Latest Equinet Updates

Call for participants: Second regional training Workshop on participatory methods for research and training for a people centred health system
The call closes on 15 December 2006.

This call invites applicants to participate and share experiences in a Regional Training Workshop for east and southern African countries on Participatory Methods for research and training for a people centred health system being held on 14-17 February 2007. TARSC and IHRDC under the EQUINET umbrella and with support from CHESSORE are carrying out capacity building on participatory reflection and action (PRA) methods for research and training for a people centred health system. The training aims to support work at national, district and local level with health systems and communities in health, with a major focus on the interactions at primary health care level. The 2007 training will focus on the relations between communities and frontline health workers. It will thus be targeted at researchers, health workers, academics, civil society organisations, NGOs, community leaders and workers and others who are involved in work with communities and health workers who are doing or involved in work on strengthening positive community - health worker interaction. Please see www.equinetafrica.org/meetings.php or send queries through admin@equinetafrica.org.

Further details: /newsletter/id/31839
Parliament briefing 1: Equity in access to AIDS treatment through stronger health systems
EQUINET; REACH Trust (Malawi); TARSC (Zimbabwe); the Association of Parliamentary Committees on Health in east and southern Africa (SEAPACOH)

Parliaments play an important role in health. Generally and through their specialised committees they can scrutinise public spending to ensure that it meets national policy goals, debate and pass laws that institutionalise social goals and provide leadership, representation and space for public participation in health. Parliaments can also provide oversight of the executive in terms of how this arm of government is implementing national policy. This brief is the first in a series jointly produced be EQUINET and SEAPACOH with institutions in the EQUINET network. This brief explores how these parliamentary roles can be applied to strengthen equitable health systems responses to AIDS. Copies of the leaflet and a feedback form on it can be obtained from the EQUINET secretariat at admin@equinetafrica.org.

Parliament briefing 2: Fair financing for health
EQUINET; Health Economics Unit (UCT); Centre for Health Policy (Wits); Association of Parliamentary Committes in east and southern Africa (SEAPACOH)

Parliaments play an important role in health. Generally and through their specialised committees, they can scrutinise and ensure that national budgets meet national policy goals, debate and pass laws that institutionalise social goals and provide leadership, representation and space for public participation in health. Parliaments can also provide oversight of the executive in terms of how this arm of government is implementing national policy. This brief is the second in a series jointly produced be EQUINET and SEAPACOH with institutions in the EQUINET network. It explores how these parliamentary roles can be applied to strengthen the fair financing of health systems. Copies of the leaflet and a feedback form on it can be obtained from the EQUINET secretariat at admin@equinetafrica.org.

PRA project report: Reproductive health challenges of students, lecturers, administration and college communities in the agricultural training institutions in Zimbabwe
Students and Youths Working on Reproductive Health Action Team (SAYWHAT)

In Zimbabwe, there are four categories of state owned tertiary institutions: universities, teachers colleges, polytechnic colleges and agricultural colleges. All institutions are either in urban or semi-urban areas, except for agricultural colleges, which are mostly located in farming communities due to the nature of their studies and are governed by the Ministry of Lands and Agriculture instead of the traditional Ministry of Tertiary and Higher Education. Such discrepancies have led to the ‘isolation’ of the students attending these institutions especially in matters concerning the students’ health. In particular there has been inadequate effort to address the reproductive health challenges of the students in these institutions despite their sexually active and high risk age group, including for risk of HIV infection. Students and Youths Working on Reproductive Health Action Team (SAYWHAT) a civil society organization in Zimbabwe, used the Participatory Reflective and Action (PRA) methodology as the starting point to involve the agricultural colleges in addressing reproductive health challenges.

PRA project report: Strengthening community–Health Centre partnership and accountability in Zambia
Equity Guage (Zambia)

The Zambia Participatory Reflection and Action (PRA) project was implemented to strengthen communication between primary care level health workers and communities in one urban and one rural area of Zambia. It was implemented following PRA training in EQUINET as a pilot of the PRA method. The work has has shown that the PRA method is useful to strengthen health worker - community interactions in health planning and is replicable in other health centres of Zambia operating under district health management teams. The PRA method was found through pre- and post intervention assessment to improve communication and interaction between community members and health providers in attaining a people-centred health system in resource limited settings such as Zambia.

Update on the programme of work on health worker migration and retention in east and southern Africa

EQUINET through Health Systems Trust, University of Namibia and its secretariat at Training and Research Support Centre, in co-operation with the Regional Health Secretariat for east, central and southern Africa, is implementing in east and southern Africa research, capacity building and programme support for the retention of health workers and for management of out- migration of health personnel. The programme will support empirical research on the costs and benefits of health worker migration within and beyond east and southern Africa (ESA); and will support evaluation of the effectiveness of current policies and agreements to manage these costs and benefits. The University of Namibia is now co-ordinating the work on HRH retention and Health Systems Trust the work on HRH migration, in co-operation with EQUINET Secretariat (TARSC) and ECSA Regional Health Secretariat. For further information on the programme please contact EQUINET (admin@equinetafrica.org) and ECSA (regsec@crhcs.or.tz).

Further details: /newsletter/id/31840
A PRA project report: Raising our voice, breaking our silence: Health workers’ experiences and needs around Occupational Health Services in Cape Town, South Africa
Industrial Health Research Group (IHRG), June 2006

This Participatory, Reflection, and Action (PRA) project on occupational health services offered an opportunity for IHRG and a group of unionised health workers to use innovative learning and research methodologies as a means to investigate and intervene in their experiences of workplace injury and illness. Following IHRG’s participation in a regional training workshop hosted by EQUINET with TARSC and Ifakara, IHRG used selected PRA tools in a participatory action research programme. The project consisted of three workshops, workplace-based investigations, and the dissemination of networking resources among the participants. The combination of workplace-based case investigations and the process of critically reflecting on these interventions provided a very powerful action-learning experience. Processes of change were evident even in this short term project. Participants’ workplace investigations uncovered real cases of workplace injury and illness that have been buried under a culture of ignorance, neglect, silence, and denial of workers’ health and safety rights.

Discussion paper 39: Community voice and role in district health systems in east and southern Africa: A literature review
Báez C, Barron P: EQUINET

This study is a review of the literature and secondary evidence on community participation in central, eastern and southern Africa. It focuses in particular on South Africa, Mozambique, Malawi, Zambia and Kenya, and presents and analyses evidence of the current situation with regard to the role of districts in promoting community participation and articulating community voice. This includes looking at how: • community voice and roles at district level are structured and integrated into planning; • the way districts carry out their functions enables or blocks participation; • districts articulate and represent community interests at national level; and • wider contexts and processes at national and district levels influence and explain these outcomes. The purpose of the review is to identify examples of enabling and blocking mechanisms for community participation at district level and to provide pointers for further research.

Report of a research workshop: The role of health systems in food sovereignty and nutrition
EQUINET, Medical Research Council, University of the Western Cape: 2006

The EQUINET and MRC meeting on Food Security and Nutrition in east and southern Africa sought to bring together case study writers and expert facilitators that have been working on nutrition initiatives, policies, and to update them on the prevailing situation, current interventions, equity and policies on food security. The meeting took a focus on how health systems can advance and encourage food sovereignty, including community control and enhanced gender equity in food production. The meeting established the framework for a series of case studies that demonstrate and examine health system approaches to food sovereignty that will be implemented in 2006.

A PRA research report: Creating nurse student awareness on community knowledge on health in “Ontevrede” (unsatisfied) informal settlement, Namibia
University of Namibia, Ontevrede Community

The nursing curriculum of the University of Namibia is based on Primary health care approach. However nursing students do not have the skills for a participatory approach to communities and perceive that communities do not know or need to be consulted on their health needs. Communication breakdown between communities and nurses is not in the interest of either. This study aimed to create awareness among the student nurses to help them view the communities as partners in health, and at the same time to empower the communities to be more responsible for own health.

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