Taking the WHO global code of practice on the international recruitment of health personnel from bottom drawer to negotiating table and action in Africa

Implementation of the World Health Organisation “Global Code of Practice on the International Recruitment of Health Personnel” (2010) is reported to be impeded by: lack of champions; resources for implementation; weak functional data (systems) on mobility of health personnel, and by limited domestication and dissemination of the Code in eastern and southern Africa (ESA) countries. This brief presents opportunities to use the Code in negotiating bilateral agreements and suggests ways of strengthening its implementation. Gains made at the global level need to be supported bilaterally, with both region and country engagement

Enhancing local medicine production in east and southern Africa

The policy brief identifies the barriers to local medicine production in East and Southern Africa (ESA) as: lack of supportive policies, capital and skills constraints, gaps in regulatory framework, small market size and weak research and development capacities. It provides highlights from case study work in selected countries, and references potential opportunities for strengthening local production. The paper proposes that African countries strengthen domestic capacities, co-operation between domestic private and public sectors within ESA countries, and regional co-operation across ESA countries to address bottlenecks

Unlocking community capability through promotion of self-help for health: experience from Chakaria, Bangladesh

Background People’s participation in health, enshrined in the 1978 Alma Ata declaration, seeks to tap into community capability for better health and empowerment. One mechanism to promote participation in health is through participatory action research (PAR) methods. Beginning in 1994, the Bangladeshi research organization ICDDR,B implemented a project “self-help for health,” to work with existing rural self-help organizations (SHOs). SHOs are organizations formed by villagers for their well-being through their own initiatives without external material help. This paper describes the project’s implementation, impact, and reflective learnings. Methods Following a self-help conceptual framework and PAR, the project focused on building the capacity of SHOs and their members through training on organizational issues, imparting health literacy, and supporting participatory planning and monitoring. Quarterly activity reports and process documentation were the main sources of qualitative data used for this paper, enabling documentation of changes in organizational issues, as well as the number and nature of initiatives taken by the SHOs in the intervention area. Health and demographic surveillance system (HDSS) data from intervention and comparison areas since 1999 allowed assessment of changes in health indicators over time. Results Villagers and members of the SHOs actively participated in the self-help activities. SHO functionality increased in the intervention area, in terms of improved organizational processes and planned health activities. These included most notably in convening more regular meetings, identifying community needs, developing and implementing action plans, and monitoring progress and impact. Between 1999 and 2015, while decreases in infant mortality and increases in utilization of at least one antenatal care visit occurred similarly in intervention and comparison areas, increases in immunization, skilled birth attendance, facility deliveries and sanitary latrines were substantially more in intervention than comparison areas. Conclusion Building community capability by working with pre-existing SHOs, encouraging them to place health on their agendas, strengthening their functioning and implementation of health activities led to sustained improvements in utilization of services for over 20 years. Key elements underpinning success include efforts to build and maintain trust, ensuring social inclusion in project activities, and balancing demands for material resources with flexibility to be responsive to community needs

Participatory methods for a people centred health system : training workshop; meeting report, held at the Paradise Hotel Bagamoyo Tanzania, February 14 to 17 2007

The workshop aimed to build skills, share experiences and strengthen work on participatory methods for people centred health systems. The meeting involved dialogue and exchange of experiences, activities to encourage reflection and discussions on follow up, with exchanges on work done in 2006 and the lessons learned. Participants reported skills building and greater community involvement in health activities; changed perceptions of and behaviours in planning; and became more aware of the constraints related to resource allocation. Other sessions explored how to identify health needs in communities, how to prioritise these needs and to look for the causes of ill health

Parliamentary committee experiences in promoting the right to health in East and Southern Africa

This report presents the findings of a survey of the work and experiences of parliamentary committees on health, and their understanding and engagement with human rights. The paper analyzes responses of parliamentarians and highlights the importance of building capacity for improved interpretation and use of rights-based analyses in their parliamentary roles. Relatively few respondents were explicit about rights-based considerations in their work. Stronger civil society engagement in health policy formulation and oversight of implementation is critical. Many countries in the region have signed international agreements that affect the right to health, with implications for legislative action