Funding for public health services paid from general taxation, provided universally and free at the point of access, is considered the most effective way of redistributing resources from high to low income groups while contributing to improvements in health. Nonetheless, in recent decades the privatisation of health services has expanded, through the in privatisation of services and expansion of private sector services in parallel with the public system, or in various forms of commercialised market reforms within public sectors, and the growth of public-private partnerships. This paper outlines equity-related evidence on privatisation in the ESA region in terms of differential entitlements, assets, endowments, and capabilities; differentials in vulnerability; health outcomes; and in life course, long-term and wider system consequences. Drawing on this evidence, the paper suggests elements of the pathways for responding to the equity dimensions of privatisation of health services and reflections on which elements may have a broad impact on multiple dimensions of inequity. The presentation of areas for action on pathways for change is not intended to be prescriptive. It rather intends to stimulate and inform dialogue and advocacy, understanding that what may be relevant and feasible depends on the country context. Motivating actions to address the inequities inherent in privatisation implies countering a common narrative that limiting privatisation of services undermines development. In contrast it implies promoting the right to health care, as embedded in many constitutions of ESA countries, and the understanding that public sector health systems are central for universal health coverage.
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The EQUINET Conference 2022 “Catalysing change for health and social justice” invites submissions from different voices and in different forms for presentation at the conference within the three strategic areas of the conference. For Day1 July 28th: Reclaiming the Resources for Health, for Day 2 September 15th: Reclaiming the State, for Day 3 October 13th: Reclaiming Collective Agency and Solidarity. The abstract submission page at https://www.equinetafrica.org/conference/abstract-submission.html provides further information on content areas and the online submission form. We are inviting presentations of research, interventions, policy engagement with a focus on actions for equity oriented change. Your presentation may be an oral presentation but we are also inviting short videos, podcasts, zoom recordings of discussions, poems, photojournalism and other forms. We expect presentations to be short (less than 15 minutes) so please indicate in the abstract how much time you envisage your input will need. We may provide some support for preparation of presentations for those with limited resources. Please complete the information in the online Abstract submission form below and ensure you submit before 15 June. Accepted abstracts will be notified by 30 June.
The EQUINET Conference 2022 “Catalysing change for health and social justice” invites participation from community members, workers, state personnel at all levels, civil society, parliamentarians, academics, trade unions, diverse professionals, innovators, producers and others. The online conference will be 9am to 5pm Southern African time for the three full days: Day1 July 28th: Reclaiming the Resources for Health, Day 2 September 15th: Reclaiming the State, and Day 3 October 13th: Reclaiming Collective Agency and Solidarity. Participants can register online for one, two or all three days of the conference at the registration page at https://www.equinetafrica.org/conference/registration.html. Please register separately for each of the three days, using all three links for all three days if you want to attend all. All those attending a day of the conference will be automatically registered for the fourth half day 9am to 1pm on November 17th. Registration is free. The inputs to the conference will inform the future work of the network. Please join and be part of it!
EQUINET is holding a regional conference in 2022. We are living in a time of widening inequity, globally and in our region, but also of intensifying levers of change. The conference is for you! The EQUINET steering committee is inviting voices from all levels, disciplines, sectors and institutions that contribute to health equity in the region to share, discuss, network and reflect on experiences, ideas and actions, and to consolidate proposals for advancing equity in health and wellbeing in our region. The conference will be online, with thematic conference days held intermittently between July and November 2022. We will include a range of forms of evidence, including studies, stories, artistic and visual evidence, on our challenges and actions to reclaim the resources for health, our states, and our public services, and collective agency and solidarity in health. Leading up to the final day, we will explore how we organise as a network of equity actors from in the region. The full announcement with information on the conference, the registration and the call for submissions will be shared in April. To receive further information by email please subscribe at https://www.equinetafrica.org/content/subscribe.html
EQUINET commissioned this study from the author at University of Zambia to explore trends in equity-related healthcare expenditures in East and southern Africa (ESA) countries prior to the pandemic (2000–2019), and, through a deeper case study of expenditures in Zambia, how financing changed during the COVID-19 pandemic in 2020/21. The regional analysis reviewed selected indicators available from the WHO Global Health Expenditure database for 2000–2019 of the: extent to which governments prioritise health in domestic budget spending; level of financial protection; level of government pro-poor spending on primary health care; and the share of public versus private financing in total health expenditure. The financing trends for 2000–2019 in ESA countries raise issues around health system preparedness for the pandemic, while the Zambia case study demonstrates the consequent impact of the responses to COVID-19 on health system financing.
EQUINET information sheets on COVID-19 summarise information from and provide links to official, scientific and other resources on east and southern Africa (ESA) covering selected themes related to equity in the pandemic. They complement and do not substitute information from public health authorities. Brief 7 summarises pandemic developments in the region to December 2021, with a focus on equity in vaccination coverage. It covers: 1: Recent trends in COVID-19 in ESA countries; 2: Vaccine supply to the ESA region; 3: Storage and distribution of vaccines in the region; 4: Vaccine uptake and vaccination coverage; and 5: Addressing equity - from vaccines to vaccinated populations.
The first East and Southern Africa Regional People’s Health University (ESA RPHU) jointly convened by the People’s Health Movement (PHM) and Regional Network for Equity in Health in East and Southern Africa (EQUINET) was held virtually between 29 July and 12 November 2021 with the theme ‘Past, present and future struggles for Health equity’. The course aimed to build and share evidence, experience, analysis, and knowledge on the drivers of health equity to support efforts and activism within countries, and regional co-operation and joint engagement, from local to global level, on shared priorities. The course further aimed to share evidence, practical experiences, insights and learning from action, including on the implications of the COVID-19 pandemic in the region. To widen uptake in the region, background readings and presentations from sessions are available on the ESA RPHU Resources page.
This sixth EQUINET/TARSC information sheet on the COVID-19 pandemic in east and southern African (ESA) countries has been produced in co-operation with the Post COVID Treatment Network - Africa. In a prolonged pandemic, capacities and understanding have grown around various dimensions of the management of COVID-19. There is now growing evidence of people who continue experience symptoms more than 12 weeks after their initial infection, or ‘long COVID’. This information sheet summarises information on long COVID, and its distribution in the ESA region, responses to it and the equity issues it raises.
The 10 week EQUINET and PHM ESA RPHU ended in mid-November. There are a number of interesting resources and reading materials on the RPHU website and videos of many of the presentations, that we welcome you to read, view and share more widely and use on your own activities. These materials, made available under fair use for your non-commercial educational purposes, cover topics from the course including on: Political economy and reclaiming resources for health; Ideas of health and wellbeing, SDH and reclaiming comprehensive public health; Health systems and Comprehensive primary health care (PHC); Power, values, rights, law and reclaiming collective agency; Commodification, privatization in health and reclaiming the state; Equity in health technology; Social participation and organising activism for health; and Building a movement for health equity.
The COVID-19 pandemic has strained the already stretched health systems in East and Southern Africa (ESA) countries, and was affected by previous levels of public leadership and engagement with the private sector. The response involved a range of collaborations between the public and private sectors. Country plans were public sector-led, in co-operation with international development partners, with partnerships between the public and private sectors in the response both in and beyond the health sector. This desk review commissioned by EQUINET presents evidence from online materials and EQUINET steering committee key informants on features of the public and private sector health system roles in the response to COVID-19. The work differentiates the private for-profit sector from the private not-for-profit sector. The review explores the equity implications of these responses, and suggests implications for (re)investing in strengthened public health system preparedness and functioning and private sector co-ordination in ESA countries.