Training Workshop on Participatory Methods for a People Centred Health System
“Strengthening community focused, primary health care oriented approaches to social accountability and action”

Zimbabwe: 7th -10th October 2013
In 2013 TARSC through COPASAH and EQUINET held a regional workshop on Participatory Approaches to Strengthening People-Centred Health Systems in the east and southern Africa (ESA) region. The training brought together 28 delegates from 7 countries in east and southern Africa (see Appendix One for list of participants) to discuss and deepen our understanding on ways to strengthen primary health care through improved public involvement and health service accountability.

The training came about because of a joint interest within all three lead organisations to explore how
Participatory Reflection and Action (PRA) approaches could be used to raise community voice in strengthening the functioning and resourcing of primary health care (PHC) systems in the region. The Community of Practitioners in Accountability and Social Action in Health (COPASAH), who initiated the training with support from Open Society Foundations (OSF), is a global network of practitioners with a strong focus on building the field of community monitoring for accountability in health. The Training and Research Support Centre (TARSC), based in Zimbabwe, has a strong community based research and community monitoring programme to build social power in health and uses a multiplicity of complementary approaches – including PRA - to generate relevant knowledge, and raise community voice and actions. TARSC is the lead for the pra4equity network in the Regional Network for Equity in Health in east and southern Africa (EQUINET), a consortium network that aims to promote and realise shared values of equity and social justice in health in east and southern Africa. Thus, this training drew on the knowledge base of the pra4equity network (coming from 20 studies in 9 countries in the ESA region), as well as the learning coming out of COPASAH, to explore ways of improving public involvement, social action and social accountability in health for local level action and advocacy.

Report of Training Workshop on Participatory Methods for A People Centred Health System at Zimbabwe, 7-10 October 2013

The training specifically aimed:

• To build an understanding of PRA approaches and their use in strengthening people centred health systems
  
• To draw on experiences in the east and southern African region for strengthening community focused and PHC oriented approaches to community roles in social accountability and action.
  
• To work through practical examples of PRA approaches and their application in areas of work that participants are involved with at community level.
  
• To provide initial mentoring and support to development of research and training proposals in this field.
  
• To strengthen participant engagement in the COPASAH and EQUINET networks in the interest of deepening knowledge, debate and actions on issues of health equity and social justice.

The training used an existing EQUINET training toolkit on ‘Organising People’s Power for Health’ produced by TARSC and Ifakara Health Institute (IHI, Tanzania) in 2005. This toolkit (called the ‘PRA toolkit’ in this report) is separately available2 and provides details on many of the sessions and how they were conducted, so this report does not record this information. As a training workshop using PRA methods, the meeting involved dialogue and exchange of experiences, activities to encourage reflection and discussions on follow up, lessons learned and many other activities (see the full programme in Appendix Two). This report cannot do justice to the rich and diverse exchanges that took place in the meeting, but we have tried to capture through quotes and pictures some of these exchanges and the major agreed areas of action and reflection arising from the meeting.

Our facilitators for different sessions of the meeting were Barbara Kaim from TARSC, Robinah Kaitiritimba from the Uganda National Health Consumers/Users Organisation (UNHCO), and Clara Mbwili and Adah Zulu from the Lusaka District Health Management (LDHMT) Team in the Ministry of Health in Zambia. This report was prepared by TARSC, with support from Isabella Matambanadzo.

The 28 participants, representing 18 organisations from 7 countries – that is, from Kenya, South Africa, South Sudan, Tanzania, Uganda, Zambia and Zimbabwe - brought a diversity of skills, experience and knowledge from different work contexts. We were community health activists, civil society organisation reps, health workers, people working in state health departments, academics and researchers. We came from different parts of the region and left as a learning community!