Latest Equinet Updates

Addressing health implications of the African Continental Free Trade Agreement in east and southern Africa
Machemedeze R, SEATINI: EQUINET Discussion paper 131, EQUINET, Harare 2023

This desk review on the health implications of the implementation of the AfCFTA within the ESA region implemented by the Southern and Eastern African Trade Information and Negotiations Institute (SEATINI) outlines the health sector and health-related areas directly or indirectly covered by the ACTFA and the relevant subsidiary instruments. It presents information on these and the AfCTA provisions and their implications for trade liberalisation, which are largely consistent with those under World Trade Organization (WTO) agreements. The paper identifies the AfCTA’s positive and negative actual and potential health sector and health- related impacts, including for health equity. It does this in terms of the products that will be subject to liberalisation, including those with potential benefit for health such as local production of health technologies and pharmaceuticals, as well as those that may be harmful to health such as tobacco and genetically modified and ultra-processed foods. It also explores the health implications of the AfCFTA on financial flows and public revenue and on the movement of people, including health personnel. Given this analysis of impacts, measures are proposed that individual countries and the ESA region as a whole may take to protect health equity goals, including monitoring mechanisms to track and report on those impacts.

Climate Change and Health Systems in East and Southern Africa: A Rapid Review
Musuka G, Dzinamarira T: EQUINET, Harare, December 2023

This desk review explored how climate change is affecting health systems in east and southern Africa (ESA); how the region’s health systems are adapting to climate change; and to identify the health system advocacy and policy issues raised in climate change negotiations by ESA countries, including in relation to issues of equity. Climate change was found to be associated with increased demand for health care services and reduced access to them. An increased demand for health services was found to arise from malnutrition caused by drought-related food shortages, an increase in food and water-borne infectious diseases because of drought and floods, especially in low-income settings, as well as heat exhaustion and heat strokes due to heat waves, particularly among people living in informal settlements. Provision of health services was found to be reduced by extreme weather events, with flooding disrupting transport and communication networks, affecting laboratory services, staff and patient travel, supplies of medication and ambulance availability, especially in rural areas. ESA countries have raised a range of advocacy and policy issues related to climate change and health systems in negotiations at the African Ministerial Conference on Environment and the UN Climate Change Conference of Parties (COP).

Communities collaborating in the Kariba Integrated Solid Waste Management Programme: From urban litter-jungles into healthy environments
Municipality of Kariba, TARSC: EQUINET, Harare, 2024

Interventions on urban waste have been integrated into one solid waste management programme in Kariba through multi-actor participation with high literacy, involving existing community structures and different age groups of people, and incorporating their aspirations for a clean town. Different interest groups select their own interventions on urban waste linking to food, energy and other urban needs, and deploy their own innovation, local knowledge systems. These are then integrated into the overall programme. The activities use affordable technologies and locally available materials, creating a demand for local goods. Information and communication technologies used in the programme have been important contributors to successful outcomes. Bringing diverse social groups together contributes to system wide and holistic awareness and links action on urban waste systems to a circular economy and climate justice.

Don’t waste the waste! A case study of promising approaches in managing organic solid waste in Manandriana Municipality, Antananarivo Avaradrano, Madagascar
FARM Madagascar, TARSC: EQUINET, Harare, 2024

Understanding how waste management systems are linked to and interact with other sub- systems and the influence and moderation effects of contextual factors including climate change is important in informing actions and approaches that promote health and wellbeing. Waste management systems provide a potential entry point for fostering innovations, collaborations and system-wide changes for healthy communities and ecosystems, such as through strengthening their linkages with food systems and promotion of circular economies. This case study showcases experiences from the municipality of Manadriana in Antananarivo, Madagascar. It has been produced within a series on integrated urban health in EQUINET to foster learning on these promising approaches within east and southern Africa.

From a Waste Dumpsite into a Food Basket in Bembeke, Dedza, Malawi
Country Minders for Peoples Development, TARSC: EQUINET, Harare 2024

Bembeke, Dedza has been transformed from one of the worst dumping sites to one of the cleanest urban sites in Malawi. CMPD, in partnership with the Environmental Affairs Department (EAD), and stakeholders in Bembeke Dedza, devised and implemented a waste management initiative to turn waste into manure, reducing waste and improving food security in Bembeke. Bembeke farmers were trained to produce manure from waste and theatre campaigns were held in eight zones to sensitise communities on ‘waste to wealth’. Urban waste and food security interventions succeed when all key stakeholders, including community members participate from conception to completion. Turning waste into fertiliser for food production contributes to food security, environmental protection, circular urban economies and mitigates the effects of climate change.

Health-promoting food and waste management systems in Kwekwe City: Turning waste into assets
City of Kwekwe, TARSC: EQUINET, Harare, 2024

Waste pickers, mostly women collect aluminium cans from shopping centres and homes and sell them to small-scale smelters based in home industries in Mbizo, Amaveni and other suburbs in Kwekwe. The aluminium scrap sells for between 45-50c (US$) per kilogram. The aluminium is moulded into useful traditional pots for local sale. Depending on their sizes, the pots sell for between US$10 to US$90. This is one of the ‘waste-to-asset’ recycling activities in Kwekwe City described in this brief. Harnessing treated wastewater for crop irrigation recycles nutrients and protects the environment. The food produced, sold and consumed locally in urban agriculture alleviates poverty, and promotes food security and health. Community participation, partnerships and collective decision-making in waste management applies local knowledge and assets for environmental protection and climate justice. Using solar energy protects urban environments, reducing dependence on polluting fossil fuels, and reducing the greenhouse gases that contribute to climate change and its negative impacts. Circular economic activities promote climate-proofing and inclusive economic development

Promoting comprehensive primary health care mental health interventions for young people: A Malawi case study
Chikaphupha K, Nanji N, Muhia J: REACH Trust, IWGHSS EQUINET, Harare, 2024

This study in Malawi aimed to assess the experiences of 15–24-year-old youth with regard to mental health problems, to evaluate the management of mental health issues and the responses to the issues they face, as well as to recommend interventions to address young people’s mental health challenges. The study employed a mixed methods approach. The 7% prevalence of depression identified in the study seems low compared to the 11–14% in youth in several other studies in Africa. Challenges identified relating to access to mental health services indicate the need for improved availability and accessibility of mental health services for young people faced with mental health problems. The COVID-19 pandemic further impacted youth by increased losses in education, income, employment and food security, as well as increased gender-based violence and sexual abuse. Based on the findings, recommendations are made on areas of primary health care, community, multisectoral, and youth interventions to better support mental health promotion, mental illness prevention, detection, counselling, care and wider responses for young people in Malawi. Although the sample size was small, these may also be relevant across other countries in sub-Saharan Africa.

Promoting the Three R’s -Reduce, Recycle and Reuse- in waste Management in Kadoma, Zimbabwe
Abdullah Dzinamarira Foundation Trust, Young Men Christian Association, TARSC: EQUINET, Harare, 2024

Waste management is a critical issue facing cities globally, particularly in low-income countries with limited resources. Responding to this challenge, the Abdullah Dzinamarira Foundation (ADF) and Young Men’s Christian Association (YMCA) implemented a comprehensive waste management programme promoting the promote the three Rs - Reduce, Reuse, and Recycle- in Rimuka, a densely populated low-income suburb in Kadoma, Zimbabwe. Waste reduction strategies can be low-cost and high-impact. They call for increased education and awareness on how waste management can create new industries and jobs. This work in Kadoma set up forums and interventions to involve local people and involved stakeholders to build awareness of the opportunities that waste reuse and recycling provides for jobs and inputs to local food and product. The programme generated interventions linking waste recycling to food production, plastic waste collection to incomes and renewal energy to improved urban conditions. Climate change affects health and is creating health inequalities. City efforts to reuse, recycle and reduce contribute to improved health climate change mitigation and adaptation.

The Nairobi Urban Health and Demographic Surveillance System: Bringing community voice and evidence to urban health in slum communities
AB[M]R, TARSC: EQUINET, Harare, 2024

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first African urban health and demographic site surveillance (HDSS) based in a slum. It seeks to address the health and social needs of urban slum dwellers. NUHDSS has generated the information and evidence needed, to strengthen and inform action and change on healthy food systems and green spaces, promoting equity, poverty reduction and climate justice; facilitating the circular economy through reduced use, reuse, and recycling of waste. The NUHDSS data and nested studies were used to assess the impacts of interventions, to inform local and national policy-making and programmes to improve community health locally, in Kenya and in other African countries. As a tool for community voice and to support governance approaches and collective learning, the NUHDSS platform and process has strengthened the voice and involvement of residents of Viwandhani and Korogocho slums in their health and socioeconomic development bringing community voice in a ‘whole of society’ approach that recognizes and engages all stakeholders.

Transforming Mbale City’s urban food system in the Good Food for Cities Programme
Food Rights Alliance, Rikolto, Global Consumer Centre, TARSC: EQUINET, Harare 2024

Rapid urbanisation in Uganda especially in cities like Kampala and Mbale is reshaping the urban food systems, altering demand and introducing food related challenges. Despite the positive aspects of urban development, there is an increase in unregulated activities that lead to unsafe food practices. The Good Food for Cities programme recognizes these challenges as opportunities to establish more sustainable, fair and healthy food systems in Mbale and Kampala. The programme aims to forge coalitions involving businesses, consumers, local authorities and other food system actors to ensure inclusive, resilient and healthy food environments for all citizens. Two crucial mechanisms of the Good Food Council and the Good Food Parliament serve as platforms for consultation, dialogue, accountability and collective decision making. The programme adopts a three-tier intervention strategy of promoting sustainable production, inclusive urban food markets and an enabling environment. These areas give emphasis to regenerative agriculture, and multi stakeholder participation, addressing climate change, and urban inequalities and food insecurity.