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<div class=Section1><pre><b><font size=2 color="#990000" face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:#990000;font-weight:bold'>EQUINET PRA Report 10: Consolidating processes for community – health centre partnership and accountability in Zambia,<o:p></o:p></span></font></b></pre><pre><b><font
size=2 color="#990000" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#990000;font-weight:bold'>C Mbwili-Muleya, M Lungu, I Kabuba, I Zulu Lishandu, R Loewenson</span></font></b><o:p></o:p></pre><pre><font
size=2 color="#663366" face=Arial><span style='font-size:10.0pt;font-family:
Arial'><o:p> </o:p></span></font></pre><pre><b><font size=2 color="#990000"
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:#990000;
font-weight:bold'>Cite as: </span></font></b><font color=purple face=Arial><span
style='font-family:Arial;color:purple'>Mbwili-Muleya C, Lungu M, Kabuba I, Zulu Lishandu I, Loewenson R (2008) ‘Consolidating processes for community – health centre partnership and accountability in Zambia,’<span style='mso-spacerun:yes'> </span>EQUINET PRA project report 10. EQUINET: Lusaka District Health Team, Equity Gauge <st1:country-region
w:st="on">Zambia</st1:country-region>, <span class=GramE>EQUINET</span>: <st1:City
w:st="on"><st1:place w:st="on">Harare</st1:place></st1:City>.<o:p></o:p></span></font></pre><pre><font
size=2 color="#663366" face=Arial><span style='font-size:10.0pt;font-family:
Arial'><o:p> </o:p></span></font></pre><pre><b><font size=2 color="#990000"
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:#990000;
font-weight:bold'>Available online at: </span></font></b><font color="#993399"
face=Arial><span style='font-family:Arial;color:#993399'><a
href="http://www.equinetafrica.org/bibl/docs/PRAequitygauge2008.pdf"
moz-do-not-send=true>http://www.equinetafrica.org/bibl/docs/PRAequitygauge2008.pdf</a><o:p></o:p></span></font></pre><pre><font
size=2 color="#993399" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#993399'><o:p> </o:p></span></font></pre><pre><font size=2
color=purple face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:purple'>This report has been produced within the capacity building <span
class=SpellE>programme</span> on participatory research and action (PRA) for people <span
class=SpellE>centred</span> health systems in EQUINET. It is part of a growing mentored network of PRA work and experience in east and southern <st1:place
w:st="on">Africa</st1:place>, aimed at strengthening people <span class=SpellE>centred</span> health systems and people’s empowerment in health. The report presents the work and outcomes from the follow up action research building on a pilot in 2006 that aimed to strengthen community-health centre partnership and accountability in two districts in <st1:country-region
w:st="on"><st1:place w:st="on">Zambia</st1:place></st1:country-region>. The action research presented consolidated the participatory approaches initiated in 2006 to further enhance the community voice in planning, budgeting and implementation activities at HC and community level; extended the process to two new health <span
class=SpellE>centres</span> in Lusaka, and built the capacity of the 2006 group to facilitate scale up of the work to other <span
class=SpellE>centres</span>. It explored through this the possibilities for scaling up such processes at wider level. The project demonstrated that using participatory approaches can de-mystify and remove suspicions surrounding the district and health centre planning process, strengthen dialogue between communities and health workers, increase community involvement in planning and budget processes and resolve issues in the interface between health workers and communities. If the processes are to be institutionalized the lessons from the action research are that participatory processes take time to have impact, need continuous mentoring and resource support in the early stages, need to be integrated within routine work and supported by authorities, with orientation of new health workers. Not investing in scale up of the process, however, leads to persistence of disharmony between health workers and communities caused by lack of communication and information flow, undermining the functioning of health systems as envisaged in policy.<o:p></o:p></span></font></pre><pre><font
size=2 color="#990000" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#990000'><o:p> </o:p></span></font></pre><pre><font size=2
color="#990000" face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:#990000'>December 2008</span></font><font face=Arial><span
style='font-family:Arial'><o:p></o:p></span></font></pre><pre><font size=2
color="#330099" face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:#330099'><o:p> </o:p></span></font></pre><pre><font size=2
color="#993399" face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:#993399'>/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\<o:p></o:p></span></font></pre><pre><font
size=2 color="#993399" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#993399'><o:p> </o:p></span></font></pre><pre><font size=2
color="#993399" face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:#993399'>This email alerts to a new publication from the Regional Network for Equity in Health in East and Southern Africa (EQUINET).<o:p></o:p></span></font></pre><pre><font
size=2 color="#993399" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#993399'>Further information on EQUINET can be found at <a
href="http://www.equinetafrica.org" moz-do-not-send=true>www.equinetafrica.org</a>, where all publications of the network can be found and downloaded.<o:p></o:p></span></font></pre><pre><font
size=2 color="#993399" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#993399'>Comments and peer review feedback on this or any other EQUINET publication are welcomed and should be sent to <a
href="mailto:admin@equinetafrica.org" moz-do-not-send=true>admin@equinetafrica.org</a> </span></font><font
face=Arial><span style='font-family:Arial'><o:p></o:p></span></font></pre></div>
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