EQUINET in co-operation with ECSA-HC have, with government and researchers in five countries, carried out review and field studies on the implementation of incentives for health worker retention and of their impact on the adequacy and distribution of health workers. A regional meeting will be held in February 2009 to review this work and other work on health worker migration and distribution in EQUINET in Windhoek Namibia, locally hosted by the University of Namibia. If you are interested in this meeting please contact us at admin@equinetafrica.org, using "HCW Retention meeting" in the subject line.
Latest Equinet Updates
Regional review meeting on Health Worker Retention, Namibia, 25-27 February 2009
Report of the discussion on the Zimbabwe equity analysis and the Zimbabwe launch of the Regional analysis of equity in health in east and southern Africa: Promoting health equity in Zimbabwe
Training and Research Support Centre (TARSC), Community Working Group on Health (CWGH), Regional Network for Equity in Health in East and Southern Africa (EQUINET) (2008)
This meeting provided an opportunity for discussion of evidence in the draft Zimbabwe equity watch from the perspective of people from community and primary health care levels of the health system. Evidence in the Zimbabwe equity analysis provided input to civil society plans within the CWGH and to the resolutions from the CWGH meeting. The discussion on the Zimbabwe equity analysis was a build up to the launch of the book ‘Reclaiming resources for health: A regional analysis for equity in Health in East and Southern Africa’. The event was attended by more than hundred people from Parliament (MPs), Ministry of Health, Ministry of education, academics, representatives from the Health Service Board, private sector, civil society, health worker unions, labour movement, and delegates from the region (Uganda, Malawi, South Africa).
Discussion Paper 66: Key issues in equitable health care financing in East and Southern Africa
McIntyre D, Govender V, Buregyeya E, Chitama D, Kataika E, Kyomugisha E, Kyomuhangi R, Mbeeli T, Mpofu A, Nzenze S, Walimbwa A, Chitah B: Health Economics Unit (UCT) and EQUINET
This report provides an overview of the status of health care financing in seven East and Southern African (ESA) countries (Malawi, Namibia, South Africa, Tanzania, Uganda, Zambia, Zimbabwe). It draws on country case-studies and a collaborative cross-country analysis undertaken at an EQUINET workshop. Health care financing issues are considered through an equity lens, with a focus on revenue collection, pooling of funds and purchasing. There remains a heavy dependency on donor funding in several countries. While debt relief initiatives are translating into increased government funding for health care in some countries, in other countries, the health sector has not benefited much from reduced debt servicing. Due to high levels of out-of-pocket payments in many ESA countries and a heavy emphasis in the tax system on VAT, individual households carry a heavy burden. Health insurance is growing in popularity, particularly community-based health insurance which has placed the financing burden on relatively poor rural communities and those living in informal urban areas. All the countries under review have poor fund pooling with little in the way of risk equalisation mechanisms, which severely limits the potential for income and risk cross-subsidies. To achieve equitable health care financing it is necessary to: eliminate, or at least reduce out-of-pocket payments; increase the funding of health services from tax revenue; and introduce mechanisms to integrate all forms of pre-payment (i.e. tax funding and health insurance).
Eight more weeks for submission of abstracts for the EQUINET conference
Abstract submission closes January 30 2009
All abstracts for the EQUINET conference must be submitted on or before January 30 2009. The Third EQUINET Regional Conference on Equity in Health in east and southern Africa will be held at Speke Conference Centre, Munyonyo, Kampala, Uganda September 23rd -25th 2009. The conference theme is 'Reclaiming the Resources for Health: Building Universal People Centred Health Systems in East and Southern Africa'.
The themes are listed in the EQUINEt website. Sessions will be 2-3 hours in length and interactive in nature. Presenters may be asked to present verbally, using Power-oint, or using a visual presentation of a paper using charts, photos, drawings and/or text mounted on a poster board. The sessions will include brief summary presentations of the accepted abstracts on the theme and aim to give adequate time for full facilitated discussions of work and the issues raised. The Abstract submission form and registration form can be downloaded at the conference website.
Abstracts are a maximum of 400 words and typed at MS Word documents in Arial 11pt font. The title should be no more than 50 characters including punctuation, but long enough to identify the nature of the study. Ensure the abstract provides information on the findings. Accepted abstracts will appear in print in a bound abstract book distributed at the conference, and may also be posted on the conference web site.
Reclamando os recursos para Saude uma Analise regional da Equidade na Saude na Africa Oriental e Austral: Introducao & Sumario Executivo
A Rede de Actividade Regional para Equidade na Saúde na Africa Oriental e Austral (EQUINET): 2008
Temos o conhecimento, habilidade, e experiência de superar desigualidades persistentes na saúde na Africa Oriental e Austral. Esta análise providencia uma mensagem inspiradora e emposada, explorando vários aspectos da saúde e sistemas da saúde e fornecendo muitos exemplos de boa prática na região. A evidência dentro desta análise aponta para três formas em quais reclamando os recursos para a saúde pode melhorar a equidade da saúde. Estas são: para as pessoas pobres reclamar uma divisão mais justa dos recursos nacionais a fim de melhorar a sua saúde; para um regresso mais justo para Africa Oriental e Austral da economia global a fim de aumentar os recursos para a saúde; e para uma divisão mais ampla dos recursos nacionais e globais para serem investidos nos sistemas redistribuitivos da saúde a fim de superar os efeitos empobrecidos da má-saúde. Embora a imagem de saúde da Africa Oriental e Austral está actualmente triste, com taxas altas de mortalidade, baixa esperança da vida e cargas altas de subalimentação, HIV e SIDA, tuberculose (TB) e malaria, a mensagem que emerge deste livro é uma de esperança e reconhecimento das nossas forças e possibilidades para acções.
Regional Meeting of Parliamentary Committees on Health in East and Southern Africa: Health Equity and Primary Health Care: Responding to the Challenges and Opportunities
PPD ARO, EQUINET, APHRC, SEAPACOH, UNFPA, Venture strategies, DSW: 2008
This report presents the proceedings and debates at a meeting, held in Munyonyo Uganda September 16-18 2008, of parliamentary committees responsible for health from twelve countries in East and Southern Africa, with technical, government and civil society and regional partners. The meeting reviewed the health equity situation in the region in relation to regional goals (e.g. Maputo Plan of Action, Abuja Declaration) as well as international frameworks (e.g. ICPD PoA, and the MDGs). Various areas of parliamentary work were reviewed in relationto health equity and primary health care: from a budget and policy oversight lens, the meeting reviewed AIDS and sexual and reproductive health policies and commodity security, and the laws and budgets for this. The meeting explored options for fair and adequate health care financing and for promoting equitable resource allocation, particularly in relation to budget processes. The legal rolesof parliament were discussed in relation to the application of international and regional treaties and conventions on the right to health; and the measures to promote health in patenting laws and the EPA negotiations and more generally in trade agreements. the meeting also explored developments in primary health care and social empowerment in health. The report presents the resolutions of the meeting and and the proposals made to strengthen SEAPACOH regional networking and organisation.
Séries Politicas 19: Será que estamos a fazer progressso em alocar equitativamente os recursos da saúde do governo na Africa Oriental e Austral?
McIntyre D, Chitah M, Mabandi L, Masiye F, Mbeeli T, Shamu S: 2008
Os diferentes distritos, regiões e províncias num país têm diferentes necessidades de saúde e recursos disponíveis dos cuidados da saúde. Os fundos do governo justamentamente distribuídos para a saúde assim chamam para uma formula que calcula a divisão dos recursos totais para seremalocados para áreas baseadas sobre indicadores da necessidade relativa para cuidados da saúde naquela área. Muitos países na região usam tais formulários. Eles usam diferentes indicadores da necessidade de saúde, incluindo a capacidade populacional e a sua composição, os níveis da pobreza, doenças específicas e mortalidade. Revelando experiência em certos países selecionadodentro da região, esta breve política sugere que os países podem fortalecer uma alocação equitativa dos recursos para a saúde através de aumentar a cota global do financiamento do governo alocada ao sector da saúde, trazendo ajuda externa e o financiamento do governo num só conjunto de fundose aloca-los atraves dum mecanismo simples. Alocação de recursos equitativos chama para os governos estabelecer alvos anuais para alocação equitativa destes fundos públicos, e colecionainformação para monitorar e reportar sobre progresso em alcançar estes alvos, incluindo parliamentos e sociedade civil. Alocação de recursos é um processo politizado e requer umcuidadosa, incluindo, planificar, oraganizar e providencia de incentivos para a re-distribuição do pessoal de cuidados da saúde para áreas onde a necessidade da saúde é alta.
Séries Politicas 20: Alcançando a a promess: O progresso sobre o compromisso da Abuja de 15% dos fundos do governo para a saúde
McIntyre D, Loewenson R, Govender V: 2008
No ano 2001, em Abuja na Nigeria, os Chefes dos estados membros da União Africana comprometeram para alocar ao menos 15% de orçamentos dos governos para seus sectores da saúde. Ao mesmo tempo chamaram os países doadores para complementar seus esforços a fim de mobilizar domesticamente os recursos através de cumprirem o seu compromisso de dedicar 0.7% do seu PBN como AOD para os países em via de desenvolvimento e cancelar a dívida externa da Afica em favor Do aumento de investimento no sector social. O alvo de Abuja, assim, consiste de três componentes; os países Africanos deveriam: mobilizar os recursos domésticos para a saúde (15% agora); estar não sobre-carregado pela prestação de contas do débito (Cancelamento de Débito agora); e ser apoiada pela AOD (0.7% PBN agora).
Workshop report: Protecting health and equitable health services in the Economic Partnership Agreements in east and southern Africa, 18 and 18 September 2008, Munyonyo, Uganda
Southern and Eastern African Trade Information and Negotiations Institute (SEATINI); Training and Research Support Centre (TARSC), 2008
This workshop brought together civil society, parliamentarians, human rights commissions, trade and health ministries officials to review and deliberate on protection of health and access to health care services in the ongoing EPA negotiations, and particularly in the services negotiations. The meeting updated on current health and trade issues, including patenting laws and the EPA negotiations and more generally legal frameworks for ensuring protection of public health in trade agreements. Delegates reviewed a technical analysis report on the services negotiations in the Economic Partnership Agreements and developed positions to be advanced for the protection of public health in trade agreements and specifically negotiating positions on the services negotiations.
A focus on Primary Health Care
EQUINET Steering Committee
The last two issues of EQUINET news have given focus to Primary Health Care (PHC), noting the thirty year anniversay of the Alma Ata declaration on PHC in 1978. The PHC philosophy recognises the need to tackle the broader social and political determinants of health, and involves wide-ranging action to promote health equity. It is focused on improving population health and generating health equity; on inter-sectoral action to address other social determinants of health and is based on social empowerment and comprehensive, integrated and appropriate health care, that emphasises health promotion and prevention and assures first contact care. EQUINET thus sees PHC oriented health systems as a basis for improving equity in health and in access to health services. This month we are making available on our website in electronic form our book "Reclaiming the Resources for Health", a resource that gives the argument for people centred, PHC oriented health systems in east and southern Africa. We report on the resolutions of an important meeting of parliaments health in east and southern Africa held in September 2008 on health equity and PHC, and we present new evidence gathered and methods for advancing PHC oriented health systems. We also present two editorials from our joint issue with Pambazuka news on PHC: Thirty years on. We invite comment and input on PHC in east and southern Africa to admin@equinetafrica.org!