Publish What You Fund is the Global Campaign for Aid Transparency, which brings together leading NGOs and NGO coalitions to draft a first set of consultation materials – the Publish What You Fund principles, which were released in July 2008. These five principles are designed to be signed by all public and private bodies engaged in funding and delivering aid: 1. Information on aid should be published proactively. 2. Everyone can request and receive information on aid processes. 3. Information on aid should be timely and accessible. 4. Information on aid should be comparable. 5. The right of access to information about aid should be promoted. The principles will be reviewed in the run-up to the Accra High Level Forum, following an initial consultation period.
Equity in Health
The Final Report of the Commission on Social Determinants of Health sets out key areas of daily living conditions and of the underlying structural drivers that influence them in which action is needed. It provides analysis of social determinants of health and concrete examples of types of action that have proven effective in improving health and health equity in countries at all levels of socioeconomic development. Part 1 sets the scene, laying out the rationale for a global movement to advance health equity through action on the social determinants of health. It illustrates the extent of the problem between and within countries, describes what the Commission believes the causes of health inequities are, and points to where solutions may lie. Part 2 outlines the approach the Commission took to evidence, and to the indispensable value of acknowledging and using the rich diversity of different types of knowledge. Parts 3, 4, and 5 set out in more detail the Commission s findings and recommendations. The chapters in Part 3 deal with the conditions of daily living the more easily visible aspects of birth, growth, and education; of living and working; and of using health care. The chapters in Part 4 look at more structural conditions social and economic policies that shape growing, living, and working; the relative roles of state and market in providing for good and equitable health; and the wide international and global conditions that can help or hinder national and local action for health equity. Part 5 focuses on the critical importance of data not simply conventional research, but living evidence of progress or deterioration in the quality of people s lives and health that can only be attained through commitment to and capacity in health equity surveillance and monitoring. Part 6, finally, reprises the global networks the regional connections to civil society worldwide, the growing caucus of country partners taking the social determinants of health agenda forward, the vital research agendas, and the opportunities for change at the level of global governance and global institutions that the Commission has built and on which the future of a global movement for health equity will depend.”
This review examines the impact of global health initiatives (GHIs) on health equity, focusing on low- and middle-income countries. It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health. The review focuses on three GHIs: the US President’s Emergency Plan For AIDS Relief (PEPFAR), the World Bank’s Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria.
The public health sector in South Africa has come under criticism over poor services and the failure to implement government policies effectively. The past 14 years have seen a widening gap between the private and the public health care sectors with the latter struggling to provide quality service, thus making it difficult for most South Africans who don’t belong to medical aid schemes to access quality health care. Advocate Khaya Zweni, a lawyer with the Human Rights Commission (HRC), says most are not happy with the service offered by public health care institutions. Following numerous complaints from the public, the Human Rights Commision conducted a survey in more than 90 public health institutions countrywide. Dr Anban Pillay, the Department of Health's cluster manager for health economics, believes that the problems in health delivery could be dealt with if the department is allocated a bigger budget by Treasury. ‘The problem with the public sector relates to a lack of funding. That lack of funding needs to be corrected. We are currently at the 11% of government expenditure on health care. We need to get around 15%. That’s what the government needs to do,’ Pillay said.
The United Nations Children’s Fund (UNICEF) and the World Health Organisation (WHO) is urging increased support for breastfeeding mothers since the practice has been shown to slash deaths by more than 10% in infants in developing countries. Despite advances in the past 15 years, only 38% of infants under six months of age in the poorer nations are exclusively breastfed, a practice which could curb infant mortality. Various studies have shown that the number of months which mothers breastfeed – especially exclusively – can be extended by education and support. The practice can reduce the number of deaths caused by acute respiratory infection and diarrhoea, as well as other infectious diseases. It also improves mothers’ health and strengthens the bond between mother and child. ‘There is a double message here: it is not enough to say that breastfeeding is an ideal source of nourishment for infants and young children; mothers also need support to make optimal breastfeeding practices a reality,’ WHO Director-General Margaret Chan said.
Sub-Saharan Africa is not on track to achieving a single Millennium Development Goal, and is the only region in the world where malnutrition, an outcome of food insecurity, is not declining. This paper presents the Red Cross Red Crescent five-year strategic framework on long-term food security for Africa. Guided by the 2000 Ouagadougou Declaration and the Algiers Plan of Action 2004, it aims to reduce food insecurity in communities vulnerable to disasters and/or affected by HIV/AIDS. The paper notes that interventions will be evidence-based and will be driven by good practice developed both internally and externally. Programmes will be developed with the full consultation and participation of vulnerable communities in order to ensure that programmes build on the existing assets, capabilities and priorities of the communities and are owned by them.
Malnutrition affects about 30% of children in Africa, caused by low birth weight and post-natal growth faltering. Child malnutrition is a persistent problem. The long term trend shows only slow improvement, and malnutrition rates worsen during droughts, economic crises, conflicts and displacement, and HIV. Without greater attention to nutrition, increased child mortality, morbidity and impaired intellectual development are inevitable. Policies must tackle intermittent crises through emergency programmes and support sustained community-based programmes. Nutrition should be reinstated as a priority programme area alongside HIV, tuberculosis and malaria.
This is the interim position paper of the People's Health Movement (PHM). The comprehensive Primary Health Care (PHC) approach articulated at Alma Ata remains as relevant today as it was 30 years ago. It was never really implemented to reflect its true spirit, i.e. the basic intent of the Alma Ata Declaration which highlighted the need for a new international economic order to ultimately solve inequities in health. A PHC policy for 2008 and beyond needs renewed commitment, which, while affirming the fundamental positions of thirty years back, also takes into account the new realities of this age. In its renewed commitment to PHC in 2008, PHM vies to address the obstacles that have blocked PHC's implementation so far and is furthermore committed to incorporate into it the new challenges that have emerged since 1978. PHM is committed to promote the still unshaken basic principles of the Alma Ata Declaration - way beyond its original eight technical components. PHM insists that PHC is to be embedded in the social and political processes in each specific context where it is applied.
Most countries do not have universal health insurance and for most people living in countries without universal access, particularly the poor, illness is a substantial financial burden, and indeed often a crippling burden. Paradoxically, a far greater proportion of out-of-pocket spending occurs in those countries least able to afford it. Inevitably, health care, far from being a basic human right, is simply beyond the reach of many. These problems are magnified in lower- and middle-income countries. For example, in Tanzania a 1997 scheme to implement evidence based health plans at an estimated cost of US$2 per capita was limited by inadequacy of infrastructure and capacity. These difficulties are particularly evident where there is increased spending on vertical programmes in areas of limited capacity and infrastructure, limiting resources available to the system as a whole. In light of this, this article highlights some key questions for tackling equity in health, including: 1) What do we mean by equity? Which aspect has primacy -dollars spent or health status or health outcomes? 2) How do we determine what is a reasonable amount to spend (or invest)? How can this best be contextualised and harmonised with other government priorities? 3) Would there be more equitable access to health services if governance and decision-making were more open to input by community stakeholders? 4) Given the resource and other infrastructure constraints, particularly in poorer countries, what are the most appropriate health care delivery models for a country to adopt?
The objective of this study was to quantify inequalities in selected Millennium Development Goal (MDG) indicators in all the 192 WHO Member States using descriptive statistics, the Gini coefficient and the Theil coefficient. The data on all the indicators were obtained from The World Health Report 2004. The main findings were as follows: (i) generally, all the MDG indicators are significantly worse in low-income countries than in the other three income groupings; (ii) for all the MDG indicators, there are inequalities within individual countries, within the four income groups, and across income groups of countries; (iii) the inequalities in the MDG indicators are higher among the low-income countries than in high-income countries; and (iv) the ranking of income groups, by various indicators, is fairly stable whether one employs the Gini coefficient or Theil coefficient. Member States striving to expand the effective coverage of heatlh strategies and interventions need to do this in a manner that redresses the inequalities in various MDG indicators, and to monitor aggregate changes in MDG indicators and inequalities across the various income quintiles. The lessons learnt from the monitoring should inform the design and targeting of MDG-related policies, strategies and interventions to eradicate inequalities.