TARSC Annual Report 2005 - Training and Research Support Centre

Training and Research Support Centre (TARSC)
Annual Report 2005

TABLE OF CONTENTS
1. ABOUT US 3
2. OUR WORK IN 2005 6
2.1: RESEARCH ACTIVITIES AND RESOURCES 6
2.1.1 Participatory and community based research 6
2.1.2 Community monitoring and sentinel surveillance 7
2.1.3 Other research 8
2.1.4 Research materials produced in 2005 10
2.2: CAPACITY BUILDING ACTIVITIES AND RESOURCES 11
2.2.1 Capacity building activities 11
2.2.2 Material Development for participatory research and training 14
2.2.3 Training materials produced in 2005 16
2.3: INFORMATION RESOURCES 17
TARSC, 47 Van Praagh Ave, Milton Park, Harare Zimbabwe
Phone: +263-4- 708 835 / 705 108 / 725 194 Fax: +263-4-737 220
Email: admin@tarsc.org Website: www.tarsc.org
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1. ABOUT US
Training and Research Support Centre (TARSC) Zimbabwe is a non profit
company registered in 1994 in terms of Sub-Section 4 of Section 13 of
Statutory Instrument 178 of 1984 by the Minister of Justice, Legal and
Parliamentary Affairs in terms of Section 26 of the Companies Act (Chapter
24;03). The full objectives of the company may be examined at the office
of the Registrar of Companies, Electra House, Samora Machel Avenue,
Harare.
The principal objective of the organisation is to provide training, research
and support services to develop social and organisational capacities within
state and civil society organisations to interact on areas of social policy
and social development.
TARSC works towards these goals through
• Research, particularly analytic and participatory research
• Capacity building and mentoring in research methods, particularly
participatory action research and community based research
methods, to inform social and economic policy debates
• Compilation, analysis and review of information on social and
economic development
• Training, skills development and mentoring of organisations working
in areas of social and economic development
• Technical advisory services and support to networking and engagement between civil society, private
sector and state on specific areas of social and economic policy. TARSC is a small organisation that
works with other organisations and areas of expertise to fulfil its goals.
TARSC provides technical support, mentoring, cadreship building and organizational development to a range of
membership based civil society organizations, to organizations in the state, in local government and in
parliament at local, national and international level. The work focuses on various dimensions of health and
social development outlined in more detail in the ten year review in the TARSC annual report for 2004. The
organization has developed partnerships, materials and other resources towards this and has made its resources
publicly available. TARSC is a learning and knowledge organization, with a particular focus on skills building
and methods to support community based work, and with a commitment to long term national capacity
building in the public sector and in civil society.
Our organisational structure is shown overleaf. In late 2005, the current directors, Dr Rene Loewenson
and Dr Nikki Jazdowska, welcomed a new director to
TARSC, Itai Rusike. Itai has had a long association
working with TARSC, first as a research officer, then
as a project officer with the Community Working
Group on Health (CWGH). In 2003 Itai became the
executive director of the CWGH when it became an
independent trust. Itai has demonstrated throughout
this time a shared commitment to the goals at TARSC
and a significant contribution towards these. TARSC
welcomed Itai formally at the launch of the new Auntie
Stella pack and of TARSC materials on health in October 2005.
TARSC ANNUAL REPORT 2005
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Directors
Policy Board
General Manager
Administration and Technical (2 posts)
Overall management responsibility for the
organisation and for delivery on its goals and
responsibilities
Policy Advisory Body
Provides the Directors and General
Manager with advice and guidance on
the key goals, institutional and
programme developments and
organisational frameworks for TARSC
Finance Unit
Financial management
services
• Finance manager
• Bookeeper
• Accounting
• Audit
Administration
Unit
Administration services
• Admin secretary
• Messenger
• Legal,
• Cleaner Gardener
and security
services
Technical Unit
Technical programmes & services
• Community based and
participatory research
• Community monitoring
• General Research
• Sectoral skills training
• Research skills training
• Material development
• Information resource centre
• Web, IT and publications
In addition to the directors named above, personnel working directly on TARSC programmes include
• The General manager (Administration):
Zvikomborero Mlambo
• Project managers, consultants, researchers:
Barbara Kaim, Rose Tindwa, Thomas
Chikumbirike, Godfrey Musuka,
Elizabeth Shoko, Faith Chikomo, Naira Khan
• Library, information and secretarial: Mevice
Makandwa
• Bookkeeper: Jacob Chakupwaza
• Office clerk/ messenger: Francis Chakupwaza
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Our work is documented in a range of research reports, training
materials and other documents, with over 700 documents that
we have directly produced available in our library and a website
(at www.tarsc.org), where we provide information on our
ongoing work, access to TARSC publications and to resources
for work on health and social development.
In October 2005 we held an evening event that was a ‘thank
you’ to our many partners over the last 10 years. We used the
opportunity to launch our new ‘Auntie Stella’ training materials
and to present the range of TARSC research and training
materials that have been produced.
Any activity in the organization is an outcome of the combined
inputs of the technical, administration and finance departments.
The administration unit provides a conducive workplace,
functional communications systems, supplies, copying, printing
and other inputs. The administrative staff have supported the
viability of the organisation under difficult economic conditions.
There is a spirit of togetherness and mutual respect among the
personnel in all departments for the role they each play. TARSC personnel have continued to deepen their own
capacities through formal training and through in-service mentoring. In 2005 TARSC personnel pursued formal
training in personnel management, business administration and accounting and skills workshops in a range of
technical areas.
In our work we formally co-operate with a range of individuals and institutions in various areas of work, too
many to mention all! We give specific mention to these in the various theme areas of this report. Our
partnerships include University and civil society trainers and researchers, web site support through Fahamu and
publications support through Designmark and Blue Apple Design. The centre contracts legal services, an
auditor, computer, edit and printing services. TARSC accounting uses ACCPAC, an internationally recognised
accounting package and finances are governed by a finance procedures manual reviewed annually. The TARSC
(Zimbabwe) financial year is July 1-June 30 and audit statements have been prepared for the financial year
ending June 30 2005, audited by Ziumbe and Co.
The policy advisory committee in TARSC comprised I Rusike (prior to his appointment as director in late 2005),
M Mushayabasa, Dr G Kanyenze, Prof Y Tandon, Prof G Woelk, W Chikuvanyanga. The advisory body met once
in 2005 to review ongoing implementation of the areas of programme focus put forward in 2004, was
consulted in various issues through the year and participated in the TARSC materials launch in October 2005.
This section has outlined our institutional goals, structure and how we work.
In the next section we outline our major areas of work in 2005, within the areas of:
• Research activities and resources
• Capacity building activities and resources
• Information resources
We recognise the massive challenges to economic and social justice that still need to be
faced in Zimbabwe. In TARSC we seek to support the knowledge, analysis and capacity
within communities and in the public sector to respond to these challenges at all levels,
towards building a just and equitable society.
TARSC ANNUAL REPORT 2005
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2. OUR WORK IN 2005
This report outlines the major areas of TARSC work in 2005. More detailed reports of the work are available
from TARSC and training and research resources are available from the TARSC website (www.tarsc.org)
2.1: Research activities and resources
The work we do is organised within three main areas:
• Participatory and community based research
• Community monitoring and sentinel surveillance
• General research
Our research programmes have involved technical inputs in TARSC from (alphabetically) Thomas Chikumbirike,
Barbara Kaim, Rene Loewenson, Godfrey Musuka, Elizabeth Shoko and Rose Tindwa. We have worked in these
programmes with consultant inputs and with a range of institutions and personnel from those institutions,
noted in the reports.
2.1.1 Participatory and community based research
Since its inception in 1994, participatory action research has been the cornerstone of much of the work
undertaken by TARSC. Drawing on our experiences and skills in the use of participatory methodologies, we
have worked with numerous community based organizations and social groups to incorporate their knowledge
and abilities in the development of programmes and training materials in specific areas. Our participatory
research has covered areas of child sexual abuse, workplace health, community perceptions of health priorities,
local government and community roles and health, and participatory mechanisms for community involvement
in health. The Adolescent Reproductive Health Programme (ARHeP) at TARSC trained youth in four
community-based organizations in Matabeleland to undertake research on the reproductive health needs of
youth, and this work was used to provide materials on how to involve youth in their own reproductive health
programmes.
In 2005 the Community Monitoring
Programme (see later) built on work
implemented to build research skills in
the CWGH to measure costs of a
‘health basket’, ie to carry out basic
research on costs of drugs and medical
care and how people are responding
to these costs. Supported by TARSC
and CWGH, Thomas Chikumbirike,
Elizabeth Shoko at TARSC with CWGH
personnel provided training to a
further 15 CWGH districts and carried
out a second ‘costs of health’ survey in
July 2005. A second round of training
was provided to give skills in basic
statistical analysis and a national
report was circulated in September
2005. The costs of health survey will
be repeated in 2006 to provide an
annual trend analysis.
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Community based research on the cost of the ‘health basket’ with CWGH and the
Community Monitoring Project
The CWGH eleventh national meeting resolved that the CWGH co-operate with the CMP and TARSC to outline
and measure the costs of a ‘health basket’ similar to the CCZ food basket, to make visible the costs of
maintaining health for different Zimbabwean households. The research aimed to identify the composition of
the health basket, (Eg: shelter, food and safe water, clothing, proper sanitation, safety and security and health
care), identify the changing costs of medical care for different care providers and communities to assess the
main elements that are driving up the cost of medical care, and build skills in research and survey methods
and work, in managing data and in reporting and using findings amongst district level CWGH members, and
use the reports to take up issues around these costs as CWGH in discussions with MPs, councilors, health
authorities and officials at district and national level.
The findings of this second round of the health basket research were not very different from those of the first
round. Food, soap and shelter continued to dominate as the highest cost drivers compared to medical care. As
in the first round, poor households showed signs of cost stress as the same items food, reproductive health
and hygiene items were being dropped from the health basket without any mention of suitable substitutes.
The nominal cost to the household for the health basket for one month found in this second round was
Z$1 916 262 an increase of over 87% compared to the Z$1 023 386 found in the first round in October 2004.
Source: CWGH, TARSC and CMP (2005)
2.1.2 Community monitoring and sentinel surveillance
TARSC work on sentinel surveillance activities in the past is outlined in its 2004 report. In 2005, TARSC
continued to provide technical support to the Community Monitoring Programme with guidance from a
steering committee of civil society organisations working in social and economic sectors, who are responsible
for producing the reports.
The Community Monitoring Programme compiles quarterly information from about 160 sentinel sites on key
areas of social and economic progress. The monitoring system is subjected to scientific and peer review in
various technical platforms and to monitor review. In 2005 the Community Monitoring Programme provided
quarterly reporting of key social and economic conditions at community level, ie in April 2005 on health and
education; in July 2005 on incomes and
employment; September 2005 on food and
production. The reports are disseminated
nationally, including to the relevant portfolio
committees of the parliament of Zimbabwe.
TARSC ANNUAL REPORT 2005
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2.1.3 Other research
While the major focus of research has been community based and participatory research, TARSC has also
implemented and reported on a number of other formal research activities in 2004, adding to a research
portfolio in occupational health, public health, HIV and AIDS, health equity, social security, food security and
nutrition, gender equity, child and adolescent health and social development, reproductive health and various
areas of social and economic progress.
The Network for Equity in Health in Southern Africa (EQUINET) is
dedicated to influencing both national and regional policies of the countries
of the Southern Africa Development Community (SADC) to ensure equity in
health. It does so by networking professionals, civil society and policy
makers to promote policies for equity in health, undertaking research,
initiating conferences, workshops, and discussions through the internet, and
providing inputs at the SADC forums. Equinet was initiated in 1997 after
the Kasane Meeting on Equity in Health in southern Africa by a network of
southern African Institutions. EQUINET is a consortium of a much larger
number of institutions and its work programme extends well beyond TARSC
activities. TARSC provides secretariat and technical support to the network
through Rene Loewenson, Godfrey Musuka and Zvikomborera Mlambo.
Further information on the network and its participating institutions and
supporting partners in specific areas of work can be found at
www.equinetafrica.org.
EQUINET has implemented research in areas where evidence is needed to support equitable public policy and
where debate exists on paths to improving health equity. Consultation across work programmes, with various
constituencies affirmed the commitment to shared values of equity, social justice and to the right to health.
The EQUINET programme as a whole is proactive and affirmative, to build the health systems that deliver on
these values in our region. Across EQUINET, the ‘reclaiming the state’ agenda defined at the conference in June
2004 was explored. The network reached a consensus on 2005 that with the current challenges and conditions
in the region, the priority that this implies is to revitalise and build national peoples’ health systems so that we
have publicly-funded comprehensive, people centred and people driven equitable and universal health systems.
The April 2005 EQUINET Steering committee meeting held in Johannesburg, South Africa reviewed, debated
and identified these major goals, perspectives and areas of work on equity and social justice in health, drawing
also on the resolutions of a meeting for fourteen major networks of health civil society held in February 2005
in Zambia that raised civil society priorities for regional work in health. The April 2005 meeting proposed two
areas of follow up to take these priorities forward.
Towards this EQUINET held in October 2005 in Harare, Zimbabwe a regional review meeting that brought
together steering committee members; theme, process and country co-ordinators; colleagues working in key
areas of work central to EQUINET’s agenda; and civil society colleagues. The meeting reviewed EQUINET current
work to shape and critically debate the form and content for the annual equity analysis at regional (and
country) level. In line with the shared framework above, the October steering committee meeting reviewed
the work of themes and processes in the network and identified a more detailed spectrum of messages arising
from existing work around which the evidence, knowledge, debates and engagement on the equity analysis
can be organised. This is contained in the full report of the meeting available on the EQUINET website.
(www.equinetafrica,org).
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EQUINET through CHESSORE and TARSC has been carrying out work on participatory mechanisms at primary
care and district level, and their role in equitable resource allocation and service provision. In 2003/4 three
field studies and a substantive literature review were implemented, and the work reported back and used at
national level to review participatory mechanisms and at regional level to synthesise knowledge on towards
policy intervention and training on participatory mechanisms for local government and health authorities.
This work was reported at the Forum 9 of the Global Health Research Forum in Mumbai, India, 12-16
September 2005 (Rene Loewenson, Itai Rusike and Memory Zulu).
Following the end of fieldwork activities, in January 2005 CHESSORE and TARSC hosted a participatory
workshop in Kafue Gorge, Zambia that presented the field work and similar work from East and Southern
Africa. This meeting is separately reported at www.equinetafrica.org.
In 2005 REACH Trust with the equity task force in the Ministry of Health Malawi with support from TARSC
carried out a study to apply the framework for monitoring in Malawi collating data up to 2004 using
indicators developed at the regional meeting (see www.equinetafrica.org). With this practical example dialogue
was established with WHO to implement this work on a wider scale with support from WHO EIP and WHO
AFRO.
We have implemented other research support to EQUINET: TARSC has worked with the parliamentary
committee on health to support both research and capacity inputs in various areas of health equity, adolescent
health and HIV and AIDS. In 2005 TARSC working within EQUINET and with the Global Equity Gauge Alliance
continued to provide this support.
In 2005 we have continued to implement a scheme to provide small grant support to student research in areas
of equity in health, with six grants awarded in the region in 2005. The EQUINET programme officer at TARSC
also carried out a study of ‘Career Plans of Parts III and IV Medical Students at the University of Zimbabwe
College of Health Sciences’ and went on a study visit to the National Institute of Public Health Sweden to
review the process of parliamentary engagement on health in Sweden and lessons for the region.
TARSC through EQUINET has also provided technical and networking support to the Centre for Health Policy in
South Africa which is the hub for the knowledge network on health systems in the WHO Commission on the
Social Determinants of Health, as well as to the African Health Research Forum and the Municipal Services
Project, South Africa.
TARSC ANNUAL REPORT 2005
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2.1.4 Research materials produced in 2005
1. TARSC , CWGH (2005) Report on the Evaluation of the Civic Health Education Programme. Study
commissioned by the CWGH. August 2005. Harare, Zimbabwe
2. EQUINET, TARSC, CHESSORE (2005) Abstract book: Strengthening community voice and agency in
health, Zambia, 26-28 January 2005
3. EQUINET, TARSC, CHESSORE (2005) Meeting Report: Strengthening community voice and agency in
health, Zambia, 26-28 January 2005
4. CHP/ SEATINI/ TARSC (2005) EQUINET Regional Workshop Report: Promoting health in Trade
Agreements, Johannesburg – South Africa, 29 October 2005
5. Kokerai T et al (2005):Protecting Rights of Access to Anti-Retroviral Therapy (ART) Under Trade and
Market Policies: The Zimbabwean Case, draft country-level audit. EQUINET programme ‘Promoting
Health in Trade Agreements’ Mimeo
6. Makwiza I; Nyirenda L; Bongololo G; Loewenson R, Theobald S, (2005) ‘EQUINET Discussion Paper 24:
Monitoring equity and health systems in the provision of Antiretroviral Therapy (ART): Malawi Country
report’, www.equinetafrica.org
7. EQUINET, REACH Trust, World Health Organisation (WHO) (2005) “Monitoring equity in ART provision in
the context of health systems,” Report of a meeting held in Lilongwe, Malawi, 29-30 August 2005
8. Loewenson R, Rusike I, Zulu M (2005) “The impact of Health Centre Committees on health outcomes in
Zimbabwe,” Plenary paper presented at Global Forum for Health Research, Forum 9: Poverty, equity and
health research Conference, Mumbai India, 12-16 September 2005.
9. EQUINET Steering Committee/ TARSC (2005) “A common agenda for equity in health in east and
southern Africa,” Report of a regional review meeting held in Harare, 10-12 October 2005.
10. Health Civil Society network / TARSC (2005) “Meeting of health civil society in east and southern Africa
at the Southern African Social Forum (SASF),” Report of a meeting held in Harare, 13 October 2005.
11. EQUINET, SEATINI, Centre for Health Policy (University of Witwatersrand) (2005) “Promoting health in
trade agreements,” Report of the regional review meeting held in Johannesburg, 29 October 2005.
12. TARSC, CWGH and CMP (2005) Research training workshop report, Harare, February 2005
13. Loewenson R, Chikumbirike T (2005) Community based monitoring and research on food security and
social welfare, “Paper for the SARPN meeting”, South Africa, May 2005
14. TARSC, CWGH and CMP (2005) Meeting the cost of health: research data workbook , July 2005
15. TARSC, CWGH and CMP (2005) The cost of health: a community research report, July 2005
16. TARSC, CWGH and CMP (2005) Research training workshop report, Harare, August 2005
17. Community Monitoring Programme (2005) Quarterly community assessment of the socio-economic
situation in Zimbabwe: health and education, March 2005
18. Community Monitoring Programme (2005) Quarterly community assessment of the socio-economic
situation in Zimbabwe: income and employment, June/July 2005
19. Community Monitoring Programme (2005) Quarterly community assessment of the socio-economic
situation in Zimbabwe: food security and production, September 2005
20. Musuka G (2005) Descriptive study of debates on health equity matters in the Zimbabwe National
Legislative Assembly. Research paper, TARSC Mimeo, Harare
21. Musuka G (2005) The Swedish Parliamentary Social Committee (Socialutskottet) and its engagement
with stakeholders on health issues, Mimeo, TARSC, Harare.
22. TARSC, EQUINET SC (2005) Report of the steering committee meeting, April 2005, South Africa, Mimeo
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2.2: Capacity building activities and resources
Our capacity building activities are reported within three main areas:
• Training and skills building programmes
• Material development
Our capacity building programmes have involved technical inputs in TARSC from (alphabetically) Thomas
Chikumbirike, Niki Jazdowska, Barbara Kaim, Rene Loewenson, Zvikie Mlambo, Godfrey Musuka, Elizabeth
Shoko and, Rose Tindwa. Consultant and institutional inputs have been provided by a range of institutions
identified within specific programme areas.
2.2.1 Capacity building activities
TARSC has since 1999 been involved with capacity development for young people in adolescent reproductive
health. As outlined in the 2004 report, TARSC has supported youth skills building in leadership
skills, HIV/AIDS & STIs, report writing, participatory action research and participatory
monitoring and evaluation. In 2003 TARSC consolidated this programme through a
memorandum of co-operation with CWGH to provide capacity support through an
umbrella CWGH youth programme and has since then provided technical support to
the CWGH youth programme with the aim of strengthening youth participation in
reproductive health and wider health programmes in their communities. Strategic
planning and review meetings held in 2004 identified areas for follow up in 2005.
In 2005, the programme focused on training in primary health care, adolescent
reproductive health and HIV, AIDS and STIs, with continued support in basic peer counseling
skills to enable them to counsel their peers in these matters. With TARSC support for content inputs, and
CWGH co-ordinating, four Primary Health Care (PHC) and peer counseling (PC) youth workshops were held,
each over five days in Hwange, Bulawayo, Insiza, Chikwaka and Umzingwane, covering 168 participants.
TARSC provided capacity building and technical support to the CWGH youth programme. TARSC supported
CWGH in the process of hiring a CWGH Youth Programme Manager, and provided orientation and support to
the newly hired Youth Programme Manager.
As a new innovation on the programme TARSC in 2005 developed with support from SAIH youth skills training
in savings and entrepreneurial skills. The programme was introduced in response to request for economic
empowerment by participating youths as reflected by their participatory Action Research reports and the 2004
Strategic Plan. The methodology was piloted through the CWGH youth programme in two communities - in
youth in Arcturus and adults in Chikwaka.
In 2005, TARSC implemented the programme with the CWGH. In the subsequent outreach by CWGH the work
amongst youth did not lead to concrete groups being formed, while it did in adults in both Chikwaka and
Arcturus. Support from CWGH trainers and from within the community is now taking place to sustain these
groups. TARSC is documenting, following up and learning through the activities of CWGH on how these groups
are functioning to improve the training in this method. For example, one group in Chikwaka
plans to divide all the funds they saved this year in January 2006 to pay for school fees in
the New Year. These examples will enrich the training materials and provide a basis for
horizontal sharing of learning. The experience has also indicated that there needs to be a
minimum cohesion amongst groups for this process to ‘work’, and it is suggested that
future training be directed at groups with longer term cohesion, such as youth groups
with a longer history of working together, or youth working with other adults in the
community. A training manual for the methodology is being adapted by TARSC in cooperation
with CARE International.
TARSC ANNUAL REPORT 2005
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The savings methodology
The savings methodology is a simple self managed micro-finance model that empowers poor people to
improve their livelihood security. It rests on the premise that low income households face constraints that
prevent them from engaging in economic activities, which would help build the resilience of the household
safety net. In response to this affording poor households access to timely and flexible loans is identified as a
means to improving economic resiliency.
Developed in Niger, it has been adapted within a few countries in Africa including Zimbabwe and applies in
contexts where there is limited access to capital or financial services in forms that meet the financial needs of
households and limited outreach by financial services providers. While other work in TARSC such as the
Community Monitoring Programme raises wider issues of access to credit, this methodology provides a means
for self determination on earnings, savings and lending at a collective level, to build social ownership and
enhance scale and sustainability. Hence in the context of wider structural and distributional interventions aimed
at access to credit, this method strengthens community cohesion across groups that build shared savings.
The approach, carried out with CWGH in 2005, aims to build understanding of and capacities in the method
within organisations that have outreach, so that they are able to identify the most appropriate application
and to deliver the methodology on their own. This involve exposure trips; one week training of staff in the
methodology using participatory approaches, supported and mentored training of community groups. The
organisations once trained take forward the follow up community activities.
TARSC was involved in developing the facilitators skills and materials for the first civic education programme
on health for the CWGH in 1998. We were approached in 2005 by CWGH to support their updating the
programme of training and to develop new materials to reflect the new needs of the programme. To take this
forward, TARSC in cooperation with CWGH, undertook an evaluation of the CWGH Civic Health Education
Programme. The evaluation was implemented by Rene Loewenson, Elizabeth Shoko and Barbara Kaim (TARSC)
and Itai Rusike and Linda Mashingaidze (CWGH). The evaluation carried out key informant interviews with
CWGH at all levels, with Ministry of health and other health providers and with other CWGH partners.
The evaluation report was completed in August 2006. In terms of past performance the programme was
judged to have generally had a positive impact and broadly achieved its major objectives. The findings
highlighted the strengths of the programme, including the ownership of the programme especially at district
level, good use of participatory methodologies, approaches and content that address organizational issues and
goals of CWGH, amonst others. In terms of weaknesses, interviewees pointed to the need to update the
material, to provide better ongoing support to facilitators, and to better orient materials to needs of
community levels and national level CWGH (as distinct to district levels). The evaluation report was tabled at a
meeting of the CWGH Information and Research Committee who endorsed the findings and recommended cooperation
with TARSC in 2006 for the development of the updated programme and material using the
findings. A programme is being developed with CWGH for this.
TARSC and CWGH are also working with the network of health civil society in EQUINET and the Health civil
society network in East and Southern Africa, particularly Malawi Health Equity network, HEPS Uganda and
TANGO Tanzania to share and further develop health literacy programmes in the region. This will draw from
the priorities expressed by EQUINET and the health civil society network for a national, people centred health
system. This work will also be taken forward in 2006.
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In 2004 EQUINET through the Southern and East African Trade and
Investment Negotiation Institute (SEATINI) initiated a programme of work to
analyse trade agreements relevant to public health (particularly GATS, TRIPS
and agreements relating to food security) and raised policy dialogue on these
at state, parliamentary, SADC and civil society forums. This work is being
used in 2005 to pilot a capacity building programme and training materials
on trade and investment and health systems for countries in southern and
East Africa, involving also the Centre for Health Policy (South Africa) and with support from the EQUINET
secretariat at TARSC. The training provides capacities for national assessments of trade and investment policies
for their impact on commercialisation of health systems to identify areas for policy, research and negotiation.
The programme was initiated with the development of training materials by SEATINI, CHP
and TARSC. The materials covered an introduction to trade and health systems, issues
related to the commercialization of health systems, an introduction to the world Trade
Organisation and the GATS and TRIPS agreements, and sections on policy analysis and a
framework for auditing health and trade links at country level. The draft materials were
peer reviewed and redrafted to be pilot tested in the workshops.
Workshops were held in Tanzania and Zimbabwe using the materials and research
implemented arising out of the training. TARSC has assisted in this follow up and in the regional workshop
that reviewed the research and programme.
CHP, SEATINI and TARSC are currently reviewing the training materials for final edit, publication and printing
by EQUINET. An overall goal for the work is have a pool of skills with similar perspective on equity contributing
to national policies on trade and health.
In 2005 TARSC, through Naira Khan and Rene Loewenson worked with SANASO and SADC to provide
guidelines on HIV and AIDS stigma reduction strategies for use by non-governmental organizations and the
communities that they work with. The guidelines cover four thematic areas: Stigma and the family; in faith
based organizations; in the workplace; and in the media. The guidelines were reviewed by a meeting of
organisations working in these sectors convened by SANASO and by the SADC regional meeting of National
AIDS Councils in Lesotho November 2005 and finalized with inputs from these meetings.
In 2004, in response to expressed demand, TARSC established a co-operation with the University of Zimbabwe
Medical School to fill a gap in the provision of short course training to certificate level in areas of public
health and health systems aimed at strengthening capabilities of field practitioners in public sector and civil
society institutions working at district level. Such programmes are not unusual- ‘summer school’ public health
training is offered through a number of institutions including in South Africa, Australia and Europe.
The two institutions jointly piloted short course training in public health from 11-16 July 2005 at the College
of Health Sciences, DCM Health Sciences building. TARSC personnel involved in planning, organizing and
acting as resource people for the course included Innocent Chingombe, Rene Loewenson, Zvikie Mlambo and
Godfrey Musuka, with lecture input from Barbara Kaim. A student on attachment to CWGH, A Makone also
assisted in the course. The focal point from UZ were Professor Godfrey Woelk, Dr Chirenda and J January. The
structure and content of the course was based on the findings from a needs and capacity assessment carried
out by the two institutions to assess the training needs of the people at district level. The assessment indicated
areas that people working at district level in Zimbabwe wanted included in short course training and the
course was designed to respond to these priority needs.
The course thus covered the following areas of public health and health systems:
• Principles of public health and epidemiology
• Major public health issues, including HIV and AIDS, TB, Malaria, nutrition
• Elements of health systems, health financing, essential drug supplies and human resources for health
• Zimbabwe’s health services at national, district and primary health care level
• Community and non-health sector roles in health.
TARSC ANNUAL REPORT 2005
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The course attracted delegates from public and private health providers, local government, parliament, nongovernment
and community based organisations and research institutions. Resource people provided inputs
from Ministry of Health, University, Non government organisations and from the two host institutions. The
course was over subscribed and the evaluation indicated that it was well received. On the basis of a post
course evaluation, TARSC and DCM plan to carry out a further basic course in 2006 and a second stage
advanced course for those who completed the basic course in 2005. The feedback from the evaluation will be
used to further improve the course in 2006.
2.2.2 Development of Materials for participatory research and training
TARSC has through its programmes developed a range of research and training materials such as the level one
research training course, the leadership training materials for organisational development, materials for youth
peer counsellor training, and the materials used in the writing skills workshop. This builds on a portfolio of
training materials developed since the early 1990s on civic education on health, on occupational health and
safety, HIV and AIDS at the workplace and social security. In 2005 TARSC will provide these training materials
through its website for wider access and use.
One major focus of TARSC work on material development in 2005 was the launching of the updated youth
reproductive health pack, called ‘Auntie Stella: Teenagers talk about sex, life and relationships’ (Kaim 2005).
The work was implemented by Barbara Kaim, with Elizabeth Shoko, Zvikomborera Mlambo (TARSC), Caroline
Mubaira and Nonjabulo Mahlangu of the CWGH Youth programme and in co-operation with government and
non government organisations in Africa from Zimbabwe, South Africa, Malawi, Zambia, Tanzania as well as
internationally. This work was done with support from John Snow International (Europe), HIVOS, SAIH
(Norway) and SIDA.
A new version of Auntie Stella
Auntie Stella, first produced in 1997, arose out of participatory action research with
youth, drawing on and reflecting their experiences, stories and concerns in relation to
their reproductive health. In 2004, TARSC began the process of updating the pack to take
into account new developments in HIV and AIDS and lessons learnt in the use of the
pack over the previous 7 years. As per the original pack, the development of the new
version involved youth and youth-serving organizations in all stages of production. The
pack reflects real life experiences of young people gathered through participatory research with in and out-ofschool
youth. During pretesting in Zimbabwe, Malawi, South Africa, Tanzania and Zambia, youth contributed
artwork, poems and proverbs which were incorporated into the final revisions of the pack.
The new version includes 40 question and answer cards, written in the style of a missive to a newspaper agony
aunt. Letters are accompanied by a reply from Auntie Stella, questions for small-group discussion and back-up
material for teachers and/or facilitators. Topics covered include: physical and emotional changes in
adolescence, relationships and communication with parents, peers, partners and the wider community, sexual
abuse, social and economic pressures to have sex, safer sex including information on STIs, HIV and AIDS. The
cards also emphasize the importance of building social networks and working to create a more supportive and
youth-friendly social environment through advocacy, collective action and involvement of community and
health services. (see www.tarsc.org and www.auntiestella.org).
‘Auntie Stella’ was officially launched in Harare in October 2005. The Shona and Ndebele versions of the pack
will be available in January 2006. As the year drew to a close, TARSC in partnership with CWGH undertook two
training workshops in Bulawayo and Harare on facilitation of ‘Auntie Stella’. Over 80 youth facilitators from 30
organisations were trained.
In 2006, we will give strong focus to building the capacity of implementing organizations in Zimbabwe and in
east and southern Africa in the use of the ‘Auntie Stella’ pack . Distribution will be undertaken together with
technical support in training of facilitators and monitoring of distribution and use. The Shona and Ndebele
versions of the pack will also be distributed, with plans for translation of the pack into Kiswahili and
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Portuguese in cooperation with organizations from
Tanzania and Mozambique. TARSC will also be
updating the Auntie Stella web version on the
TARSC website (www.tarsc.org and
www.auntiestella.org) in the coming year.
In 2004 TARSC established a co-operation with
CHESSORE Zambia and the Ifakara Health Research
and Development Centre Tanzania to strengthen
capacities in researchers, health system and civil
society personnel working at community level to
use participatory methodologies for research, training and programme support. TARSC and Ifakara, with peer
review support from CHESSORE and support from EQUINET and IDRC Canada developed a toolkit of
participatory methodologies for health research and training. This work was implemented by Rene Loewenson,
Barbara Kaim and Faith Chikomo from TARSC, working with Selemani Mbuyita and A Makemba at Ifakara
Tanzania and TJ Ngulube at CHESSORE Zambia.
Participatory methods for a people centred health system
The toolkit aims to strengthen capacities in researchers, health workers and civil society personnel working at
community level to use participatory methods for research, training and programme support. We hope that the
users of the toolkit will use participatory approaches within various areas of work aimed at building peoplecentred
health systems. The toolkit uses experiences from different countries in the east and southern African
region.
Activity 4:
TO IDENTIFY EXISTING SOCIAL GROUPS AND SHOW THEIR
DISTRIBUTION ON A MAP. ON THE SAME MAP PARTICIPANTS WILL ALSO
SHOW DISTRIBUTION OF WEALTH IN THEIR COMMUNITY.
METHOD: COMMUNITY MAPPING
Time: 60 – 80 minutes, depending
on the number of people
involved
Material: On the ground –
sticks, stones, leaves, etc
On the floor – chalk or charcoal
On paper – pencils, markers,
crayons, pens
The toolkit is divided into 7 modules. The earlier sections build understanding of what we mean by
‘community’ ‘health’ and ‘health systems’. The later discuss how to build people-oriented health systems, what
it means for the way health workers and communities interact, and for how communities are involved in their
health systems. The last modules move from community and district levels to explore how communities are
brought into national and global dialogue on health. Throughout the toolkit, informative text is interspersed
with examples of how community voice can be raised through the use of participatory methods. There are over
30 participatory activities in the toolkit, collectively using a wide range of methods including roleplay, picture
codes, diagrams, ranking and scoring.
TARSC ANNUAL REPORT 2005
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The toolkit was developed in 2005 and in March 2006 TARSC and Ifakara through EQUINET will be holding a
four day workshop in Bagamoyo, Tanzania to train health workers, researchers, leaders and community
organizations in participatory methods for strengthening community voice in health systems. The toolkit will
form the basis of this workshop.
In 2006 TARSC will continue to provide mentoring and capacity support nationally and within the region on
use of PRA skills in health. We will document and disseminate publications on this, including through the
TARSC website, and provide training on participatory methodologies for health. TARSC will further build its
capacities to meet the demands it is facing in this area.
2.2.3 Training materials produced in 2005
1. Tindwa R (2005), The CWGH staff Training Of Trainers report on the Savings Methodology, May 6-13,
23 – 28, Arcturus and Chikwaka, Zimbabwe
2. Murevachimwe, N (2005) Training of Trainers report for the CWGH staff on the Savings Methodology,
May 6 – 13, 23-28 Arcturus and Chikwaka, Zimbabwe
3. TARSC (2005) The Savings Methodology Training Manual, Harare, November 2005
4. Loewenson R, Kaim B, Chikomo F (TARSC) Mbuyita S, Makemba A (IFAKARA) (2005) Organising
People’s Power for Health: A Toolkit for a People-centred Health Systems, In cooperation with
CHESSORE and EQUINET, Ideas Studio, Harare
5. Kaim, B et al (2005) ‘Auntie Stella: teenagers talk about sex, life and relationships’ – Facilitators and
Adaptation Guide, 40 question and answer cards. Revised version. TARSC, Harare
6. TARSC (2005) Report on Training Workshop for Facilitators of ‘Auntie Stella’ Elangeni Training Centre,
Bulawayo, 31st October - 2nd November 2005, Mimeo
7. TARSC (2005) Report on Training Workshop for Facilitators of ‘Auntie Stella’ Zimbabwe Women’s
Bureau, Harare, 8th -10th November 2005 Mimeo
8. Regional initiative of parliamentarians on health, EQUINET, GEGA and SADC-PF in co-operation with
the (2005) Meeting report: Regional initiative of parliamentary committees on health in East and
Southern Africa, Kafue Gorge Hotel, Zambia 24-25 January 2005
9. Khan N, Loewenson R (2005) Guidelines for reducing stigma and discrimination and enhancing care
and support for people living with HIV and AIDS, Commissioned by SANASO, TARSC Mimeo, Harare
10. TARSC , UZ Department of Community Medicine (2005) Needs and capacity assessment for short
course public health training, March 2005, Mimeo, Harare
11. TARSC , UZ Department of Community Medicine (2005) Report of the public health Winter School
training, 11-16 July 2005, Mimeo, Harare
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2.3: Information resources
Our information resources have involved technical inputs in TARSC from Mevice Makandwa, Jacob
Chakupwaza, Rene Loewenson, Zvikie Mlambo and Frances Chakupwaza. Consultant inputs have been provided
by Fahamu and Rebecca Pointer.
TARSC maintains an information resource centre that is widely used by its co-operating partners and other
organisations. The information resource centre provides:
• Publications on major areas of social and economic policy complementary with TARSC activities sorted
by category, captured in an electronic data base using ISIS and retrievable as hardcopy publications
• TARSC publications within its major areas of activity, captured in an electronic data base and
retrievable as hardcopy and in some cases electronic publications
A website with an information listing of TARSC publications and selected publications downloadable as pdf
files (www.tarsc.org )
The library of several thousand publications held by TARSC on key areas of health and social policy includes
publications on:
• Occupational health,
• Public participation in health,
• AIDS and employment,
• Equity in health,
• Reproductive health
• Zimbabwe health,
• Zimbabwe social and economic policies, and
• Food security and nutrition
Apart from the data bases that are Zimbabwe specific, all others include information from the southern Africa
region and other international sources. These data bases are searchable by author, subject area and year and
have been used by researchers, academic institutions, civic, state and international organisations and others in
work on the areas covered.
TARSC’s own publications, numbering more than 700, are organised within the following categories
• Occupational health and safety
• Economic and employment and HIV/AIDS
• Community and public health
• Health equity
• Child health and child welfare
• Gender and reproductive health
• Socio-economic policies
• Food Security and nutrition
The full list is available from TARSC.
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TARSC maintains in co-operation
with other partners three databases
of publications to support research
and training work:
• a web based searchable data
base on civil society and health
(see www.tarsc.org/WHOCSI/ )
• a web based searchable
database of publications on
equity in health (at
www.equinetafrica.org)
• a web based searchable data
base of publications by or about
civil society in Zimbabwe
(www.tarsc.org)
TARSC also provides various training
materials on health at its website and will load and update these in 2006.
Publications produced by TARSC are available for purchase at replacement printing costs (about US$3 /
publication). Please direct requests to the TARSC Information Resource Centre to obtain information on prices
email: tarsc@mweb.co.zw or Ph: 263-4- 705108 / 708835 Fax: 737220. TARSC provides its materials on an
exchange basis with other major libraries as well as to the National Archives.
The TARSC website redesign was completed in 2005 (Rene Loewenson, Zvikomborera Mlambo working with
Fahamu). The new site updates on TARSC training and research programmes and provides access to its
publications in an easily accessible format. The backlog of publications will continue to be loaded in 2006.
TARSC information materials and publications were displayed at the October 2005 launch. The information
centre resources, library, website and web based databases will be maintained in 2006.
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