Health Centre Committees (HCCs) as a vehicle for social participation in health in East and Southern Africa

The programme seeks to capacitate Health Centre Committees (HCCs) by strengthening advocacy, laws and approaches on a regional level. Encompassed in the overall goal of the programme is the principle that HCC roles should be clearly located within national health system processes.
As the lead organisation on the programme, CWGH is working in partnership with the Training and Research Support Centre (TARSC) on photovoice and information sharing; University of Cape Town (UCT) School of Public Health on training programmes; and the Lusaka District Health Management Team (LDHMT) on legal provisions.
Work in Kenya, Zambia, Malawi, South Africa, Uganda and Zimbabwe also focuses on advocating for policy and legal recognition of HCCs, giving visibility to their roles as well as identifying and strengthening the different capacities that committees and the health systems need for HCCs to implement these roles. This includes areas such as tracking and monitoring health system budgets and resources and their use and health system performance as well as building social dialogue and accountability.
As part of the work, UCT in South Africa is building a database of information on the current training materials and training programmes for HCCs to enable us to share materials, skills and experiences on capacity building in the region, and to advocate for HCC training that addresses their roles comprehensively. and their coverage of the key areas of functioning. LDHMT in Zambia has initiated an in-country process to review the laws and regulations that provide for the establishment and functioning of HCCs, and to document the Zambia experience for wider regional exchange. In Zimbabwe, the CWGH has supported the HCCs to engage with government, so that HCC members can speak out about their concerns on the health system and on the support they need to successfully implement their roles. Training on community photography by TARSC means that the members have visual tools as well as words to raise evidence on their problems and progress.
Social participation in health systems has been a consistent element of post-independence health policies in East and Southern Africa (ESA) countries and central to Primary Health Care (PHC) approaches that meet the health needs of target populations. A 2007 Regional Equity analysis done by the Regional Network for Equity in Health in East and southern Africa (EQUINET) highlighted that social participation and power are key for equitable health systems and for reclaiming and using resources for health. The report noted that regionally access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as health policies.