of the Global Health Diplomacy Network: Chatham House, 2011

The Inaugural Conference of the Global Health Diplomacy Network was held on 28 June 2011 in London, United Kingdom. More than 190 diplomats, health professionals, senior government officials, academics, and representatives of business and non-governmental organisations gathered to discuss contemporary issues in global health diplomacy and outlooks for the future of the Network. After the presentations were held, the Network made a number of resolutions, concluding that the Network should help the health sector understand that the top priorities of foreign policy are national security and economic growth, not health. The health sector must not view the link between health and foreign policy as an opportunity to exploit the foreign policy sector to reach health goals. Instead, it must think how it can advance foreign policy goals and be aware and acknowledge that health policy can have a positive or negative impact on foreign policy and its goals, just as foreign policy can have positive or negative impacts on health. Participants acknowledged that much health diplomacy in Geneva focuses on trade and about intellectual property issues, while there is a wider lack of coherence across the different global institutions and their goals, a problem which has been exacerbated by the proliferation of global actors.

Increasing evidence for the efficacy of tobacco control mass media communication programming in low- and middle-income countries
Mullin S, Prasad V, Kaur Jand Turk T: Journal of Health Communication 16(Suppl 2): 49-58, 14 September 2011

Anti-tobacco mass media campaigns have had good success at changing knowledge, attitudes, and behaviors with respect to smoking in high-income countries provided they are sustained. Mass media campaigns should be a critical component of tobacco control programs in low- and lower-middle-income countries, the authors of this article argue. Mounting evidence shows that graphic campaigns and those that evoke negative emotions run over long periods of time have achieved the most influence. These types of campaigns are now being implemented in low- and middle-income countries. The authors provide three case studies of first-ever graphic warning mass media campaigns in China, India, and Russia, three priority high-burden countries in the global Bloomberg Initiative to Reduce Tobacco Use. In each of these countries, message testing of core messages provided confidence in messages, and evaluations demonstrated message uptake. The authors argue that given the initial success of these campaigns, governments in low- and middle-income countries should consider resourcing and sustaining these interventions as key components of their tobacco control strategies and programmes.

Interview with civil society activist: Gino Govender
CIVICUS: August 2011

In this interview with Gino Govender, who recently joined Amnesty International’s International Mobilisation team, Govender reveals that Amnesty International has decided to grow in the global south and move closer to the communities and rights holders with whom the human rights organisation works. One of the outcomes of an extensive consultative process is the development of an Africa Growth Strategy, which involves the creation of three regional offices, one of which will be located in and responsible for Southern Africa. With regard to the current state of civil society in the Southern African Development Community (SADC) region and in South Africa in particular, Govender is optimistic, arguing that, regionally, civil society is undergoing an important stage of evolution. However, within SADC there are important political, social and economic challenges still to be confronted if the vision of a people-centred regional community that is thriving on the values of solidarity, social justice, equality, dignity, freedom, democracy and production that meets basic human needs are to be realised. He points to a general consensus on the need for a strong and effective civil society in the region and argues that collective leadership united under a common vision for the region is the key. The future for civil society in the region lies in a blend between historically vital sectors that have a wealth of organisational knowledge and experience - like the labour movement, faith-based organisations, womens’ organisations and intellectuals – and newly established organisations that are dedicated to a single campaign.

Civil society, public action and accountability in Africa
Devarajan S, Khemani S and Walton M: World Bank, Development Research Group Policy Research Working Paper 5733, July 2011

In this paper, the authors examine the potential role of civil society action in increasing state accountability for development in Sub-Saharan Africa. They build on the analytical framework of the World Development Report 2004 on accountability relationships, to emphasise the underlying political economy drivers of accountability and implications for how civil society is constituted and functions. The main argument is that the most important domain for improving accountability is through the political relations between citizens, civil society and state leadership. The evidence broadly suggests that when higher-level political leadership provides sufficient or appropriate powers for citizen participation in holding within-state agencies or frontline providers accountable, there is frequently positive impact on outcomes. However, the big question remaining for such types of interventions is how to improve the incentives of higher-level leadership to pursue appropriate policy design and implementation. The paper concludes that there is substantial scope for greater efforts in this domain, including through the support of external aid agencies. Such efforts and support should, however, build on existing political and civil society structures (rather than transplanting ‘best practice’ initiatives from elsewhere), and be structured for careful monitoring and assessment of impact.

Emerging economies and the development aid discourse
Tiwana MS: CIVICUS, August 2011

As the centre of global geo-politics continues to shift, much attention is being focused on the BRICS (Brazil, Russia, India, China, South Africa) group of emerging economies and the IBSA (India, Brazil and South Africa) group of emerging democracies as their power in global political and economic affairs has increased substantially, the author notes in this article. He calls attention to the implications of the growing power of BRICS and IBSA countries both individually and collectively for global civil society and development cooperation. From civil society’s point of view, concerns have been raised about the fact that while aid is offered to other developing countries by BRICS countries, there is an overall lack of information about the basis on which aid is given by them. Civil society is notably absent from BRICS meetings and summits. Additionally, there is the question of BRICS countries’ limited participation in ongoing multi-lateral processes to ensure harmonisation and transparency of aid. Traditionally, external funder countries have been involved in multiple processes and discussions to reduce aid overlap, faulty prioritisation and wastage. The author recommends greater south-south cooperation led by the democratic trio of IBSA countries. Their civil societies are active and also well placed to connect with their peers in the developing world to promote sustainable development underpinned by democratic values. But this will require some key foreign policy shifts for which civil society needs to lobby hard.

Engaging media in communicating research on sexual and reproductive health and rights in sub-Saharan Africa: experiences and lessons learned
Oronje R, Undie C, Zulu E and Crichton J: Health Research Policy and Systems 9(Suppl 1): S7, 16 June 2011

In sub-Saharan Africa media coverage of reproductive health issues is poor due to the weak capacity and motivation for reporting these issues by media practitioners, the authors of this paper argue. They describe the experiences of the African Population and Health Research Centre and its partners in cultivating the interest and building the capacity of the media in evidence-based reporting of reproductive health issues in sub-Saharan Africa. The authors note that the Research Centre’s media strategy evolved over the years, including: enhancing journalists’ interest in and motivation for reporting on reproductive health issues through training and competitive grants for outstanding reporting; building the capacity of journalists to report reproductive health research and the capacity of reproductive health researchers to communicate their research to media through training for both parties and providing technical assistance to journalists in obtaining and interpreting evidence; and establishing and maintaining trust and mutual relationships between journalists and researchers through regular informal meetings between journalists and researchers, organising field visits for journalists, and building formal partnerships with professional media associations and individual journalists. The authors conclude that a sustained mix of strategies that motivate, strengthen capacity of, and build relationships between journalists and researchers can be effective in enhancing quality and quantity of media coverage of research.

Kenya’s governance reforms ‘unstoppable’, says Kibaki
AfriMap: 18 July 2011

Kenyan President, Mwai Kibaki, has assured members of the African Peer Review Mechanism (APRM) that his government is committed to undertaking far-reaching reforms in the management of public affairs and entrenchment in constitutionality. President Kibaki affirmed that Kenya’s process of reforming governance would continue and urged the APRM team to share their experiences, particularly positive developments realised in other parts of the world that would be of value to Kenya and other African nations. Prime Minister, Raila Odinga, noted that Kenya was a pioneer in the review mechanism and was keen to evaluate the status of the country’s governance and explore ways of improving weak areas. He added that Kenya was open to scrutiny by peers and looked forward to a full examination and recommendations for appropriate remedy for various challenges facing the nation and its people.

The architecture and effect of participation: a systematic review of community participation for communicable disease control and elimination. Implications for malaria elimination
Atkinson JM, Vallely A, Fitzgerald L, Whittaker M and Tanner M: Malaria Journal 10(225), 4 August 2011

This paper reports the findings of an atypical systematic review of 60 years of literature in order to arrive at a more comprehensive awareness of the constructs of participation for communicable disease control and elimination and provide guidance for the current malaria elimination campaign. Of the 60 papers meeting the selection criteria, only four studies attempted to determine the effect of community participation on disease transmission. The studies showed statistically significant reductions in disease incidence or prevalence using various forms of community participation. The use of locally selected volunteers provided with adequate training, supervision and resources is crucial to the success of the interventions in these studies, the authors argue. After a qualitative synthesis of all 60 papers, they elucidate the complex architecture of community participation for communicable disease control and elimination. The authors stress the importance of ensuring that current global malaria elimination efforts do not derail renewed momentum towards the comprehensive primary health care approach. They recommend that the application of the results of this systematic review be considered for other diseases of poverty in order to harmonise efforts at building 'competent communities' for communicable disease control and optimising health system effectiveness.

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