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.
Equitable health services
Social determinants of health and health inequalities: what role for general practice?
Furler J: Health Promotion Journal of Australia 17:264-5, 2006
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.
Call to Action: Health System Strengthening through the Global Fund
The Global Fund
Round 7 of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which launches March 1, 2007, offers an important opportunity to fund health system strengthening, including the health workforce. To prepare for Round 7, health workers, ministry of health officials, and other individuals and institutions that have an interest in their countries' health systems are strongly encouraged to consider utilizing this opportunity for strengthening health systems. If interested, you should immediately contact members of your country's Country Coordinating Mechanism to discuss this potential, as well as the national process and timeline for developing these proposals. The proposals are expected to be due to the Global Fund in early July 2007.
Further details: /newsletter/id/32113
SOUTH AFRICAN HEALTH REVIEW 2006 - Maternal, Womens and Child Health - the unfinished agenda
Health Systems Trust, 22 February 2007
Great strides have been made in improving maternal care in South Africa over the last decade. A record high of ninety percent of pregnant women attend antenatal care and 92% of deliveries of babies are conducted by skilled health workers. Despite such achievements in access to care, maternal deaths are on the increase, mostly fuelled the HIV and TB epidemics.
The cost of uncomplicated childhood fevers to Kenyan households: implications for reaching international access targets
Larson BA, Amin AA, Noor AM, Zurovac D, Snow RW: BMC Public Health 6:314, 29 December 2006
We assemble data developed between 2001 and 2002 in Kenya to describe treatment choices made by rural households to treat a child's fever and the related costs to households. Using a cost-of-illness approach, we estimate the expected cost of a childhood fever to Kenyan households in 2002. We develop two scenarios to explore how expected costs to households would change if more children were treated at a health care facility with an effective antimalarial within 48 hours of fever onset.
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.