In Part 2, the authors drew on many people and organisations around the world, including their project reference group, to generate a list of organisations to survey. They sent the questionnaire by email to 176 organisations and followed up periodically with non-responders by email and telephone. They received completed questionnaires from 152 (86%) organisations. More than one-half of the organisations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organisation. The findings confirm that the principles of evidence-based medicine dominate current guideline programmes and underline the importance of collaborating with other organisations. The survey also provides a description of the history, structure, processes, outputs, and perceived strengths and weaknesses of existing organisations from which those establishing or leading similar organisations can draw.
Values, Policies and Rights
In Part 3, the authors purposively sampled organisations from among those who completed a questionnaire in the first phase of the study, developed and piloted a semi-structured interview guide, and conducted the interviews by telephone, audio-taped them, and took notes simultaneously. They interviewed the director (or his or her nominee) in 25 organisations, of which 12 were GSUs. Using rigorous methods that are systematic and transparent (sometimes shortened to 'being evidence-based') was the most commonly cited strength among all organisations. GSUs more consistently described their close links with policymakers as a strength, whereas organisations producing CPGs, HTAs, or both had conflicting viewpoints about such close links. With few exceptions, all types of organisations tended to focus largely on weaknesses in implementation, rather than strengths.
Zimbabwe is a party to the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, the Convention on the Elimination of All Forms of Discrimination against Women and the African Charter on Human and Peoples’ Rights. It has a legally binding obligation to respect, protect and fulfill these rights for all people within its jurisdiction. The report argues that a causal chain runs from Mugabe’s economic policies, to Zimbabwe’s economic collapse, food insecurity and malnutrition, and the current outbreaks of infectious disease. The determinants of health, such as broken sewerage systems, chronic food insecurity and widespread starvation, underlie disease epidemics such as cholera and anthrax and a deterioration of maternal health care. The authors recommend that the international community needs to resolve the political impasse, launch an emergency health response with services controlled by a United Nations-designated agency or consortium, refer the situation to the International Criminal Court for Crimes against Humanity, convene an emergency summit on HIV, AIDS and TB and prevent further deterioration of household food supply.
In this paper, some of the right-to-health features of health systems are identified, such as a comprehensive national health plan, and 72 indicators are proposed that reflect some of these features. Globally processed data on these indicators was collected for 194 countries. Globally processed data was not available for 18 indicators for any country, suggesting that organisations that obtain such data give insufficient attention to the right-to-health features of health systems. Where available, indicators show where health systems need to be improved to better realise the right to health. The paper provides recommendations for governments, international bodies, civil-society organisations, and other institutions and suggests that these indicators and data, although not perfect, provide a basis for the monitoring of health systems and the progressive realisation of the right to health. Right-to-health features are obligations under human rights law.
The People’s Health Movement ((PHM) has significantly advanced in the campaign's expansion since its last update in May 2008. India, Ecuador, Zimbabwe and South Africa are involved in the campaign without receiving funding. New PHM circles have been formed in the last three months in Mali, Kenya, Morocco and Uganda and they will be submitting campaign proposals shortly. The countries that have almost completed the assessment are now eligible for a small additional funding to hold a national workshop in which to present the results to the government, UN agencies, international and national NGOs and the media. Any country not mentioned here is welcome to inquire with PHM how they can get a PHM circle going so as to launch the campaign.
Benchmarking exercises have become increasingly popular within the sphere of regional policy-making. This paper analyses the concept of regional benchmarking and its links with regional policy-making processes. It develops a typology of regional benchmarking exercises and benchmarkers, and critically reviews the literature. It is argued that critics of regional benchmarking fail to take account of the variety and development of regional benchmarking systems. It is suggested that while benchmarking exercises are informing policy adaptation and innovation, they have been constrained by political and financial factors. It is concluded that regional benchmarking is facilitating the heightened regional interaction necessitated by globalisation.
Cancer is causing a lot of suffering and death in Africa but is not considered a major health problem in Africa. This needs to change. Cancer should be given equal emphasis to HIV/AIDS, tuberculosis (TB) and malaria. A national cancer policy is required in Malawi to develop and improve evidence-based cancer prevention, early diagnosis, curative and palliative therapy. A national cancer policy is crucial to ensure a priotised, clear, coordinated and sustained fight against cancer. When no policy exists, events are likely to be random, stakeholders and practitioners in the fight against cancer may not agree on how to proceed, may duplicate efforts or may neglect areas that would have greater nationwide impact resulting in poor quality activities and haphazard development.
Few empirical studies of research utilisation have been conducted in low- and middle-income countries. This paper explores how research information, in particular findings from randomised controlled trials and systematic reviews, informed policy making and clinical guideline development for the use of magnesium sulphate in the treatment of eclampsia and pre-eclampsia in South Africa. A qualitative case-study approach was used to examine the policy process, which included a literature review, a policy document review, a timeline of key events and the collection and analysis of 15 interviews with policy makers and academic clinicians The paper concludes that networks of researchers were important not only in using research information to shape policy but also in placing issues on the policy agenda. A policy context that creates a window of opportunity for new research-informed policy development is crucial.
AIDS activists in Uganda have slammed a proposed new law that will force HIV-positive people to reveal their status to their sexual partners, and also allow medical personnel to reveal someone's status to their partner. The HIV Prevention and Control Bill (2008) is intended to provide a legal framework for the national response to HIV, as well as protect the rights of individuals affected by HIV. The bill in its current form could worsen the difficulties many HIV-positive people experience. Certain sections of the bill needed to be revised, for instance, the provision that HIV status disclosure would be mandatory for couples planning to marry, which can only have serious repercussions in a male-dominated society; at least three women have been killed by their husbands this year because they were positive.
This paper identifies some of the right-to-health indicators of health systems, such as a comprehensive national health plan, and proposes 72 indicators that reflect some of these features. It collected data on these indicators for 194 countries. Data was not available for 18 indicators for any country, suggesting that organisations that obtain such data give insufficient attention to the right-to-health features of health systems. Where available, the indicators show where health systems need to be improved to better realise the right to health. Although not perfect, the indicators provide a basis for the monitoring of health systems and the progressive realisation of the right to health. The right to health is not just good management or justice, it is an obligation under human-rights law.