Governance and participation in health

Using stakeholder analysis to support moves towards universal coverage: Lessons from the SHIELD project
Gilson L, Erasmus E, Borghi J, Macha J, Kamuzora P and Mtei G: Health Policy and Planning 27(Suppl 1), March 2012

The aim of this paper is to support all stakeholders who are developing or researching universal health care (UHC) reforms and who wish to conduct stakeholder analysis to support evidence-informed pro-poor health policy development. It presents practical lessons and ideas drawn from experience conducting stakeholder analysis around UHC reforms in South Africa and Tanzania, revealing that differences in context and in reform proposals generate differences in the particular interests of stakeholders and their likely positioning on reform proposals, as well as in their relative balance of power. It is, therefore, difficult to draw cross-national policy comparisons around these specific issues, the authors caution. Nonetheless, they argue that cross-national policy learning is possible with regard to choosing approaches to policy analysis and management of policy processes, but stakeholders should avoid generalisations when comparing UHC reform packages and should rather focus on how to manage the reform process within a particular context. The authors emphasise that stakeholder analyses can be used both to think through the political viability of new policy proposals and to develop broader political management strategies to support policy change.

Video on Health Committees
Learning Network for Health and Human Rights: University of Cape Town, South Africa, July 2016

The Learning Network for Health and Human Rights is a network is a collection of 5 civil society organisations (The Women's Circle, Ikamva Labantu, Epilepsy South Africa, The Women on Farms Project and the Cape Metro Health Forum) as well as 4 higher education institutions (UCT, UWC, Maastricht University, in the Netherlands, and Warwick University in the UK). The network collaborates to explore how collective action and reflection can identify best practice with regard to using human rights to advance health issues. The work of the Learning Network seeks to operationalise the right to health as stated in South Africa’s Constitution and other international treaties and agreements. This is accomplished through a programme in which research, training and advocacy are linked to empower organisations and their members to assert rights for health. One of their latest training materials, this video explores the role of Health Committees from different perspectives – from that of a facility manager, a health care provider, health committee members and patients. It aims to enhance understanding of what Health Committees can do, what the challenges are in building effective health committees and how they can strengthen the health system.

Voices of the Poor: Crying Out for Change

Deepa Narayan, Robert Chambers, Meera K. Shah and Patti Petesch - 2001
This book is based on the realities of poor people. It draws upon research conducted in 1999 involving 20,000 poor women and men from 23 countries. Despite very different political, social and economic contexts, there are striking similarities in poor people's experiences. The common theme underlying poor people's experiences is one of powerlessness. Powerlessness consists of multiple and interlocking dimensions of illbeing or poverty. The organisation of this book roughly follows the 10 dimensions of powerlessness and illbeing that emerge from the study. The remainder of the book presents methodology and the challenges faced in conducting the study.

Volunteering: The impact on civil society
Adebayo ST: Department of Social Work and Social Administration, Kabale University, 2009

This essay begins by describing various areas of volunteering, such as volunteering to build social capital and skills-based volunteering, where volunteers offers specific skills, such as medical skills. It goes on to outline the benefits of volunteering. Volunteering contributes to the development agenda by strengthening the voice of civil society organisations so they can influence policy, both at local and national levels, for the promotion of sustainable development and the improvement of livelihood security. Volunteering also helps to support communities to participate in development at local and national levels, as well as support communities to gain access to resources for local development and the improvement of essential services and to respond effectively to the HIV pandemic through programmes of prevention, care and support. Volunteering can support communities to realise their human rights, especially those of women and children.

Voter Sentiment on Governance in South Africa
Good Governance Africa: GGA, South Africa, 2017

In 2015 Good Governance Africa (GGA), in conjunction with specialist researchers MarkData, conducted a survey to test public attitudes towards key aspects of governance in South Africa. In 2016 GGA commissioned MarkData to conduct a Voter Sentiment Survey. Respondents were selected using a random multistage sampling process. The survey findings are to some extent in line with the 2011 South African Reconciliation Barometer. The survey showed that in cases relating to government performance, the widely held view was that all areas (administration, economic development and service delivery) required attention and improvement. Participants suggested that service delivery is the priority, followed by economic development and then administration. It was also found that more voters are deploying their vote strategically in relation to their perceptions of governance, despite feeling that they have little say in how they are governed. The authors argue that this reinforces the need for further research and for greater engagement with the voters on the ground, particularly in areas where poor local government performance has been detected.

Watchdogs or Critical Friends?
Bourgoing R: AID Transparency, 3 December 2013

The field of transparency is packed with vocabulary that suggests opposition or conflict, with labels that imply, somehow, that the watchers are above the watched, like white knights fighting the dark forces of development aid, the corrupt and incompetent. However collaboration between watched and watchers may also offers a better chance of generating positive change, by understanding the political context of the activities being monitored, targeting the right people, in a non-threatening way, offering solutions as much as identifying problems. In other words, being a successful ‘watchdog’ is argued to be all about knowing how to approach different people in different circumstances to achieve mutually beneficial goals. This article explores how to build the demand side of aid transparency. It raises that beyond accessing relevant, timely and accurate data, is to learn to make use of it in a strategic way, with a constructive mind, taking into consideration local political dynamics, and the reality and psychology of the people whose performance one aims to monitor and improve.

We cannot fight AIDS unless we do much more to fight TB
SAfAIDS\' statement on World TB Day : Nelson Mandela. International AIDS Conference. Bangkok 2004

Tuberculosis (TB) is a curable and preventable disease, yet it is still infecting and killing millions of people throughout the world. This article discusses how more efforts are needed to address the increasing incidence of TB and HIV in many southern African countries. Advocacy efforts need to encourage governments and international funding agencies to develop appropriate responses to urgently address the co-pandemics.

Further details: /newsletter/id/31363
What can a teacher do with a cellphone? Using participatory visual research to speak back in addressing HIV&AIDS
Mitchell C, de Lange N: South African Journal of Education; 33,4: 1-13, 2013

Their ubiquity in South Africa makes cellphones an easily accessible tool to use in participatory approaches to addressing HIV and AIDS issues, particularly in school contexts. In this article the authors explore a participatory visual approach undertaken with a group of rural teachers, using cellphones to produce 'cellphilms' about youth and risk in the context of HIV and AIDS. Noting that the teachers brought highly didactic and moralistic tones into the cellphilms, the authors devised a “speaking back” approach to encourage reflection and an adjustment to their approaches when addressing HIV and AIDS issues with learners. They draw on the example of condom use in one cellphilm to demonstrate how a “speaking back” pedagogy can encourage reflection and participatory analysis, and contribute to deepening an understanding of how teachers might work with youth and risk in the context of HIV and AIDS.

What communities want: Putting community resilience priorities on the agenda for 2015
Community Practitioners Platform for Resilience: May 2013

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.

What is postcolonial thinking? An interview with Achille Mbembe
Mbembe A: African Health Sciences 11(1):2011

Talking to French magazine Esprit, theorist Achille Mbembe discusses a postcolonial thinking that has developed in a transnational, eclectic vein, enabling a specific take on globalization. He outlines three cardinal moments in the development of postcolonial thought. The first, of anti-colonial struggles, included the self-reflection by people of their colonization and debates on the relationship between class and race as factors. The discourse centred on the politics of autonomy, to acquire citizen status and, thereby, to participate in the universal. The second moment, around the 1980s, he outlines as the moment of "high theory", with new thinking on knowledge about modernity. This understood the colonial project beyond its military-economic system, to one that was underpinned by a discursive infrastructure and a whole apparatus of knowledge the violence of which was as much epistemic as it was physical. The second post colopnial discourse sought to recover the voices and capabilities of decolonization's rejects (peasants, women, underprivileged people) and to better understand why the anti-colonial struggle led not to a radical transformation of society. Mbembe argues also argues that it sought to expose the procedures by which individuals are subjugated to categories of race and class that block access to the status of subject in history. In the third moment, Mbembe argues that globalisation has, as for colonial capitalism, subjugated living spheres to economic appropriation, and that the "colony" was in fact a laboratory for the wider authoritarian destiny of today’s globalisation. He proposes that in this context the reinvention of politics in postcolonial conditions first requires people to reinvent their place in history, not in a logic of repeating the same violence as vengeance, but in a demand for a justice that supports an "ascent in humanity“.

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