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.
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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.
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.
The research was located in Cape Town, South Africa where the need for equity policies to be implemented is great. However ongoing restructuring and change lead to fatigue in the management and staff of the primary health services. Their resistance could block the implementation of equitable staffing plans. It is necessary to understand the management and workplace factors leading to potential resistance of equitable staffing plans and thus these were explored. A policy analysis approach using a case study analysis was sought to provide understandings, approaches and tools to illuminate the processes involved in health policy.
The workshop on Protecting Health in Trade Agreements held in Malawi in June 2006 aimed to build capacities in state, legislative and civil society institutions to understand, analyse and promote public sector equity-oriented health systems within trade and investment policies and agreements. The course aim to enable participants to carry out assessments nationally of the key trade and investment agreements that impact on health and to identify options for promoting public sector equity-oriented health systems within current trade and investment policies and agreements.
The work presented in this policy brief was prompted by a request from the Zambian parliamentary committee on Health, Community Welfare and Social Development. The parliamentarians had wanted to know why despite all the funding to the health sector, there were no ‘visible’ gains to speak of from the on-going health reforms.
Human resources for health have become a topical issue at local, regional and global levels. In Namibia health worker mobility remains a concern for those in human resources planning. Achieving equity in this area needs a concerted effort from all sectors involved. However little is understood about the role that conditions of service play in influencing health professional mobility in Namibia. The study set out to explore and describe the influence of conditions of service on the movement and retention of the health professionals in Namibia. It is a qualitative study targeting mainly professional nurses, doctors, social workers and health inspectors at both operational and managerial levels, in public and private sectors.
his study explored the possibility of joint health worker and community activism at a primary care level in South Africa, and the human resource requirements needed for the effective treatment and care of HIV/AIDS within the public health service. The study used participatory approaches and involved five SAMWU shop stewards in the design, data collection and analysis of the research. The study was implemented between October and November 2005 in five primary health care (PHC) clinics in the Western Cape, Free State and KwaZulu Natal. Twenty-four health workers (fifteen of which were interviewed in depth) and eighteen health committee members were interviewed across the five different sites using a semi-structured interview guide.
EQUINET is part of a consortium that was appointed in September 2005 to co-ordinate the Health Systems Knowledge Network of the WHO Commission on the Social Determinants of Health. The Centre for Health Policy in South Africa has been appointed as the hub of the Knowledge Network on Health systems. The Commission is a global strategic mechanism to improve equity in health through action on the social determinants of health at global, regional and country level. This outline briefly describes the function and key areas of work of the Health Systems Knowledge Network, exploring the important role that health systems can play in reducing social differentials in health.
Malawi, like many southern African countries, is facing a critical human resources for health (HRH) crisis, preventing it from delivering acceptable quality health care services to its population. The reasons underlying the shortage of health professionals are multiple and include limited output from training institutions, high attrition rates resulting from migration and disease, and increased workloads because of HIV and AIDS. Despite the increasing levels of migration of health professionals from Malawi which have caught international attention, many continue to serve their country. The challenges encountered by these health workers (which may eventually become push factors), and the coping or survival strategies that they utilise deserve attention if any meaningful solutions to retain health professionals in Malawi are to be developed.