The authors investigated community and health-care workers’ perspectives on COVID-19 and on early pandemic responses during the first 2 weeks of national lockdown in Zimbabwe between March and April 2020. Phone interviews were done with with one representative from each of four community-based organizations and 16 health-care workers involved in a trial of community-based services for young people. In addition, information on COVID-19 was collected from social media platforms, news outlets and government announcements. Data were analysed thematically. It emerged that individuals were overloaded with information but lacked trusted sources, which resulted in widespread fear and unanswered questions; communities had limited ability to comply with prevention measures, such as social distancing, because access to long-term food supplies and water at home was limited and because income had to be earned daily; health-care workers perceived themselves to be vulnerable and undervalued because of a shortage of personal protective equipment and inadequate pay and other health conditions were side-lined because resources were redirected, with potentially wide-reaching implications. The authors recommend providing communities with basic needs and reliable information to enable them to follow prevention measures, health-care workers with personal protective equipment and adequate salaries and sustaining health-care services for conditions other than COVID-19.
Governance and participation in health
This thematic brief discusses actions that governments, employers’ and workers’ organisations, can take to advance gender equality through social dialogue, drawing on case studies from around the world, in different sectors, in the formal or the informal economy, and during the pandemic. It identifies the circumstances and factors that can help bring about transformative change. The brief examines the role of social dialogue in the application of relevant International Labour Standards on gender equality, including the ground-breaking Violence and Harassment Convention, 2019 (No. 190) and Recommendation No. 206 on the same subject matter. It concludes with some key recommendations for governments and employers’ and workers’ organisations.
An emerging movement of self-organized, decentralized community action networks is responding to the local realities of COVID-19 in Cape Town, South Africa. It reflects an unprecedented city-wide response to COVID-19, based on principles of self-organizing, mutual aid and social solidarity. In early March 2020, just as South Africa was waking up to the spectacle of COVID-19 within its borders, a group of community organizers, activists, public health folk and artists came together and kick-started a community-led response to the pandemic. This became known as Cape Town Together, a growing network of neighbourhood-level Community Action Networks (CANs) spread across the city. The CANs act locally, while also sharing collective wisdom and various resources through the broader network of Cape Town Together. They work collaboratively, recognizing that everyone brings something to the table. Some are weavers and builders, others are storytellers, caregivers or healers. Some are disruptors whilst others are experimenters and guides. The CANs have galvanized a significant number of people from across the city around a shared experience. Many are seeing the inequality exposed by COVID-19 in a new light and will remain galvanized beyond the immediate crisis.
WHO has defined community engagement as “a process of developing relationships that enable stakeholders to work together to address health-related issues and promote well-being to achieve positive health impact and outcomes”. The organisation notes undeniable benefits to engaging communities in promoting health and wellbeing. This guide is intended for change agents involved in community work at the level of communities and healthy settings.
The authors raise that the COVID-19 pandemic reveals what is wrong and toxic — in ourselves, in relation with others, and in relation with the rest of non-human nature and ask: 'is it possible to also look for what is good and life-affirming?' The authors argue that the future must be founded on ‘kindness, social solidarity and an appropriate scale of time’, a future that cherishes life and the connections that transcend borders. This pamphlet, part of Daraja Press’s Thinking Freedom Series, distills learnings from the work of activists on the ground in the Church Land programme in KwaZulu-Natal province, South Africa.
This video, accompanying a song by Mzikhona Mgedle from the Langa Community Action Network (CAN), captures the dynamism and energy of Cape Town Together and the Community Action Networks while highlighting the many ways in which COVID-19 has challenged South Africans to demonstrate new and better forms of solidarity. Across the geographic, economic and social barriers that are a consequence of Apartheid history, community-led COVID-response networks are forming partnerships based on trust, inter-personal connection and shared goals. The music video draws footage from a range of CAN projects, including community kitchens, medicine-delivery schemes and food gardens to demonstrate the power of collective action. As the song states, none of us are safe, until we are we are all safe
This study from Zambia in 2018 examines the sociodemographic and psychosocial factors that are associated with whether parents communicate with their daughters about sexual issues, through structured, face to face interviews with 4343 adolescent girls and 3878 parents. Adolescent girls who felt connected to their parents and those who perceived their parents to be comfortable in communicating about sex were more likely to speak to their parents about sexual issues than those who did not. Girls whose parents used fear-based communication about sexual issues, and those who perceived their parents as being opposed to education about contraception, were less likely to do so. Girls enrolled in school were less likely to communicate with their parents about sex than those out of school. The authors suggest that parents can improve the chances of communicating with their children about sex by conveying non-judgmental attitudes, using open communication styles and neutral messages.
The authors review how the global plan fits with national health policies and ownership in Uganda, and global health governance. They report that despite a ‘whole-of-society’ approach, the decision-making power in the global plan remains with governments. Community and civil society participation are highlighted throughout the GAP and comprise one of its seven core themes. However, despite the announcement of the GAP plan in October 2018, it was not until June 2019 that a public consultation process started, seeking feedback from non-state and state actors to some chapters of the GAP. At the same time, the authors raise concern that a ‘whole-of-society’ approach opens the door for the private-for-profit corporate sector to engage in health, further encouraging a move to a privatised, undemocratic and inequitable global health governance. Without explicit and concrete frameworks for monitoring, mutual accountability and clear and effective participation to address ever-growing power imbalances, they question whether the goal of accelerating achievement of health for all by 2030 can be met, and suggest that the COVID-19 pandemic could be a first test case for the GAP.
This paper is a case study of legal empowerment through community paralegals and Village Health Committees in Mozambique. The authors explored how community paralegals solved cases, the impact they had on health services, and how their work affected the relationship between the community and the health sector at the local level. Case resolution conferred a sense of empowerment to clients, brought immediate, concrete improvements in health service quality at the health facilities concerned and seemingly instigated a virtuous circle of rights-claiming. The program also engendered improvements in relations between clients and the health system. The authors identified three key mechanisms underlying case resolution, including: bolstered administrative capacity within the health sector, reduced transaction and political costs for health providers, and provider fear of administrative sanction.
The webinar, chaired by ROAPE’s Yao Graham in Ghana, asked what is happening across Africa since governments ordered the clampdown. The discussants looked at the impact on the continent of the Covid-19 pandemic and the measures taken against it. All the speakers addressed what was happening at grassroots and national level, and how the popular classes were being affected. Reporting from Kenya, Gacheke Gachihi and Lena Anyuolo asked if the state was really fighting Covid-19 or the poor? They argued that since the curfew was enforced across the country the police continue to brutalise and terrorise people living in informal settlements. Femi Aborisade reported a constant struggle for food and survival in Nigeria, and an intensification in the repression of the poor during the country’s lockdown. In South Africa, Heike Becker looked at the reaction of the government, the struggles of poor communities and the urgency of building new activist groups and politics in the country. Tafadwza Choto from Zimbabwe reported that the government was using the virus as a cover for wider repression. Taking on the broader political economy of the crisis, Gyekye Tanoh addressed how economies and politics are likely to be reshaped by the virus and its consequences, with a likely impact of the global recession on the continent, the IMF and IFI responses and the costs for workers, peasants, social movements, activists, and radical projects.