EQUINET NEWSLETTER 169 : 01 March 2015

1. Editorial

Bring the right to health into Uganda’s Constitution this year!
Moses Mulumba, Executive Director, Center for Health, Human Rights and Development, Uganda

Uganda’s Constitution has much to make our country proud—including chapter four which has strong commitments to fundamental rights and freedoms, such as freedom of expression and the promise of non-discrimination.

These sacred freedoms are not always upheld or enforced—but that is a matter for another day! As a first principle, the fact that these guarantees are enshrined in our Constitution shows the potential to protect, promote and defend the human rights of all people in the country. They provide the entry point for citizens from all walks of life to hold our duty bearers to account.

Every ten years we must ask: what is missing from our Constitution? What should be amended to adapt to our changing environment? In 2015, Parliament will consider proposed revisions to our Constitution.

It is this vital opportunity that motivated the Center for Health Human Rights and Development (CEHURD) and a team of partners, on World Human Rights Day, to submit a bold proposal to the Uganda Law Reform Commission —that included in the revisions being considered by parliament in 2015, there should be an explicit guarantee for all citizens of the right to the highest attainable standard of physical and mental health.

Those who framed our Constitution, despite their wisdom, did not expressly cater for the right to the highest attainable standard of health in its substantive articles, but rather placed it under the non binding State policies and objectives. It is now urgent for the country to correct this.

Why? Simply put: because when it comes to health, our leaders and policy makers are failing the citizens.

Uganda’s astonishingly poor health indicators speak volumes. Unlike its neighbours, which have shown important advances, Uganda has had a stagnant rate of maternal deaths for the past decade alongside rising HIV incidence and declining condom use. Uganda has a stubborn burden of drug resistant tuberculosis and, according to the World Health Organisation 2005 report on malaria, Uganda has the world's highest malaria incidence, with 478 cases for every 1 000 people every year. This disease burden is coupled with ailing public health facilities that lack essential services like water and electricity.

Unfortunately, health services have been eclipsed by rural electrification and infrastructure as political priorities for investment. Health care is seen by government as an area for charitable donation or as spending on ‘consumption’. This is extremely shortsighted. There should be no trade-off between building roads or building health services. This is a false dichotomy. We cannot develop as a country economically if our population is sick, or if families are one attack of cerebral malaria short of impoverishment!

Countries that have expanded access to free, essential services have found that those investments have yielded real benefit to their citizens, including in terms of less absenteeism from work and schooling due to ill health, and increases in economic productivity at the household level.

In reality, in receiving taxes from people, government is bound by a social contract to account back to the people on how their resources are being used.
The structural adjustment programmes that liberalized and reduced public funding to social services located health in the market place and weakened this state duty. Now is the time to redeem it. We believe that a strong constitutional norm is needed to raise the role and accountability of the state in health care and raise pressure to address the social conditions that affect our health.

Including the right to the highest attainable standard of health as a constitutional right provides a bench mark for government, private sector and society to respect, protect, fulfil and promote it. Without a clear obligation, incontrovertibly stated in the Constitution, our policymakers will continue to look on this right as ‘optional’, not fundamental to the duties of government.

Other countries, such as South Africa, Kenya and recently Zimbabwe, have taken this step to ensure clear expression of the right to health care and to the social determinants of health in their Constitutions. Their people have raised social pressure for these rights and taken up their implementation through social action and strategic litigation, to ensure that government is accountable for these obligations and to build more equitable health systems.

CEHURD and partners have thus submitted a proposal to the Uganda Law Reform Commission to include in the Constitution provisions for citizens to realize the right to the highest attainable standard of health; to access basic medical and emergency treatment, reproductive health services including family planning, medicines and health information, and for people who would otherwise not be able to afford health services and commodities to access social protection to enable them to do so.

Having health as a constitutional right does not mean that people should expect to immediately be healthy, nor does it mean that our government must put in place expensive health services for which they have no resources. It means that government and public authorities should take progressive measures such as investing resources and developing and implementing policies and action plans which will lead to available and accessible health care for all in the shortest possible time, and to fair distribution of public resources for this. It also means that the public and private sector have a duty to promote public health.

Isn’t it time that our politicians and leaders take this step to commit to the right to the highest attainable standard of health? Citizens will be watching closely how far government gives priority to this critical right in the current constitutional reform process, at a time of common epidemics of preventable sickness and death. Surely we cannot wait another decade to make this commitment as a country!

Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat: admin@equinetafrica.org. For more information on the issues raised in this op-ed please visit the CEHURD website: www.cehurd.org

2. Latest Equinet Updates

Contributions of Global Health Diplomacy to equitable health systems in east and southern Africa
EQUINET Regional research workshop, Johannesburg, South Africa March 13-14 2015

This workshop is being held to discuss the evidence from research in EQUINET and related research with a particular focus on east and southern Africa (ESA) on global health diplomacy. It will present and discuss the findings from the EQUINET research programme and from related research in Africa, and the implications for policy, negotiations and programmes in east and southern Africa; review methods and challenges for implementing research and analysis on global health diplomacy for policy relevance, from review of research and experience of the work; and discuss and propose areas for follow up policy, action and research, within ESA and through south-south collaboration. The reports of the EQUINET research are on the website

Zimbabwe Association of Doctors for Human Rights; Zimbabwe National Network or People living with HIV and AIDS; Training and Research Support Centre
PRA report: Community Strengthening for a People Centred Primary Health Care System: The Case of Cassa Banana Community in Zimbabwe

This report documents work undertaken in Cassa Banana Community from February – July 2014. The programme aimed to use Participatory Reflection and Action (PRA) methodologies in working with members of Cassa Banana to work with a representation of community members and health providers/authorities to explore and document the health challenges faced by the Casa Banana community and to formulate actions to solve these health challenges. The project also sought to support community action in demanding accountability from the relevant duty bearers in the formulation and delivery of health services, and to strengthen community/stakeholder engagement for the provision of people-centered Primary Health Care services to the Casa Banana community.

3. Equity in Health

After Ebola: What next for West Africa’s health systems?
Mcilhone M: African Brains, February 2015

As rates of Ebola infection fall in Guinea, Liberia and Sierra Leone, planning has begun on how to rebuild public health systems and learn lessons from the outbreak. Nobody is declaring victory yet. But in Sierra Leone, the worst-affected country, there were 117 new confirmed cases reported in the week to 18 January, the latest statistics available, compared with 184 the previous week and 248 the week before that. Guinea halved its cases in the week to 18 January – down to 20 – and Liberia held steady at eight. The epidemic is not over until there are zero cases over two incubation periods – the equivalent of 42 days. This article discusses the role of citizen and state, external funders and local community action in addressing the epidemic.

4. Values, Policies and Rights

Post-2015 and FFD3: Debates Begin, Political Lines Emerge
Adams B, Luchsinger G: Social Watch Report 2014, February 2015

2015 is a said to be pivotal year. The post–2015 sustainable development agenda currently being drafted is premised on the reality that the present model of development is not working, given worsening inequalities and straining planetary boundaries. All countries and peoples—and the planet –have the right to live with a better model, one that is inclusive and sustainable. The authors argue that an increasingly urgent imperative for change informs the two–track negotiations unfolding at the United Nations from now until September. One track involves the post–2015 sustainable development agenda; the second focuses on financing for development, an independent process that began at the 2002 Monterrey Conference. While the two talks are separate, the issues in each are observed to be deeply interlinked, and the success of any new model to depend on the outcomes of both. The political stakes are high, but so too the authors argue are the opportunities—perhaps once–in–a–generation—for genuine transformation. The article discusses the implications of these two tracks of negotiation.

SA follows WHO guide on low-risk yellow fever arrivals
Maqutu A: BDlive, 4 February 2015

The World Health Organisation has included some African countries on its low-risk yellow fever list, which means their citizens no longer need clearance certificates when visiting SA. Visitors from Zambia, Tanzania, Ethiopia, Eritrea, and Sao Tome and Principe would no longer be expected to produce a yellow fever certificate when entering SA. In accordance with international health regulations, SA requires a yellow fever certificate from all citizens and non-citizens over the age of one who have travelled from a yellow fever risk country or have been in transit for more than 12 hours at the airport of such a country.

‘Rural-proofing’ policy launched
Nkosi S: Health-e News, January 2015

Rural health advocacy groups in South Africa have developed guidelines aimed at ensuring that policy makers and government address the rural context when developing and implementing policies. The guidelines are proposed to assist government departments in taking into account rural contexts when designing programmes. The guidelines and related presentations from the launch can be accessed through the link.

5. Health equity in economic and trade policies

Africa Forum on Inclusive Economies 2014
Rockefeller Foundation, African Development Bank, United Nations Economic Commission for Africa: December 2014

The Rockefeller Foundation, the African Development Bank and the United Nations Economic Commission for Africa convened in December 2014 at the Africa Forum on Inclusive Economies, a Pan African convening aimed at bringing together key thought leaders and policy makers to closely interrogate and propel forward, thinking around the theme of advancing inclusive economies. The convening aimed to focus new ideas and narratives towards the advancement of an inclusive economies approach with key African institutions and influencers and to provide a platform to further enhance thinking and critical debate on the issue of inclusive economies. Reports, videos and a blog from the convening can be found on the website.

The Heretic's Guide to Global Finance: Hacking the Future of Money
Scott B: Pluto Press, 10 May 2013

The Heretic's Guide to Global Finance: Hacking the Future of Money is a friendly guide to the complex maze of modern finance but also tells us how to utilise and subvert it for social purposes in innovative ways. It sets up a framework to illuminate the financial sector and helps the reader develop a diverse DIY toolbox to undertake their own adventures in guerilla finance and activist entrepreneurialism. Part 1 (Exploring) covers the major financial players, concepts and instruments. Part 2 (Jamming) explores innovative forms of financial activism. Part 3 (Building) showcases the growing alternative finance movement - including peer-to-peer systems, alternative currencies, and co-operative economies - and shows how people can get involved in building a democratic financial system.

6. Poverty and health

The death of international development
Hickel J: Al Jazeera, 20 Nov 2014

International development is dying; people just don't buy it anymore. The West has been engaged in the project for more than six decades now, but the number of poor people in the world is growing, not shrinking, and inequality between rich and poor continues to widen instead of narrow. People know this, and they are abandoning the official story of development in droves. They no longer believe that foreign aid is some kind of silver bullet, that donating to charities will solve anything, or that Bono and Bill Gates can save the world. This crisis of confidence has become so acute that the development community is scrambling to respond. The Gates Foundation recently spearheaded a process called the Narrative Project with some of the world's biggest NGOs - Oxfam, Save the Children, One, and others. They commissioned research to figure out what people thought about development, and their findings revealed a sea change in public attitudes. People are no longer moved by depictions of the poor as pitiable, voiceless "others" who need to be rescued by heroic white people. The author observes that this is a racist narrative that has lost all its former currency; rather, people have come to see poverty as a matter of injustice, that poverty is created by rules that rig the economy in the interests of the rich.

Water and power: Are public services still public?
Municipal Services Project, February 2015

Public water and electricity are back in vogue! Yet many state-owned utilities are now undergoing “corporatization”: they have legal autonomy and manage their own finances. Is this a positive development in the struggle for equitable public services? Or a slippery slope toward privatisation? This video draws from in-depth research on corporatization cases from around the world.

7. Equitable health services

Access to Cancer Treatment: A study of medicine pricing issues with recommendations for improving access to cancer medication
t Hoen E: Oxfam International, 4 February 2015

According to the World Health Organization, cancer is one of the leading causes of death around the world, with 8.2 million deaths in 2012. More than 60 percent of the world’s new cases of cancer occur in Africa, Asia, and Central and South America and these regions account for 70 percent of the world’s cancer deaths. In low- and middle-income countries, expensive treatments for cancer are not widely available. Unsustainable cancer medication pricing has increasingly become a global issue, creating access challenges in low-and middle-income but also high-income countries. This report describes recent developments within the pricing of medicines for the treatment of cancer, discusses what lessons can be drawn from HIV/AIDS treatment scale-up and makes recommendations to help increase access to treatment for people with cancer.

Advancing the application of systems thinking in health: why cure crowds out prevention
Bishai D, Paina L, Li Q, Peters DH, Hyder AA: Health Research Policy and Systems 12(28), 2014

This paper illustrates unintended consequences of apparently rational allocations to curative and preventive services, using computer modelling. The model exhibits a “spend more get less” equilibrium in which higher revenue by the curative sector is used to influence government allocations away from prevention towards cure. Spending more on curing disease leads paradoxically to a higher overall disease burden of unprevented cases of other diseases. The authors suggest that this paradoxical behaviour of the model can be stopped by eliminating lobbying, eliminating fees for curative services and ring-fencing public health funding. The authors have created an artificial system as a laboratory to gain insights about the trade-offs between curative and preventive health allocations, and the effect of indicative policy interventions. The underlying dynamics of this artificial system resemble features of modern health systems where a self-perpetuating industry has grown up around disease-specific curative programs like HIV/AIDS or malaria. The model shows how the growth of curative care services can crowd both fiscal and policy space for the practice of population level prevention work, requiring dramatic interventions to overcome these trends.

8. Human Resources

Time savings – realized and potential – and fair compensation for community health workers in Kenyan health facilities: a mixed-methods approach
Sander LD, Holtzman D, Pauly M, Cohn J: Human Resources for Health 2015, 13:6

Sub-Saharan Africa faces a severe health worker shortage, which community health workers (CHWs) may fill. This study describes tasks shifted from clinicians to CHWs in Kenya, places monetary valuations on CHWs’ efforts, and models effects of further task shifting on time demands of clinicians and CHWs. Interviews were conducted with 28 CHWs and 19 clinicians in 17 health facilities throughout Kenya. Twenty CHWs completed task diaries over a 14-day period to examine current CHW tasks and the amount of time spent performing them. A modelling exercise was conducted examining a current task-shifting example and another scenario in which additional task shifting to CHWs has occurred. CHWs worked an average of 5.3 hours per day and spent 36% of their time performing tasks shifted from clinicians. The authors estimated a monthly valuation of US$ 117 per CHW. The modelling exercise demonstrated that further task shifting would reduce the number of clinicians needed while maintaining clinic productivity by significantly increasing the number of CHWs. The authors’ argue that this costing of CHW contributions raises evidence for discussion, research and planning regarding CHW compensation and programmes.

Transforming health professions’ education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative
Talib ZM, Kiguli-Malwadde E, Wohltjen H, Derbew M, Mulla Y, Olaleye D, Sewankambo N: Human Resources for Health 2015, 13:1 doi:10.1186/1478-4491-13-1

African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward resources to support African medical schools. The Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning, through semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes. All of the consortia have prioritised efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilise limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalisation of collaborative activities. The consortia demonstrate a paradigm shift in the relationship between medical schools. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding has created a culture of collaboration, with positive impact reported on the quality and efficiency of health workforce training. It suggests that future funding for global health education should prioritise such south-south collaborations.

9. Public-Private Mix

Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa
Ashmore J, Gilson L: Human Resources for Health 13:3, 2015

Dual practice or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries’ public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Findings suggest dual practice can impact both positively and negatively on specialists’ intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a ‘stepping stone’ to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.

10. Resource allocation and health financing

Financing and access to health care in West Africa: empirical data, cartoons and received ideas
Queuille L, Ridde V, University of Montreal, School of Public Health: January 2015

The project Access to healthcare for vulnerable groups in West Africa with the Help NGO produces publications in order to make research results and knowledge more accessible. The authors have worked for 10 years on producing and applying scientific knowledge about healthcare access and financing in Africa and aim to share their observations by experimenting with using satirical cartoons as a knowledge sharing tool. Made by the designer Glez, this series of cartoon focuses on preconceived ideas that people can have about the implementation of free health care and health insurance coverage in Sub-Saharan Africa.

Overcoming challenges to sustainable immunisation financing: early experiences from GAVI graduating countries
Saxenian H, Hecht R, Kaddar M, Schmitt S, Ryckman T, Cornejo S: Health Policy and Planning 30(2) 197-205

Over the 5-year period ending in 2018, 16 countries with a combined birth cohort of over 6 million infants requiring life-saving immunizations are scheduled to transition from outside financial and technical support for a number of their essential vaccines. This support has been provided over the past decade by the GAVI Alliance. Will these 16 countries be able to continue to sustain these vaccination efforts? To address this issue, GAVI and its partners are supporting transition planning, entailing country assessments of readiness to graduate and intensive dialogue with national officials to ensure a smooth transition process. The report presents learning form a pilot and observes that the experience of countries that have already transitioned should contribute to thinking about how such transition away from external funding can be achieved in low and middle income countries.

The health system cost of post-abortion care in Rwanda
Vlassoff M, Musange SF, Kalisa IR, Ngabo F, Sayinzoga F, Singh S, Bankole A: Health Policy and Planning 30(2) 223-233

Based on research conducted in 2012, the authors estimated the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalisation. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs.

Who pays for and who benefits from health care services in Uganda?
Kwesiga B, Ataguba JE, Abewe C, Kizza P, Zikusooka CM: BMC Health Services Research 15:44 February 2015

Equity in health care entails payment for health services according to the capacity to pay and the receipt of benefits according to need. In Uganda, as in many African countries, although equity is extolled in government policy documents, not much is known about who pays for, and who benefits from, health services. This paper assesses both equity in the financing and distribution of health care benefits in Uganda. Data are drawn from the most recent nationally representative Uganda National Household Survey 2009/10. Equity in health financing is assessed considering the main domestic health financing sources (i.e., taxes and direct out-of-pocket payments). This is achieved using bar charts and standard concentration and Kakwani indices. Benefit incidence analysis is used to assess the distribution of health services for both public and non-public providers across socio-economic groups and the need for care. Need is assessed using limitations in functional ability while socioeconomic groups are created using per adult equivalent consumption expenditure. Overall, health financing in Uganda is marginally progressive; the rich pay more as a proportion of their income than the poor. The various taxes are more progressive than out-of-pocket payments. However, taxes are a much smaller proportion of total health sector financing compared with out-of-pocket payments. The distribution of total health sector services benefits is pro-rich. The richest quintile receives 19.2% of total benefits compared to the 17.9% received by the poorest quintile. The rich also receive a much higher share of benefits relative to their need. Benefits from public health units are pro-poor while hospital based care, in both public and non-public sectors are pro-rich.

11. Equity and HIV/AIDS

Implementing rapid testing for tuberculosis in Mozambique
Cowan J, Michel C, Manhiça I, Monivo C, Saize D, Creswell J, Gloyd S, Micek M: Bulletin of the World Health Organisation 93(2) 65-132

In Mozambique, pulmonary tuberculosis is primarily diagnosed with sputum smear microscopy. However this method has low sensitivity, especially in people infected with human immunodeficiency virus (HIV). Patients are seldom tested for drug-resistant tuberculosis. The national tuberculosis programme and Health Alliance International introduced rapid testing of smear-negative sputum samples. Four machines were deployed in four public hospitals along with a sputum transportation system to transfer samples from selected health centres. Laboratory technicians were trained to operate the machines and clinicians taught to interpret the results. The results indicated that using rapid tests to diagnose tuberculosis is promising but logistically challenging. More affordable and durable platforms are needed. All patients diagnosed with tuberculosis need to start and complete treatment, including those who have drug resistant strains.

When HIV is ordinary and diabetes new: Remaking suffering in a South African Township
Mendenhall E, Norris SA: Global Public Health, DOI: 10.1080/17441692.2014.998698 2015

Escalation of non-communicable diseases (NCDs) among urban South African populations disproportionately afflicted by HIV/AIDS presents not only medical challenges but also new ways in which people understand and experience sickness. In Soweto, the psychological imprints of political violence of the Apartheid era and structural violence of HIV/AIDS have shaped social and health discourses. Yet, as NCDs increasingly become part of social and biomedical discussions in South African townships, new frames for elucidating sickness are emerging. This article employs the concept of syndemic suffering to critically examine how 27 women living with Type 2 diabetes in Soweto, a township adjacent to Johannesburg known for socio-economic mobility as well as inequality, experience and understand syndemic social and health problems. For example, women described how reconstructing families and raising grandchildren after losing children to AIDS was not only socially challenging but also affected how they ate, and how they accepted and managed their diabetes. Although previously diagnosed with diabetes, women illustrated how a myriad of social and health concerns shaped sickness. Many related diabetes treatment to shared AIDS nosologies, referring to diabetes as ‘the same’ or ‘worse’. These narratives demonstrate how suffering weaves a social history where HIV becomes ordinary, and diabetes new.

12. Governance and participation in health

Ethical considerations related to participation and partnership: an investigation of stakeholders’ perceptions of an action-research project on user fee removal for the poorest in Burkina Faso
Hunt MR, Gogognon P, Ridde V: BMC Medical Ethics 15(13), February 2013

Healthcare user fees present an important barrier for accessing services for the poorest in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are poorest in implementing user fee removal. The authors explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research in 39 in-depth interviews in the affected community, local healthcare professionals, management committees of local health clinics, researchers and regional or national policy-makers. Using constant comparative techniques, the authors carried out an inductive thematic analysis of the collected data. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatisation, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships.The investigation illuminated the distinctive ethical terrain of a participatory public health action-research project. The authors indicate that careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups.

WHO: Members States propose guidance for engagement with non-State actors
TWN Info Service on Health Issues (Jan15/06), 2015

A new time line with guidance from Member States has been proposed for improving a framework on engagement with non-State actors at the World Health Organization. Discussions on the framework document prepared by the WHO Secretariat were held at the meeting of the 136th session of the WHO Executive Board (EB). During the plenary session, many countries expressed their dissatisfaction with the current draft framework and Argentina proposed a draft decision to convene a working group for deciding on the way forward. This document provides the current draft of the framework.

13. Monitoring equity and research policy

Sex and gender matter in health research: addressing health inequities in health research reporting
Gahagan J, Gray K, Whynacht A: International Journal for Equity in Health 14(12), 2015

Attention to the concepts of ‘sex’ and ‘gender’ is increasingly being recognised as contributing to better science through an augmented understanding of how these factors impact on health inequities and related health outcomes. However, the ongoing lack of conceptual clarity in how sex and gender constructs are used in both the design and reporting of health research studies remains problematic. Conceptual clarity among members of the health research community is central to ensuring the appropriate use of these concepts in a manner that can advance our understanding of the sex- and gender-based health implications of our research findings. During the past twenty-five years much progress has been made in reducing both sex and gender disparities in clinical research and, to a significant albeit lesser extent, in basic science research. Why, then, does there remain a lack of uptake of sex- and gender-specific reporting of health research findings in many health research journals? This question, the authors argue, has significant health equity implications across all pillars of health research, from biomedical and clinical research, through to health systems and population health.

14. Useful Resources

Cartooning for Peace
Foundation of cartooning for peace, Geneva

Kofi Annan, former Secretary General of the UN, said in 2006 “Cartoons make us laugh. Without them, our lives would be much sadder. But they are no laughing matter : They have the power to inform, and also to offend.” With Plantu, French editorial cartoonist at “Le Monde” newspaper, he gathered together twelve of the greatest international cartoonists at the United Nations Headquarters in New York on October 16, 2006, at a symposium entitled “Unlearning Intolerance”. The Cartooning for Peace initiative started with this meeting. It aims to promote a better understanding and mutual respect between people of different cultures and beliefs using editorial cartoons as a universal language. Cartooning for Peace facilitates meetings of professional cartoonists of all nationalities with a wide audience, to promote exchanges on freedom of expression and recognition of the journalistic work of cartoonists. Cartooning for Peace also provides protection and legal assistance to cartoonists working in difficult environments, as well as advice and support in the exercise of their profession.

Health in All Policies Training Manual
World Health Organisation, 2015

The WHO has launched its Health in All Policies Training Manual. The manual provides a resource for regional and country training workshops to increase understanding of HiAP by health professionals and others. WHO is developing a global plan to raise awareness among the end-users regarding this tool, and is seeking to consolidate a strong network of institutions to support responses to training requests at national and sub-national levels.

ND-GAIN Global Climate Change Vulnerability and Readiness Mapping

ND-GAIN ranks 175 countries both by vulnerability and readiness to adapt to climate change. The group measures vulnerability by considering the potential impact of climate change on six areas: food, water, health, ecosystem service, human habitat and infrastructure. The readiness rank weights portions of the economy, governance and society that affect the speed and efficiency of adaptation projects.The project presents this information through a series of interactive maps and rankings.

15. Jobs and Announcements

2015 Postdoctoral Fellowship Competition
Deadline for submissions: 15 March 2015

CODESRIA’s postdoctoral fellowship program is meant to give scholars at different levels of their careers the resources to undertake sustained work over multiple years on a project of their choice with the goal of producing empirically grounded and theoretically innovative work that will constitute original contributions to their field of work and to the understanding of Africa in the world. In addition to a financial grant of USD 15,000 over a 15-`month period, selected scholars will be provided access to CODESRIA’s library. Priority thematic areas from which the Council seeks to draw participants for its 2015 postdoctoral fellowships relate to a range of areas relating to African youth, economic transformation, human rights, social security and social welfare systems, African arts, education and gender analysis. Further detail on the themes and requirements for applications can be found on the website.

Call for Abstracts for the Prince Mahidol Award Conference 2016 “Priority Setting for Universal Health Coverage”
Abstract submissions by 31 March 2015

The Prince Mahidol Award Conference (PMAC) is an annual international conference focusing on policy-related health issues. The Conference will be held in Bangkok, Thailand, from 26 – 31 January 2016. The theme for PMAC 2016 is “Priority Setting for Universal Health Coverage”. The objectives are to advocate and build momentum on evidence- informed priority setting and policy decisions to achieve UHC goals; to advocate for the global movement and collaborations to strengthen the priority setting of health interventions and technology in the long-term; to share knowledge, experience, and viewpoints on health-related priority setting among organisations and countries; and to build capacity of policymakers and respective stakeholders for development and introduction of contextually-relevant priority setting mechanisms in support of UHC. The abstract should contain no more than 300 words that illustrate original research, or experience from the field on the subjects which have never been presented at any international conference. All submissions should fall under three main sub-themes as follows: firstly, organising priority setting: what evidence is needed? Secondly, using priority setting evidence in making UHC decisions. Thirdly, priority setting in action: learning and sharing country experiences.

Call for applicants: SADC Civil Society expert
Call closes 6 March 2015

The Open Society Initiative for Southern Africa and the Southern African Trust are seeking a SADC Civil Society Expert who has extensive experience working with civil society in the SADC region to undertake a mapping and analysis of civil society in the SADC region, and contribute to the development of a Sustainability Mechanism. Interested applicants are requested to submit their applications including a cover letter detailing their understanding of the scope of the assignment, a budget, the curriculum vitae and a sample report of at least one previous assignment undertaken by the 6 March 2015 to the email address below.

Further details: /newsletter/id/39335
Call for papers: Informing the Establishment of the WHO Global Observatory on Health Research and Development
Submissions by 8 March 2015

WHO has announced a new Call for Papers for a peer-reviewed Journal Series on “Informing the Establishment of the WHO Global Observatory on Health Research and Development”. This Call is launched in association with the WHO Global Observatory on Health Research and Development (R&D) called for by WHO’s Member States in the 2013 WHA Resolution 66.22, as part of a strategic work plan to promote innovation, build capacity, improve access and mobilise resources to address diseases that disproportionately affect the world’s poorest countries. With this collection of papers, WHO aims to provide global stakeholders with up-to-date knowledge on methods, strategies, tools, experiences and applications to draw from when developing future investment decisions and implementation plans for new R&D. More importantly, the aim is to push the frontier for knowledge and innovation in this field by inviting new thinking, approaches, analysis and information and welcome a wide range of perspectives and disciplines relevant to understanding the availability of and funding for health R&D. Papers will be published during the course of 2015/16 in Health Research Policy and Systems.

Call for Papers: New Solutions: A Journal of Environmental and Occuappational Health Policy Extractive Industries
Submissions by: 31 March 2015

New Solutions seeks submissions for a special issue that will focus on the extractive industries. Extractive industries are defined as processes that involve the extraction of raw materials from the natural environment to be used for consumption and include the mining of precious and other metals (e.g. gold, silver, iron, manganese, tin, asbestos and rare-earth metals, amongst others), and the extraction of energy sources such as coal, uranium, natural gas, oil sources such as oil shale and tar sands, as well as dredging and quarrying for primary materials. Because New Solutions is a policy journal, manuscripts, including scientific papers, should include a perspective that addresses relevant policy concerns. Manuscripts are welcome for any of its journal sections, including: Scientific Solutions, Feature Articles, Movement Solutions, Documents, Voices, and Comment and Controversy. The editors encourage submissions that highlight possible alternatives or solutions and examples of positive community responses and activities.

Call for proposals: Scaling Up Food Security and Nutrition Innovations - Canadian International Food Security Research Fund
Submissions by: 27 March 2015

International Development Research Centre and Foreign Affairs, Trade and Development Canada have announced the 2015 open call for proposals under the Canadian International Food Security Research Fund. With a strong focus on taking effective, pilot-tested innovations to a wider scale of use and application, this call will fund outstanding research-for-development projects that promise consistent and meaningful development outcomes (i.e. reaching important numbers of end-users) by testing, demonstrating and effectively scaling up models, delivery mechanisms, and approaches. This is an open, competitive call for proposals, and will fund projects submitted by strong partnerships between research, development, private sector, and other organisations from Canada and from eligible countries.Projects are anticipated to begin in October 2015. The size of the projects funded by this call will be in range from CA$0.5 to $1.5 million.

CDRA: Planning, Monitoring, Evaluation and Learning Course
Cape Town, March and November; Johannesburg, July

The Community Development Resource Association (CDRA), a civil society organisation, established in 1987, based in Cape Town, South Africa, is conducting courses on Planning, Monitoring, Evaluation and Learning between 9 March - 27 November 2015 in Johannesburg and Cape Town. The pressure that organisations face for external accountability leave many tasked with ticking the boxes and filling in the blanks with a sense of unease. The same questions tend to plague researchers. Does the evaluation framework represent what the project is about? Are researchers bringing learning into practice adequately? Are partners learning and growing? This five-day course is for those keen to design monitoring and evaluation processes that foster learning.

Children Health Foundation: Innovative Small Grants Program 2015
Call closes: 30 April 2015

The Child Health Foundation is currently accepting letters of intent from interested health workers, investigators, or community organisations for innovative research or innovative service projects directed at improving the health of infants, children, and pregnant women. Selected individuals or groups will be notified to further send a full proposal. The Foundation has been supporting innovative approaches to adapting ORT to the health care and social situations around globe. Small innovative projects can make a major impact on child health in diverse settings, and find out the answers to some persistent health problems. The number of projects approved depends on the amount of funding available. The 2014 Innovative Small Grants have been awarded for the health and well-being of children to organisations in Tanzania, India, Kenya, Colombia, Ethiopia, Rwanda, Cambodia, and Vietnam.

Global Forum on Research and Innovation for Health, Manila, Philippines, 24-27 August 2015
Deadline for abstract submissions: 5 May 2015

Forum 2015 is a unique global platform to promote the role of research and innovation in creating better health, enhancing equity and stimulating development. The Forum 2015 organisers invite abstract submissions from policymakers, business and community leaders, researchers and scholars, non-profit and international organisations, and any others from various disciplines and sectors whose work addresses key concerns in research and innovation for health and development. The abstracts may be research-focused, clinical-focused, policy-focused or program-focused. The abstract should describe clearly developed-work that is evidence-based. Abstracts describing work that is in early stages of development will not be considered. At the time of the abstract submission, authors may request a poster presentation, an oral presentation, or both. The Forum 2015 will make the final decision on what type of presentation method will be awarded based on the overall program needs

Health Information Systems Program - SA 2015 International Conference
23- 25 March 2015, Bloemfontein, South Africa

Over the last 20 years, the District Health Information System in South Africa and in many countries in Sub- Saharan Africa and Asia has evolved significantly from a paper based system to a web based system. The conference is expected to be a platform through which this evolution is explored and where best practices and lessons learned are being shared. The conference will bring together a wide range of practitioners from health information users, systems developers, health leaders ranging from programme managers, district managers, provincial managers and health planners from South Africa and around the world. The audience will also include public health and health informatics students as well as researchers. The conference hopes to provide a platform to explore new developments, innovations and possibilities around health information systems development and information use. The conference will be preceded by 2 days of field visits to selected health facilities on 23rd and 24th March 2015 where candidates will be taken through practical aspects of the development process and where they can experience the use of the DHIS software first hand. Delegates may also wish to join the DHIS2 Academy which will be held from 13 – 22 March 2015 at the same venue



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