Transcript Regional Network for Equity in Health in Southern Africa

Bringing local evidence to global processes
for strengthening African voice in GHD
R Loewenson,
Training and Research Support
Centre, EQUINET
www.tarsc.org;
www.equinetafrica.org
Programme on globalisation and
womens health with
S Wamala, Karolinska, Sweden
Case studies with
M Nyamongo AIHD, Kenya
J Kanyamurwa Makerere, Uganda
P Kamuzora TARSC Tanzania
Rates of childhood stunting 1995-2005
Source WHO 2003 de Onis et al 2003, 2004
Food crises in southern Africa 2002
ZIMBABWE
: food
shortages:
ZAMBIA: second year
of crop failure: few
food stocks:
MALAWI: >70% of
population facing
food shortages;
Highest food insecurity ->
LESOTHO: second
year of food
shortages: maize
prices high;
MOCAMBIQUE:
severe floods
2000 and 2001:
drought 2002:
Chopra 2004
Global dimensions to the food crisis in Africa
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Climate change and water stress- 1990 twelve
countries in stress; 2025 trends predict 22
countries in stress
TNC control of agrochemicals, patents, grain
distribution, retail sales
Rising trade in/ consumption of fast foods
Trade and food prices – 67% increase in FPI
March 2009 to March 2011
Trade rules- Unresolved market access issues
New pattern of large scale land acquisitions for
export production, biofuels, bioengineering
Sources: Loewenson et al 2010, GRAIN 2010, Shrecker 2011, UN ECA 2009
Literature review of Globalisation, womens occupational
roles and nutritional outcomes
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199 peer reviewed, cross national, large scale studies,
official sources, review 1990-2009
Positive (12 papers): Improved technology,
information, normative commitments, investment in
low income producers, urban employment
Negative (58 papers): Falling national/local food self
sufficiency, livelihood, nutritional losses, inequalities,
insecure access to production inputs, local foods and
heath care
Time, labour, resource burdens amenable to public
policy with nutritional benefits – diplomacy for a green
revolution or a gender revolution in agriculture Africa?
Source: Loewenson et al 2010 SJPH 38(Supp 4)6-17
Equalising production
inputs between men and
women in Burkina Faso
Source: Udry et al in Chopra 2004;
Improving soil
fertility and
nutrition through
legume production
in Malawi
IDRC Ecohealth 2011
Analysis of MDG panel database
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2000-2006 data including 48 African countries
Analysis of associations in MDG1 (poverty,
underweight, diet), MDG3 (gender equality in
literacy, education, employment, parliament)
MDG8 (global partnership- duty free imports;
tariffs, ODA to trade capacity)
MDG database cannot measure trade impacts
on womens health – trade disaggregations not
to country level; inadequate gender
disaggregation.
Evidence needed from other sources to
support negotiations
Source: Wamala et al 2010 SJPH 38(Supp 4)18-21
What contribution from African research?
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Body of relevant evidence – not linked to global
policies or made accessible to global negotiators
AREAS FOR A RESEARCH AGENDA
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Bringing local, national, regional evidence and analysis
to global policy development and global financing
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Highlighting and explaining gaps between global policy
commitments and goals and local realities
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Asking and exploring ‘what if’ questions to examine
and inform alternatives based on African realities and
interests
Source: Loewenson 2011, AIHD, TARSC Karolinska 2011
Challenges to research supporting GHD
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Understanding global policy, complex
attribution, linking paradigms across
disciplines
Lack of data specific to globalisation and
health; limits to information access, especially
from TNC and global processes
Design issues
Funding and resourcing research
Accessing and engaging communities and
policy personnel on globalisation and health
issues
Source:AIHD, TARSC Karolinska 2011
Options and innovations
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Involving policy personnel and multiple disciplines and
countries, investment in training and problem
formulation
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Systematic reviews on policy relevant questions;
monitoring and evaluation; multicountry work;
community based evidence on ‘what if’ questions
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Drawing on wider disciplines and regions: Case
studies; scenario building; policy analysis
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Integrate evaluation / evidence into global programmes
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Develop and engage partnerships early in the process,
across sectors and integrating in existing networks
Source:AIHD, TARSC Karolinska 2011
Partnerships and links in ESA
Regional training programmes – eg UWC SoPH,
U Nairobi, SA Inst Diplomacy, IPHU, web courses
Regional transdisciplnary research networks EQUINET, Ecohealth, CODESRIA, INDEPTH
Regional policy and advocacy forums – SADC,
EAC, COMESA; Civil society, economic/social
justice networks, PHM; parliament associations
Supporting Strategic Leadership in Global
Health Diplomacy in East, Central and Southern
Africa ECSA Health Community, MoPHS Kenya,
Uni Nairobi, SA Dept of Int Relns and Coopn,
EQUINET (TARSC, SEATINI)