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.
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This review is part of EQUINET's programme of work on Contributions of global health diplomacy in east and southern Africa. Access to essential medicines is one of the key requirements for achieving equitable health systems and better public health in east and southern Africa (ESA). One constraint to this is that the region’s medicine production capacity remains weak. In May 2007, the African Heads of State and Government adopted the Pharmaceutical Manufacturing Plan for Africa (PMPA) to maintain a sustainable supply of quality essential medicines to improve public health and promote industrial and economic development in Africa. The PMPA includes six priority areas: mapping productive capacity; situation analysis; developing a manufacturing agenda; addressing intellectual property issues; political, geographical, economic considerations; and financing. This review compiles from existing literature bottlenecks to local medicine production in the region. It seeks to inform follow-up case study work on the extent to which relationships and agreements with Brazil, India and China are addressing the bottlenecks identified in the African Union (AU), SADC and EAC plans for pharmaceutical manufacturing.
This review is part of EQUINET's programme of work on Contributions of global health diplomacy in east and southern Africa. This includes work on the WHO Global Code on Ethical Recruitment of Health workers. The research seeks to explore the extent to which the policy interests of African countries were carried (or not carried) into the Code in the negotiations around the code and the perceived factors affecting this; the extent to which countries in east and southern Africa view and implement the Code as an instrument for negotiating foreign policy interests concerning health workers; and the motivations, capabilities and preparations for monitoring the Code to engage on African policy interests concerning health workers. The paper presents a review of published and grey literature on relevant codes of practice on health workers and on bilateral and multilateral agreements on the health workforce. The information was analysed using the policy analysis triangle to capture the changing context, processes, content and major actors in the development of the WHO Code, and documentation on its progress and implementation since its adoption. It raises issues that are being followed up through field research.
This report documents the proceedings of a skills workshop on financing incidence analysis (FIA) that was held to review international experience on the social distribution of burdens of various financing sources and the methods used for assessing financing incidence, drawing on work that has been carried out in Africa. Specifically the workshop sought to: explore ways to realise additional funding from different progressive financing sources; draw input from the Health Economics Unit, University of Cape Town, on methodologies for analysing the progressivity and regressivity of different financing sources; draw lessons from international and local experiences on FIA of different financing sources; and answer questions on how to address challenges with data collection and analysis, review of tools, preliminary results and reporting.
Financing universal health coverage (UHC) is not only about how to generate funds for health services. It is also about how these funds are pooled and used to purchase services. This policy brief explores options for financing UHC in East and Southern Africa (ESA). It presents learning from countries that have made progress towards UHC, including the need to increase domestic funding and to use mandatory pre-payment (tax and other government revenue, possibly supplemented by mandatory health insurance contributions) as the main mechanism for funding health services. The brief indicates the problems associated with introducing or expanding health insurance to fund UHC. With tax funding often the most equitable and efficient option, there is scope for increasing government revenue and health expenditure in many ESA countries.
This policy brief reviews how far the promises of fair globalisation, rights to sustainable development, equity and global solidarity in the 2000 UN Millennium Declaration were delivered for East and Southern Africa. It raises key issues for the post 2015 agenda: There is an unfinished agenda in the MDGS, with wide inequalities in some areas, and monitoring of progress must be socially disaggregated. An agenda for universal health coverage should explicitly address equity in access and investment in strong primary health care services. Thirdly, economic growth is not enough, and public policies should also close wide gaps in access to resources for health, Finally, beyond development aid, global solidarity needs to more explicitly accelerate measures for wider benefit from markets, innovation and wealth in globalisation.
Access to essential medicines is one of the key requirements for achieving equitable health systems and better population health. The number of people with regular access to essential medicines increased from 2.1 billion to about 4 billion between 1997 and 2002. However, access to medicines in sub-Saharan Africa remains low. One reason for this is the low level of domestic production on the continent. This brief outlines the factors that affect medicines production in East and Southern Africa, drawing on the African Union, Southern Africa Development Community (SADC) and East African Community (EAC) pharmaceutical plans. It identifies the barriers to local production as: lack of supportive policies, capital and skills constraints, gaps in regulatory framework, small market size and weak research and development capacities. There are potential opportunities available through south-south cooperation in medicines production. Negotiations on such south-south arrangements would need to look not only at the immediate production investment, but at strengthening capacities for research and development, for regulation, medicines price and quality monitoring, prequalification, infrastructure and human resource development.
This report documents discussions at a regional review meeting held in April 2013, eight months after the start of the 2012 Health Literacy (HL) Programme in Uganda and Zambia. The meeting reported on and reviewed the programme to date and identified progress markers for the outcomes, and identify issues to address, as well as develop future actions for HL in the year ahead. Participatory sessions covered a range of themes, such as to review a protocol for the participatory work for health literacy on sexual and reproductive health (SRH) and to review and plan the next phase of work.
The Regional Network for Equity in Health in East and Southern Africa (EQUINET) is implementing a three year policy research programme to address selected challenges to health and strengthening health systems within processes of global health diplomacy (GHD). In the June 2012 inception workshop for the programme, delegates called for a paper that explains the concepts and emergence of global health diplomacy, the different approaches being taken in GHD, including African approaches. Given the de facto rise in health diplomacy, this paper explores questions on GHD, to inform debate and dialogue in Africa on raising health within global diplomacy. The authors briefly present the roots and emergence of GHD, and the debates on raising public health within global diplomacy. They outline how the concepts of and approaches to GHD differ across countries and regions. They explore the perspectives that have informed diplomacy in Africa, and ask what this means for African engagement in GHD, and for public health in Africa. At various points in this paper they raise questions on what implications the developments described have for health diplomacy in Africa. Given the limitations of documented evidence on African approaches or analysis of health diplomacy from an African lens, it is difficult to draw conclusions. The authors thus raise questions that they hope will provoke dialogue, debate and response.
Financing universal health coverage (UHC) is not only about how to generate funds for health services. It is also about how these funds are pooled and used to purchase services. This policy brief explores options for financing UHC in East and Southern Africa (ESA). It presents learning from countries that have made progress towards UHC, including the need to increase domestic funding and to use mandatory pre-payment (tax and other government revenue, possibly supplemented by mandatory health insurance contributions) as the main mechanism for funding health services. The brief indicates the problems associated with introducing or expanding health insurance to fund UHC. With tax funding often the most equitable and efficient option, there is scope for increasing government revenue and health expenditure in many ESA countries.