This Drum Beat is one of a series of commentary and analysis pieces. Getting communication included is an integral element in development programmes, for example improving maternal health. Addressing this challenge needs actions at many levels, all of which entail particular types of communication.
Governance and participation in health
The role of communication in sustainable development
The Drum Beat: The Communication Initiative, (410), 3 September 2007
Tradition a force against HIV/AIDS?
Integrated Regional Information Network, 14 September 2007
Circumstance, rather than planning, has placed the battle against HIV/AIDS firmly in the hands of Swaziland's 355 chiefdoms. The decentralisation strategy has evolved from government's failure to command the fight against the disease, or even deliver healthcare at its urban hospitals, and much less so in rural areas, where four out of five Swazis live. Swaziland, ruled by sub-Saharan Africa's last absolute monarch, King Mswati III, has a well-established traditional hierarchy, and the use of it to coordinate efforts against HIV/AIDS is being seen as a grassroots-driven solution.
HIV/AIDS and democratic governance in Africa: Illustrating the impact on electoral processes
Chirambo K, IDASA, 22 May 2007
The research presented in this paper responds to years of academic speculation and subsequent policy concerns about the possible collapse of Africa’s democratic project under the complex waves of impacts introduced by the HIV/AIDS pandemic. It is the result of three years of exploratory studies in seven countries: Botswana, Namibia, Malawi, Tanzania, South Africa, Senegal and Zambia. Anecdotes of Lesotho and Zimbabwe have also been highlighted.
Tackling, developing and sustaining stewardship and health system management for health equity
Gilson L: Commission on the Social Determinants of Health (CSDH), June 2007
This paper argues that stronger and values-based public sector management and leadership is essential in building health systems that better address health inequities. By considering evidence on existing weaknesses in health system action to redress inequity, it identifies a complex and inter-locking set of problems involving individuals, organisational culture and the ways in which wider political, economic and socio-cultural forces influence public sector organisations. It then examines the particular features of organisational culture in organisations judged to be better performing, and considers how change in organisational culture can be brought about. It also identifies the particular competencies of public sector managers and reviews evidence on how these competencies can be developed.
Reducing social inequalities in health: Public health, community health or health promotion?
Ridde V: 63-67
While the Consortium on ’Community Health Promotion’ is suggesting a definition of this new concept to qualify health practices, this article questions the relevance of introducing such a concept since no one has yet succeeded in really differentiating the three existing processes: public health, community health, and health promotion. Based on a literature review and an analysis of the range of practices, these three concepts can be distinguished in terms of their processes and their goals. Public health and community health share a common objective, to improve the health of the population. In order to achieve this objective, public health uses a technocratic process whereas community health uses a participatory one. Health promotion, on the other hand, aims to reduce social inequalities in health through an empowerment process, which is argued to be more effective.
The benefits of participatory methodologies to develop effective community dialogue in the context of a microbicide trial feasibility study in Mwanza, Tanzania
Vallely A, Shagi C, Kasindi S, Desmond N, Lees S, Chiduo B, Hayes R, Allen C, Ross D: BMC Public Health 7:133, 2 July 2007
During a microbicide trial feasibility study among women at high-risk of HIV and sexually transmitted infections in Mwanza, northern Tanzania the researchers used participatory research tools to facilitate open dialogue and partnership between researchers and study participants. Participatory techniques were instrumental in promoting meaningful dialogue between the research team, study participants and community representatives in Mwanza, allowing researchers and community representatives to gain a shared understanding of project-related priority areas for intervention.
Understanding the Impact of Decentralisation on Reproductive Health Services in Africa (RHD) - South Africa
Hall W: Health System Trust, November 2006
The provision of appropriate reproductive health care remains one of the main health care challenges in developing countries. The delivery of reproductive health services is continually confronted by challenges from the changing environment, as health sector reforms are implemented, and particularly by decentralisation.
Community involvement in youth reproductive health and HIV prevention
Tipton P, Finger W, Shears KH: Family Health International , 2007
Are reproductive health and HIV prevention outcomes for young people better when a project makes an explicit effort to involve community members? This briefing paper summarises the findings of a range of studies that have sought to investigate this question. Most evaluations reviewed identify positive effects including empowerment of participants, increased sustainability, greater acceptance of the initiative, and improved knowledge and attitudes. However, while studies that compared programmes that involved communities with standard programmes found these positive effects, some noted little or no differences in young people’s behaviour. The paper also provides references and links to resources on community involvement and youth reproductive health and HIV prevention.
Community mental health care in Botswana: approaches and opportunities
Seloilwe ES, Thupayagale-Tshweneagae G: International Nursing Review 54 (2): 173-178, June 2007
Care of the mentally ill in Botswana is provided at different levels of coverage and sophistication. There is a single mental hospital in the country. Attached to the district hospitals are psychiatric outpatient clinics run by psychiatric nurses and a psychiatrist who visits them on monthly basis. Mental health care in Botswana has gone through a paradigm shift, from the prepenal years, penal years and institutional to community based care, which reflects a philosophy of citizen involvement and collaboration. The purpose of this article is to provide an insight into the developmental trends in community mental health care in Botswana. Different approaches are discussed and the opportunities that have emanated from them.
Community-based management of severe acute malnutrition
World Health Organization, World Food Programme (WFP), United Nations (UN), May 2007
Severe acute malnutrition remains a major killer of children under five years of age. Until recently, treatment has been restricted to facility based approaches, greatly limiting its coverage and impact. New evidence suggests, however, that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre.