Equitable health services

Global health organisation prepares to name leader
Donnely J: The Boston Globe, 9 January 2007

The next leader of a global organisation that fights major infectious diseases, including AIDS, may come from a group that includes the former health minister of Mexico, France's AIDS ambassador, the former leader of UNICEF, and several leaders of the World Health Organization, according to a list of names obtained by the Globe. The board overseeing the organization, Global Fund to Fight AIDS, Tuberculosis and Malaria, failed to select a new executive director last November and now hopes to name one at a meeting in Geneva early next month.

Political economy from a clinical perspective
Hart JT: Policy Press, 2007

Hart describes the background of the creation of NHS and its history. Although NHS was relatively under-funded in the 1960s and 1970s, it was still extremely efficient: The UK was under a long period of time the OECD country with the lowest government allocation for health. Despite this, the outcome was impressive: Equal health care for all, evenly distributed throughout the country. The cost for administration was unbeatable: Initially it was 2%, but increased to 6% when the conservative government introduced the principles of ”New Public Management”. Since NHS became subject to privatisation and the introduction of internal markets, the administration cost has risen to 12%. One of Hart’s points is that public health care is cheap, partly because the administration cost is low.

Uganda: Drastic drop in measles deaths
Integrated Regional Information Network, 24 January 2007

Aggressive immunisation campaigns in Uganda have cut the numbers of children dying of measles from 6,000 to 300 annually over the past 10 years, a Ministry of Health official said. The director of health services, Sam Okware, said on Tuesday the ministry used to record up to 60,000 cases, with 6,000 deaths, 10 years ago, "but now the cases have reduced by 10 times and last year we recorded about 300 deaths, which is a great achievement".

Zanzibar redoubles efforts to combat cholera
Integrated Regional Information Network, 24 January 2007

Cholera outbreaks in Tanzania's semi-autonomous island of Zanzibar have continued due to poor hygiene standards, health officials said on Wednesday, while announcing renewed efforts to raise public awareness. "We need to double our efforts of awareness; we also need to strengthen by-laws to make sure that the islands are kept clean," Dr Omar Suleiman, an officer in the Ministry of Health, said in Stone Town, capital of Zanzibar.

Drug prescribing habits in private surgeries and public hospitals in South Africa
HSRC Review 4 (4), November 2006

This study looks specifically at prescribing habits in South Africa and examines the following questions: what impact the national drug policy (NDP) has on pharmaceutical use in the public sector; whether the NDP achieved rational prescribing and dispensing of drugs by medical, paramedical and pharmaceutical personnel; whether the essential drugs list is used effectively; and what the level of generic prescribing is.

Family planning: The unfinished agenda
Cleland J, Bernstein S, Ezeh A, et al: The Lancet 368 (9549), 1810-1827, 18 November 2006

Promotion of family planning in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. It would also contribute substantially to women's empowerment, achievement of universal primary schooling, and long-term environmental sustainability. However, in half the 75 larger low-income and lower-middle income countries (mainly in Africa), contraceptive practice remains low and fertility, population growth, and unmet need for family planning are high. The author discusses in detail how a revitalisation of the agenda is urgently needed.

Hospital admissions resulting from unsafe abortion: Estimates from 13 developing countries
Singh S: The Lancet, 369 (9550), 25 November 2006

Complications from unsafe abortion are believed to account for the largest proportion of hospital admissions for gynaecological services in developing countries. The WHO estimates that one in eight pregnancy related deaths result from unsafe abortions. The social stigma and legal restrictions associated with abortion in many countries means that data on the magnitude of this problem are scarce; this article estimates the rate and numbers of hospital admissions resulting from unsafe abortions in developing countries to help quantify the problem.

Opportunities for Africa's newborns: Practical data, policy and programmatic support for newborn care in Africa
The Partnership for Maternal, Newborn and Child Health (PMNCH), 2006

This report provides an overview of the continuum of care for maternal, newborn and child health (MNCH) in Africa. The report investigates the prevalence and causes of neonatal deaths and highlights the gaps in coverage of care through the pre-pregnancy, pregnancy, childbirth and postnatal period. It also discusses how to integrate care with key programmes aimed at preventing mother to child transmission of HIV, controlling malaria, and immunisation. The report presents case studies of six African countries which have progressively reduced newborn death rates despite low gross national income. The authors find that two thirds of the 1.6 million newborn deaths in sub-Saharan Africa could be avoided if essential interventions already in policy reached 90 per cent of African mothers and newborns.

Problems in providing universal access to services highlighted at UNCTAD meeting
Tayob R: Third World Network, 21 November 2006

A recent United Nations Conference on Trade and Development (UNCTAD) expert meeting discussed how developing countries face challenges and problems in providing universal access to services to their people. The meeting comprised panels looking at general issues as well as various sectors, including water, health, education and telecommunication services. It also had a session on the WTO's General Agreement on Trade in Services (GATS). Among the problems highlighted were the adverse effects of user fees, with the imposition of charges and fees to citizens in exchange for public services, introduced in many countries as part of World Bank-IMF programmes, the effects of privatisation of services, and the negative effects of patents and bilateral free trade agreements on access to medicines and health services.

Reducing maternal mortality stymied by lack of funds and absence of national laws
Macan-Markar M: Third World Network, 7 December 2006

Among all reproductive health indicators, the least progress has been made in reducing maternal mortality. This means that the fifth Millennium Development Goal to reduce by three quarters the maternal mortality ratio, given that over half a million women die every year during pregnancy or childbirth – will not be reached in many countries. Lack of funds and the slow progress to implement laws that protect maternal healthcare and reproductive health rights are undermining this goal.