Governance and participation in health

Patient Satisfaction and Factor of Importance in Primary Health Care Services in Botswana
Bamidele AR, Hoque ME, and van der Heever H: Afr. J. Biomed. Res. 14;1 -7

This study aims to assess patient satisfaction and factor of importance on the service they receive at the primary health care facility in Botswana. The study was a cross sectional study in which 360 systematically selected participants completed 5 point likert scale self-administered questionnaire to rate their satisfaction level as well as factors of importance where best service was provided. Results showed that pharmacy received the highest satisfaction level while the nurse got the least level of satisfaction in terms of services rendered. 14.4% of participants still think time is not important to them as factor as long as they got what they wanted. Participants mentioned that an increase in personnel and staff training stood out as areas that need to be significantly considered
for improvement.

What can a teacher do with a cellphone? Using participatory visual research to speak back in addressing HIV&AIDS
Mitchell C, de Lange N: South African Journal of Education; 33,4: 1-13, 2013

Their ubiquity in South Africa makes cellphones an easily accessible tool to use in participatory approaches to addressing HIV and AIDS issues, particularly in school contexts. In this article the authors explore a participatory visual approach undertaken with a group of rural teachers, using cellphones to produce 'cellphilms' about youth and risk in the context of HIV and AIDS. Noting that the teachers brought highly didactic and moralistic tones into the cellphilms, the authors devised a “speaking back” approach to encourage reflection and an adjustment to their approaches when addressing HIV and AIDS issues with learners. They draw on the example of condom use in one cellphilm to demonstrate how a “speaking back” pedagogy can encourage reflection and participatory analysis, and contribute to deepening an understanding of how teachers might work with youth and risk in the context of HIV and AIDS.

Male partner involvements in PMTCT: a cross sectional study, Mekelle, Northern Ethiopia
Haile F, Brhan Y: BMC Pregnancy and Childbirth14:65, 2014

Male partner participation is a crucial component to optimize antenatal care/prevention of mother to child transmission of HIV(ANC/PMTCT) service. Involving male partners during HIV screening of pregnant mothers at ANC is key in the fight against mother to child transmission of HIV(MTCT). This study aimed to determine the level of male partner involvement in PMTCT and factors that affecting it. A Cross-sectional study was conducted among 473 pregnant mothers attending ANC/PMTCT in Mekelle town health facilities in January 2011 to identify factors that affect male involvement in ANC/PMTCT. Twenty percent of pregnant mothers have been accompanied by their male partner to the ANC/PMTCT service. Knowledge of HIV sero status, maternal willingness to inform their husband about the availability of voluntary counselling and testing services in ANC/PMTCT and previous history of couple counselling were found to be the independent predictors of male involvement in ANC/PMTCT service. Male partner involvement in ANC/PMTCT was found to be low and the authors argue that comprehensive strategies should be put in place to sensitize and advocate the importance of male partner involvement in ANC/PMTCT and reach out male partners.

WHO criticised for not following policy on recognising NGOs
Rema Nagarajan: Times of India, Jan 31 2014

Civil society groups have expressed disappointment with the number of "industry groupings" that have "incorrectly gained NGO status" with the World Health Organization (WHO). There are 187 organizations or networks recognized as NGOs in official relations with the WHO. According to the International Baby Food Action Network (IBFAN), a new entrant into this WHO list of NGOs, industry groups which have been recognized as NGOs by WHO include Croplife International (representing Monsanto, Syngenta, Bayer, CropScience, Dow Agrosciences, DuPont and other companies promoting GMO technologies ) the International Federation of Pharmaceutical Manufactures and Associations, International Life Sciences Institute (representing Nestle, Coca Cola, Kellogg, Pepsi, Monsanto, Ajinomoto, Danone, General Mills and others) and the Industry Council for Development (representing Nestle, Mars, Unilever and Ajinomoto). "All are guided by market profit-making logic (whose primary interest clashes with that of WHO). Their inclusion goes against WHO's current NGO policy," said a statement issued by IBFAN.

Further details: /newsletter/id/38870
Bringing Justice to Health: The Impact of Legal Empowerment Projects on Public Health
Open Society Foundations: October 2013

Bringing Justice to Health profiles 11 legal empowerment projects based in Indonesia, Kenya, Macedonia, Russia, South Africa, and Uganda. These projects were selected because they show the range of approaches to legal empowerment that they support in their broader effort to promote health-related human rights interventions. The report tells the personal stories of people around the world - such as sex workers, people who use drugs, palliative care patients, people affected by HIV, and Roma - for whom human rights violations are part of everyday life. Sexual violence, discrimination in housing, unwarranted dismissal from employment, unfair evictions, denial of child support, and police harassment are only a few such violations. The report shows how the non-governmental organisations (NGOs) that founded projects to address these issues set about resolving problems in a way that is designed to empower those who are often least able to exercise their rights.

Knowledge, attitudes and practices of Ugandan men regarding prostate cancer
Nakandi H, Kirabo M, Semugabo C, Kittengo A, Kitayimbwa P, Kalungi S, Maena J: African Journal of Urology, 19, 165–170: August 2013

The incidence of prostate cancer in Uganda is one of the highest recorded in Africa. Prostate cancer is the most common cancer among men in Uganda. This study assessed the current knowledge, attitudes and practices of adult Ugandan men regarding prostate cancer through a descriptive cross-sectional study using interviewer administered questionnaires and focus group discussions among 545 adult men aged 18–71 years, residing in Kampala, the capital of Uganda. The majority of the respondents had heard about prostate cancer but 46% had not. The commonest source of information about prostate cancer was the mass media. Only 13% of the respondents obtained information about prostate cancer from a health worker. Respondents confused prostate cancer with gonorrhea and had various misconceptions about its causes. Only 10% of the respondents had good knowledge of the symptoms of prostate cancer.

Mobilizing communities to improve maternal health: results of an intervention in rural Zambia
Ensor T, Green C, Quigley P, Badru AR, Kaluba D and Kureya T: Bulletin of the World Health Organization 92:51-59, 2014

In Zambia, as in other low-income countries, maternal health indicators have remained stubbornly resistant to improvement. This intervention involved revitalizing Safe Motherhood Action Groups to raise awareness of the need to prepare for pregnancy complications and delivery. The main aim was to improve both understanding of maternal health and access to maternal health-care services. The approach was predicated on the assumption that women require not only knowledge about when they should seek skilled help but also their husbands’ approval for care seeking, which can be encouraged by community leaders. The authors adopted a quasi-experimental approach to evaluating the effect of a complex community-based intervention that was devised to reduce barriers to the use of maternal health-care services and to increase deliveries involving a skilled birth attendant. The intervention was novel because it involved the whole community and emphasized social approval and its ability to bring about changes in behaviour. The intervention was associated with significant improvements in women’s knowledge of when they should receive antenatal care and of obstetric dangers signs, in the use of emergency transport, in deliveries involving a skilled birth attendant and in the use of modern contraception. However, the increase in the proportion of women who received four or more antenatal care visits and in those who received postnatal care within 6 days was not significant.

PHM watches the 134th WHO's EB session
Peoples Health Movement: January 2014

134th session of the WHO's Executive Board 20-25 January 2014. The watching team in association with a number of PHM affiliate networks have published an 'Open Letter' to the delegates of the members of the Executive Board. The commentary includes analysis and comments on each of the items on the meeting's agenda.

Kenya: Statute Law Bill poses grave threat to civil society and must be rejected – UN rights experts
Editor, Pambazuka News 657: 5 December 2013

A group of United Nations Special Rapporteurs today urged the Government of Kenya to reject legislation that would impose severe restrictions on civil society. “The Bill is an evidence of a growing trend in Africa and elsewhere, whereby governments are trying to exert more control over independent groups using so-called ‘NGO laws,’” the human rights experts warned. The Bill, which was presented to Parliament on 30 October, would amend Kenya’s Public Benefit Organization Act of 2012 and grant the Government sweeping powers to deny registration for such organizations, including non government organisations. It would also cap foreign funding at 15% of their total budgets and channel all their funding through a government body, rather than going directly to beneficiary organizations.

The treatment action campaign and the three dimensions of lawyering: Reflections from the rainbow nation
Ahmad H: Journal of Social Aspects of HIV/AIDS 10(1) 16-24: March 2013

The spread and perpetuation of the HIV/AIDS epidemic in South Africa has hindered the country’s social and economic growth after apartheid. This paper documents experiences of interactions with the Treatment Action Campaign (TAC), an organization which has taken a multidimensional approach in order to educate people about HIV/AIDS and to provide access to medicines. It reports how TAC has used both traditional and non-traditional methods of advocacy to combat the epidemic and equate access to health care to a social justice issue by empowering marginalized communities. The author uses three dimensions of lawyering and equates TAC to a single cause lawyer, signifying that multi-dimensional activism is not limited to individuals, but can also be applied at the firm level. The three dimensions include: (a) advocacy through litigation, (b) advocacy in stimulating progressive change, and (c) advocacy as a pedagogic process. He suggests that TAC’s multi-dimensional approach and its inherent practice of the three dimensions has contributed to its success and may be useful for other processes.

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