Latest Equinet Updates

This call invites applicants from east and southern African countries to participate and share experiences in a three day skills workshop of the EQUINET pra4equity learning network on an ‘Participatory action research in people centred health systems’ being held on 4-6 October in Cape Town South Africa, following the Global Symposium on Health Systems Research (30th Sept–3rd October). It includes at the same venue on the first day (4 October) the one day post GSHSR workshop on PAR hosted by EQUINET and ALAMES (for which there is a separate call open to all regions), and the following two days (5-6 October) the skills training for the east and southern African delegates, hosted by EQUINET.

EQUINET will hold a Workshop on ‘Participatory action research in people centred health systems’ immediately after the Global Symposium on Health Systems Research ending 3rd October as a one day post symposium workshop (4th October) and a two day skills training (5-6 October) in Cape Town South Africa. We invite you to send us expressions of interest in participating in the workshop and will post more information on the workshops on the EQUINET website in May.

This update reports on one of the presentations at the EQUINET Regional meeting on Health Centre Committees (HCCs) in East and Southern Africa held in January-February that exchanged experience and learning between partners doing work on training and strengthening HCCs in the region. HCCs are mechanisms for public participation and joint planning at primary care level of health systems. The next newsletter will include the full report, more experiences on HCCs and the resolutions of the meeting. For example, we found that HCCs are often not provided for in law: Does that weaken their recognition, power or effectiveness? From Zambia, we heard experience around neighbourhood health committees (NHCs) that dated back to 1991, when the new government committed to building a health system that guaranteed “equity of access to cost effective quality health care as close to the family as possible.” The 1995 National Health Services Act set in law District Health Boards and NHCs, as well as the Central Board of Health at national level. NHCs became the vital link between the community and the health institutions. Over the next 10 years the number of NHCs in the country grew. While formally recognised, they also faced a series of challenges related to the voluntary nature of the work of NHC members, their lack of planning skills, and political interference. In 2006 the National Health Services Act was repealed, and the structures under it were dissolved, except for the NHCs. Despite the change in their legal status, the MoH continued to recognise their role in PHC and maintained it through policy guidelines. In Lusaka, an NHC Working Group was set up to provide support, operational guidelines and a constitution was developed for NHCs to clarify their role, they worked actively in budgeting, planning and community health, and annual meetings were held to review NHC experiences and activities. The case study led to interesting discussion on the legal status of to HCCs. On the one hand fornalising their status was seen to be important for their recognition and for HCCs to receive and account for public funds. On the other, even if there is a legal framework, there is no guarantee that communities will know about or understand it and the Lusaka experience showed the many ways HCCs can be formally supported, even in the absence of laws. Also it was noted that laws may be important, but they need to arise from and be upheld by the actions of communities.

Health Centre committees (HCCs) (known by a range of names) are mechanisms that exist at community and primary care level for co-determination by communities and health workers on their health systems and on PHC. In January 2014 EQUINET through TARSC and with CWGH is holding a regional meeting on the role of health centre committees in primary health care. The regional workshop includes organisations doing work on training and strengthening HCCs in east and southern African countries. It aims to exchange and document information on the laws, capacities, training materials used, and monitoring systems used in HCCs, and to develop a shared monitoring framework for assessing how HCCs are functioning.