Zimbabwe, like many other countries in the region, is badly affected by a shortage of health workers. Many of the health indicator improvements achieved during the first ten years of independence are on the decline and a major reason for this is shortage of skilled and experienced health workers at a time when demand for services is increasing due to a growing population and the challenges posed by HIV and AIDS. The public sector provides as much as 65% of health care services in the country, so a shortage of public sector health workers affects the majority of the population. Against a background of increasing shortages, the report argues for improved management practices and better distribution of human resources in health care systems. This study presents evidence on the distribution of public sector health workers in Zimbabwe and the impacts on equity objectives in health care.
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This study reviewed the available published and grey literature, with a focus on primary health care and the district health systems in sub-Saharan Africa, in order to explore the facilitators and barriers to community participation. Six African countries were selected for deeper review and analysis: Botswana, Lesotho, Namibia, Rwanda, Swaziland and Tanzania. The work signals a need for more culturally informed interventions that draw from indigenous knowledge bases, with evidence-based data that is culturally relevant, and that contextualises poverty, health risks and systems in sub-Saharan Africa. The review identifies a number of challenges, not the least of which is the prevailing perspective of the citizen as an object of health rather than as an active subject.
This study was implemented to identify trends in the health budget in Zimbabwe 2001-2006, assess the equity oriented nature of these trends and make recommendations to strengthen pro-equity dimensions of the health budget. The review examines the budget in three major respects: how far the opportunities for equity in revenue mobilization are being tapped; how far the allocation and expenditure patterns are promoting policy targets, particularly equity; and how far incentives and investments are levering health promoting investments (and penalizing those that undermine health). The study drew evidence from secondary data and national surveys, from reported Ministry of Finance estimates and from the reported budget allocations provided by government, with a focus on the years 2000-2006.
This report prepared under a capacity building programme analyses the relevant provisions of the World Trade Organisation (WTO) Trade Related Aspects of Intellectual Property Rights (TRIPs) and the General Agreement of Trade in Services (GATS) agreements with respect to the provision and accessibility of health services in Malawi. The paper explores the manner in which Malawi's legal and institutional systems are able to ensure access to essential medicines under TRIPS and the implications of GATS for essential health care services and for meeting health obligations.
This report prepared in capacity building programme analyses the relevant provisions of the World Trade Organisation (WTO) Trade Related Aspects of Intellectual Property Rights (TRIPs) and the General Agreement of Trade in Services (GATS) agreements with respect to the provision and accessibility of health services and essential medicines in Zambia.
The Regional network for equity in health in east and southern Africa (EQUINET) is calling for expressions of interest from researchers based in countries within East and Southern Africa (ESA) to undertake country level research into distribution of the costs and benefits of health worker migration. The country research will be implemented between April 2007 and April 2008 and aims to inform policy negotiation, design and evaluation on managing health worker migration within ESA. Applications should be sent by February 1st 2007
This review was prepared as an outline for the WHO Commission on the Social Determinants of Health for a knowledge network exploring the role of health systems in health equity and the social determinants of health. It presents data showing that health services tend to be used proportionately more by richer than poorer social groups. It analyses the social factors affecting access to, and uptake of, health services and shows how these interact with inequitable features of the health care system. Overall, the review argues that the interaction between household health-seeking behaviour and experience of the health system generates differential health and economic consequences across social groups. The long-term costs of seeking care often impoverish poorer households, reinforcing pre-existing social stratification. These are costs that can be addressed by deliberate aspects of health system design.
The World Health Organization’s 2006 World Health Report “Working Together for Health” highlights the urgent need to improve human resources (HR) in the health sector in developing countries (HRH). the report does not address the shortfall specifically in the persdonnel for health research, nor the skills and human resources needed by developing countries to improve health research. A conference on Human Resources for Health Research (HR-HR) was held on July 2-5, 2006 on this issue. The conference opened discussion on the health research environment; the role of research networks and of communities in health research and skills to improve health research communication. This is the final report and record of the HR-HR expert meeting in Nairobi. Two further products
are under preparation: A short synthesis report of key messages from the conference; and a publication featuring reviewed papers produced by each HR-HR theme.
In 2001 the Doha Declaration on TRIPS and Public Health provided a landmark political commitment reaffirming the option for World Trade Organisation (WTO) member states to use all flexibilities provided in the TRIPS Agreement to ensure access to affordable medicines, and to prevent patent monopolies stopping access to medicines where they are needed for public health. By 2006, many of these flexibilities are not yet exploited in Africa, despite the massive demand for cheap medicines. This brief outlines the opportunities that African countries have to use these flexibilities and the legal and other changes needed for this. It also outlines the challenges that we may face and the measures to respond to them.
In 2007 EQUINET with Centre for Health Policy University of the Witwatersrand is implementing a programme that aims to build capacity in health policy analysis in east and southern Africa. The participants will meet for the first time in February 2007 in Johannesburg to attend a policy analysis course, after which they will spend a further week developing their study protocols. The research will be conducted between March and September 2007, with all the participants meeting again in October 2007 for a workshop that will support data analysis and report writing.