Equitable health services

Seeking treatment for childhood fevers in Tanzania
Kamat VR: id21 Research Highlight, 18 July 2006

In Tanzania, parents seeking treatment for children with severe, often malaria-related, fever vary in their choice of care. Their choice is influenced by a range of social and cultural factors that need to be better understood if children are to be successfully treated. In urban and peri-urban areas of Tanzania, many parents would prefer to take their children to a biomedical facility. However, opening and closing times are not always convenient. Consequently, parents often have no choice but to seek out a traditional healer who can provide treatment and comfort at more convenient hours.

Top level push to tackle priorities in sexual and reproductive health
World Health Organisation/ United Nations Population Fund, 20 June 2006

Globally, inadequate sexual and reproductive health services have resulted in maternal deaths and rising numbers of sexually transmitted infections (STIs), particularly in developing countries. Leaders of the World Health Organization (WHO) and UNFPA, the United Nations Population Fund, are coordinating action to reverse the global trend of deteriorating levels of sexual and reproductive health and reduce the adverse impact on mothers, babies and young people.

How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania
von Both C, Flessa S, Makuwani A, Mpembeni R, Jahn A: BMC Pregnancy and Childbirth 6:22, 23 June 2006

Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organisation (WHO). In this study we assess the time health workers currently spent on providing ANC services and compare it to the requirements anticipated for the new ANC model in order to identify the implications of Focused ANC on health care providers workload.

Sexually transmitted infections among adolescents: The need for adequate health services
Riedner G, Dehne GL: WHO

Attempts to date to promote the sexual health of young people have tended to focus on prevention, education and counselling for those who are not yet sexually active, while the provision of health services to those who have already engaged in unprotected sexual activity and faced the consequences, including pregnancy, STIs or sexual violence, has lagged behind. This document presents a review of the literature documenting existing experience with the provision of services for sexually transmitted infections (STIs) to adolescents.

Bridging the gap between biomedicine and traditional healing
Buisnessinafrica, 17 April 2006: Etkind J

Nearly 18 months ago, South Africa’s Traditional Health Practitioners Bill made a triumphal passage through parliament, raising hopes in the hearts of the 300 000 or so practising traditional healers in South Africa that they might at last begin to ply their trade on an equal footing with their biomedical counterparts. The legislation included allowing traditional healers’ patients to claim through medical aid schemes, giving them access to government hospitals and clinics and demanding the same respect and courtesy accorded to general practitioners, surgeons and other biomedical professionals.

The right reforms? Health sector reforms and sexual and reproductive health
Eldis: Sundari RavindranTK, de Pinho H

This publication pulls together available information on how health sector reform (HSR) has impacted on sexual and reproductive health services (SRH), and identifies information gaps and advocacy issues. The findings comes from the work of three research teams from Africa, Asia and Latin America who carried out systematic research on six elements on HSR. These elements include: financing, public-private interaction, priority-setting, decentralisation, integration of services and accountability.

Africa malaria day: Action or bombast?
The American Daily: Innis R

Parents and children will continue dying from malaria, until Europe rejects its colonialist past. But every year calls for action turn out to be mere bombast, as healthcare agencies refuse to go beyond bed nets and capacity building, radical greens continue to obstruct proven strategies, and disease and death rates climb. This year, however, things may be different. Archbishop Desmond Tutu, Greenpeace co-founder Patrick Moore, and hundreds of physicians, clergy and human rights advocates have joined in demanding that DDT be put back into the malaria control arsenal.

Fever treatment and household wealth: the challenge posed for rolling out combination therapy for malaria
Tropical Medicine and International Health 11 (3): 299–313: Njau JD, Goodman C, Kachur SP

In mid-2001 a large rural household survey was conducted in Tanzania to investigate the variation in malaria parasitaemia, reported fever, care seeking, antimalarials obtained and household expenditure by socio-economic status (SES), and to assess the implications for ensuring equitable and appropriate use of antimalarial combination therapy. Findings reflected greater use of non-governmental organisation (NGO) facilities, which were the most expensive source of care, and higher expenditure at NGO facilities and drug stores. Also, poorest groups benefited least from these new and highly effective antimalarials. The report was presented at the EQUIWRITE Workshop in Durban, South Africa.

Patterns of sexually transmitted infections in adolescents and youths in Dar es Salaam, Tanzania
Muhimbili University Health Exchange Forum: Chalamilla C, Mbwana J, Mhalu F, et al

This study set out to investigate the relationship between the syndromic management of STI, specific aetiology diagnosis and its relationship with HIV infection and health seeking behaviour among youth attending a reproductive health clinic in Dar es Salaam, Tanzania. Findings reflected that the burden of STIs in this youth population is large indicating that youth are at increased risk of STIs and will certainly require youth friendly clinics, and the need to refine the current syndromic management guidelines.

Assessing health systems for type 1 diabetes in sub-Saharan Africa: developing a 'Rapid Assessment Protocol for Insulin Access'
Beran D, Yudkin JS, de Courten M: BioMed Central Health Services Research 2006; 6: 17

In order to improve the health of people with Type 1 diabetes in developing countries, a clear analysis of the constraints to insulin access and diabetes care is needed. We developed a Rapid Assessment Protocol for Insulin Access, comprising a series of questionnaires as well as a protocol for the gathering of other data through site visits, discussions, and document reviews. The Protocol was piloted in Mozambique then refined and had two further iterations in Zambia and Mali.