Health departments in the new South Africa are undergoing major restructuring and, in some cases, severe financial cutbacks as new policies attempt to redress the inequities of the past. A district system is being phased in, with a shift in funding from academic hospitals to secondary and primary level care. The process is being undermined by the current recession, which also affects Welfare and Education facilities, and by widespread poverty, violence, and other adverse conditions. Child mental health services are discussed in the light of current human resources, epidemiological data, the effects of violence and cultural issues, together with some reflections on their future.
Equitable health services
Child Mental Health Services in the New South Africa
Milne M, Robertson B: Child Psychology and Psychiatry Review 3: 128-134
Diabetes care in Africa
Mbanya JC, Kengne AP, Assah F: The Lancet 368 (9548) 1628-1629, 2006
Diabetes is a growing problem in Africa and will continue to be so, as a high risk of diabetes is tied to highly active retroviral therapy for AIDS. Data for diabetes in Africa is small, as the subject has received little attention, and many of the African studies have not been published in Western, peer-reviewed journals. This paper highlights many of the issues surrounding diabetes treatment in Africa.
Ethiopia: Shortage of vaccines for meningitis
IRIN News, 20 November 2006
The Ethiopian health ministry is short of vaccines to contain the spread of meningitis that has so far claimed 10 lives in the Southern Nations Nationalities and People’s Region (SNNPR) and infected 612 more, a health update said. A meningitis outbreak has been reported in Derashe and Selamago areas of Mursi in the SNNPR region. An earlier outbreak in Wolayita zone of the same region was contained due to the quick response of health ministry and humanitarian partners, according to the update by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA).
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.