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.
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Sad passing of Dr TJ Ngulube, Zambia
Skills building on methods and tools for learning from action in participatory action research: Building action learning within affected actors and communities for resilient and responsive health systems
Tuesday 15 November 2016 8:30am–12pm Convention Centre, Health System Global, Vancouver, Canada
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’.
Contact: admin@equinetafrica.org
EQUINET Information brief: Global emergency financing and health system strengthening
Brown G; Wills O; Loewenson R
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.
Fair publication of qualitative research in health systems: a call by health policy and systems researchers
SHaPeS TWG of Health Systems Global; EQUINET; Emerging Voices for Global Health; Daniels K; Loewenson R; et al.: International Journal for Equity in Health 15(98) June 2016, doi: 10.1186/s12939-016-0368-y
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.
Global health diplomacy in east and southern Africa, Report of a Regional Meeting, 8-9 April 2016, Nairobi Kenya
ECSA HC; EQUINET
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.
EQUINET Brief
EQUINET, June 2016
This brief introduces EQUINET, our organisation, work and the lessons we have learned in the struggle for equity and social justice in health. EQUINET is a consortium network of institutions registered in different countries in the region, with its secretariat at TARSC, a non-profit organization registered in Zimbabwe. The network constitution sets out its vision, principles, composition, structures, governance and procedures. The network is governed by a steering committee of institutions leading key areas of work from within and beyond east and southern Africa. The steering committee includes academic, government, civil society, parliament and non-profit institutions that co-ordinate different theme, process and country activities in the network and the secretariat. The five clusters of EQUINET work are: 1. Cross cutting equity analysis, integrating work in other clusters and the pra4equity network on PAR and the newsletter, together with theme work on the equity watch and district health systems. 2. Health rights and the law, integrating work of the learning network on heath rights, theme work on law and constitutional rights in health, and work in national networks. 3. Fairly resourcing health systems, integrating theme work on health financing and health workers. 4. Social empowerment for health, integrating theme work on health centre committees, and with parliamentarians and civil society. 5. Global engagement, including work on trade and health and health diplomacy.
EQUINET Discussion paper 107: Literature Review: Essential health benefits in east and southern Africa
Todd G; Mamdani M; Loewenson R: IHI, Tanzania, TARSC, EQUINET, Harare, June 2016
An Essential Health Benefit (EHB) is a policy intervention designed to direct resources to priority areas of health service delivery to reduce disease burdens and ensure equity in health. Many east and southern Africa (ESA) countries have introduced or updated EHBs in the 2000s. Recognising this, EQUINET, through Ifakara Health Institute and Training and Research Support Centre is implementing research to understand the role of facilitators and the barriers to nationwide application of the EHB in resourcing, organising and in accountability on integrated health services. This literature review provides background evidence to inform the case study work and regional dialogue. It compiles evidence from published and public domain literature on EHBs in sixteen ESA countries, including information on the motivations for developing the EHBs; the methods used to develop, define and cost them; how they are being disseminated and communicated within countries; how they are being used in budgeting, resourcing and purchasing health services and in monitoring health system performance for accountability; and the facilitators and barriers to their development, uptake or use.
EQUINET Policy brief 40: Implementing the International Health Regulations in east and southern Africa: Progress, opportunities and challenges
SEATINI, TARSC
When the International Health Regulations (IHR) were adopted in 2005 by member states of the World Health Organisation (WHO), State Parties were given up to June 2012 to have developed minimum core public health capacities to implement them. This included having surveillance, reporting and response systems for public health risks and emergencies and measures for disease control at designated airports, ports and ground crossings. In East and Southern Africa (ESA), the IHR are being implemented within an Integrated Disease Surveillance and Response (IDRS), which is a comprehensive, evidence-based strategy for strengthening national public health surveillance and response systems in African countries. This policy brief outlines the progress made and deficits in ESA countries in achieving the core capacities to implement the IHR. It proposes national measures to strengthen public health systems to both meet gaps in the implementation of the IHR and to link responses to health emergencies and outbreaks to health systems strengthening in ESA countries.
EQUINET PRA paper: Reflections on actions and learning from participatory work on health in Cassa Banana, Zimbabwe.
Kaim B: TARSC, ZADHR, Cassa Banana Community Health Committee, EQUINET, Harare, 2016
Over the last two years (2014-2015), the Training and Research Support Centre in cooperation with the Zimbabwe Association of Doctors for Human Rights has been building a programme that aims to foster local and national dialogue to build active citizenship and public and private accountability on water and sanitation, as a key element of primary health care. The work draws on experiences and learning arising from the Health Literacy programme and pra4equity network within EQUINET. This paper explores the Cassa Banana residents’ response to their health situation over the last two years, with a particular focus on the role of the Community Health Committee (CHC) in meeting community health needs and in trying to strengthen relations with the Harare City Council and other key stakeholders. In doing so, the paper reflects on the successes and challenges faced by the CHC, and looks at issues of leadership, social cohesion and power within the community as key components to the successful mobilisation of a diverse and fractured community in trying to get its needs met. It ends by recommending possible actions to deal with the problems identified and comments on the extent to which the challenges faced in Cassa Banana can be generalised to other communities in Zimbabwe.
Discussion paper 106: Responding to inequalities in health in urban areas: A review and annotated bibliography
Loewenson R; Masotya M: TARSC, EQUINET, Harare
Training and Research Support Centre (TARSC) as cluster lead of the “Equity Watch” work in EQUINET is following up on the findings of the 2012 Regional Equity Watch and the country Equity Watch reports with a deeper systematic analysis of available evidence on inequalities in health and its determinants within urban areas and the responses to urban inequalities from the health sector and through health promoting interventions of other sectors and communities acting on public health and the social determinants of health. This document presents evidence from 105 published papers in English post 2000 on patterns of and responses to urban inequalities in health in east and southern African countries. The evidence is presented in an annotated bibliography and analysis. It is being used to identify key areas of focus and parameters for deeper review and analysis. The picture presented in the literature is not a coherent one- it is rather a series of fragments of different and often disconnected facets of risk, health and care within urban areas. There is also limited direct voice of those experiencing the changes and limited report of the features of urbanisation that promote wellbeing. The literature found was significantly more focused on the challenges than on the solutions. The papers sourced confirmed the relevance of primary care and community-based approaches, with CHWs, to carry out participatory assessments, promote new PHC approaches, use social media and support service uptake to address urban determinants. However the documented interventions made weak links between PHC services, urban public health and the work of other sectors. The rapid, diverse and multifactorial changes taking place in urban areas, some of which are poorly documented, also call for participatory approaches that include the direct voice of those experiencing urban life.