Equitable health services

Mental health in Africa: The role of the WPA
Okasha A, World Psychiatry 1 (1) 32–35

The World Psychiatry Association program seeks to initiate mental health policies and their integration in primary health care, to promote adoption of mental health legislation, equity in the provision of mental health services and adequate funding of those services. In the early 1990s, only 23% of member states of the African Region of WHO were reported to have a mental health legislation. Mental health legislation in Africa needs to be updated to secure the rights of mentally ill people, and support to their families. An integrated mental health policy reduces morbidity and burden by emphasising primary and secondary prevention and all forms of mental rehabilitative care of the more severely ill. Policy goals may include bringing families with mentally ill members together, encouraging the creation of common interest groups, and developing broader views of rehabilitation.

Socioeconomic differentials in caesarean rates in developing countries: A retrospective analysis
Ronsmans C, Holtz S, Stanton C: The Lancet 368 (9546) 1516-1523, 2006

Little is known about socioeconomic differences in access to life-saving obstetric surgery, yet access to a caesarean for women is essential to achieve low levels of maternal mortality. The study examined population based caesarean rates by socioeconomic groups in various developing countries. In the poorest countries-mostly in sub-Saharan Africa-large segments of the population have almost no access to potentially life saving caesareans, whereas in some mid-income countries more than half the population has rates in excess of medical need. These data deserve the attention of policymakers at national and international levels.

Tanzania: Control cholera outbreak in two weeks or lose jobs, Prime Minister says
IRIN News, 22 November 2006

Tanzanian Prime Minister Edward Lowassa has given Dar es Salaam regional administrative officials two weeks to eradicate cholera or lose their jobs. "I give you up to December 3," he told the officials on Monday during a brief health inspection of the city's cholera-infected neighbourhoods of Temeke, Buguruni and Mburahati. Over the past 12 months, the disease has killed 117 people in the city, the nation's commercial capital.

Tuberculosis diagnosis and drug sensitivity testing: An overview of the current diagnostic pipeline
Guillerm M, Usdin M, Arkinstall J: Medecins Sans Frantiers, October 2006

Tuberculosis (TB) remains the leading cause of death from a curable infectious disease, despite the availability of short-course therapy that can be both inexpensive and effective. New diagnostic tests that are simple and robust enough to be used in the field, accurate enough to diagnose all infected individuals, and able to identify drug resistance are desperately needed, and represent an essential complement to new drug development efforts and to effective control and treatment programmes.

A health systems development agenda for developing countries: Time to be clear and visionary
Global Health Watch

This discussion paper argues for the development of an advocacy agenda to promote comprehensive health systems development in developing countries. It aims to promote discussion amongst health policy experts and civil society organisations (CSOs) about the need for and content of a health systems advocacy agenda. This document is intended to stimulate discussion and is accompanied by a pro-forma document to facilitate your comments, opinions and recommendations in shaping the content of a health systems development agenda and the way forward for appropriate health care systems development.

Demand for health care services in Uganda: Implications for poverty reduction
Sewanyana S, Nabyonga JO, Kasirye I, Lawson D: World Institute for Development Research (WIDER), 2006

Using the 2002/3 Uganda National Household Survey data, this study examines the nature and determinants of individuals' decisions to seek care on condition of reporting illness. A nested logit model, which captures correlations among health care provider alternatives, is used to estimate a behavioural model for health care demand. The three options in the model are: no-care, and formal care (public or private health care).

Essential Health Services workshop in South Africa
Oxfam International, August-September 2006

This two-day gathering begun with participants noting their concerns and expectations about the state of essential services in general, as well as the workshop itself. Oxfam said the purpose of the workshop was to welcome participants’ input in shaping Oxfam’s thinking on essential services, and though Oxfam chose to focus on health, education and water internationally, participants should point the report in the right direction.

Access to vaccines: Obstacles and solutions
Arnodei I: Geneva Health Forum, 31 August 2006

More than 2,600,000 deaths have been prevented in 2003 thanks to the Hepatitis B vaccine currently available. This is only one impressive example of the benefits of good vaccination and immunisation programmes. Although vaccination programmes are very cost-efficient, costing as less than 1,000 USD per life saved, the world still faces over 100,000 neonatal tetanus deaths and over 400,000 deaths from measles per year. The international community has a very ambitious plan: to completely eradicate diseases which are preventable by global vaccine coverage. How can such a goal be accomplished?

Breathing life into DRC's sick hospital
Winter J: BBC News International, 8 August 2006

This story describes the experience of Professor Stanis Wembonyama as director of the main hospital in Democratic Republic of Congo's second city, Lubumbashi, last year. Gecamines, the state-owned mining monopoly used to be in charge - theoretically - of the Jason Sendwe Hospital, but the institution had been left to rot. Most of the beds had been either stolen or stripped down and sold as scrap metal. Doctors and nurses had not been paid their salaries for five years and so they earned their living by demanding cash before treating their patients. The story outlines the steps to clean up the hospital and instil management discipline.

Critical view on the role of hospitals in increasing access to health
Krebs V: Geneva Health Forum, 1 September 2006

Hospitals have always played a pivotal role in the global healthcare system. They have power, authority and professional competences in both the rich and poor worlds. But what if we all begin to re-think the mission of hospital care and re-design the way we deliver it in order to increase access to health? The moment has arrived for reform in order to achieve optimal care, to learn from examples of real innovation and disseminate this knowledge, sharing ideas as well as best practices. For example one speaker at this session of the August 2006 Geneva Health Forum noted that the mission of hospitals has shifted from delivering specialized care to our patients; to responsibility for the care in our region; to promoting health to all our citizens.

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