Asmera Getachew had completed a teacher training course when she saw an advert inviting applications from those interested in joining the government Health Service Extension Programme (HSEP). The advert posted on a wall, changed her life. After a one-year training course, she was assigned to Tensyie, a rural village of 5,092 people in North Gonder Zone of Amhara Regional State, to work as a health extension worker. One of 2,800 graduates from 14 HSEP training centres in Ethiopia, quickly settled in to implement a three month plan focusing on health education, environmental health, family health and disease prevention.
Equitable health services
This report outlines key interventions for maternal and newborn health care programmes to improve maternal and newborn health and survival. These should be delivered by the health services, family, and the community to the mother during pregnancy, childbirth and in the postpartum period, and to the newborn soon after birth. They include important preventive, curative and health promotional activities for the
present as well as the future.
Zambia has recently articulated an ambitious national health program designed to meeting health-related MDGs. Public expectations are high and Zambia continues to receive significant resources from global and bilateral donors to support its health agenda. Although the lack of adequate resources presents the most important constraint, the efficiency with which available resources are being utilised is another challenge that cannot be overlooked. Inefficiency in producing health care undermines the service coverage potential of the health system. This paper estimates the technical efficiency of a sample of hospitals in Zambia. This study demonstrates that inefficiency of resource use in hospitals is significant. Policy attention is drawn to unsuitable hospital scale of operation and low productivity of some inputs as factors that reinforce each other to make Zambian hospitals technically inefficient at producing and delivering services. It is argued that such evidence of substantial inefficiency would undermine Zambia's prospects of achieving its health goals.
In this study commercial shopkeepers and groups of community leaders were trained to promote and sell ITNs in 19 sites in central Mozambique between 2000 and 2004. Pregnant women and children under 5 years of age comprised the target population. Sales records, household survey results and project experiences were examined to derive ‘lessons learned’. The authors conclude that this project failed to achieve adequate or equitable levels of ITN coverage in a timely manner in the programme sites. Its findings helped support a subsequent Mozambican decision to conduct targeted distribution of long-lasting nets to the neediest populations in the provinces where the project was conducted.
Weak infrastructure and limited distribution systems in low-income countries complicate access to health services, especially in rural areas. Government health outlets may be relatively few and widely dispersed, and private-sector sources often favor wealthier urban areas, resulting in uneven service availability within a country. In the absence of a solid heath infrastructure, strengthening primary health care and innovative community-based health service delivery systems help provide more equitable access to health services. Some programs are underway in Ethiopia whose successes do not depend on the availability of a strong infrastructure.
South Africa was asked to review the progress made by Africa on the implementation of the Plan of Action on the African Union (AU) Decade of Traditional Medicine (2001-2010). The challenge was noted of getting as broad a representation and information from all regions, to foster collaboration among countries and regions as well as to promote information sharing on how best to put African Traditional Medicine in its rightful place.
This paper outlines the main findings on reasons for adherence to TB treatment in Ethiopia, including physical lack of access to the treatment centre as the main cause of failure to adherence to therapy.
As more Africans move from rural areas to the cities the risk of urban malaria increases. City health services need to focus on poor people who are most at risk from the disease. Malaria programmes should operate on a district by district basis as levels of malaria can vary dramatically throughout the city.
Early recognition of symptoms and signs perceived as malaria are important for effective case management, as few laboratories are available at peripheral health facilities. The validity and reliability of clinical signs and symptoms used by health workers to diagnose malaria were assessed in an area of low transmission in south-western Uganda.
The Eastern Cape Department of Health has certified 36 hospitals under the Baby Friendly Hospital Initiative (BFHI). The assessment of hospitals started in 1999 in the province when one hospital received "baby friendly" status. The BFHI is a global strategy implemented by healthcare facilities that render care to both mothers and children worldwide. It aims to increase awareness of the critical role of health services in the romotion of breastfeeding and to give guidelines for appropriate information and support to mothers. It also focuses on maternity care services which involves the holistic care of mother and baby both within the facility.