While health systems constraints are increasingly recognized as primary barriers to the scaling up of health services and achievement of health goals, knowledge regarding how to improve health systems is often weak and frequently not well-utilised in policy-making. This Review addresses a mismatch between what is known about how to respond to particular health problems in poor economies and what is actually done about them. It focuses on one cause of the problems that ensue from the mismatch – capacity constraints.
Equitable health services
Sound Choices at the Global Forum for Health Research, Beijing, October 2007
Alliance for Health Policy and Systems Research, December 2007
Transgender bodies, identities, and healthcare: Effects of perceived and actual violence and abuse
Witten TM: Research in the Sociology of Health Care 25: 225-249, 15 December 2007
“Disparity” implies the existence of a “markedly distinct in quality or character,” difference between one group and another. Some groups, due to elevated stigma associated with group membership, are invisible as a disparate minority and therefore, while there may be a great inequity in healthcare between that group and the normative population, the invisible minority is ignored. This chapter addresses the issue of healthcare for the transgender-identified population. It addresses how the normative viewpoint of mental illness and unacceptable religious status, along with lifelong perceived and actual abuse and violence, creates a socially sanctioned inequality in healthcare for this population.
Not enough research to treat TB-HIV properly
Thom A: Health-e, 2 November 2007
Health systems cannot properly diagnose, treat, or contain the co-epidemic of HIV and tuberculosis (TB) because not enough is known about how the two diseases interact. A report by leading global health experts warned that the largely “unnoticed collision” of the global epidemics of HIV and TB has exploded to create a deadly co-epidemic that is rapidly spreading in sub-Saharan Africa. About one-third of the world’s 40 million people with HIV/AIDS are co-infected with TB, and the mortality rate for HIV-TB co-infection is five-fold higher than that for tuberculosis alone.
Cancer care in sub-Saharan Africa – urgent need for population-based cancer registries
Okobia MN: Ethiopian Journal of Health Development, 2007
This article reviews literature on cancer statistics in sub-Saharan Africa, and assesses the need for population-based cancer registries to enhance cancer care and prevention within the region. The article finds that there are few cancer registries in sub-Saharan Africa and most of these are hospital based. This is partly because in many countries cancer is a low priority as more emphasis is placed on the control of communicable diseases and improving environmental sanitation.
Challenges Facing Community Home Based Care Programmes in Botswana
Odek AW, Oloo JA: East African Social Science Research Review 23 (2): 1-18, 2007
This study examines the role of Community Home-Based Care in Botswana for people with HIV/AIDS and those with other terminal illnesses. Kerkhoven and Jackson (1995) attribute the popularity of Community Home-Based Care (CHBC) programmes in the developing countries to high rates of HIV/AIDS. Botswana has adult HIV/AIDS prevalence rate of 37 per cent and over 350,000 people living with HIV/AIDS. Rapid rise in incidences of HIV/AIDS has hence resulted in increasing need for CHBC and thus many CHBC services have been established through disorganized and fragmented manners. This paper is an extended literature review. It identifies and discusses challenges facing CHBC programmes in Botswana. The findings indicate that poverty, high cost of community care, inadequate medical facilities, poor infrastructures and socio-cultural issues have threatened the sustainability of CHBC programmes in Botswana. Recommendations and policy options are discussed.
Controlling cancer in developing countries: prevention and treatment strategies merit further study
Disease Control Priorities Project, 2007
This paper discusses the burden of cancer in developing countries and examines which types of cancers can be prevented and treated affordably in low-resource settings and which interventions can be used to control them. The paper concludes that to guide policymakers on the most effective cancer control strategies in developing countries, more work is needed in: clinical evaluations of cancer control interventions, health services research, and country specific economic evaluations. It recommends that since current knowledge about cancer control is incomplete, developing countries should start in small areas and gain knowledge from well-documented pilot programmes. Starting small might entail focusing on individuals with certain high-risk characteristics or in a limited geographic area, and scaling up should occur only after pilot programmes have been shown to perform well.
HIV-TB co-infection: meeting the challenge
Forum for Collaborative HIV Research
Ten per cent of individuals infected with TB develop the active disease but this is greatly increased in those whose immune systems have been weakened by HIV. This report highlights the difficulty in managing the co-epidemic of HIV and TB and identifies priority areas in need of further research: better population-based data on the incidence of drug-resistant TB is required, increased laboratory capacity is needed to make the currently difficult diagnosis of co-infection of HIV-TB accessible to a larger proportion of Africans, more child-specific research is needed especially on paediatric drug formulations. The low uptake of drugs that treat co-infection remains a real problem, with concerns over drug efficacy and the creation of drug resistant strains of TB cited as the main reasons. The report concludes that strategies for dealing with TB and HIV currently exist in isolation, often reinforced by vertical programme financing. Efforts must be made to integrate these disease treatment programmes which will involve stakeholders working together within an evidence based collaborative framework.
Is malaria eradication possible?
The Lancet Editorial 370 (9597): 1459, 27 October 2007
Malaria remains a leading global health problem that requires the improved use of existing interventions and the accelerated development of new control methods. In this editorial we reflect on the possibility of eradicating malaria in infants in Africa with the introduction of the malaria vaccine RTS,S/AS02D.
London Declaration on Cancer Control in Africa
Programme of Action for Cancer Therapy, 2007
The purpose of this declaration is to raise awareness of the magnitude of the cancer burden in Africa and to call for immediate action to bring comprehensive care to African countries. The establishment of cancer care programmes in African countries requires the integration of clinical and public health systems. A comprehensive cancer control strategy must bring together prevention, early detection and diagnosis, treatment and palliative care. More investment is needed to deliver these services in terms of trained staff, equipment, relevant drugs and information systems, as well as public education.
Malawi Essential Health Package
Government of Malawi, 2002
This report presents a draft of the proposed Essential Heath Package (EHP) and its costing for Malawi. It is intended to stimulate comment and debate, and to move the process to a final stage whereby the contents can be incorporated into a broader implementation plan for the Ministry of Health and Population (MOHP) and partners. By MOHP, we mean the various departments at headquarters, the technical programmes, and the districts who will ultimately deliver the EHP services.