Latest Equinet Updates

African Labour Radio Project: Health Worker Retention and Migration
EQUINET, Workers World Media Productions and SABC Channel Africa: April 2009

The fifteen minute pre-recorded show, ‘Health Worker Retention and Migration’, was produced by WWMP, in conjunction with labour journalists in east and southern Africa. It provided an in-depth analysis of the situation for health workers in Africa, and discussed incentives for retaining health workers. In the pre-recorded show, a Khayelitsha nurse who used to work at Groote Schuur hospital in Cape Town and migrated to Saudi Arabia Mavis Mpangele, Bongani Lose from Democratic Nurses of South Africa (DENOSA), Kwabena Otoo from the Ghana Trade union Congress, Joel Odijie from Nigeria Trade Union Congress, Professor Yoswa Dambisya of the University of Limpopo Department of Pharmacy and EQUINET Steering Committee, Nyasha Muchichwa from the Labour and Economic Research Institute of Zimbabwe and Percy Mahlathi, the South African Director General of the Department of Health were interviewed. The feature covers the push factors and experiences from different African countries. The feature also explores government responses to the problem as well as African trade unions response. It rounds off with examples of success stories in Zambia and Tanzania.

African responses to the 2014/5 Ebola Virus Disease Epidemic
Loewenson R, Papamichail A, Ayagah I: EQUINET Brief, Harare, 2015

There has been significant documentation on the various international responses to the 2014/5 Ebola epidemic in West Africa. There is also evidence that the epidemic
triggered new developments in epidemic prevention and response from Africa. In April 2015 the AU called for the lessons learned to be identified for future responses. This brief summarises the publicly available documentation on the response of African countries to the epidemic. It is based on 63 documents accessed through key word search in July–August 2015 of online databases, supplemented by documents obtained from snowballing in September 2015. The brief presents evidence on
a. The actions taken by African governments and institutions at national, regional and continental level to support the response to the epidemic.
b. The identified positive features and challenges in the African response.
c. The links between the African emergency response to the EVD epidemic and health system strengthening.

An assessment of the Zimbabwe government strategy for retention of health professionals
Chimbari MJ, Madhina D, Nyamangara F, Mtandwa H, Damba V

This poster presentation at the Global Health Worker Alliance Conference, March 2008, is based on a study that aimed to determine and assess the impacts of incentives instituted by the Zimbabwe government and non-government sector to retain Critical Health Professionals. It found that the tendency of health professionals to migrate has increased, even among low levels of staff and the macro-economic environment is the main driver of megration. Sustaining the retention incentives in this environment seems unattainable and bonding is unpopular and further increases migration.

Annotated bibliography of e- platforms used in participatory and peer to peer exchange and learning
Loewenson T: TARSC, EQUINET Harare, 2014

Visual and information technologies are now more diversified and widely accessible. Digital images and mapping enhance access and exchange on local realities; social media (blogs, tweets and others) provide new methods for communicating experience for collective analysis, mobile phones facilitate communication and pooling of evidence across wider social networks and mapping and crowd-sourcing technology provide systems for citizen reporting, including in poorest communities. internet based resources point to the possibilities for information technology to support peer to peer learning and participatory action research to overcome the ‘local’ nature of processes and link groups with shared interest. To support discussion on these areas this work aimed to provide an annotated description of existing internet resources that have features that may guide out thinking in developing an e platform for participatory reflection and action across similar groups in different areas.

Annotated bibliography: Social power, participation and accountability in health
Loewenson R and Tibazarwa K: TARSC, May 2013

This annotated bibliography was prepared as a resource for people working on different dimensions of social power, social participation and social accountability in health. Social power, participation and accountability are central concepts in building people centred health systems. This annotated bibliography was commissioned by the Community of Practitioners on Accountability and Social Action in Health (COPASAH) and prepared by Training and Research Support Centre (TARSC) within the Regional Network for Equity on Health in East and Southern Africa (EQUINET). The annotated bibliography captures English language literature, and includes materials that are open access in full online. It focuses with a few exceptions on materials published post 2000 and is based on materials accessed through the use of social power / accountability/ participation in health as key words in online searches and literature forwarded from COPASAH members. The limitations of the compilation are discussed. The bibliography is presented in four parts: Section 1 presents papers on social power in health, Section 2 presents papers on social participation in health, Section 3 presents papers on social accountability in health, and Section 4 presents papers on the use of these three concepts in knowledge generation.

Are Health Centre Committees a Vehicle for Social Participation in Health? Report on a Regional HCC Review Meeting, June 2017

EQUINET through the Community Working Group on Health (CWGH) as the cluster lead for the work on social empowerment in health, in partnership with Training and Research Support Centre (TARSC), University of Cape Town (UCT) and Lusaka District Health Office (LDHO), with support from Open Society Initiative for Eastern Africa (OSIEA) have embarked on a regional programme, ‘HCCs as a vehicle for social participation in health systems in East and Southern Africa’ to address some of the outcomes mentioned above. This report documents the proceedings during the Regional HCC exchange visit held at Mwanza clinic, Goromonzi district on the 20th of June 2017 and the review meeting held in Harare on the 21st of June 2017. The meeting aimed to: discuss experiences with laws, policies, guidelines and constitutions on HCCs; share experiences in using Photovoice to enhance the role of HCCs; discuss current training materials and programmes for HCCs in the region and discuss strengthening of internal capacities of institutions working with HCCs through information exchange and skills inputs.

Areas of investigation for the Health Systems Knowledge Network: An initial scoping of the literature
Gilson L, Doherty J, TARSC, for the The Health Systems Knowledge Network Hub

This review was prepared as an outline for the WHO Commission on the Social Determinants of Health for a knowledge network exploring the role of health systems in health equity and the social determinants of health. It presents data showing that health services tend to be used proportionately more by richer than poorer social groups. It analyses the social factors affecting access to, and uptake of, health services and shows how these interact with inequitable features of the health care system. Overall, the review argues that the interaction between household health-seeking behaviour and experience of the health system generates differential health and economic consequences across social groups. The long-term costs of seeking care often impoverish poorer households, reinforcing pre-existing social stratification. These are costs that can be addressed by deliberate aspects of health system design.

Brief: Strengthening health centre committees for people-centred health systems

Stakeholders working with Health Centre Committees (HCCs) in East and Southern Africa (ESA) raised proposals in EQUINET policy brief 37 to improve the functioning and impact of HCCs as potential contributors to equitable, people centred health services. These proposals advocated for legal, institutional and social measures to support and clarify HCC roles, composition, powers and duties, to ensure the capacities and resources for them to function. They also proposed that HCCs strengthen their communication with the communities they represent backed up by wider measures for health literate and informed communities. Since then, institutions in EQUINET have followed up to act on the recommendations, building on existing work. This brief shares information on these developments. It reports some progress in legal recognition and setting of clearer constitutions for HCCs, clearer guidelines for the functioning, use of community based processes like photovoice to connect them with communities and their conditions in their dialogue with health services and efforts to share resources for capacity building of HCCs. It highlights that HCCs continue to play a role in improved frontline health systems. However the potential of HCCs still needs to be realised and the work continues.

Bringing African Perspectives to Global Health Diplomacy discourse
Dept of Health South Africa, University of Pretoria, EQUINET: Public Health Association of South Africa Conference workshop, Cape Town, 25 September 2013

EQUINET co-operated with Department of Health South Africa and University of Pretoria to co-host a workshop at the September 2013 PHASA conference on African Perspectives in Global Health diplomacy. The workshop explored, through an interactive panel discussion, how African countries could and are positioning themselves to advance African health interests in global health discourse. It involved speakers from Ministry of Health, Kenya, from EQUINET, from Department of International Relations and Cooperation, South Africa and ambassadors and programmes from countries that have health co-operation with Africa. The panellists and delegates explored African experiences of foreign policy and global diplomacy for health and the opportunities, risks, key issues and lessons for African countries in raising health as a foreign policy issue.

Bringing evidence on equity to health policy in Africa: Experiences of the Equity Watch
Session at the Global Forum for Health Research, Cape Town, April 2012

Convened by EQUINET, in association with the ECSA Health Community and IDRC Canada, a session was held at Forum 2012 in Cape Town on April 25th to present evidence and experience from work carried out in 2010-2012 in five countries - Mozambique, Zambia, Zimbabwe, Uganda, Kenya - and at regional level in East and Southern Africa to assess progress in key areas of equity in health outcomes, in social determinants of health and in redistributive health systems. The session reviewed the learning from the work, particularly in relation to monitoring policy commitments to equity in health, and discuss the opportunities and the challenges for institutionalising and using equity analysis within health policy and planning. The session explored why equity analysis is important for strategic planning and what has been learned from the Equity Watch; what challenges countries face in implementing equity analysis and what opportunities exist for linking equity analysis to processes within the health system; and recommendations from the work for institutionalizing equity analysis across different sectors of government and with other actors. A concluding PechaKucha (20 images in 20 seconds each) flagged the key messages and continuing debates in taking equity monitoring and analysis from research to institutional practice in health and health systems. A regional meeting to have deeper dialogue on the national and regional Equity Watch work was held after the forum and the report will be made available through the June newsletter and EQUINET website.