In this open letter to the World Bank, a group of 110 international civil society organisations (CSOs) call on the Bank to play a truly progressive and transformative role in health by supporting countries to achieve universal health coverage (UHC). The World Bank is well-placed to be a vocal champion of UHC by deploying its knowledge and experience in health system reform, as well as its financial support. However, the Bank must reform the approach of its programmes and policy advice in order to deliver on this potential, and ensure it positively impacts poor and vulnerable populations. The CSOs call on the Bank to actively support countries to offer care that is free at the point-of-use for all people, as well as scale up investment in public health systems in developing countries, by supporting them to expand public financing, and by offering balanced policy advice that does not privilege private sector solutions over publicly financed and delivered health systems. The Bank can take further steps to promote UHC by ensuring all Bank programs benefit the poorest two quintiles in the countries where it works, actively supporting involvement of civil society in national health policy development, in order to improve democratic oversight and accountability for improved health outcomes, and collaborating with the World Health Organization and other global health institutions in the push for UHC.
Governance and participation in health
This report documents perspectives from civil society organisations (CSOs) on the performance of the health sector in Uganda, against the background of the government’s Health Sector Strategic and Investment Plan III (HSSIP). Researchers found that most priority areas are in the integrated health systems, including health workforce development, increasing production and equitable deployment of health workers, increasing financial resources, strengthening the role of civil society in monitoring and accountability, and ensuring reliable access to medicines and health supplies. They call for the Ministry of Health to demonstrate its leadership, stewardship, and political will to push forward the recommendations not only elucidated in this report, but also in the HSSIP. Specific critical areas of intervention are also highlighted, including mental health and non-communicable diseases (including cancer and sickle cell disease), malaria, HIV and AIDS, health promotion and human rights. The authors recommend critical interventions in health financing, human resources for health, essential medicines and health supplies, and delivery of the Uganda Minimum Health Care Package (UMHCP).
After a series of multi-million-dollar scandals recently unearthed in Kenya, the Auditor General’s report for 2015 says only 1% of the national budget was properly accounted for. In this letter, civil society organisations (CSOs) in Kenya express deep concern and consternation for the worrying escalation of corruption scandals in Kenya in the recent past with little or no consequences for perpetrators, many of whom are reported by the author to have been heavily mentioned in a series of scandals and continue to unashamedly occupy, and therefore bring dishonour, to public office. The CSOs rebuke what they cite as the culture of impunity that continues owing to an apparent lack of political will to address corruption. They make 14 demands to the president and government including the immediate sacking of state and public officers within the Executive adversely mentioned in corruption scandals, initiating legal process of freezing of bank accounts of all those implicated in grand corruption scandals pending investigations, instantaneously stopping and recovering salaries paid illegally to officers who have been suspended or removed from public service on graft allegations
Civil society members and advocates for health care from all over the world met to discuss the International Health Partnership and Related Initiatives (IHP+) 'Scaling Up for Better Health Plan', aimed at strengthening primary health care to achieve the health-related MDGs for developing countries around the world, including Africa. In order to deliver on its stated goals, they believe the IHP+ must commit to a minimum set of guidelines. These civil society member and advocates stand united on three key principles that they consider non-negotiable: 1) Comprehensive primary health care must be provided for all. 2) Governments must pay their fair share. 3) The people’s voices must be heard.
Civil Society Organisations, especially those actively engaged with the health sector, have been largely of the opinion that the Commission constitutes a major opportunity to address key issues in the health sector. This is especially so as the Commission is seen to be engaged in examining and taking forward some of the key fundamentals of the Alma Ata declaration – viz. a Health Systems approach that foregrounds Primary Health Care and locating health in a larger social, economic and political context.
At a meeting on 1-2 November 2012 in Johannesburg, child rights organisations from across Southern Africa brought together a number of stakeholders – including parliamentarians, government officials and various civil society organisations – to meet under the auspices of the Child Rights Network for Southern Africa (CRNSA) and to reflect on building a strong child rights movement in Southern Africa. In this statement, they call on the Southern African Development Community (SADC) to adopt a specific children’s protocol, ensuring meaningful participation of children at various levels of decision making, in particular helping each country to establish a state-funded children’s Parliament. At the same time, SADC should make state parties implement its basic minimum package of services for children, domesticate regional and international instruments that state parties have ratified and allocate and increase budgets for children at all levels while guaranteeing meticulous budget monitoring. The signatories further call on SADC governments to ensure timeous reporting to treaty bodies, especially the African Charter on the Rights and Welfare of the Child – to whom only Tanzania has reported – as well as prioritise child abuse prevention and early intervention programmes, expeditiously pass comprehensive child-related laws and policies, act as role models in championing children rights and address the contradictions arising from the existence of dual legal systems (customary law and civil law), notably in the case of harmful cultural practices.
In this statement, a group of international civil society organisations welcomes the appointment by the UN Secretary-General of a diverse High-level Panel to advise on a post-2015 development agenda. However, the statement also expresses concern the Panel does not include the voices of people living in poverty, and their representative associations. The current composition of the Panel is largely state-centric with insufficient civil society representation, the organisations argue, and the Panel should include people from women's associations, farmers cooperatives, indigenous groups, workers or organisations of the impoverished. They highlight the fact that such voices must be represented as part of any effort to tackle poverty and in building a just, equitable and sustainable world.
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.
Despite the significant success of global health programs, there is a continuing gap between policy analysis and action. This paper is the first in a series, cosponsored by Results for Development Institute and the Global Health Council, which presents examples and opportunities of how evidence-based research can be translated into policies and programmes that will improve the health of poor people in developing countries. The series includes six presentations that draw from Results for Development's expertise in transparency and governance, the role of the private sector in health, health ministry capacity building, health financing and the health workforce. The first of these talks, 'Civil Society: A Missing Link in Development' took place on 29 March 2010 and featured civil society leaders from India, South Africa and Uganda, who are participating in the Institute's Transparency and Accountability Programme. You can watch the presentations on the website given above.
According to this article by the secretary general and policy manager of CIVICUS, too little partnership and too little space for civil society is marring progress on the UN Millennium Development Goals (MDGs). The writers express their utmost concern that there is insufficient political will among governments to acknowledge the role of other stakeholders, including civil society, in charting a course for accelerated action on the Millennium Development Goals (MDGs) between now and 2015 and to work in partnership with them. They refer to the increasing trend to systemically restrict freedoms of expression, association and assembly — freedoms that are key to the work of civil society. Against this background, they argue that it is increasingly clear that civil society organisations – which include non-governmental organisations, social movements, think tanks, faith-based charities and community-based organisations – must play a key role in supplementing the efforts of governments and the private sector in order to make substantial progress towards achieving the MDGs.