Early recognition of symptoms and signs perceived as malaria are important for effective case management, as few laboratories are available at peripheral health facilities. The validity and reliability of clinical signs and symptoms used by health workers to diagnose malaria were assessed in an area of low transmission in south-western Uganda.
Equitable health services
The Eastern Cape Department of Health has certified 36 hospitals under the Baby Friendly Hospital Initiative (BFHI). The assessment of hospitals started in 1999 in the province when one hospital received "baby friendly" status. The BFHI is a global strategy implemented by healthcare facilities that render care to both mothers and children worldwide. It aims to increase awareness of the critical role of health services in the romotion of breastfeeding and to give guidelines for appropriate information and support to mothers. It also focuses on maternity care services which involves the holistic care of mother and baby both within the facility.
European executive directors and alternates have written a letter to staff in the World Bank human development network to explain their rejection of the draft health, nutrition and population strategy. Gender and reproductive health groups have been bombarding the directors with complaints over the alleged watering down of the strategy. In their letter, the directors raise concern that the strategy makes virtually no reference to sexual and reproductive health.
Rape survivors are not getting the healthcare they need. Teenage girls who are raped are often scolded or branded liars by healthworkers attending to them, while men, gays and lesbians and sex workers who have been raped are also discriminated against. Other problems facing rape survivors include the denial of healthcare to those who have not reported the rape to police, the lack of privacy for examinations and staff ignorance of basic treatment procedures. This is according to the South African National Working Group on Sexual Offences, a group of 25 organisations including Childline, the Teddy Bear Clinic, People Opposing Women Abuse and the Tshwaranang Legal Advocacy Centre.
In January, PIH launched its newest project, located in Neno, Malawi – an impoverished rural area in one of Africa’s poorest and most densely populated countries, with an HIV infection rate among adults of more than 14 percent. By mid-February, PIH doctors were working with Malawian nurses who had staffed the hospital prior to our arrival to provide care for more than 100 patients a day and treat 129 HIV patients with antiretroviral therapy.
Clinicians often diagnose and treat patients for malaria in Africa when they do not have the disease. Over diagnosis and treatment may be acceptable when the drugs are cheap and safe. However, new more expensive drugs whose side effects are less well known are now being used. Over diagnosis in these circumstances would not be appropriate.
This paper suggests a model for sustainable improvement of health system performance which takes into consideration historical lessons, and current opportunities and challenges facing Africans. The essential elements of the suggested model include decentralized governing structures linking the health system to communities; identification of an essential care package for health (ECPH) based on peoples’ priorities; an improved information system to provide evidence of improvement in service access, delivery, and outcomes; and regular dialogue among stakeholders to enhance informed demand, responsibility, and accountability. The model attempts to pay due regard to the people's own beliefs, knowledge, customs, experiences, practices, systems, and structures that give meaning to the ECPH and mitigate the discontinuity between people’s perceptions and the health intervention package through regular dialogue.
The availability of drugs to treat two leading killer diseases in the country's public health facilities still falls below the internationally recommended benchmark, a survey shows. On average, the availability of two anti-retrovirals meant to treat HIV/Aids and that of the newly launched anti-malarial drug fell at least 10 marks below the recommended 75 per cent.
The healthcare system in South Africa is based on the district health system through a primary healthcare approach. Although many vision and mission statements in the public healthcare sector in South Africa state that the service aspires to be holistic, it is at times unclear what exactly is meant by such an aspiration. The term ‘holism’ was coined in the 1920s and describes the phenomenon of the whole being greater than the sum of the parts. Over the past two decades the term has entered into many academic disciplines as well as popular culture. As part of a larger research study, the limitations to working holistically in the public sector in a rural sub-district in South Africa were explored. This study used a participatory action research design that allowed participants a large degree of influence over the direction of the study. The close relationship between difficulty in providing a holistic healthcare service and burnout was an important finding that deserves further exploration.
Influential women from all over the globe have come together in London to urge the world to redouble efforts and boost investments to reduce the global burden of maternal and newborn death. The policy makers and parliamentarians from developing and developed countries are meeting to mark UK Mother's Day on 18 March 2007. Key participants include Cherie Blair, wife of the UK Prime Minister and international lawyer, Hilary Benn, MP, Secretary of State, Department for International Development, UK, Liya Kebede, Supermodel and World Health Organization Goodwill Ambassador for Maternal, Newborn and Child Health, and the First Lady of Lesotho, Mrs Mathato S. Mosisilli. A Global Plan of Action agreed at the meeting calls for a universal right to health for mothers and their babies by ensuring equitable skilled care. The plan calls on governments to take the lead in fighting maternal and newborn illness and death.