Brief nine of the National Reconciliation and Transitional Justice Audit reveals perspectives on issues of conflict, peace and justice by the community in Nakapiripirit in Karamoja, in the north-east of Uganda. The major concern of the participants in Nakapiripirit was the strained relationship between themselves as citizens in Karamoja and the state. According to them, the relationship has been characterized by mutual distrust right from colonial times up to now, coupled with deliberate marginalization and an attempt to take away the Karimojong's way of life. They lamented that the rest of Uganda looks at Karamoja as a region apart and says that 'we shall not wait for Karamoja to develop'. In their view, conflicts in Uganda are a reflection of bad governance practices, such as corruption, unfree and unfair elections, lack of term limits, and an absence of border security. This inspires anger towards the Government and provokes rebellion. Impacts of conflicts include more strained relationships between citizens and the state, and delayed development. In that sense, causes and impacts of conflict constitute a vicious cycle.
Governance and participation in health
In Tanzania, the policy of decentralisation and the health sector reform have placed an emphasis on community participation in making decisions in health care. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. study was carried out in the Mbarali District of Tanzania. A qualitative study design was used, with in-depth interviews and focus group discussions conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. The study findings indicate differences in influence on health care decision-making processes in terms of gender, wealth, ethnicity and education, as men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. The authors conclude that these inequalities in decision making in health care need to be addressed if greater participation is desired. There must be an emphasis on the right of all individuals to participate in decision-making processes, and role players should ensure that information, training and education is fairly distributed so individuals can participate fully in informed decision making.
In this statement, issued before the United Nations Conference on Sustainable Development (Rio+20), held in Brazil from 20-22 June 2012, CIVICUS affirms that the Zero Draft outcome document for Rio+20 must advance a rights-based approach to sustainable development that reaffirms past political commitments, and in particular, the need to protect civil society space, ensure maximum public participation and advance democratic freedoms, by establishing legally binding commitments which support the three dimensions of sustainable development: social justice, environmental sustainability and economic development. CIVICUS argues that the reason why global governance is failing so badly is partly because we have multinationals whose operations are now global beyond the national jurisdiction of any one government to regulate, police or manage. States have reneged on the democratic values they committed themselves to uphold, and governments have become less accountable to the people. Universal norms and standards are being ignored or sidestepped by new rules that favour markets. To achieve and maintain sustainable development, CIVICUS urges UN member states to commit to improve continuously the implementation and enforcement of environmental policies and legislation, with no regression on environmental protection. Commitments to the principle of non-regression at all levels should be a major objective of Rio+20.
The author argues that the stalemate that emerged following the contest between Jean Ping of Gabon and Nkosasana Dlamini-Zuma for the position of African Union Commission Chairperson in Addis Ababa had repercussions for South Africa's foreign policy in Africa, paralysed the institution and divuded it at a time of need. He argued that South Africa should rather have sought consensus among African leaders than choosing a public and political way of challenge, which he observes created camps along lines of language and politics. Naidoo warned that South Africa’s desire to be the dominant economic force on the continent should not raise barriers to effective African unity and urged African leaders to resolve the stalemate before the next AU head of state conference in July 2012.
International capital mobility has long been associated with financial and banking crises. The Articles of Agreement of the International Monetary Fund (IMF) contain multi‐lateral rules to govern global capital flows. For some countries, especially those in the developing world, the IMF Articles of Agreement remain the core framework under which they have autonomy to regulate cross‐border capital flows. For others, these rules have been partly superseded by more recent trade and other economic integration agreements. Thus what used to be a regime of ‘cooperative decentralisation’ has become a patchwork of overlapping and inconsistent governance structures that pose significant challenges to nations attempting to regulate global capital flows for stability and growth, according to the author of this paper. He traces the history of governing global capital flows and presents a framework for understanding three distinct eras in the modern governance of global capital. The framework emphasises how power, interests, ideas, and institutions interact to shape each era in different combinations to yield different outcomes.
A petition backed by over 50 non-governmental organisations and charging Uganda's government with failing to prevent the deaths of two expectant mothers, Sylvia Nalubowa and Jennifer Anguko, was thrown out by the constitutional court on 5 June, but the petition's supporters plan to appeal. The Constitutional Court argued that upholding the petition, which urges the government to boost health services, would have forced judges to wade into a political issue that was outside their jurisdiction, saying that it was the work of the parliament to review the efficiency of the health sector. However, the petitioners said the court relied on outdated international law in making its decision and overlooked its constitutional obligation to protect Uganda's mothers. In throwing out the case, the justices suggested the petitioners seek an order from the High Court compelling a public officer, such as a government health worker, to carry out his or her duties, or to request compensation for individual deaths from the government.
Two lawsuits have been filed against the Ugandan government for alleged negligence in the handling of nodding disease. The disease has killed at least 200 children since 2009 and currently affects 3,500 others, according to the Ministry of Health. A local charity, Health Watch Uganda, has filed one lawsuit, and two members of parliament have filed a separate case. Health Watch Uganda has accused the government of violating the rights of affected children by not providing them with adequate health care. In February, the government rolled out a plan to fight the disease, opening three specialised clinics and training 99 health workers, but critics say it is overdue and inadequate. The Health Ministry says lack of funding has made it difficult to implement the plan. The government has vowed to fight the lawsuits, arguing that it has been conducting research into the disease in cooperation with the World Health Organisation.
A group of leading international humanitarian, development, social justice, environmental, and workers' organisations have warned that June 2012’s UN Conference on Sustainable Development (Rio+20) looks set to add almost nothing to global efforts to deliver sustainable development. The warning from Development Alternatives, Greenpeace, the Forum of Brazilian NGOs and Social Movements for Environment and Development (FBOMS), International Trades Union Confederation (ITUC), Oxfam, and Vitae Civilis comes at the end of two weeks of negotiations between governments on the conference outcomes, with less than 50 days before the summit in Rio de Janeiro, Brazil, from 20 - 22 June. The group warns that the current negotiating text does not adequately capture human rights and principles of equity, precaution, and 'polluter pays', despite the urgency provided by the current financial crises, growing inequalities, broken food As a benchmark against which to assess the outcome of Rio+20, the organisations have set out a 10-point agenda that includes global goals for sustainable development, designed to eradicate poverty, reduce inequality and realise justice and human rights, while respecting the finite limits of Earth's natural resources.
This research explored communities’ views on the elements of public health services that they find particularly problematic. It aimed to quantify the priority placed on each of these aspects of public service delivery that requires attention. Communities view the routine availability of effective medicines as the greatest priority for improved public sector health services; the least important priority is treatment by doctors. Routine availability of medicines is ten times more important than treatment by doctors. A thorough examination and clear explanation of a patient’s diagnosis and treatment by health professionals are also highly valued community priorities. Communities tolerate poor quality public sector service characteristics such as long waiting times, poor staff attitudes and the lack of direct access to doctors if they receive the medicine they need and a thorough examination and if a clear explanation of their diagnosis and treatment is provided.
The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Using cross sectional data from 46 countries in the African region of the World Health Organisation, an ecological analysis was conducted to examine the relationship between governance and health systems performance. Governance was found to be strongly associated with under-five mortality rate (U5MR) and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the causal relationship, and its generalisability beyond U5MR as a health outcome measure, as well as the geographical generalisability of the results.