When specifically viewed with Africa’s history in mind, administrative corruption, though rampant across Africa today, is an alien culture, argues the author of this article. Pre-colonial Africa, for the most part, was founded on strong ethical values sometimes packaged in spiritual terms, but with the end result of ensuring social justice and compliance. The author argues that colonialism introduced systemic corruption across much of sub-Saharan Africa, repudiating indigenous values, standards, checks and balances. The author makes several recommendations: restoration of indigenous values and institutions; improving access to formal, informal and non-formal education; promotion of the ‘African’ nation state; and strengthening of anti-corruption institutions. The author argues that African countries should not just seek the deceptive increment in Gross Domestic Product, but real development in terms of standard of living, with health, education, food security and infrastructural growth given prominence.
Governance and participation in health
Today, civil society is facing serious threats across the globe, according to this report. Civil society activists continue to face traditional forms of repression, such as imprisonment, harassment, disappearances and execution. In addition, many governments have increasingly become more subtle in their efforts to limit the space in which civil society organisations (CSOs), especially democracy and human rights groups, operate. In the report, the World Movement for Democracy (WMD) highlights the well-defined international principles protecting civil society and underscoring proper government-civil society relations, which are already embedded in international law. These principles include: the right of CSOs to entry (that is, the right of individuals to form and join CSOs); the right to operate to fulfill their legal purposes without state interference; the right to free expression; the right to communication with domestic and international partners; the right to freedom of peaceful assembly; the right to seek and secure resources, including the cross-border transfer of funds; and the state’s positive obligation to protect CSO rights. WMD calls for greater collaboration between civil society and government.
To address the research gap on health care leadership in low-income settings, researchers in this qualitative study documented the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. They conducted in-person interviews with health care leaders in four countries in sub-Saharan Africa: Ethiopia, Ghana, Liberia and Rwanda. Individuals were identified by their country's minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of their countries, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. While current models of leadership capacity building only address the need for core technical and management competencies, skills relevant to managing relationships are also critical in the sub-Saharan African context, the authors argue. Developing such skills may require more time and a deeper level of engagement and collaboration than is typically invested in efforts to strengthen health systems.
Civil society space in Uganda is rapidly shrinking, says international civil society network, CIVICUS, and Uganda-based East and Horn of Africa Human Rights Defenders Project (EHAHRDP). Independent civil society organisations are being openly threatened and placed under excessive scrutiny by senior government officials. The Ugandan Parliament is currently considering the Public Order Management Bill, which would place a number of restrictions on the freedom of assembly, and violations of the proposed law carry a high penalty of two years’ imprisonment. Both CIVICUS and EHAHRDP urge the Ugandan government to respect the right of civil society actors to freely express, associate and assemble, in line with the country’s obligations under the Constitution and the International Covenant on Civil and Political Rights, to which Uganda is a party.
Mitchell Sutika Sipus is an urban planning advisor to the Mayor of Mogadishu. He also lives and works in Kabul, Afghanistan. Here he writes about the rebuilding of Mogadishu’s physical infrastructure and the need for ‘psychological healing’ amongst the residents of the city. He writes of the initiation of trauma workshops for residents. Rebuilding the physical landscape is only part of the struggle. How can the city heal psychologically? Mogadishu's deputy mayor, Iman Icar, believes that to transform the city it is essential to transform the minds of residents. The mayor set up a new initiative to provide training in trauma healing and reconciliation for 50 people in each district. On July 19, 2012, the program concluded with a grand ceremony attended by President Sharif Sheikh Ahmed. The first 800 graduates will train another group of 800. In a city of three million, 1600 people may not be much, but it is argued to be a ripple in the pond that, with continued effort and support, will grow ever wider.
The outcome of Rio+20, held in June 2012, with negotiating countries unable to reach consensus on most issues, left most commentators disappointed as the summit failed to live up to its ambitious title “The Future We Want”. However, UHC Forward argues that health activists have a minor victory to celebrate, as issues regarding health, absent in the initial drafts circulated in advance of the Summit, are now mentioned in the texts. Health has had its relationship with sustainable development firmly recognised in terms of Universal Health Coverage by: strengthening health systems; complying with Beijing, Cairo and TRIPs flexibilities to ensure access to essential medicines; reducing infant and maternal mortality; and providing universal access to family planning and sexual and reproductive health. However, UHC Forward acknowledges that the Rio+20 outcome text contains too many divergent viewpoints and no tangible political commitments. It does, though, mark the beginning of the next phase of negotiations, and UHC Forward calls on all activists to demand that new agreements must reflect the challenges of the new global landscape, accounting for new health challenges, widening inequality and the increased proportion of the world’s poor in middle-income countries.
Zambian civil society organisations, especially those devoted to women’s rights, have welcomed Zambia’s new Constitution, which contains progressive provisions on gender equality and the promotion of women’s rights. The public is expected to vote on the Constitution in a national Referendum in 2013. Women’s rights organisations are reported to be preparing for educational campaigns amongst women to vote in favour of the new Constitution in the proposed Referendum in 2013. The parties to the Women’s Declaration on Engendering the Republican Constitution include the labour movement, the private sector, traditional leaders and groups under the umbrella of the Non-Governmental Organisations Coordinating Council (NGOCC). The draft version will enshrine gender equity in the Constitution in terms of economic empowerment. Activists have further demanded for the recognition of education as an important tool for the empowerment of women and women’s political empowerment through proportional representation in all decision making structures.
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.
This review investigated international cooperation in health, particularly between developed and developing nations. Standard database and web-based searches were conducted for publications in English between 1990 and 2010, from which 65 articles were included in the final analysis. While some articles identified intangible benefits accrued by developed country partners, most pointed to developing country innovations that can potentially inform health systems in developed countries. Ten key health areas in which developing countries led the way were identified, such as rural health service delivery, skills substitution, decentralisation of management, creative problem-solving and innovation in mobile phone use, and health financing. The authors argue that combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is still basic and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardised method for reporting partnership benefits is needed for realising the full potential of international cooperation between developed and developing countries.
In 2008, South Africa’s National Tuberculosis Programme (NTP) implemented a community mobilisation programme in all nine provinces to trace TB patients that had missed a treatment or clinic visit. The objective of this study was to assess the impact of the NTP’s TB Tracer Project on treatment outcomes among TB patients. The study population included all smear positive TB patients registered in the Electronic TB Registry from Quarter 1 2007-Quarter 1 2009 in South Africa. Results for all provinces combined suggested that, in tracer districts, fewer patients defaulted on their treatment and there was an increase in successful treatment outcomes. However, the results were not consistent across all provinces, and significant differences in treatment default were observed between tracer and non-tracer sub-districts over time in five of nine provinces. The authors conclude that community mobilisation of teams to trace TB patients that missed a clinic appointment or treatment dose may be an effective strategy to mitigate default rates and improve treatment outcomes. Additional research is called for to identify best practices and elucidate discrepancies across provinces.