Training and Research Support Centre (TARSC) as cluster lead of the “Equity Watch” work in EQUINET implemented a multi-methods approach to gather and analyse diverse forms of evidence and experience on inequalities in health and its determinants within urban areas. We explored current and possible responses to these urban conditions, from the health sector and the health promoting interventions of other sectors and of communities. We aimed to build a holistic understanding of the social distribution of health in urban areas and the distribution of opportunities for and practices promoting health and wellbeing from different perspectives and disciplines. We worked with Harare and Lusaka youth, the Civic Forum on Human Development and Lusaka District Health Office for the participatory validation This brief, the fifth in the series on urban health, reports on the combined findings and their implications for improving equity in urban health and wellbeing.
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This case study is produced by the Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN), working with Charles Dulo as a contributor, in the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). This Paper’s objective is to answer the question, “What difference have constitutional rights to health made in practice and what have been the issues affecting the capacity to claim and deliver on the rights in Kenya?” It is a follow up on the results of work on the right to health that highlighted a need to do further studies in countries that do not have expressed provision on the rights to health. It is a desk review of literature that explores the historical background on the right to health before the current constitution that was promulgated in 2010. This is followed by a review of the legislative framework after 2010 and jurisprudence on the right health, and concludes by highlighting key challenges in the realization of the right to health in Kenya.
TARSC as cluster lead of the “Equity Watch” work in EQUINET has been exploring these questions in east and southern African (ESA) countries, gathering diverse forms of evidence from literature review, analysis of quantitative data, internet searches on practices and a participatory validation amongst different social groups of youth in Harare and Lusaka. In Harare, TARSC worked with Civic Forum on Human Development (CFHD) and youth living in low density, medium income suburbs; in formal employment; in tertiary education; unemployed youth; youth in informal employment and in informal settlements. Briefs and reports capturing some of this work are available on the EQUINET website. This report compiles in one document the several rounds of participatory review and validation carried out in Harare with young people from low density, medium income suburbs; youth in formal employment; youth in tertiary education; unemployed youth; youth in informal employment and youth in informal settlements on their perceptions of health and wellbeing, the drivers of wellbeing in their areas, the approaches and practices that are and could be implemented to improve their wellbeing and the implications for urban services, including for health systems.
This review paper examines the extent to which the core, public health capacities developed for the 2005 International Health Regulations (IHR) are also being applied in a manner that supports health systems strengthening (HSS). Produced under the Regional Network for Equity in Health in East and Southern Africa (EQUINET), the paper reviews evidence on the IHR 2005 design, capacities and implementation on HSS in east and southern African countries, particularly in relation to: a. Capacities of community health and primary-level health personnel and service capacities, including health information systems to this level; b. Public health system capacities and functioning relevant to food safety; and c. Ensuring laboratory and pharmaceutical personnel capacities. The paper explores the synergies and opportunities being generated, or not, between investments in IHR implementations and these three areas of HSS in the 16 ESA countries covered by EQUINET. It identifies key weaknesses and challenges and highlights case studies of good practice within the region.
New resources have been added to the Participatory Action Research Portal. The portal has resources on Participatory Action Research (PAR) with a growing number of resources on PAR related to training courses, training guides and reports of training activities; methods, tools and ethics; PAR work and journal publications on PAR. The portal is a resource for all those working with PAR and includes resources in any language. There is a form for people to send videos, photojournalism, organisations, journal papers, training guides and other resources for the portal. The url link shown here is in English but there is also a Spanish version at http://www.equinetafrica.org/content/portal-de-recursos-para-la-investigaci%C3%B3n-acci%C3%B3n-participativa-iap
This case study is produced by the Centre for Human Rights and Development (CEHURD) in the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). It examines how the right to health is enforced in Uganda, how it was implemented, and how health rights advocates have suggested the provision be constitutionally interpreted. It is a follow up on the results of work on the right to health that highlighted a need to do further studies in countries that do not have expressed provision on the rights to health. While the right to health is yet to be explicitly incorporated in the Ugandan constitution, the case study points to a number of ways to implement it within judicial, political and popular measures. Several issues merit future attention to support this, including: developing increased measures and capacities for accountability; integrating a rights based approach in a multi-sectoral response; ensuring adequate resources to the health system; strengthening judicial understanding and implementation of health rights; and strengthening issue based civil society groups and processes that are focused on advancing the right to health with the intention to realize positive public and policy outcomes.
This literature review, implemented within an EQUINET programme of theme work on health workers at the University of Limpopo, presents published evidence on the recruitment and retention of skilled healthcare workers in rural areas of east and southern Africa. It reviewed published documents in English with a focus on east and southern Africa from 2000-2017. From the literature reviewed the following strategies emerged as key for health worker retention: Education and training of healthcare workers; review of regulations and policies regarding provision of healthcare services in rural areas; provision of financial incentives; and personnel and professional support of healthcare workers. The report identified strategies relating to: Reviewing admission policies and criteria for health worker education; including rural practice issues and skills in health worker training and exposing students to rural areas during training; improving access to continuing professional development (CPD) in rural areas; ensuring that compulsory measures are accompanied by relevant support and incentives; ensuring that mitigatory strategies such as task shifting are not ‘task dumping’, do not replace more substantive solutions and that they are accompanied by suitable regulatory systems, training and management support; using financial and non-financial incentives to address issues prioritised by health workers, in a way that does not motivate some while demotivating others, and not as a substitute for a more substantive review of working conditions of healthcare workers and strategies to reduce the disparities in salaries between different health professionals; and improving health worker management and support, and the skills of HRH managers.
In 2015-2018, CEHURD, under the Regional Network for Equity in Health in East and Southern Africa (EQUINET) conducted a desk review of the implementation of constitutional provisions on the right to health in east and southern Africa. The objective of the workshop was to introduce the OPERA framework in the region, using evidence from Uganda. It aimed to 1. identify the main bottlenecks in implementing the right to health; 2. devise a common advocacy strategy that aims at removing the bottlenecks;. and 3 explore opportunities for applying this within the region. The workshop built on the previous validation of the Ugandan draft report on constitutional implementation of the right to health.
This critical assessment of different health financing options in east and southern African countries is being commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET) through and in collaboration with key regional partners. It aims to inform policy makers on the positive and negative implications and issues to consider in applying the different domestic public health financing options current being explored, advocated and implemented in east and southern Africa - including mandatory national health insurance; social health insurance, community based health insurance, voluntary insurance, earmarked taxes, wealth taxes, other direct/ indirect taxes and other sources. Read more at the link shown.
TARSC as cluster lead of the “Equity Watch” work in EQUINET has been exploring urban health in east and southern African (ESA) countries, gathering diverse forms of evidence from literature review, analysis of quantitative data, internet searches on practices and a participatory validation amongst different social groups of youth. Lusaka District Health Authority (LDHO) has a history of over a decade of using participatory reflection and action (PRA) approaches to strengthen health literacy, working with TARSC and other organisations in EQUINET. In 2018, TARSC and LDHO colleagues involved with the Zambian health literacy programme identified that it would be important to explore the views of youth in the city on their health and wellbeing to better integrate this group within the health literacy programme. Involving Lusaka youth in a similar process as in Harare of identifying their experiences, perceptions and proposals on health and wellbeing added further grounded evidence in the work in EQUINET. Further, the Harare youth were interested in sharing experience with youth in Lusaka. A two day participatory process was thus held with young people from various social settings in Lusaka on 26-27 June 2018 hosted by LDHO and TARSC, with the objectives to: a. Hear from different groups of Lusaka urban youth their perceptions and experiences on urban health and wellbeing. b. Facilitate exchanges between Lusaka and Harare youth on urban health and wellbeing, and identify their similar and different experiences and priorities. c. Identify what implications the information gathered have for urban health literacy and urban primary health care, and share this with relevant authorities involved in health and wellbeing of urban youth in Lusaka. This report presents the proceedings of the meeting.