Do global health platforms provide meaningful opportunities to advance equitable health systems and population health in east and southern Africa? What factors have supported effective negotiation of African policy goals on health systems within international and global health diplomacy?
Zimbabwe is a lower middle income country with a highly literate population and significant natural resources. The country experienced a fall in life expectancy in the 1990s due to AIDS, but the prevalence of HIV fell after 2002 and life expectancy improved. Economic decline in the 2000s was associated with falling incomes and health, but has also improved somewhat after 2008.
Malawi is a low income country in southern Africa, with a high rate of poverty. Like many others in the region, the country is experiencing combined burdens of communicable disease, chronic conditions and maternal, neonatal and child mortality. In 2006, according to Ministry of Health data, HIV/AIDS was the leading cause of death, accounting for a third of all deaths, followed by respiratory infections and malaria.
Charlotte M Zikusooka, Mark Tumwine, Patrick Tutembe HealthNet Consult
Global health initiatives (GHIs) are an emerging and global trend in health that focus on partnerships. The introduction of GHIs in Uganda has had significant impacts on the overall health care financing, but there has been no assessment of their impact on equity in overall health sector financing in Uganda.
A Participatory Reflection and Action Project Report
In the DR Congo, where the national HIV prevalence is around 5%, testing and treatment services are more available in urban than rural areas, despite the latter being more affected by the epidemic. In Bunia and Aru, North eastern DRC, people living with HIV and AIDS (PLWHA) cannot access testing or treatment services unless they travel to Bunia town, some distance away.
EQUINET discussion paper No. 45
In 2006 the Regional Network for Equity in Health in east and southern Africa (EQUINET) and the Health Systems Research Unit of Medical Research Council (MRC), South Africa commissioned a series of country case studies on existing food security and nutrition programmes in the region that demonstrate good practice in health systems promotion of food sovereignty and equity. This report outlines one of the case studies.
In 2006, the Regional Network for Equity in Health in East and Southern Africa (EQUINET) and the Health Systems Research Unit of the Medical Research Council (MRC) of South Africa commissioned a series of country case studies on existing food security and nutrition programmes in East and Southern Africa that promote food sovereignty and equity.
The report describes the exodus of healthcare workers from areas of poverty and low socio-economic development, to more highly developed areas. The flows follow a hierarchy of 'wealth' and result in a global conveyor belt of health personnel moving from the bottom to the top, increasing inequity. The report describes personnel flows and migration from rural to urban areas, from public to private sectors, from lower to higher income countries within southern Africa and from African countries to industrialised countries.