Commissioned by the World Health Organization (Department of Ethics, Equity, Trade and Human Rights - Social Determinants of Health) and the Regional Network for Equity in Health in East and Southern Africa (EQUINET) through REACH Trust and Training and Research Support Centre (TARSC) – 2010. “….Barriers that prevent access to antiretroviral treatment services (ART) are often socially determined. Using the Tanahashi model of health service coverage and by identifying areas of health systems and programs where action needs to be strengthened to improve equity, this publication proposes a set of potential indicators to monitor equity in access to ART. Monitoring equity in access helps decision-makers to reach people frequently excluded from treatment and facilitates efforts to overcome barriers by addressing their social determinants, within and beyond the health system. This jointly prepared publication follows up previous WHO work that explores the barriers and social determinants that impact on specific health conditions presented in the book "Equity, social determinants and public health programmes" (2010). It also builds on over 8 years of policy dialogue and research in east and southern Africa in EQUINET on equity in health, with a particular focus on HIV and AIDS. The rationale, concepts and indicators included in this publication can be further refined and adapted in the future to measure equity in access to health services or to other public health programs (e.g. TB, non-communicable diseases).
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A report released by HEPS Uganda and partner organisations in the Uganda Health Equity Network (UHEN) entitled ‘Right to Health: A Civil Society Perspective on the 12th Annual Report of the Uganda Human Rights Commission’, has criticised Uganda Human Rights Commission (UHRC) for taking a narrow approach in reporting on the status of the Right to Health in Uganda. Noting that the report is a key tool and an opportunity to inform Parliament on the state of the Right to Health in Uganda, the civil society organisations are concerned that the Uganda Human Rights Commission’s silence on the key determinants of health and the country’s emerging public health challenges suggests that it is not doing enough to fulfil its mandate of promoting and monitoring human rights in the country. The HEPS/UHEN report, analysing the Commission’s most recent report to Parliament, points out that UHRC’s report inexplicably does not report the impact on health of trade, the proposed health insurance scheme, climate change, urbanisation, environmental degradation and similar socioeconomic determinants of health.
The course brought together senior officers from the health and related sectors in the East, Central and Sothern Africa-Health Community region (ECSA-HC). The need to build capacity and create strategic leadership in global health diplomacy is clearly manifest in the performance of the regional delegations in regional and global fora. The purpose of the course is to introduce, provide an overview and share information on Global Health Diplomacy, discuss key issues and challenges for GHD for the region and hear inputs about other regions on their response to these challenges. The participants discussed an assessment of institutional capacities and needs, information resources and sources at regional and country level support for Global Health Diplomacy; and shared and enhance their negotiation GDH negotiation skills. This course has been developed in close cooperation between the School of Public Health-University of Nairobi, the Ministry of Public Health and Sanitation Kenya, ECSA-Health Community Secretariat, the Regional Network for Equity in Health in East and Southern Africa (EQUINET), with support from Graduate Institute of International and Development Studies Geneva
This study was undertaken by University of Zambia within the Health Financing theme work of the Regional Network for Equity in Health in East and Southern Africa (EQUINET) within a regional programme that is exploring progress in integrating equity into resource allocation. The study was undertaken to update the experiences and progress on the design, review and implementation of an equity-based resource allocation formula in the Zambian health sector. The author found that the formula has only been implemented in partial form, and that second and third generation formulae have not been adjusted in the implementation process. A severe lack of funding for the public health system, whose funding is smaller than the financing for specific health programmes like HIV and AIDS, remains a significant concern. The study makes a number of recommendations. The author calls for more research evaluating the changes in health outcomes, outputs or processes as a consequence of implementing resource allocation formulae. He calls for integration of financing and expansion of the pooled funding for the health sector to raise possibilities for a realistic implementation of the resource allocation formula. Richer districts should not have to risk a revenue reduction. The way to achieve the formula should rather use limited revenue growth in these districts relative to accelerated revenue growth for the poorer districts. A clear time line should be established with regard to the transformation of resource allocation and this should be updated based on emerging evidence. A monitoring and evaluation process should track performance of both resource allocation and health and health care outcomes. Finally, the Ministry of Health should evaluate the effect of structural changes with regard to resource management and performance so as to ensure optimum implementation.
The 52nd Health Ministers Conference of the East, Central and Southern African Health Community that took place from 25-29 October 2010 in Harare, Zimbabwe, under the theme: Moving from Knowledge to Action: Harnessing Evidence to Transform Healthcare. The meeting recognised the limited production and use of locally generated evidence to influence policy within the region, and resolved to promote use of evidence in decision making and policy formulation within the region and make more effective links with existing resources and institutions within the region for this. This report provides information to support the connections particularly between regional institutions and regional policy forums. It provides summary information from desk review, internet sites and email follow up on the 25 institutions and networks in East and Southern Africa (ESA) identified that are local to the region and that undertake health policy, strategy, and health systems work at regional level. The report further presents the perceptions from key informant interview of six regional policy institution personnel of the current links with technical institutions in the region, and how they can be improved. The evidence gathered is used to suggest implications for strengthening links between regional technical institutions and regional policy forums. The recommendations identify actions that can be taken with current resources, and those that call for additional investment or re-orientation of resources. The authors welcome feedback and comment on the issues raised, as well as information on other institutions from within the region working at regional level on health policy issues to add to the database compiled.
The course will bring together senior officers from the health and related sectors in the East, Central and Sothern Africa-Health Community region (ECSA-HC). The need to build capacity and create strategic leadership in global health diplomacy is clearly manifest in the performance of the regional delegations in regional and global fora. The purpose of the course is to introduce, provide an overview and share information on Global Health Diplomacy, discuss key issues and challenges for GHD for the region and hear inputs about other regions on their response to these challenges. The participant will discuss an assessment of institutional capacities and needs, information resources and sources at regional and country level support for Global Health Diplomacy. The facilitation at the course will also enable the participants to share and enhance their negotiation GDH negotiation skills. This course has been developed in close cooperation between the School of Public Health-University of Nairobi, the Ministry of Public Health and Sanitation Kenya, ECSA-Health Community Secretariat, the Regional Network for Equity in Health in East and Southern Africa (EQUINET), and the Global Health Programme with support from Graduate Institute of International and Development Studies Geneva.
On 20-22 September 2010, world leaders gathered in New York to examine what needs to be done to meet the Millennium Development Goals (MDGs). The United Nations called for accelerated progress to meet the MDGs, citing unpredictable and insufficient international financing as the main obstacle. New mechanisms proposed for health financing included a currency transaction tax, in addition to overseas development aid. Mechanisms already launched have been projected to raise a further approximately US$$1billion annually. The transaction tax will raise an estimated US$30 billion per year. Multilateral tax funding has been blocked in the past by concerns over democratic oversight and how the revenues will be spent. The Summit recognised in its draft resolution that ‘innovative financing mechanisms can make a positive contribution’ and called for such financing to scale up and supplement, but not substitute, traditional sources. This article argues that it is likely that attention will grow around effective means to levy global economic activity to pay for global public goods, raising new resources for health and new challenges for African health diplomacy and systems to encourage, orient and effectively apply these resources. (Authors from TARSC and SEATINI in EQUINET contribute to the Global Health Diplomacy Monitor).
This radio series was developed from a participatory communications process undertaken in Monkey Bay, Malawi. The participatory communication process was a follow up to previous PRA research, and sought to identify a key message, the audience participants wanted the message to reach and the medium appropriate for doing so. In the participatory process, it was decided to communicate a positive message about how girl orphans and vulnerable children could avoid sex work to local stakeholders such as community-based organisations, families and local government officials. The participants chose to create a radio drama, for broadcast in Chichewa on Dzimwe Community Radio station. The script was developed by participants in the workshop, including orphans and vulnerable children and reformed sex workers; the children then acted in the show, and the show was later broadcast in several parts. The radio drama focuses on the ordeals of one character, Irene, who is an orphan staying with an abusive aunt. Despite the ordeals she goes through she finally succeeds, while the promiscuous children around her who turn to sex work, loose. The show encourages listeners to love and understand the needs of orphans and encourages orphans to seek positive ways out of their difficulties, not sex work. The file size for the programme is too large to upload but can be sent by direct email on request to admin@equinetafrica.org
The Learning Network for Health & Human Rights (South Africa) through University of Cape Town and HEPS-Uganda co-convened this regional meeting in Kampala Uganda on 8 October 2010 within the Regional Network for Equity in Heath in East and Southern Africa (EQUINET). The primary intention of the meeting was to enable the regional sharing of best practice around the right to health and community participation, as well as to explore the development of a toolkit/training manual on the Right to Health for Civil Society groups in the region. Discussions for the way forward included plans for future action on the toolkit, a human rights curriculum for health workers, and for community governance structures for health.
African countries are currently negotiating economic partnership agreements (EPAs) with the European Union to replace existing preferential trade agreements. The proposed EPAs cover a wide range of issues and are likely to impact on health, this article notes. The impacts include effecfts on public revenues for health and health care, access to medicines and determinants of health like food security. Without careful analysis during the negotiations, the author of this article warns EPAs could have negative impacts on the health systems and population health in Africa. Market liberalisation under structural adjustment programmes (SAPs) have so far weakened public health systems in Africa, the article argues, resulting in increased commercialisation of public services, falling public budgets for public health care, a shift in government away from direct health service provision to outsourcing contractors and the liberalisation of health insurance rather than tax-based financing. There have been concerns trade commitments in the EPA would translate into more market-based reforms and the negative effects they have been associated with. As negotiations are still underway, the author urges for government and other stakeholders to ensure clauses are included that explicitly protect health and do not mitigate national health objectives and commitments. (Authors from SEATINI and TARSC in EQUINET are contributing to the Global Health Diplomacy Monitor).