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.
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The extractive (or mining) sector is a major economic actor in east and southern Africa. The mineral resources extracted are sought after globally, and how the sector operates affects the lives of millions of people. This brief aimed mainly civil society discusses the health impacts of the sector, how far these risks are recognised in policy and controlled in practice, and what civil society can do to ensure that health is protected in EI activity. It presents the proposals made at the 13th Southern Africa Civil society Forum in 2017 to advocate for regional health standards for EIs and a bottom up local to regional campaign for civil society to advocate for these harmonised standards for health in the mining (extractive) sector in SADC.
The extractive (or mining) sector is a major economic actor in east and southern Africa. The mineral resources extracted are sought after globally, and how the sector operates affects the lives of millions of people. This brief aimed mainly civil society discusses the health impacts of the sector, how far these risks are recognised in policy and controlled in practice, and what civil society can do to ensure that health is protected in EI activity. It presents the proposals made at the 13th Southern Africa Civil society Forum in 2017 to advocate for regional health standards for EIs and a bottom up local to regional campaign for civil society to advocate for these harmonised standards for health in the mining (extractive) sector in SADC.
This case study report compiles evidence on the experience of the Essential Health Benefit (EHB) in Zambia. The paper aims to contribute to national and regional policy dialogue regarding the role the EHB plays in budgeting, resourcing and purchasing of health services as well as monitoring health system performance for accountability. It outlines the motivations for developing the EHBs in Zambia, the barriers encountered in the process, the methods used to develop EHBs, and issues related to dissemination and communication of its content. The paper was done under the auspices of an EQUINET research programme through Ifakara Health Institute (IHI) and Training and Research Support Centre (TARSC), in association with the ECSA Health Community, supported by IDRC (Canada), and with the permission of the Ministry of Health of Zambia.
The Essential Health Benefit (EHB) is known as Essential Health Care Package (EHCP) in Swaziland. This desk review provides evidence on the experience of EHCPs in Swaziland and includes available policy documents and research reports. It was implemented in an EQUINET research programme through Ifakara Health Institute (IHI) and Training and Research Support Centre (TARSC), in association with the ECSA Health Community, supported by IDRC (Canada). The desk review presents the motivations for and methods used to develop, define and cost EHCP. It includes key informant input from a multi-disciplinary national task team through a workshop of key stakeholders with technical support from the World Health Organisation (WHO). It outlines how the EHCP has been disseminated and used in the budgeting and purchasing of health services and in monitoring health system performance for accountability. The paper also reports on the facilitators and barriers to development, uptake and use of the EHCP. In guiding the provision of services for all, the EHCP was envisaged to contribute towards the alleviation of poverty and as a tool for universal health coverage. Its implementation calls for a health service Infrastructure that is in good condition, competent health personnel, readiness to undergo training in new medical technology, supporting laws and capacity in the health financing unit. The EHCP in Swaziland was intended to guide the provision of health services. However, its costs were beyond the national resources to fund it. The adoption of a more restricted health service package currently being assessed in ten clinics in all four regions of the country suggests that a phased approach to delivery of an EHB may be more affordable financially for the country.
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. Mainland Tanzania’s most recent benefit package – the National Essential Health Care Interventions Package-Tanzania (NEHCIP-TZ) – describes the EHB as a minimum or “limited list of public health and clinical interventions.” The package identifies where priorities are set for improved public health. This report shows the challenges of turning a policy ‘wish list’ and package into a reality of services that can be accessed across different facility levels. This report describes the evolution of mainland Tanzania’s EHB; the motivations for developing the EHBs, the methods used to develop, define and cost them; how it is being disseminated, communicated, and used; and the facilitators (and barriers) to its development, uptake or use. Findings presented in this report are from three stages of analysis: literature review, key informant perspectives and a national consultative meeting. The case study on Tanzania was implemented in a research programme of the EQUINET through Ifakara Health Institute and Training and Research Support Centre. The programme is being implemented in association with the East Central and Southern African Health Community, supported by IDRC (Canada).
The Essential Health Benefit (EHB) policy interventions aim to optimize efficiency while extending coverage by increasing equity of access to the defined benefits. Uganda’s EHB is referred to as the Uganda National Minimum Healthcare Package (UNMHCP) introduced in the 1999 Health Policy. The UNMHCP is composed of cost efficient interventions against diseases or conditions most prevalent in the country. This report compiles evidence from published, grey literature and key informants on the UNMHCP since its introduction in Uganda’s health system, and findings were further validated during a one day national stakeholder meeting. It includes information on the motivations for developing the EHBs, the methods used to develop, define and cost them, and how it has been disseminated, used in budgeting, resourcing and purchasing health services and in monitoring health system performance for accountability. It was implemented in an EQUINET research programme through Ifakara Health Institute and Training and Research Support Centre, in association with the ECSA Health Community, supported by IDRC (Canada).
The new “Participatory Action Research Portal” for resources on Participatory Action Research (PAR) is now live on the EQUINET website. The portal has a homepage and a series of ‘subpages’ for Training, resources - which will provide links to online training courses, whole training guides and reports of training activities; Methods, tools and ethics - which will provide links to online specific papers on PAR methods, to specific examples of tools, and to discussions/ guidelines on ethical issues; PAR work – which will provide links to stories, case studies, briefs, videos, text or photojournalism stories of PAR work, including facilitator reflections; Organisations and networks - which will provide the name, snippet of information, country and link to organisations and networks involved PAR; Publications - which will provide published journal papers and reports on PAR through links to the urls or on the EQUINET database; and Other - which will provide ad hoc information that doesn’t fit anywhere else. The portal is a resource for all those working with PAR and includes resources in any language. There is a form for people to send videos, photojournalism, organisations, journal papers, training guides and other resources for the portal. The url link shown here is in English but there is also a Spanish version at http://www.equinetafrica.org/content/portal-de-recursos-para-la-investigaci%C3%B3n-acci%C3%B3n-participativa-iap
The 13th Southern African Civil Society Forum was held from 14-17 August 2017 at Birchwood Hotel and Conference Centre Johannesburg, organised by the Southern African Development Community (SADC) Council of Non government organisations (CNGO), Southern African Trade Union Co-ordinating Council (SATUCC) and Federation of Churches in Southern Africa (FOCISA). It involved about 300 delegates from different constituencies and civil society organisations across the SADC region. A commission session was convened by EQUINET and SATUCC within the 13th Southern African Civil Society Forum to share information on the findings and proposals for harmonised regional standards on health in the extractive sector. The session objectives were to discuss the key issues and formulate concrete strategies for responding to the regional context and priority challenges for protection of health in the extractive sector in the region and to make proposals for harmonised regional standards to protect health in the sector. Delegates recommended that health be included in the SADC harmonised standards for the mining sector, with a comprehensive focus on public health and environment, with details of what this means and actions proposed at national, regional and local level.
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.