Role of Civil Society in Achieving Health for All India Country Study
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Role of Civil Society in Achieving Health for All India Country Study August 2016 - 1 - Contents 1. Background ................................................................................................................................... 3 2. Methodology ................................................................................................................................ 4 1. India Research Team ................................................................................................................. 4 2. Data Collection .......................................................................................................................... 6 3. The Report ................................................................................................................................ 6 3. Social Movements and Health for All: Review of Literature.......................................................... 7 3.1 Part I: Approaches to Movement Building .................................................................................. 7 3.2 Part II: The Movement for Health in India................................................................................. 21 4 Role of Civil Society in Achieving Health for All: Analysis of Primary Research ........................... 32 4.1 Movement Building ................................................................................................................... 32 4.2 Campaigns ................................................................................................................................. 46 4.3 Civil society led knowledge generation, dissemination and use for Health for All in India ....... 56 4.4 Civil society led training and capacity building for Health for All in India.................................. 60 4.5 Global Health Governance ........................................................................................................ 75 Annexes .............................................................................................................................................. 82 Annex 1. Final Protocols – IDRC Project – India Study .................................................................... 82 Annex 2. Consent Form ................................................................................................................... 89 Annex 3. The PHA Process .............................................................................................................. 90 Annex 4. Campaign Examples ......................................................................................................... 99 - 2 - 1. Background The 4 year action research project initiated by Peoples Health Movement (PHM) with support from IDRC. The project incorporates two major objectives/components: • A formative evaluation of PHM’s five main programs: the Global Health Watch (GHW), the International People’s Health University (IPHU), the ‘Health for All campaign’ (HFAC), the ‘Democratizing Global Health Governance focusing on watching the WHO (WHO-watch), and the movement building at country level. • Empirical research into civil society engagement in working towards Health for All. It aims to document (and support) the People’s Health Movement (PHM) and other Civil Society Organisations (CSOs) in their activities that promote ‘Health For All’ (HFA), while locating health in an understanding that embraces the structural and social determinants. A major portion of the research at the country level is located in 6 countries: Brazil, India, South Africa, Italy, Colombia and the DR Congo. While the study is designed to focus on PHM, its scope also includes a range of other CSOs that are not necessarily part of PHM but that actively promote or support the cause of HFA. In addition there is a global component of the study directed at researching PHM’s global programs and other aspects of PHM’s work directed at ‘movement building’. Thus the study aims to generate knowledge about how social movements and CSOs are influencing health systems and the social and structural determinants of health and building a larger and stronger people’s movement for Health for All at both national and global levels. The term ‘Health for All (HFA) movement’ is used to refer in aggregate to represent various civil society organisations and networks who are trying to achieve Health for All including for decent health care for all and for social conditions which support good health, as part of PHM or independently. To understand engagement of CSOs in HFA movement in different country settings, country study teams were tasked with studying CSO contributions on: (1) campaigns and advocacy; (2) movement building; (3) knowledge generation, dissemination and use; (4) capacity building; and (5) engagement with global health governance; towards promoting ‘Health for All’ in the specific country. This report presents the country study for India. - 3 - 2. Methodology 1. India Research Team In accordance with the expectation of the involvement of the India PHM country circle in supervising, conducting and participating in the research for India, an India Research Team was convened. The group comprised JSA members who expressed an interest in undertaking the responsibility of . The JSA members of the India Research Group were: • Amit Sengupta • Susana Barria • Vandana Prasad • Ganapathy Murugan • Indranil Mukhopadhyay • Joe Varghese • Raman VR • Deepa Venkatachalam • Sarojini N.B. The India Research Team was assisted by Rohan Mathews in conducting the literature review and by Kajal Bhardwaj in the research and in writing of this report. The India Research Team convened three meetings at the beginning of the research to adapt the global research to the situation in India. In these meetings, the following decisions were taken: a. Formative Research (as opposed to action research): The research conducted in India would not be action research but would be formative research instead given the timeline for the research, the limited human and financial resources and the unique nature of the PHM in India. b. Case Studies and Processes: The data collection for the research would focus on case studies and processes c. JSA and non-JSA Groups: Given the nature of the health movement in India, the interviews would be conducted with JSA and non-JSA groups. Non-JSA groups would include those that are formally members of the JSA as well but would be interviewed on their work outside of the JSA. d. Selection of non-JSA groups for the research: Across the 5 main themes of the research, the India Research team first identified as many key networks, groups and organisations as possible working in the area. The long list is at Annex 3. Based on their own experience and knowledge, a short list was prepared and the groups identified were further categorised based on their area of expertise. Five of these were selected for in-depth interviews across all the areas of research while the rest would be interviewed only in select areas of research. To account for bias and lack of knowledge, a call was put out on the JSA list serve for the submission of experiences in the different areas of research. Based on the submissions, the short list was modified to include additional groups in the list of interviewees. The final list along with the areas that they were interviewed on is below. - 4 - Campaigns Movement Training/ Knowledge Engagement building capacity generation & to Global building dissemination Health Governance Jan Swasthya Abhiyan (JSA) Right to Food Campaign Medico-Friends Circle (MFC) All India Democratic Women’s Association Delhi Network of Positive People (DNP+) SAMA – Resource Group for Women and Health Peoples Health Resource Network (PHRN) Action Northeast Trust (ANT) Jan Swasthya Sahyog (JSS) Breastfeeding Promotion Network of India (BPNI) Third World Network (TWN) Society for Community Health Awareness Research and Action (SOCHARA) JSA Chhattisgarh e. Adaptation of Global Data Collection Protocols and Consent form: With the inclusion of the non-JSA groups, the protocols prepared by the global research team were adapted for the India research and a consent form was drafted for interviewees. The Final Protocols used in India are at Annex 1. The Consent Form is at Annex 2. e. Ethics Committee Approval: The research proposal, the final protocols and the consent form were submitted to the Ethics Committee of the Peoples Health Resource Network (PHRN) for review and approval. The Ethics Committee gave its approval to the research in April 2015. f. Literature Review: Before commencing the interviews the research team commissioned a literature review to analyse the secondary literature on the health movement in India. The Literature Review is presented in Section 3 of the report. - 5 - 2. Data Collection Interviews were conducted by members of the India Research Team between May 2015 and March 2016. Interviews were recorded through hand notes and voice recordings that were destroyed after the writing of the report. Interviewers also provided assessments and key points emerging from the interviews to inform the analysis in the report 3. The Report The Report was written as a joint effort by the India Research Team. Each area of the research in the report is preceded with a thematic explanation written by various members of the research team. - 6 - 3. Social Movements and Health for All: Review of Literature Editor's Note: As the literature review progressed it became apparent that there is insufficient