More than 2,600,000 deaths have been prevented in 2003 thanks to the Hepatitis B vaccine currently available. This is only one impressive example of the benefits of good vaccination and immunisation programmes. Although vaccination programmes are very cost-efficient, costing as less than 1,000 USD per life saved, the world still faces over 100,000 neonatal tetanus deaths and over 400,000 deaths from measles per year. The international community has a very ambitious plan: to completely eradicate diseases which are preventable by global vaccine coverage. How can such a goal be accomplished?
Equitable health services
This story describes the experience of Professor Stanis Wembonyama as director of the main hospital in Democratic Republic of Congo's second city, Lubumbashi, last year. Gecamines, the state-owned mining monopoly used to be in charge - theoretically - of the Jason Sendwe Hospital, but the institution had been left to rot. Most of the beds had been either stolen or stripped down and sold as scrap metal. Doctors and nurses had not been paid their salaries for five years and so they earned their living by demanding cash before treating their patients. The story outlines the steps to clean up the hospital and instil management discipline.
Hospitals have always played a pivotal role in the global healthcare system. They have power, authority and professional competences in both the rich and poor worlds. But what if we all begin to re-think the mission of hospital care and re-design the way we deliver it in order to increase access to health? The moment has arrived for reform in order to achieve optimal care, to learn from examples of real innovation and disseminate this knowledge, sharing ideas as well as best practices. For example one speaker at this session of the August 2006 Geneva Health Forum noted that the mission of hospitals has shifted from delivering specialized care to our patients; to responsibility for the care in our region; to promoting health to all our citizens.
What is the best way to address the health care needs of an underserved population? Is it through disease prevention or is it through a more comprehensive and coordinated approach? According to a session of the August 2006 Geneva Health Forum integration of the two approaches is the key to a successful health care delivery system, providing wider access to a greater number of the population. The vertical approach is disease-centred, while the horizontal approach is patient-centred. The use of resources in a vertical approach is dictated by a centralized authority, while the horizontal approach encompasses area-wide planning at the centre with final decision-making devolved to the local or district level. Experiences reported from Uganda and Tanzania indicated limitations of the vertical approach and the better results provided by the adoption of a horizontal approach.
The fifth largest nation in the world does not have sufficient access to health. Indeed if migrants were seen as a country, they would represent a significant nation in terms of population. How can we explain that so many people do not have access to health care? The focus of this symposium, chaired by Angela Davies from the International Organization of Migration (IOM) and Sandro Cattacin from the University of Geneva, was on the unequal provision of health services for migrants.
This framework paper is aimed at policy makers who are involved in the development or management of programmes in the health sector in developing countries. It provides a ‘snapshot’ of the type of information and communication technology (ICT) interventions that are being used in the health sector, and the policy debates around ICTs and health. It draws from the experience of use in both the North and South, but with a focus on applicability in the South to identify the most effective and relevant uses of ICTs.
This Briefing Note reviews the extent of emergency livelihoods responses during the most recent drought and resulting food crisis in the Horn of Africa. Drawing on secondary data and interviews with national and international actors in affected areas, it asks why accurate and timely early warning did not lead to a rapid and appropriate response to mitigate the drought’s effects, and highlights how inadequate contingency planning, limited capacity in livelihoods programming and inflexible funding mechanisms resulted in delays and deficiencies in livelihoods interventions, and the predominance of food assistance in the emergency response.
The strengths and weaknesses of the sector wide approach (SWAP) have been extensively analysed, but much less has been written on country experience to inform good practice elsewhere. This technical paper draws some lessons from SWAP in health in Mozambique. SWAP is not a panacea for donor coordination, and cannot address deep-rooted constraints typical of a young national health system. This paper explores how the key elements of the SWAP have been developed, how processes and mechanisms are working now, and studies some of its successes and challenges.
The first "International Expert Consultation on Paediatric Essential Medicines", jointly held by the World Health Organization (WHO) and the United Nation’s Children’s Fund (UNICEF), has delivered a plan to boost access to essential medicines for children. During two days of intensive discussion held 9-10 August at WHO's headquarters in Geneva, a mix of more than twenty developed and developing countries, non-governmental organizations including Médecins Sans Frontières, regulatory agencies, UNICEF and WHO staff prioritised a long-needed approach to overall paediatric care.
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). This study assesses 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.