Poverty reduction and regional integration: a comparative analysis of SADC and UNASUR health policies

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Inadequate access to health care and medicines is a persistent issue among impoverished populations in low-income Southern Africa and South America; it is a recognised social determinant of ill-health, and is disproportionately borne bywomen and girls. This project examines the scope for enhancing Southern multilateral regional organisations' contributions to poverty reduction through regional health policy, and it is guided by the following question: what regional institutional practices and methods of regional policy formation are conducive to the emergence of embedded pro-poor health strategies and what can national, regional and initernational partners do to promote such practices and methods?The growing presence of regional organisations in public policy making is increasingly the subject of North-South and South-South development agendas, and is generating development initiatives and research into the benefits of regional economic integration for public goods provision and for people living in poverty. There is growing recognition that regional integration ambitions and initiatives extend beyond commercial trade and investment to embrace health and welfare policy, but little is known about whether and how regional commitments on poverty are being implemented in these domains and what kinds of regional policy development processes are conducive to the emergence of embedded pro-poor approaches and effects in regional and national spheres. We investigate this by undertaking a comparative analysis of SADC and UNASUR's regional agendas and ambitions, regional programmes of action and regional processes of policy development in relation to access to health care, undertaking in-depth fieldwork in low income countries of Zambia, Swaziland, Bolivia and Paraguay confronted with serious socio-economic challenges, low levels of service delivery and immense public health challenges. We undertake data collection and data analysis using mixed methods, comparative and participatory approaches and methodologies. We involve stakeholders from policy, practice and end-beneficiary communities throughout the research process, designed to have demonstrable potential for impact. We use collaborative Participatory Action Research methods todesign monitoring Toolkits. In doing so, the project seeks to contribute new analytical and evidence to debates about the role and effectiveness of regional formations in health-poverty reduction programmes and what actors such as international donors, civil society organisations, governments and business and philanthropic organisations can do to support pro-poor regional health policies.The project brings together a cross-disciplinary team of researchers linking social and health policy analysts concerned with health care system strengthening and social equity, with regional integration studies specialists concerned with the institutional, political and methodological foundations and consequences of regionalism, with the concerns of area studies specialists concerned with the politics, economies, societies and cultures of South America and Southern Africa. The project is a research collaboration between highly respected international researchers in renowned institutions in Southern Africa (South African Institute of International Affairs, South Africa), South America (FLACSO, Buenos Aires), and Europe (United Nations University Institute for Comparative Regional Integration Studies, Belgium, the Open University and the University of Southampton in the UK). It brings together complementary expertise in comparative analysis, policy analysis and monitoring methodologies, health care systems, regional governance, and international political economy, and excellent contacts in the two case study regions and internationally. The project team's capabilities combine with effective project design and organisation for sustained stakeholder participation throughout the research process, dissemination and impact