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The role of civil society in putting equity on the research agenda

Date: Thursday 1 November 10.45–12.15
Source: Forum 11
Authors: Itai Rusike, Steering Committee Member, Regional Network for Equity in Health in East and Southern Africa (EQUINET), Zimbabwe


Analysis of the current health conditions in east and southern Africa (ESA) set out in the Regional Network for Equity in Health in East and Southern Africa (EQUINET) Regional Equity Analysis point to three major areas of action to improve health equity: 1) for poor people to claim a fairer share of national resources to improve their health; 2) for a more just return for countries in ESA from the global economy to increase resources for health; and 3) for a larger share of global and national resources to be invested in redistributive health systems to overcome the impoverishing effects of ill- health.

Health systems can make a difference in these areas, by providing leadership, shaping wider social norms and values, demonstrating health impacts and promoting work across sectors. Evidence shows that this calls for comprehensive, primary health care-oriented, people-centred and publicly led health systems, especially to reach the most disadvantaged people with greatest health needs. These approaches are not without challenges, whether from local elites, competing approaches or global trade pressures.

These challenges meet two strong counter-forces for health equity: the universal human right to health and the international conventions that protect this right, and the social pressure, resources, networks and capabilities that exist to achieve equity- oriented goals. The paper identifies the ways health systems and civil society in ESA can and do act to empower people, stimulate social action and create powerful constituencies to advance public interests in health, including through the use of research.

Civil society has an important role to play in strengthening the collective capability of people to assert their own needs and interests, in influencing, monitoring and holding systems accountable for the allocation of resources towards health needs and in challenging inequity in power and resources. In the research sector, this is done by influencing and setting research agendas, collecting of evidence and active engagement in the use of evidence. Engagement is most effective when health systems adequately resource community roles, invest in and recognize their communication and facilitation functions, and provide functional mechanisms for dialogue and interaction with communities.