From 26-28 April 2012, EQUINET held a regional methods workshop in Cape Town, South Africa. It gathered the lead institutions of country teams in the Equity Watch work, the EQUINET steering committee, regional and international agencies and networks involved in work on health equity. The workshop aimed to: provide training on equity analysis and discuss future approaches to capacity building on equity analysis; review Equity Watch work at country level and the learning and implications from the work for future monitoring of health equity within countries; and review and discuss the draft regional Equity Watch and the follow up and dissemination. Equity Watch presentations were delivered at the meeting for five of the countries in east, central and southern Africa included in the EQUINET network, namely Kenya, Uganda, Zambia, Zimbabwe and Mozambique. Results were mixed from the various countries, indicating success in improved aggregate health in most countries, some closing of rural-urban disparities in health, but widening social and economic inequalities in health and the social determinants of health. Delegates argued that aggregated data obscured inequities in health in the region. They identified decreases in public health spending as a major problem in giving ministries the leverage over other sources of spending on health. They also called for ‘mainstreaming’ health equity into the national and regional health agendas, as well as for the dissemination of the Equity Watch results at country and regional level to all stakeholders, identifying champions who will take Equity Watch forward, putting effective monitoring and evaluation in place to measure progress in health equity in the region, and conducting district-level analysis (so far Equity Watch analysis has been on regional and national levels only). Presentations were also given on various aspects of equity analysis, such as disaggregating health expenditure, analysing the social determinants of health equity and universal health coverage and linking equity analysis to the Millennium Development Goals.
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Convened by EQUINET, in association with the ECSA Health Community and IDRC Canada, a session was held at Forum 2012 in Cape Town on April 25th to present evidence and experience from work carried out in 2010-2012 in five countries - Mozambique, Zambia, Zimbabwe, Uganda, Kenya - and at regional level in East and Southern Africa to assess progress in key areas of equity in health outcomes, in social determinants of health and in redistributive health systems. The session reviewed the learning from the work, particularly in relation to monitoring policy commitments to equity in health, and discuss the opportunities and the challenges for institutionalising and using equity analysis within health policy and planning. The session explored why equity analysis is important for strategic planning and what has been learned from the Equity Watch; what challenges countries face in implementing equity analysis and what opportunities exist for linking equity analysis to processes within the health system; and recommendations from the work for institutionalizing equity analysis across different sectors of government and with other actors. A concluding PechaKucha (20 images in 20 seconds each) flagged the key messages and continuing debates in taking equity monitoring and analysis from research to institutional practice in health and health systems. A regional meeting to have deeper dialogue on the national and regional Equity Watch work was held after the forum and the report will be made available through the June newsletter and EQUINET website.
The Ministry of Health and Child Welfare and Training and Research Support Centre with EQUINET hosted a one day meeting in February in Harare to report on and review the findings of the 2011 Zimbabwe Equity Watch; to involve health and non health sector actors in identifying priorities and actions to strengthen equity in universal health coverage and action on the social determinants of health; and to propose how to institutionalise health equity monitoring. The meeting involved 52 delegates from different sectors of government, parliament, civil society, private sector, technical institutions and international organisations. The meeting identified a number of recommendations and areas of follow up action flowing from the discussions on the Equity Watch report and the presentations in the plenary and parallel sessions that are presented in the report. Stakeholders endorsed equity as a guiding principle for universal health coverage, as well as health in all policies and made proposals for short and medium term steps to work towards equity in universal health coverage. They called for strengthened consistent co-ordination of the institutions and agencies that influence the determinants of health and delivery on universal health coverage. It was proposed that the Equity Watch be institutionalised and repeated in future with the involvement of other sectors, with indicators also identified for annual monitoring in the routine information system. Specific additional areas for equity analysis were identified.
This call is for applicants for grants for policy research into global health diplomacy , and particularly in relation to the manner in which African interests around equitable health systems are being advanced through health diplomacy. Applicants are invited to indicate their capacities and proposals for implementing the work in ONE of the three areas below
1. On the reflection of African interests and issues around equitable health systems in the stages of motivating, negotiating, implementing, monitoring and reporting of the WHO Code on international Recruitment of health personnel;
2. On collaborations on access to essential drugs through south- south relationships with China, Brazil and India, particularly in relation to medicines production, distribution and regulation across countries within the ESA region, the alignment with and outcomes for national health systems, regional and global health diplomacy processes and the lessons learned for health diplomacy.
3. On the involvement of African actors in global health governance, particularly in relation to the participation, issues raised, outcomes and thus influence of African state and non-state actors on the decision making processes in the WHO and Global Fund, particularly on universal access to prevention, treatment and care for HIV and AIDS, and the lessons for health diplomacy.
This report was commissioned by EQUINET to look at the characteristics and extent of private sector involvement in health financing and provision in East and Southern African countries. It synthesises available information on the private health sector in the following ESA countries: Angola, Botswana, the Democratic Republic of the Congo (DRC), Kenya, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, the United Republic of Tanzania, Uganda, Zambia and Zimbabwe. For each country the core health financing issues, including available NHA data, are briefly discussed. As external financial resources play a key role in the funding of private sector initiatives (both for-profit and not-for-profit), the extent of external funding is also considered. Thereafter, an overview is provided of the presence (or not) of private health insurance, and different types of private providers. A trend observed in this review is the expansion of South African private health care organisations into other African countries.
The Ministry of Health and Child Welfare and Training and Research Support Centre/ EQUINET hosted a one day meeting on Thursday 23rd February in Harare to report on and review the findings of the 2011 Zimbabwe Equity Watch; involve health and non health sector actors in identifying priorities and actions to strengthen equity in universal health coverage and action on the social determinants of health; and propose how to institutionalise health equity monitoring. The meeting involved 52 delegates from different sectors of government, parliament, civil society, private sector, technical institutions and international organisations. The meeting identified a number of recommendations and areas of follow up action flowing from the discussions on the Equity Watch report and the presentations in the plenary and parallel sessions that are presented in the report. Stakeholders endorsed equity as a guiding principle for UHC, as well as health in all policies. They called for strengthened consistent co-ordination of the institutions and agencies that influence the determinants of health and delivery on UHC. It was proposed that the Equity Watch be institutionalized and repeated in future with the involvement of other sectors, with indicators also identified for annual monitoring in the routine information system. Specific additional areas for equity analysis were identified.
This call is for applicants for grants for policy research into global health diplomacy, and particularly in relation to the manner in which African interests around equitable health systems are being advanced through health diplomacy. Applicants are invited to indicate their capacities and proposals for implementing the work in ONE of the three areas:
1. On the reflection of African interests and issues around equitable health systems in the stages of motivating, negotiating, implementing, monitoring and reporting of the WHO Code on international Recruitment of health personnel.
2. On collaborations on access to essential drugs through south- south relationships with China, Brazil and India, particularly in relation to medicines production, distribution and regulation across countries within the ESA region, the alignment with and outcomes for national health systems, regional and global health diplomacy processes and the lessons learned for health diplomacy.
3. On the involvement of African actors in global health governance, particularly in relation to the participation, issues raised, outcomes and thus influence of African state and non-state actors on the decision making processes in the WHO and Global Fund, particularly on universal access to prevention, treatment and care for HIV and AIDS, and the lessons for health diplomacy.
Visit the website for information on the work, the grant call and the necessary information to include in the applications.
The Equity Watch monitors progress in areas of equity in health, household access to the resources for health, equitable health systems and global justice. This report provides evidence on the performance of Kenya's public policies and systems in promoting and attaining equity in health using the Equity Watch framework. The evidence presented in this report indicates progress towards closing geographical, rural–urban, wealth and other social disparities in some health outcomes, such as in immunisation coverage, access to primary education, contraceptive use, access to antiretrovirals and access to safe sanitation. Nevertheless, other areas are reported on that have made less progress or now have wider differentials. The report suggests that the health care system cannot make progress on its own. It will be difficult to achieve health equity unless we also address the social and economic determinants of health. However the health sector does also play a role. For example, the report shows the progress made in areas where health workers have been capacitated suggesting that the role health workers play in health equity needs more attention and support.
The Health Economics Unit (University of Cape Town, South Africa) has a new Facebook page. The Unit conducts research in health economics, health policy & health systems, offers Master's and PhD training and facilitates regional and international academic and policy networking. The Unit is particularly interested in using their research to influence health policy and practice. You can follow the Unit on Facebook to see their regular updates, post on their wall and communicate with them about health care issues.
The World Health Organisation (WHO) Global Code of practice on the international recruitment of health personnel was adopted by the 63rd World Health Assembly in May 2010 in response to the intensifying movement of health workers, especially from low to high income countries. This movement of health workers aggravates inequity, particularly with regard to the number of health workers relative to health need. The WHO Code is a voluntary ethical framework. This policy brief looks at the developments in Sub-Saharan Africa since the adoption of this code with regards to its implementation. It presents the activities required to monitor its implementation and what actions have so far been implemented.