Governance for Health in Developing Countries

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    Obijiofor Aginam

    Based on the definition of governance as the “sum of the many ways individuals and institutions, public and private, manage their common affairs”, the aim of this project is to explore how local, national, regional and global governance processess, institutions, and policies can work better for human health and well-being. While most studies have focused on how the rules, norms and practices of formal and informal governance institutions (states, international organizations, and non-state actors) tackle health challenges, few studies have focused on how governance processses outside the health sector can be harnesed towards the protection and promotion of human health. Focusing on developing countries where governance poses enormous challenges, this project focuses on two issue areas: (i) Urban Governance for Health, and (ii) HIV/AIDS and the Security Sector in Africa. Governance has become an important theme in urbanization in most countries because of rapid economic growth, development, and rural-urban migration in search of economic opportunities in the cities. In most developing countries, urbanization carries a number of health challenges including exposure to outdoor pollution; infectious/communicable diseases; overcrowding, violence and crime; stress; dietary changes; and sedentary lifestyles. The “urban poor”, including most residents of slums and informal settlements, often face inadequate housing, poor sanitation, water and food insecurity, overcrowding, indoor pollution, substance abuse, crime and violence, and lack of social support and health care. As the International Council for Science (ICSU) observed, urban health and wellbeing is shaped by many formal and informal policies, budgetary and regulatory decisions made at global, national, city and local scales as well as negotiations over access to power and services that may enhance or detract from urban health and wellbeing. To address these complex governance challenges for urban health, this project shall explore relevant case studies from countries in Africa, South East Asia, Latin America and the Caribbean. The other sub-project focuses on the impact of HIV/AIDS on the security sector in Africa. Although this has been the subject of numerous studies, certain sub-sectors (e.g. prisons) within the broad security sector have been neglected. Problems of over-crowding and embedded prison culture (power relations, exploitation, and related internal dynamics) are well-known factors that drive the spead of HIV in the prisons. This project seeks to generate policy-oriented recommendations to catalyze policy reform to address the spread of HIV in the prison sectors of selected African countries. It builds on earlier UNU study on HIV/AIDS and the security sector in Africa.