Governance and participation in health

AIDS activism – new opportunities for citizenship in South Africa?

Post-apartheid South Africa has witnessed the growth of social movements using on-the-ground and network-based modes of organisation that operate at the same time in local, national and global political environments. Networks across countries and grassroots mobilisation have allowed HIV/AIDS activists to use tactics confronting the state while supporting it to be more inclusive. Research from the University of Stellenbosch in South Africa explores the organisational practices and strategies of the Treatment Action Campaign (TAC), a Cape Town-based social movement.

Aids, TB and malaria: Africa declares commitment
Ogbonnaya R: This Day (Lagos), 18 February 2007

Friends of the Global Fund Africa popularly referred to as Friends Africa, a new pan-African advocacy organisation, chose Kigali as the venue for the inauguration of its board and first board meeting to chart the way forward in the fight against HIV/Aids, tuberculosis and malaria, the three diseases it claimed have been dealing a great blow to African continent. In Kigali , Friends Africa brought together some of the most committed, credible and influential voices of Africa as an indication of African leaderships' determination to lead the fight against the three diseases.

An approach to addressing governance from a health system framework perspective
Mikkelsen-Lopez I, Wyss K and de Savigny D: BMC International Health and Human Rights 11(13), 2 December 2011

In this paper, researchers reviewed contemporary health sector frameworks which have focused on defining and developing indicators to assess governance in the health sector. Based on these, they propose a simplified approach to look at governance within a common health system framework which encourages stewards to take a systematic perspective when assessing governance. Although systems thinking is not unique to health, examples of its application within health systems has been limited. This approach is built largely on prior literature, but is original in that it is problem-driven and promotes an outward application taking into consideration the major health system building blocks at various levels in order to ensure a more complete assessment of a governance issue rather than a simple input-output approach. Based on an assessment of contemporary literature the authors propose a practical approach which we believe will facilitate a more comprehensive assessment of governance in health systems leading to the development of governance interventions to strengthen system performance and improve health as a basic human right.

An assessment of the World Social Forum 2011 in Dakar
Miglioretto B: Feminist Dialogues, February 2011

In this interview, Lilian Celiberti of Feminist Dialogues reports that the World Social Forum (WSF), held in Dakar, Senegal from 6–11 February 2011, was an opportunity for a variety of activists and other civil society stakeholders to take part in discussions across varying perspectives and experiences. She highlights the strong and active participation of African women and youth, and the barriers of poor logistics and translation. She comments that the Declaration of the Women's Organisations was heavily focused on international conventions and UN-Resolutions, despite multiple tensions and conflicts amongst African groups and regions. She recognises that although interpersonal exchanges enable the deepening of debates, ‘colonisation continues in the divisions that we experience in different parts of the world’, and questions remain unanswered about how to develop collective thinking and solidarity in social movements.

An exploratory study of community factors relevant for participatory malaria control on Rusinga Island, Western Kenya
Opiyo P, Mukabana RW, Kiche I, et al: Malaria Journal 6 :48, 2007

Capacity strengthening of rural communities, and the actors that support them, is needed to enable them to lead their own malaria control programmes. The existing capacity of a rural community in western Kenya was evaluated in preparation for a larger intervention. The study shows that culturally sensitive but evidence-based education interventions, utilising participatory tools, are urgently required which consider traditional beliefs and enable understanding of causal connections between mosquito ecology, parasite transmission and the diagnosis, treatment and prevention of disease.

An Independent Review and Accountability Mechanism for the Sustainable Development Goals: The Possibilities of a Framework Convention on Global Health
Friedman E: Health and Human Rights Journal 18(1), 2016

The author argues that the proposed Framework Convention on Global Health (FCGH) could establish a nuanced, layered, and multi-faceted regime of compliance and accountability to the right to health and strengthen accountability for the health-related Sustainable Development Goals (SDGs). If legally binding, he argues that the FCGH could facilitate accountability through the courts and catalyze comprehensive domestic accountability regimes, requiring national strategies that include transparency, community and national accountability and participatory mechanisms, and an enabling environment for social empowerment. A “Right to Health Capacity Fund” could ensure resources for these strategies. Inclusive national processes could establish targets, benchmarks, and indicators consistent with FCGH guidance, with regular reporting to a treaty body, which could also hear individual cases. State reports could be required to include plans to overcome implementation gaps, subjecting the poorest performers to penalties and targeted capacity building measures. Regional special rapporteurs could facilitate compliance through regular country visits and respond to serious violations. And reaching beyond government compliance, from capacity building to the courts and contractual obligations, the author proposes that the FCGH could establish nationally enforceable right to health obligations on the private sector.


Fund the Fund have produced an advocacy kit aimed at civil society organisations (including nongovernmental, community-based, people living with the diseases, faith-based, and trade unions) to promote their advocacy for increased investment in the Global Fund.

Further details: /newsletter/id/29809
Analysing and addressing governance in sector operations
Boesen N: 2008

This guide, produced by the EuropeAid Co-operation Office, offers guidance to European Community (EC) sector specialists on how to analyse and address governance in sector operations in a more systemic and comprehensive way, without being a compulsory blueprint. It aims to strengthen understanding of governance issues at sector level. It is divided into four chapters, which provide a broad definition of governance and overall EC policy on governance, experiences in dealing with governance at sector level reasons for strengthening efforts, a focus on an overall approach in addressing sector governance, and a methodology that can guide the process of analysing governance at sector level.

Analysing and managing the political dynamics of sector reforms: A sourcebook on sector-level political economy approaches
Edelmann D: Overseas Development Institute Working Paper 309, November 2009

This book identifies four types of dynamics impact on reforms at the sector-level: sector-specific dynamics, cross-sectoral dynamics, the dynamics of the political process and country-wide dynamics. It divides approaches into two groups: sector-level political economy approaches; and country-level and politics-centred political economy approaches. Based on this analysis, the book found that sector-level political economy approaches can be characterised by a series of strengths, weaknesses and gaps. Strengths tended to be their focus on core development challenges, methodological diversity and dynamic evolution. Weaknesses, on the other hand, tended to be around having a very small number of empirical, comparable and publicly accessible sector studies; too few policy management-oriented action frameworks and an insufficient theoretical guidance on using some approaches, frameworks and matrices. Gaps were identified in the assessment of political viability of sector reforms; in the analysis of domestic decision making and subsequent implementation; and in the consideration of concrete operational implications. One of the sectors covered in this book is the health sector.

Annotated bibliography on participatory consultations to help aid the inclusion of marginalized perspectives in setting policy agendas
Siddiqui FR: International Journal for Equity in Health 13(124), December 2014

This bibliography presents studies from peer-reviewed and grey literature that used consultations and other participatory strategies to capture a community’s perspective of their health priorities, and of techniques used to elevate participation from the implementation phase to a more upstream phase of prioritisation, policymaking and agenda setting. It covers studies that worked with marginalised populations or sub-populations. It begins by first offering some philosophical and conceptual frameworks that link participatory interventions with inclusive policy making or agenda setting, and a rationale for prioritising marginalised populations in such an undertaking. It further looks at various participatory instruments for consultations, for reaching out to marginalised populations, and for communicating the results to policymakers. A final section presents a reflective and evaluative look at the recruitment, instruments and examples.