While international and global guidance documents set out health obligations for extractive industries (EIs), these standards, including UN conventions, may be voluntary if they are not included in national laws, unless the national constitutions specifically provide otherwise. Given the spread of EIs across the ESA region, it would be important to ensure that corporate duties in relation to health are upheld across the region, including through regional guidance to harmonise laws. This document was produced by EQUINET through Training and Research Support Centre and with support from Medico International. It aims to inform policy dialogue to improve the legal frameworks for the duties and corporate social responsibility of EIs in the ESA region. It presents evidence to support policy dialogue and health advocacy. It reviews the literature on EIs and health in ESA countries, explores key guidance principles/ standards on health in EIs, and analyses from review of laws how far they are contained in domestic legislation of ESA countries. Using good practice in existing ESA laws and international guidance, the document proposes the content for regional guidance for policy and law in the region. As is being implemented in other regions of Africa, there is scope for regional guidance and harmonisation of laws relating to EIs, including in relation to health. While no single law in ESA countries addresses all aspects of international guidance on protection and health and social welfare in EIs, in combination the laws in ESA countries provide clauses that could form the basis of such regional guidance. Drawing from different ESA laws legal guidance is proposed for health and social protection covering: 1. Award of prospecting rights/licenses and EI agreements; 2. Resettlement of affected communities due to mining activities; 3. OHS for employed workers and contractors in the mining sector; 4. Health benefits for workers, families and surrounding communities; 5. Environment, health and social protection for surrounding communities; 6. Fiscal contributions towards health and health services; 7. Stimulation of forward and backward links with local sectors and services supporting health; 8. Post-mine closure obligations for public health; and for 9. Governance of these issues, including for good corporate governance practices, public transparency and accountability, constructive dialogue, reporting and oversight, to foster a relationship of confidence and mutual trust between EIs and the societies in which they operate.
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This brief discusses the strategies used for attracting and retaining skilled health workers in ESA countries, especially to address under-served rural and remote areas, primary care settings and in the public sector. It reviews practice to date and identifies strategic options, given both regional learning and the opportunity of the 2016 Global Strategy on Human Resources for Health. Whereas ESA countries have implemented various attraction and retention regimes, the results have not been well documented, with still limited evaluation and reporting of impact of these strategies. The evidence suggests a need for a comprehensive, multi-sectoral and co-ordinated approach to planning and implementation, to make the case for improved funding and with greater use of information and monitoring systems.
This participatory skills session convened under the umbrella of the pra4equity network is being held at the Heath System Global Conference. In the session we will discusses methods and tools to build learning from action as a key element of participatory action research, directly engaging affected communities to build responsive health systems. The session draws on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. From prior global symposia, methods for learning from action were identified as weak in PAR practice. This session seeks to address this gap. It is targeted at researchers and practitioners. It uses methods resources and group discussions of case studies from health managers, policy actors, civil society and researchers in low and middle income countries to discuss the participatory processes and methods for learning from action at different levels, and the issues in applying and institutionalising these methods. We will also review what these participatory efforts to transform and build knowledge on health systems implies for the understanding of ‘resilience’. As the places are limited if you will be in Vancouver on the 15th November morning and would like to participate in this skills session please can you notify on the email shown with your name, institution and a line or two on any prior PAR experience.
This participatory skills session convened under the umbrella of the pra4equity network is being held at the Heath System Global Conference. In the session we will discusses methods and tools to build learning from action as a key element of participatory action research, directly engaging affected communities to build responsive health systems. The session draws on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. From prior global symposia, methods for learning from action were identified as weak in PAR practice. This session seeks to address this gap. It is targeted at researchers and practitioners. It uses methods resources and group discussions of case studies from health managers, policy actors, civil society and researchers in low and middle income countries to discuss the participatory processes and methods for learning from action at different levels, and the issues in applying and institutionalising these methods. We will also review what these participatory efforts to transform and build knowledge on health systems implies for the understanding of ‘resilience’. As the places are limited if you will be in Vancouver on the 15th November morning and would like to participate in this skills session please can you notify on the email shown with your name, institution and a line or two on any prior PAR experience.
This brief discusses the strategies used for attracting and retaining skilled health workers in ESA countries, especially to address underserved rural and remote areas, primary care settings and in the public sector. It reviews practice to date and identifies strategic options, given both regional learning and the opportunity of the 2016 Global Strategy on Human Resources for Health. Whereas ESA countries have implemented various attraction and retention regimes, the results have not been well documented, with still limited evaluation and reporting of impact of these strategies. The evidence suggests a need for a comprehensive, multi-sectoral and co-ordinated approach to planning and implementation, to make the case for improved funding and with greater use of information and monitoring systems.
EQUINET is saddened by the news of the passing of Doctor TJ Ngulube, a long-time colleague in EQUINET, director of the Center For Health Science and Social Science Research in Zambia and significant contributor to EQUINETs early work on social participation in health, on parliamentary roles and equitable health systems. Colleagues in EQUINET have noted memories of TJ’s warmth, wisdom and friendship; his leadership and his consistent contribution to work in the region. We send sympathies to his family and colleagues and are the poorer for his passing.
This participatory skills session convened under the umbrella of the pra4equity network is being held at the Heath System Global Conference. In the session we will discusses methods and tools to build learning from action as a key element of participatory action research, directly engaging affected communities to build responsive health systems. The session draws on approaches and experience from Africa, Latin America and participants globally to discuss the methods/tools, their application and their integration in health systems. From prior global symposia, methods for learning from action were identified as weak in PAR practice. This session seeks to address this gap. It is targeted at researchers and practitioners. It uses methods resources and group discussions of case studies from health managers, policy actors, civil society and researchers in low and middle income countries to discuss the participatory processes and methods for learning from action at different levels, and the issues in applying and institutionalising these methods. We will also review what these participatory efforts to transform and build knowledge on health systems implies for the understanding of ‘resilience’.
The 2005 International Health Regulations (IHR) adopted by member states in the World Health Organization (WHO) require that all countries have the ability to detect, assess, report and respond to potential public health emergencies of international concern at all levels of government, and to report such events rapidly to the WHO to determine whether a coordinated, global response is required. Recent epidemics have strengthened the demand to improve the capacities to implement the IHR and the effectiveness of health system prevention and detection of and responses to epidemics. Evidence from ESA countries suggests that this demands effective communication between local levels of health systems and national responses, and capacities for prevention, detection and response at community, primary care and district level. In 2016 two new global financing mechanisms were introduced to support emergency responses, the WHO Contingency Fund for Emergencies (CFE), that aims to fill the gap from the beginning of a declared emergency and a World Bank Pandemic Emergency Facility (PEF), to support follow up measures after initial CFE funding. This report provides information on the new CFE and PEF financing mechanisms, to explore any stated or implied links with the IHR goals and health system strengthening in the response to emergencies. It is based on a desk review of available literature by the University of Sheffield and the Training and Research Support Centre, under the umbrella of EQUINET. The report aims to inform African policy-makers and stakeholders about the CFE and PEF financial mechanisms and their relationship to the IHR to locate areas where links could be more explicitly made between the new financial mechanisms, the IHR and the health system strengthening needed for longer-term preparedness for and prevention of emergencies.
An open letter from Trisha Greenhalgh et al. to the editors of the British Medical Journal (BMJ) triggered wide debate by health policy and systems researchers (HPSRs) globally on the inadequate recognition of the value of qualitative research and the resulting deficit in publishing papers reporting on qualitative research. One key dimension of equity in health is that researchers are able to disseminate their findings and that they are taken into account in a fair and just manner, so that they can inform health policy and programmes. The Greenhalgh et al. letter and editorial responses were actively discussed within “SHAPES”, a thematic group within Health Systems Global, focused on Social Science approaches for research and engagement in health policy & systems (http://healthsystemsglobal.org/twg-group/6/Social-science-approaches-for-research-and-engagement-in-health-policy-amp-systems/) and within EQUINET (www.equinetafrica.org). The discussion precipitated this follow up open letter/commentary, which has 170 co-signatories. Collectively, the signatories feel that barriers to publication of qualitative research limit publication of many exemplary studies, and their contribution to understanding important dimensions of health care, services, policies and systems.
This 2016 regional meeting was convened by ECSA HC with EQUINET in line with HMC Resolution – ECSAHMC50/R2 to prepare and discuss issues on the 69th World Health Assembly (WHA) Agenda and Regional GHD work. The objectives of the meeting were to 1. Update participants from ECSA-HC member states on Global Health Diplomacy (GHD) and its health impact. 2. Share information and discuss, from a GHD perspective, selected WHA agenda items and related issues from other key global health platforms. 3. Present and discuss research findings, recommendations on effective engagement on GHD and proposals for future work. 4. Discuss proposals for strengthened regional co-ordination and communication on GHD and a framework for monitoring progress. The meeting included senior officials delegated or responsible for health diplomacy from ECSA HC member states and South Africa, diplomats from the Africa group from ECSA HC member states, technical personnel from EQUINET and other institutions, including regional organisations and partners.