The Ugandan Government wants non-government organisations (NGOs) to align their projects to government’s development priorities. At the national civil society fair held in Kampala early in July 2013, James Baba, the state minister for internal affairs, said NGOs should strive to understand government priorities and work on them both in the local and central governments. The Cabinet has charged the Ministry of Internal Affairs in consultation with the Minister of Finance to closely work with NGOs to ensure that all projects are aligned with government priorities. The National Development Plan outlines various strategies for the socio-economic transformation of Uganda from a peasant economy to a modern and prosperous country within 30 years. Baba promised to enhance the co-ordination of NGO stakeholders to ensure improved communication flow aimed at promoting smooth relations between the Government and the NGOs.
Governance and participation in health
This is the story of the leaders of a women's organisation, Mahila Swasthya Adhikar Manch (Women’s Health Rights Forum) in the state of Uttar Pradesh in India. It recounts how a group of women from the extremely marginalised sections of society have become empowered and are monitoring their entitlements around health services and other services which are related to the social determinants of health. It describes the evolution of the group, its activities and some of the results of their advocacy action with a focus on their empowerment process. This story of women’s empowerment is closely inter-twined with that of a group of facilitating organisations, who have not only contributed to this process, but also gained in confidence and credibility to strengthen the overall call for greater state accountability at different levels. The case study also discusses how this process which has led to a series of gains for these marginalised women both at a personal level and in improving accountability processes at the local level; still remains incomplete in the context of their overall political empowerment and autonomy.
The Uganda National NGO Forum has launched the first CSO-NDP monitoring report that captures citizen voices on Government’s National Development Plan (NDP) and public service delivery. The monitoring strategy for the NDP addressed the demand side challenge of limited Monitoring and Evaluation activities. The report ensured well documentation of citizens’ views which were later shared with stakeholders at different levels of Government. The monitoring survey was conducted in 51 districts and reached 20,000 households in the districts covered. Data was collected from seven sectors through review of government documents and questionnaires administered at four different levels; households, community, sub county and district levels. The report covers findings from seven selected NDP sectors; agriculture; markets and cooperatives; transport; labour and employment; health; water and sanitation; and justice, law and order. With regard to health, most households meet their healthcare costs despite the free primary healthcare policy. Nearly seven out of ten households do not receive their full drug prescription. Sanitary conditions are far from the minimum norms and standards in most households. No more than three in 10 homesteads have a given sanitary facility.
Activists from the People’s Health Movement met during the World Health Organisation’s 8th Global Conference on Health Promotion to critique the official Conference Statement (included in this newsletter) and develop a progressive call for action based on strong social justice principles. This draft reflects their deliberation and is being circulated for further comment and debate. They support the leadership of WHO Director-General Margaret Chan in condemning the economic power of large industries, including food, tobacco, soda and alcohol, and their destructive impact on the health of people around the globe. They note further that speakers and discussants in this Conference have highlighted the link between the “Health for All” Declaration of Alma Ata in 1978 and the unfinished agenda of health promotion, stemming from the Ottawa Declaration of 1986. They support the calls in this conference for a ‘whole‐of‐government’ approach that includes Health in All Policies, a social justice framework in monitoring and evaluation of health policies, and the health‐related human rights that promote health for all. They believe, however, that the Helsinki Statement does not sufficiently translate the analysis of the determinants of health inequities and poor health into specific actions which address the unfair economic system that underpins health inequities. They therefore issue this call to action, recognising that this entails both short and long term political struggle for social justice.
This paper describes the Ghana Essential Health Intervention Project (GEHIP), a plausibility trial of strategies for strengthening Community-based Health Planning and Services (CHPS). The researchers found that GEHIP improves the CHPS model by: extending the range and quality of services for newborns; training community volunteers to conduct the World Health Organisation service regimen known as integrated management of childhood illness (IMCI); simplifying the collection of health management information and ensuring its use for decision making; enabling community health nurses to manage emergencies, particularly obstetric complications and refer cases without delay; adding $0.85 per capita annually to district budgets and marshalling grassroots political commitment to financing CHPS implementation; and strengthening CHPS leadership at all levels of the system. By demonstrating practical means of strengthening a real-world health system while monitoring costs and assessing maternal and child survival impact, GEHIP is expected to contribute to national health policy, planning, and resource allocation that will be needed to accelerate progress with the Millennium Development Goals.
This briefing paper elicits the perspective of the African non-governmental organisations (NGOs) on the concept of universal health coverage (UHC). It defines the basic concepts and also explores the role NGOs can play to improve the definition and implementation of UHC to improve health outcomes for all. It describes some of the common misunderstandings and misgivings expressed by NGOs, such as the belief that UHC is limited in scope and does not address the social determinants of health. Examples from African countries that have successfully implemented UHC are provided. UHC does not only mean protection from catastrophic expenditure – it means that all people are able to access health services when they need them. In this regard it specifically targets the poorest and most vulnerable. In most instances, civil society organisations have played a significant role in ensuring that national policies reflect in the reality on the ground.
This action research is an effort to capture the voices of community leaders and bring the resilience priorities of poor, disaster-prone communities into debates that will shape the new policy frameworks on disaster risk reduction to be launched in 2015. For the most part members of poor, disaster-prone neighbourhoods worst affected by natural hazards and climate change are absent from current consultations. Yet, it is these communities whose survival and wellbeing will be most affected by the policies and programmes that emerge from these debates. Five recommendations emerged from this study. 1. Invest in community-led transfers to scale up effective resilience practices. 2. Incentivise community-led, multi-stakeholder partnerships; create mechanisms that formalise community roles in government programmes to make them more responsive and accountable to community resilience priorities. 3. Foster community organising and constituency building in addition to technical know-how for building resilience. 4. Set aside decentralised, flexible funds to foster multi-dimensional community resilience building efforts. 5. Recognise grassroots women’s organisations and networks as key stakeholders in planning, implementing and monitoring resilience programmes.
Governments across Africa are clamping down on dissent, hiding their secrets and attacking the funding base of their critics. In this article the author points out that political movements that once fought for freedom and prosperity, having assumed power, are now undermining both by trying to restrict civil society. He argues that what these governments ignore at their peril is that debate and dissent are vital to both vibrant democracy and economic prosperity. Rather than seeing civil society as a threat, they should see it as a building block of a stable democracy; one that needs to be nurtured, not over-regulated. Community-based organisations can deliver grounded and cost-effective services, helping to educate and skill-up people to take advantage of economic opportunities. They are also big employers in their own right, and a new generation of social entrepreneurs across the continent is emerging with innovative and profitable ways of tackling intractable social problems.
In late 2012, the board of the Global Fund to Fight Malaria, Tuberculosis and AIDS approved a new funding model (NFM), which significantly changes the manner in which funds are allocated, applied for, awarded, disbursed, and monitored. The NFM was formally launched on 28 February 2013, though it will remain in a transitional phase until 2014. While there is much promise in the NFM, there are many questions, some of which are raised in this report. The Fund has established a framework for the core aspects of grant funding under the NFM, but there remain countless details to be uncovered through real-world experience and regulated by Fund policy and protocol. This report reviews the key components of the NFM from a civil society and key population perspective, with a focus on its impact on AIDS programmes. Incorporating the views of leaders from key populations and civil society around the world, the report provides a summary of some current top-level concerns related to the roll-out of the NFM and offers recommendations on how to implement the NFM in a manner which is responsive to and inclusive of civil society and key populations, and ultimately which has the greatest impact on ending the AIDS epidemic globally.
Civil rights groups and communities have expressed concern about the failure of South Africa's Department of Health to release the National Aids Vaccine Strategic Plan (NAVSP) for 2013-2017. In 2012, the Department of Health requested the South African Aids Vaccine Initiative (SAAVI) to develop the NAVSP in collaboration with researchers all over the world and communities and Community Advisory Groups in South Africa. However, since its development the document has been embargoed for public scrutiny without any reason given. At a recent community roundtable on Aids Vaccine Research and Development indicated their dissatisfaction with the embargo on the document as they believe it contains clear objectives on community involvement in AIDS vaccine research that is happening in the country. Researchers from various organisation, including the Perinatal HIV Research Unit, the Aurum Institute for Health Research and the Desmond Tutu HIV Foundation agreed that the embargo creates suspicion about the department’s activities to reduce HIV infections through vaccines and ARVs prevention research.