The principal challenge to achieving the Abuja Declaration goal was to develop an efficient, equitable and sustainable mechanism to deliver insecticide treated nets to the poor and most vulnerable segments of the population. One method—social marketing, employs the principles and practices of commercial marketing techniques to deliver socially beneficial goods at affordable, and often, at subsidized prices to particular groups. Social marketing of insecticide treated nets, through a public-private partnership and meaningful community participation in Tanzania, has successfully and quickly increased the distribution of mosquito nets among the poorest populations, particularly children and pregnantwomen. This program has resulted in improved health outcomes with respect to morbidity and mortality impact of Malaria on the population of children.
Equitable health services
The Code of Conduct for Health Systems Strengthening is a response to the recent growth in the number of international non-governmental organizations (INGOs) associated with increase in aid flows to the health sector. It is intended as a tool for service organizations – and eventually, funders and host governments. The code serves as a guide to encourage NGO practices which contribute to building public health systems and discourage those which are harmful. The working document was drafted by a coalition of activist or service delivery organizations, including Health Alliance International, Partners in Health, Health GAP, and Action Aid International. EQUINET also contributed to the consultations on the code. It will be revised in a series of consultations over 2008.
Health Minister Manto Tshabalala-Msimang has called on the continent's health industry to improve access to affordable medicine. Access to healthcare is a constitutional right for all citizens of this continent.
All waste generated at health care facilities in the past was regarded as hazardous and was incinerated before disposal. Today however, waste generated at health facilities is separated out and disposed of according to the risks it poses. The purpose of this study was to investigate health care waste (HCW) management practices used in public health clinics in the iLembe Health District, with a view to developing a HCW management intervention strategy. The management of health care waste is of great concern. There is need to develop a health care waste management intervention strategy to be implemented consistently and universally in the district.
In line with international developments in mental health legislation, the Mental Health Care Act (2002) was promulgated in South Africa. Its core principles – human rights for users; decentralisation and integration of mental health care at primary, secondary and tertiary levels of care; and a focus on care, treatment and rehabilitation – are progressive and laudable. However, the task of implementing the requirements of the Act at community and district hospital levels is fraught with problems. Lack of infrastructure, inadequate skills and poor support and training undermine its successful implementation. Health workers already burdened with enormous workloads and inadequate resources struggle to manage mentally ill patients at district hospitals. The 72-hour observation is a particular area of difficulty throughout the country. This paper outlines the rationale and sense behind this legislation, discusses the problems encountered at the ‘rock face', and offers solutions to the problem of translating principles into practice.
This study in Western Cape South Africa shows that while immunisation coverage indicates that a lot of good work is being done, the coverage is insufficient to prevent outbreaks of measles and other common childhood conditions including polio. The coverage is too low to consider not running periodic mass campaigns for measles and polio. The coverage will need to be sustainably improved before introducing rubella vaccine as part of the EPI schedule. The reasons given by caregivers for their children not being immunised are valuable pointers as to where interventions should be focussed.
Inadequate patient tracking at one of South Africa's largest antiretroviral (ARV) distribution sites, has led to many patients disappearing from the clinic before treatment starts, a new report has found. The report by the Reproductive Health & HIV Research Unit (RHRU) of the University of the Witwatersrand, based on a 2006 review of patient files at the Tshepong Wellness Clinic, about 120km southwest of Johannesburg, shows that a standard percentage - about 14 percent - stop taking treatment, but more than 20 percent of patients never get to the treatment stage.
Health authorities reported the first known cases of virtually untreatable tuberculosis in Botswana, following fears that the highly contagious strain has spread beyond South Africa. For the past few months, health professionals have warned that XDR-TB, although only confirmed in South Africa, had spread to other Southern African nations like Swaziland and Lesotho hard hit by the AIDS pandemic, but hadn't been diagnosed because of lack of laboratory facilities.
Malaria fever is a common medical presentation and diagnosis in Malawi. The national malaria policy supports self-diagnosis and self-medication for uncomplicated malaria with first line anti-malaria drugs. While a qualitative appreciation of the burden of malaria on the health system is recognised, there is limited quantitative estimation of the burden malaria exacts on the health system, especially with regard to human resources and financial burden on Malawi. The burden of malaria was assessed based on estimated incidence rates for a high endemic country of which Malawi is one. Data on the available human resources and financial resources committed towards malaria from official Malawi government documents and programme reports were obtained. Malaria exacts a heavy toll on the health system in Malawi. The national recommendation of self-medication with first-line drug for uncomplicated malaria is justified as there are not enough clinicians to provide clinical care for all cases. The Malawi Ministry of Healthas promotion of malaria drug prescription including other lower cadre health workers may be justified.
A longitudinal study followed approximately 100 randomly selected farming households over six months in Kilombero Valley, Tanzania. Every household was visited monthly and whereabouts of household members, activities in the fields, fever cases and treatment seeking for recent fever episodes were recorded. Fever incidence rates were lower in the shamba compared to the villages and moving to the shamba did not increase the risk of having a fever episode. Children aged 1-4 years, who usually spend a considerable amount of time in the shamba with their caretakers, were more likely to have a fever than adults. Despite the long distances to health services, 55.8% (37.9-72.8) of the fever episodes were treated at a health facility, while home-management was less common (37%, 17.4-50.5). Living in the shamba does not appear to result in a higher fever-risk. Mosquito nets usage and treatment of fever in health facilities reflect awareness of malaria. Inability to obtain drugs in the fields may contribute to less irrational use of drugs but may pose an additional burden on poor farming households. A comprehensive approach is needed to improve access to treatment while at the same time assuring rational use of medicines and protecting fragile livelihoods.