Latest Equinet Updates

EQUINET Information sheet 3 on COVID-19
TARSC: EQUINET, April 2020

This is the third information brief from EQUINET to summarise and provides links to official, scientific and other resources as of April 14 2020 to support an understanding of and individual to regional level responses to COVID-19. This brief complements and does not substitute information from your public health authorities. This brief covers: developments in the COVID-19 epidemic; a discussion on population evidence and models; initiatives on health technologies; an update on the African engagement on releasing resources from debt and various resources.

EQUINET Information sheet 4 on COVID-19

This is the fourth information sheet on COVID-19 from EQUINET. It summarises information from and provides links to official, scientific and other resources as of end April 2020 on 1: Developments in the COVID-19 epidemic 2: Rolling back lockdowns- when and what next? 3: What COVID-19 has meant for the risks and returns from migration 4: An update on access to medicines and vaccines, and 5: Resources, COVID-19 and the creative economy.

Call for applicants: Desk review on "Public-private partnerships (PPPs) in the health sector- what implications for equity in east and southern Africa"
Deadline for Applications: 9 March 2020

This is a call for a desk review of public private partnerships (PPPs) in the health sector (health services) in east and southern African countries commissioned by the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The paper aims to inform public sector professionals, policy makers, civil society and parliamentarians on the health sector and health equity impacts of PPPs in health services in the countries of east and southern Africa. It will cover the full spectrum of services provided in the health sector, viz promotive, preventive, curative and rehabilitative in East and Southern African countries.. The paper will be drafted, reviewed and final version produced between March and end July 2020. EQUINET will organise internal and external review. The commissioned author will be paid a gross fee of US$6000 for the paper. See the website for further detail.

Regional Meeting of the Extractives and Health Group
TARSC; EQUINET; SATUCC; SAMA; Benchmarks: Meeting report, 1-2 February 2020, Cape Town, South Africa

EQUINET, SATUCC, SADC CNGO and Benchmarks Foundation have co-operated on regional engagement on extractives and health at the Alternative Mining Indaba, and with the Southern African ex mineworkers Association met in a regional meeting on health literacy in the mining sector in March 2019 to form a mining and health group to strengthen alliances and co-operation in the grassroots to regional and global engagement on the issue. The March 2019 meeting agreed to hold a follow up meeting at the time of the Alternative Mining Indaba (AMI) in February 2020 to follow up on the agreed actions, exchange information and widen the alliances and health literacy activities and processes in the region. The meeting was organised by TARSC / EQUINET and held in co-operation with SATUCC, SAMA and Benchmarks. It was held in Cape Town in the two days before the AMI to enable delegates to also engage in the AMI. It was supported by Medico International and OSF and by TARSC and all the organisations involved who also contributed own resources to their participation. The meeting aimed to i. Share information on mining and health in the region in terms of the risks, responses, rights and actions ii. Review activities on health literacy in mining and use of the EQUINET health literacy module on Mining and health iii. Review the work of the mining and health working group and its members in various platforms and proposed work on extractives and health equity in the region and identify priorities, alliances, actions and roles for follow up and iv. Identify issues to take forward in the AMI and other regional platforms. This report presents the information shared and discussions at the meeting and the plans for follow up work.

Discussion paper 120: Research that supports health equity: Reflections and learning from EQUINET
Loewenson R; Mamdani M; Loewenson T; Dambisya Y; Chitah B; Kaim B; Machemedze R; Gilson L; Zulu A: EQUINET, Harare, 2019

This paper reflects on experience from over two decades of EQUINET research practice to promote health equity in east and southern Africa. The paper was written by members of the EQUINET steering committee and the newsletter team. It draws examples and research features from EQUINET publications available online, a search of publications in the 221 issues of the EQUINET newsletter, and papers, reports, blogs, articles and editorials obtained from key word searches in Google. Despite policy commitments and gains in selected aspects of health, conditions in the region are increasingly driven by a global economy and a regional response that is generating instability, environmental and social costs; intense extraction of natural resources; rising levels of precarious labour, social deficits and weakened public institutions, disrupting social cohesion, solidarity and collective agency. These conditions call for certain features and forms of research. The paper describes diverse research on the costs to health equity of social deficits, inequitable resource outflows and the commodification of public services, as well as research on alternatives and policies on food security, health services, environment and rights that confront these trends. The paper describes specific features of research that respond more directly to the understanding that power relations are central to inequities in health. These research processes explain and show alternatives to disempowering narratives of the inevitability of the status quo and generate knowledge in ways that intend to empower those affected. They pay attention to who defines the research questions, who designs, implements and uses the research. This implies designs and methods that involve people in affirming and validating their realities, generating reflection on causes and building analysis, self-confidence and organisation to act and to learn from action. It presents specific examples of research approaches and the role of a consortium network in advancing them, while noting the ways in which many researchers face the double task of investigating inequities, while also challenging inequity in a global research system.

Ensuring that target-driven funding supports and does not harm comprehensive primary health care in east and southern Africa: Briefs for local, district, regional and international level
EQUINET PAROnline community: EQUINET, Harare, 2019

Primary Health Care (PHC) has inspired and galvanized action on health. PHC affirms that health is a state of complete physical, mental and social wellbeing and not merely the absence of disease and that health is a fundamental human right. In the past decade, global institutions have promoted and channeled external funds through performance-based financing (PBF), as a strategy to improve service delivery and access. While there have been studies on whether these particular services targeted under PBF have improved, there has been little systematic evaluation of its system-wide effects, nor of its impacts on comprehensive PHC. In EQUINET, we thus saw it to be important to ask: How is the use of targets in PBF affecting health workers’ professional roles, work and interaction with communities and their ability to deliver comprehensive PHC? In 2018-2019 the PAR involved 21 online participants from seven sites in five ESA countries, including health workers from primary health cent res, community members in HCCs and country site facilitators from seven national health civil society organisations in the region, referred to in this brief collectively as the ‘online participants’. We also included offline local discussions with an average of 19 community members and 15 health workers per site. Four major areas of action and ten proposals were made within them for PBF to enable and not detract from PHC. These are 4 briefs each of which present the general findings and proposals from the work with separate final points in the first brief for local level; in the second for district and national level; in the third brief for regional level agencies and in the fourth brief for international agencies. The link is to one of the briefs but all four are on the website.

EQUINET workshop on health literacy for the mining and extractive sector
1-2 February, 2020, Cape Town, South Africa

Most countries in east and southern Africa have rich deposits of a range of mineral reserves that are highly sought after in global trade. Extractive industries (EIs), largely multinationals from all regions of the world, extract these minerals, oil and gas from the earth through mining, dredging and quarrying. Countries in east and southern Africa thus face a challenge to make and implement policy choices that link these natural resources to improved social and economic development, and to ensure that extraction processes do not harm health or environments. EQUINET is working with trade union partners in the Southern Africa Coordination Council (SATUCC), Ex mineworkers in the Southern Africa Miners Association (SAMA) and civil society through Benchmarks SA on health in the mining sector in east and southern African (ESA) countries. EQUINET are holding a regional meeting on February 1 and 2 2020 in Cape Town South before the Alternative Mining Indaba to share health literacy information on mining and health, distribute the health literacy module on mining and health, and share other materials and experiences in EQUINET’s ongoing programmes and advocacy on mining and health in the region. The workshop is aimed at trade union, ex mineworker and civil society health organisers. There are very limited sponsored places and self-sponsored places left so those interested, and those attending the AMI who wish to join the meeting, are asked to apply soonest by email.

EQUINET Discussion paper 118: Comparative review: Implementation of constitutional provisions on the right to healthcare in Kenya and Uganda
Centre for Health, Human Rights and Development (CEHURD): EQUINET, Uganda, 2019

This discussion paper is produced by the Centre for Human Rights and Development (CEHURD) as part of the theme work on health rights and law of the Regional Network for Equity in Health in East and Southern Africa (EQUINET). The paper examines the implementation of constitutional provisions on the right to healthcare in Kenya and Uganda, two countries in East Africa. It aims to identify factors and mechanisms that have facilitated implementation of constitutional provisions on the right to healthcare, including how the constitutions were developed and framed. It compares implementation in Kenya, where the right to healthcare is explicit in their 2010 Constitution, and in Uganda, where the right to healthcare is implicit in the National Objectives and Directive Principles of State Policy. The paper draws on two EQUINET case studies on implementation of constitutional provisions on the right to health, one each in Kenya and Uganda, published in 2018, a 2017 regional workshop that discussed the implementation of constitutional provisions on the right to health, and additional review of published literature. It presents a thematic analysis of the findings from the two case studies in terms of the judicial, political and popular implementation mechanisms, exploring further the factors and mechanisms that have facilitated or blocked their implementation. As the two constitutions address the right to healthcare differently, this analysis of their application provides insights into the factors and mechanisms for practice that may be useful in other settings.

EQUINET Discussion paper 119: Critical assessment of different health financing options in east and southern African countries
Doherty J: EQUINET, Harare

EQUINET commissioned this desk review paper. It aims to contribute to a regional understanding of the positive and negative implications of the different domestic health financing options being explored, advocated and implemented in the East and Southern African (ESA) region. It presents issues to be addressed in the implementation of these financing options from the perspective of equitable progression towards universal health coverage (UHC), to inform policy dialogue and decisions on domestic health financing in ESA countries. The paper considers only one aspect of health financing reform, namely, revenue collection. It distinguishes between policy instruments, i.e., the sources of finance, and policy strategies, i.e., how these instruments are deployed to achieve various objectives or to address contextual features. Non-contributory sources (essentially tax-financed) and contributory (employment-based) options are explored. The paper presents: a. A typology of domestic revenue instruments and strategies; b. Domestic financing trends and options in place, or under consideration, in ESA countries; c. A review of low- and middle-income country experiences of domestic financing options; and d. Conclusions on the findings and lessons for ESA countries.

Policy brief 45: Features of domestic revenue sources for universal health systems: a contribution to policy dialogue
University of the Witwatersrand and Training and Research Support Centre: EQUINET, Harare

This brief aims to present the positive and negative implications of the different domestic revenue sources being explored, advocated and implemented in the East and Southern African (ESA) region. It presents issues to be considered in choosing between, and implementing, the different non-contributory and contributory options for revenue collection, given the policy commitments in the region to equity and universal health coverage (UHC). The brief draws information from experiences of other low and middle income countries globally, including on the fiscal, revenue, progressiveness and acceptability implications of different options. The brief highlights that revenue collection measures need to be accompanied by measures to strengthen strategic purchasing and access to equitable, effective, quality care. The full report the brief is drawn from is also being made available on the EQUINET website.