This paper is part of a series exploring the role of health systems in promoting food sovereignty in Africa being implemented in EQUINET through Health Science Research Council, South Africa. The paper explores the effect of food aid on Malawi’s food security and on the domestic market for food. The paper highlights the impact of food aid interventions on domestic food markets and argues for food aid interventions to be designed and implemented in a way that takes domestic market operations into account. This needs a supportive policy framework, a social protection programme that responds to both transitory and chronic food insecurity, functional markets that support household food production and strengthened rols of national vulnerability assessment committees to support evidence based identifcication of vulnerable groups.
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The second regional training workshop on participatory methods for a people centred health system was hosted by the regional network for equity in health in east and southern Africa (EQUINET) , TARSC and Ifakara HRDC in Bagamoyo Tanzania from February 14-17 2007. It involved 35 delegates from in east and southern Africa and built skills, share experiences and strengthen work on participatory methods for people centred health systems, and particularly for strengthening the relationship between between communities and health workers.
This poster highlights the main findings from a PRA project report. It explains that Health workers are not recognised as a community that requires health care. The link between the health and well being of health workers and the quality of health care that they are able to provide to the community needs to be recognised and positively developed.
A proposed Economic Partnership Agreement (EPA) between the eastern and southern African countries (ESA) and the European Union (EU) is currently under negotiation. The final agreement to be signed in December 2007 could have a profound impact on areas of health and health services. Recognising this, in this report we examine the health implications of this proposed EPA between the ESA and the EU. The report aims to inform government, civil society, parliaments and professionals working in health and in trade. It examines: • the key areas of the EPA; • the health implications of the EPA, specifically in terms of health inputs (examining food security) and health services (examining organisation of health services, health workers, and access to medicines); • the options that countries have to protect health in the current EPA; and • general issues and principles for protecting health in negotiating the EPA.
Although prepayment schemes are being hailed internationally as part of a solution to health care financing problems in low-income countries, literature has raised problems with such schemes. This paper reports the findings of a study that examined the factors influencing low enrolment in Tanzania’s health prepayment schemes (Community Health Fund). The paper argues that district managers had a direct influence over the factors explaining low enrolment and identified in other studies (inability to pay membership contributions, low quality of care, lack of trust in scheme managers and failure to see the rationale to insure). District managers’ actions appeared, in turn, to be at least partly a response to the manner of this policy’s implementation. In order better to achieve the objectives of prepayment schemes, it is important to focus attention on policy implementers, who are capable of re-shaping policy during its implementation, with consequences for policy outcomes.
Human rights approaches to health have been criticized as antithetical to equity, principally because they are seen to prioritise rights of individuals at the expense of the interests of groups, a core tenet of public health. The objective of this study was to identify how human rights approaches can promote health equity. The paper argues that Where it is clear that rights approaches are predicated upon understanding the need to prioritize vulnerable groups and where the way rights are operationalised recognizes the role of agency on the part of those most affected in realising their socio-economic rights, human rights
approaches appear to offer powerful tools to support social justice and health equity.
This student capacity building project aimed at comparing information on the knowledge and attitudes of intern doctors at two urban hospitals and three rural hospitals in Uganda regarding international migration. The key informant interviews suggested that the search for better pay is the most significant push factor for migration; while the most significant retention factor is feeling indebted to the government and family who sponsor their education. The respondents from both settings think that the workload and working conditions will affect their eventual specialty and location of practice.
The Health Systems Knowledge Network of the WHO Commission on the Social Determinants of Health in co-operation with the Regional Network for Equity in Health in east and southern Africa (EQUINET) commissioned a desk review of the role of parliaments and parliamentary portfolio committees on health in building equitable and people centered national health systems. This review presents evidence from published literature, and other secondary evidence in the east and southern African regions.
This article synthesises data reported in EQUINET discussion paper 30 about the outflow of Africa’s wealth, to reveal structural factors behind the continent’s ongoing underdevelopment. The flow of wealth out of sub-Saharan Africa to the North occurs primarily through exploitative debt and finance, phantom aid, capital flight, unfair trade, and distorted investment. Although the resource drain from Africa dates back many centuries—beginning with unfair terms of trade, amplified through slavery, colonialism, and neocolonialism—today, neoliberal (free market) policies are the most direct causes of inequality and poverty. They tend to amplify preexisting class, race, gender, and regional disparities and to exacerbate ecological degradation. Reversing this outflow is just one challenge in the struggle for policy measures to establish a stronger funding base for the health sector.
This report explores the health equity issues in Malawi, as a country equity analysis and contribution to the regional picture. It explores the current equity situation in Malawi through a review of literature and a meeting of local institutions, and proposes areas of focus for future work. It addresses the potential to promote equity in health through a strong network of equity actors whose voice would advocate for equitable access to basic quality health care in Malawi.