Developing Research Partnerships to Bring Change : Experiences from REACH Trust Malawi

Drawing on the experiences of REACH Trust; this paper highlights practical lessons of using research processes and outcomes to promote equity in health policy and practice. The REACH Trust is first introduced. Case studies are then used to highlight how REACH Trust has worked in a participatory manner with key stakeholders at community; national and international levels. In addition to participatory working there are a number of cross-cutting themes that facilitate the uptake of research findings which is discussed in turn: (1) multi-disciplinary and multi-method approaches (2) advocating research findings at strategic forums; and (3) the use of strategic frames. In the conclusion it is argued that research has a critical role to play in responding to the urgent need for the Malawian health sector to develop and act on evidence-based practice in a more gender equitable and pro-poor manner

Framework for Monitoring Equity in Access and Health Systems Issues in ART Programmes in Southern Africa

Universal provision of antiretroviral therapy (ART); while feasible; is expensive. In light of this limitation; the World Health Organisation (WHO) has launched the 3 x 5 initiative; to provide ART to 3 million people by the end of the year 2005. In Southern Africa; large-scale provision of ART will likely be achieved through fragile public health systems. ART programmes should therefore be developed and expanded in ways that will not aggravate inequities or result in the inappropriate withdrawal of resources from other health interventions or from other parts of the health system. This paper; proposes a framework for monitoring equity in access and health systems issues in ART programmes in Southern Africa. It proposes that an equity monitoring system should comprise seven thematic areas. These thematic areas encompass a national monitoring system which extends beyond one agency or single data collection method. Together with monitoring of targets in terms of numbers treated; there should also be monitoring of health systems impacts and issues in ART expansion; with reporting both nationally and to a regional body