Equitable health services

Health strategy rejected
Powell J 23 April 2007

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.

Many obstacles to healthcare for rape survivors
Cullinan K: Health-e, 28 April 2007

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.

New project in Malawi
Partners In Health, March 2007

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.

Over diagnosis and treatment of malaria in Kenya
id21 Health News, 21 November 2006

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.

Health care in Africa: Challenges, opportunities and an emerging model for improvement
Kaseje D, November 2006

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.

Kenya: Study says drugs availability low
Ndegwa A: The East African Standard, March 2006

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.

Limitations to practising holistically in the public sector in a rural sub-district in South Africa
Gaede B, Mahlobo S, Shabalala K, et al: Rural and Remote Health 6 (online) 607, 2006

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.

Parliamentarians and activists from across the world gather to combat maternal and newborn deaths
World Health Organisation, 13 March 2007

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.

Social determinants of health and health inequalities: what role for general practice?
Furler J: Health Promotion Journal of Australia 17:264-5, 2006

This paper argues that general practice is potentially an important social determinant of health and health inequalities. The way it is influential is consistent with models of causal pathways in the way social and societal factors influence health. General practice clinical care can be thought of as a material resource. Evidence exists at many levels that this resource is inequitably distributed. But encounters in general practice are profoundly social processes, embedded in wider society. Debating and reflecting on the values underpinning relations between GP and patient may help challenge and illuminate wider inequitable processes in society that sustain inequalities in health.

TB control programmes in East Africa inadequate according to WHO report
Integrated Regional Information Networks, 2007

Several countries in eastern Africa have a high incidence of tuberculosis but have yet to develop effective national strategies to curtail the disease, the United Nations World Health Organization said in its 2007 global TB report, ‘Global tuberculosis control - surveillance, planning, financing’. Citing Democratic Republic of Congo, Kenya and Tanzania as among the 22 countries with a high tuberculosis burden, WHO said their national plans were not effective enough to combat it. Nigeria and Mozambique are the other African countries on the list. While noting the provision of free TB the report cites constraints in plans for human resource development made by national TB control programmes, inadequate screening of HIV-positive people for TB, and limited facilities for diagnoses and treatment of multi-drug resistant TB.

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