Learning from Brazil and Mozambique on Universal Health Coverage and accountability politics

Published on 10 December 2019

The Unequal Voices project has produced vibrant policy engagements from the local to the global level, and for its final output, a set of flagship articles synthesising the evidence and insights from São Paulo, Amazonas, Maputo and Zambézia have been published. The latest of which is the Novos Estudos special issue.

The special issue features five articles on issues of accountability and health inequalities in Brazil and Mozambique, including:

The project’s local policy engagements included a feedback workshop with grassroots indigenous leaders in the Northwestern Amazon that focused on learning and sharing the lessons from their successful mobilisation to demand government action on a malaria epidemic. Key findings from this Amazonian case study were shared by Unequal Voices Principal Investigator Alex Shankland and Brazil team anthropologist Danilo Paiva Ramos at the COPASAH Global Symposium in Delhi in October 2019, as part of a series of engagements with COPASAH in the lead up to the UHC Day launch of the Social Accountability Charter on 12 December.

The project’s global policy engagements also included a panel and other activities at the HSR2018 conference plus a series of powerful interventions by Denise Namburete in global debates about health rights and accountability, the most recent of which calls for ‘re-thinking UHC’ in the light of a critical analysis of the failure of international actors and national governments alike to deliver on past promises.

Following the Unequal Voices project, Denise Namburete’s work through N’weti has also featured in the process of institutionalizing social accountability in Mozambique’s health sector, and in the use of the Community Score Card as a tool to facilitate health user monitoring of service quality and provision.

The Unequal Voices project – Vozes Desiguais in Portuguese – aimed to strengthen the evidence base on the politics of accountability via multi-level case studies in health systems in Brazil and Mozambique, exploring how accountability can be strengthened to deliver better health services for citizens everywhere.  It was led by Alex Shankland (IDS) with Gerry Bloom (IDS), Denise Namburete (N’weti Comunicação e Saúde), and Vera Schattan Coelho (CEBRAP).

The project’s work has helped to inform and inspire a series of new initiatives to defend health rights and promote equity in the face of new challenges in Brazil, such as the political situation and attacks on indigenous rights and Mozambique after the debt scandal and political conflict, as well as globally.

Further reading on Unequal Voices and Universal Health Coverage:

IDS Bulletin Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage

Rethinking community participation in Mozambique’s health service

Rethinking health accountability in Mozambique: Beyond donors and government?

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