East and Central Africa Region workshop
Summary Report
People’s Health Movement (PHM)
East and Central Africa Region workshop
Dar es Salaam, Tanzania
29 Apr - 2 May 2002
Seventeen participants from six countries took part in the first
regional workshop of the People’s Health Movement (PHM) in Africa. The
aims of the workshop were to
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reflect on the experience of the People’s Health Assembly (PHA) -
held in Savar, Bangladesh in December 2000 - including the way the
People’s Health Charter can be used to help strengthen health
activities and systems in Africa and campaign for greater support for
comprehensive primary health care (PHC). (The concept of comprehensive
primary health care was first articulated at an international conference
in Alma-Ata in 1978.)
-
identify key health issues that are important for people in Africa
-
strengthen the work of the People’s Health Movement in Africa.
During the four-day meeting, participants:
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developed an interim coordinating circle for PHM activities in Kenya,
Tanzania, Uganda and Zimbabwe that will work to expand involvement of
other organisations, institutions and networks in those countries, and
to reach out to other countries in the region and elsewhere in Africa
-
confirmed support for the People’s Health Charter and identified
several areas within it that were a particular focus for Africa at the
present time
-
welcomed the availability of a draft version of the Charter in Swahili
and confirmed the need to encourage the development of other language
versions to ensure greater awareness of the issues raised in the Charter
-
reaffimed PHM’s commitment to listen to and work with grassroots
people and organisations and to provide opportunities and spaces for
their voices to be heard, listened to, and acted upon by policy and
decision makers
-
planned for a larger follow-up workshop in September 2002, in
conjunction with a series of training and information workshops that the
Africa PHM will hold as part of the World Alliance for Breastfeeding
Action (WABA) global forum in Arusha, Tanzania
-
identified issues to raise at a series of PHM meetings planned at the
2002 World Health Assembly (WHA) in Geneva in May - both to inform
government delegates at the WHA and to discuss with colleagues within
the PHM from other regions.
The workshop was opened by Dr Upunda G. L., Chief Medical Officer on
behalf of the Permanent Secretary for the Ministry of Health, Tanzania. Dr
Upunda said that ‘primary health care was and still is the correct pathway
for us all’. He said holding such a meeting in East Africa was ‘bringing
the agenda home’. He challenged the participants, and included himself and
the government in the challenge, by asking: ‘Do our plans allow for our
communities to re-strategise when things go wrong? Do we give them that
opportunity? Let’s listen to these communities. Do we? Do we? How many
times do we allow them to be part of their development?’
He said that ‘genuine people-centred initiatives must be strengthened
to increase pressure on decision-makers, governments and the private sector
to ensure that the vision of Alma-Ata becomes a reality’.
During the meeting, Mwajuma Masaiganah from Tanzania, who was selected as
the interim regional coordinator, responded to the challenge issued by Dr
Upunda by noting that ‘As non-governmental organisations (NGOs), we may
not have been keen enough to let power go to the people, and have maintained
the status quo. We should consider ourselves as a movement, a group that
pressures and leads a people-centred process.’
Participants reviewed and discussed the health issues in Africa, looking
at the range of disease conditions and the social, political and economic
determinants that affect people’s health. Among the diseases highlighted
were:
Participants stressed that HIV/AIDS was a serious problem for health in
Africa, but not the only problem, and that it was important to look at the
context and ensure that sufficient resources are available to prevent and
treat other leading diseases.
The social, political and economic determinants that were impacting on
health and that needed to be considered were identified as:
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Structural adjustment programmes
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Trade-related intellectual property rights (TRIPs)
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Corruption - which impacts at every level: bribes sometimes have to be
paid just to see a health worker
-
Gender insensitivity - increases the disparity in access to health
services. The health system tends to be gender blind
-
Conflicts and wars
-
Gender violence
-
Cultural beliefs and practices - particularly affecting sexual and
reproductive health
-
Environmental issues - including water and sanitation, deforestation
and natural disasters
-
Lack of basic infrastructure - transport, deterioration of the health
system, including lack of quality services.
Participants discussed a range of cultural beliefs and practices that
contribute to poor health and increase the risk of disease. They also
identified some practices that were helpful in strengthening healthy
behaviour. They recognised the need to support and encourage positive
practices, while working towards changing or eliminating those that impact
adversely on health.
Participants identified the need for pro-active strategies and the need to
increase critical thinking among communities, so that they could play a
stronger role in finding their own solutions to health concerns and would be
empowered to take action to demand their rights.
A key link in this process was the need to develop partnerships with local
and national governments, to complement their work and strengthen their
ability to provide services that people need. Governments should help
peoples’ organisations, including the PHM, to be recognised and
represented at decision making forums where issues affecting health are
discussed, and to facilitate their recognition and support from national and
international donors as channels for resources to facilitate the process of
grassroots involvement.
The People’s Health Charter was seen as a useful tool to help in a
people-centred process of mobilisation and awareness building at the
grassroots level. The PHM should work hand in hand with existing public
health care committees at the grassroots level. Communicating the issues
expressed in the Charter is a way of breaking the silence around many of
these health concerns and strengthening peoples’ ability to be involved in
the process of both contributing to and demanding the development and
strengthening of relevant and effective health services.
Particular attention needs to be paid to engendering the process so that
gender specific needs are considered and communicated at every step - from
planning, resourcing, implementing, and monitoring and evaluation of the
process.
Participants identified the role of the PHM in Africa as being that of a
strong unifying force, helping to bring together many of the people and
organisations involved in effective initiatives to improve health. Interim
national coordinators were selected to help with this. They are:
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Tanzania: Mathew Kimario
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Kenya: Malachi Orondo
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Uganda: Alice Drito
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Zimbabwe: Mary Sandasi.
A full report of the proceedings will be available by the end of June
2002.
Thanks are due to One World Action, Dag Hammarskjold Foundation and Exchange
whose support helped make this workshop possible.
Peoples’ Health Movement
East and Central Africa Circle
PO Box 240, Bagamoyo, Tanzania
E-mail: masaigana@africaonline.co.tz
Tel: +255 23 2440062
Mobile: 0744 2812600/ 0741 434116
