At this year’s World Health Day the WHO will be launching its annual report which focuses on human resources for health. In Africa, as we have raised in previous editorials in this newsletter, we are experiencing a ‘global conveyor belt’ of health workers flowing from rural, primary health care level in the public sector to urban, private care; from poor to rich areas and countries in the region and from the continent, with its high health needs and under-resourced health services to developed, high income countries such as USA, Canada, UK and Australia. The loss of public investment and social resources in this outflow is significant and outweighs any returns in remittances or aid for education.
However health workers will certainly continue to go to where they can work in adequately resourced health services, in decent jobs and where they can secure their own family needs. This draws attention to the much wider question of how in Africa we secure the resources to retain and value our health workers, and more widely to meet our population health needs. The latest EQUINET discussion paper, written by Patrick Bond and produced jointly by EQUINET with the Centre for Economic Justice in southern Africa points to a South-North drain of African wealth that undermines the resources for health and development, and that increases our dependency on the global North, and our loss of health workers.
The 2005 Commission for Africa report leaves the impression of a continent receiving a vast inflow of aid, with rising foreign investment, sustainable debt payments and adequate remittances from the African diaspora to fund development. Our discussion paper tells a different story: of significant and dramatically rising flows of resources out of Africa northwards, draining the continent of the important resources needed to address its own development, including in health. The paper synthesizes data about the outflow of Africa’s wealth, to reveal factors behind the continent’s ongoing underdevelopment, as the basis for proposing policy measures to reverse these flows.
The statistics speak loudly of a continent being progressively dispossessed of its wealth, and thus the resources it needs to improve health and human development:
* A debt crisis with repayments in the 1980s and 1990s that were 4.2 times the original 1980 debt levels, and annual debt repayments equivalent to three times the inflow in loans and, in most African countries, far exceeding export earnings, leaving a net flow deficit of by 2000 of $6.2 billion.
* Unequal exchange in trade and trade liberalisation policies that have lowered rather than increased Africa’s industrial potential and exacted an estimated toll in sub-Saharan Africa of $272 billion over the past 20 years.
* Flows of private African finance that have shifted from a net inflow during the 1970s, to gradual outflows during the 1980s, to substantial outflows during the 1990s.
* Falling foreign direct investment (FDI) from roughly one third of FDI to third world countries in the 1970s to less than 5% by the 1990s, and a shift to highly risky speculative investment in stock and currency markets – with erratic and overall negative effects on African currencies and economies.
Africa is commonly and mistakenly represented as the (unworthy) recipient of a vast aid inflow. Aid flows in fact dropped 40% during the 1990s, and the phantom aid that flows back to the source countries in technical and administrative costs was estimated in one study to be $42 billion of the 2003 total official aid of $69 billion, leaving just $27 billion in ‘real’ aid to poor people.
There is also a perverse subsidy in the extent to which industrialised countries exploit the global stock of non renewable natural resources . This takes place through the extraction of minerals and natural resources from Africa by Northern investors with little investment in return and few royalties provided. It also takes place through use of global goods like the earth’s clean air. Forests in the South absorbing carbon from the atmosphere are estimated for example to provide Northern polluters an annual subsidy of $75 billion. A method for measuring resource depletion used by the World Bank suggests that a country’s potential GDP falls by 9% for every percentage point increase in a country’s dependency on resource extraction. This implies, for example, that Gabon’s people lost $2,241 each in 2000, based on oil company extraction of oil resources,
These outflows deplete the resources available for productive and human development. They are felt most heavily by women and poor communities, and undermine progress towards the achievement of human security for the majority of African people.
They imply that the first step to effect genuine growth and to deliver welfare and basic infrastructure is for African societies and policymakers to identify and prevent the vast and ongoing outflows of the continent’s existing and potential wealth.
Current global reform agendas do not address these outflows. While they point to debt and unfair trade, they do not seek to reverse the outflow of African wealth.
Campaigns to reverse resource flows and challenge perverse subsidies are emerging from grassroots struggles and progressive social movements, such as those in Africa that are resisting privatisation and commodification of basic services, pressuring for rights to generic anti-retroviral medicines and resisting encroachments on human development through trade and macroeconomic policies that intensify inequities.
These grassroots struggles can be consolidated by national governments and regional co-operation to improve disclosure of financial flows and apply policies within Africa to prevent the outflows and encourage the ‘stay’ of domestic investment resources. The paper points to some options - systemic default on debt repayments, strategies to enforce domestic reinvestment of pension, insurance and other institutional funds; national-scale regulation of financial transfers from offshore tax havens; clearer identification and renegotiation of tied or phantom aid; and improved calculation and negotiation around of the costs of FDI (not simply the benefits), including natural resource depletion, transfer pricing and profit/dividend outflows.
EQUINET welcomes the focus on this year’s World Health Day on one area through which Africa is bleeding- its loss of human resources. We would however urge that to deal with this effectively in the continent, and address the inequity globally in the resources needed for health and human development goals, we need to deepen the debate. In 1998 EQUINET highlighted that a critical dimension of equity is the power and ability people have to make choices over health inputs and their capacity to use these choices towards health. For Africa this must surely include bringing control over the resources for health and development back within the continent.
Please send feedback or queries on the issues raised in this briefing to the EQUINET secretariat at TARSC, email admin@equinetafrica.org . EQUINET work on economic policy and health is available at the EQUINET website at www.equinetafrica.org
1. Editorial
2. Latest Equinet Updates
EQUINET through the Health Economics Unit University of Cape Town, Cape Town South Africa invites applicants for medium scale research grants (of up to £9000 each) for experienced individuals working in the field of health care financing in East and Southern Africa. Interested participants are encouraged to submit proposals for the development of country level case studies and to undertake research on a particular area of resource mobilisation or mechanisms for strengthening cross-subsidies in the overall health system.
EQUINET through the Health Economics Unit University of Cape Town, Cape Town South Africa invites applicants for two small research grants (of £1500 each) to undertake small-scale country level case studies on the implementation of equitable resource allocation. Applicants should come from countries that are currently implementing health care resource allocation based on a needs-based resource allocation formula or similar approach.
3. Equity in Health
The Global Health Watch for 2005-2006 looks at some of the most important problems, suggests solutions, and monitors the efforts of institutions and governments concerned with promoting health world-wide. This report arises out of many civil society and professional campaigns and struggles for better health, and has been released to coincide with the Second People's Health Assembly, held in Cuenca, Ecuador, at which two thousand people from across the world have gathered to discuss and debate strategies to overcome the political, economic and social barriers to better and fairer health.
Despite impressive improvements in aggregate indicators of health globally over the past few decades, health inequities between and within countries have persisted, and in many regions and countries are widening. Our recommendations regarding research priorities for health equity are based on an assessment of what information is required to gain an understanding of how to make substantial reductions in health inequities. We recommend that highest priority be given to research in five general areas; described in detail in this article.
Rampant disease in poor countries impedes development and contributes to growing North-South disparities; however, leading international medical journals underreport on health research priorities for developing countries. The medical information gap between rich and poor countries as judged by publications in the NEJM appears to be larger than the gap in the funding for research. Under-representation of developing world health issues in the medical literature is a global phenomenon. International medical journals cannot rectify global inequities, but they have an important role in educating their constituencies about the global divide.
In the last two decades, powerful international trends in health care reform have been observed around the world. Although health care reform is a global phenomenon driven by common financial and political actors, adopted reforms vary by country and region. Albeit from a European perspective, this article discusses how, regardless of the national and regional contexts in which health care reforms are implemented, the changes have fundamental consequences for many people's day-to-day lives and well-being.
4. Values, Policies and Rights
Healthcare research is haunted by a history of unethical studies in which profound harm was caused to vulnerable individuals. Official systems for gaining ethical approval for research, designed to prevent a repetition of these shameful examples, can prove bureaucratic and inflexible in practice. The core ethical principles of respect for autonomy, prevention of harm, promotion of benefit, and justice (which form the basis of professional codes of research conduct) must be applied flexibly to take account of contextual, methodological, personal and practical considerations. Ensuring that the design and conduct of all research is ethically sound is the responsibility of all involved—including researchers, research institutions, ethics review committees and regulatory bodies.
The 42nd Regional Health Ministers' Conference with the theme “Scaling up Best Practices in health care in East, Central and Southern Africa” took place at the Sun n Sand Hotel in Mombasa, Kenya from the 6th to the 11th of February, 2006. The conference was ttended by Health Ministers from the ECSA Region, representatives of regional and international organizations as well as developmental agencies. Resolutions were passed at the conference in twelve major areas of health in the region.
This publication examines the links between the practical situation of children in South Africa, South Africa’s commitments to child rights, and society’s progress in this regard. The document discusses the country’s response to different aspects of the challenge of realising children’s rights, and presents a set of broad-based indicators aimed at gauging improvements in the situation of children over time. This issue focuses on children and policy; HIV and AIDS and children, and the number of children with access to social assistance and basic services.
The Regional Committee for Africa of the World Health Organization (WHO) in 2001 expressed concern that some health-related studies undertaken in the Region were not subjected to any form of ethics review. In 2003, the study reported in this paper was conducted to determine which Member country did not have a national research ethics committee (REC) with a view to guiding the WHO Regional Office in developing practical strategies for supporting those countries. In the current era of globalized biomedical research, good ethics stewardship demands that every country, irrespective of its level of economic development, should have in place a functional research ethics review system in order to protect the dignity, integrity and safety of its citizens who participate in research.
5. Health equity in economic and trade policies
Thirteen countries joined forces Wednesday to adopt a tax on plane tickets to raise money to fight Aids and other killer diseases, Reuters reported, despite resistance from airlines. Brazil, Britain, Chile, Congo, Cyprus, France, Ivory Coast, Jordan, Luxembourg, Madagascar, Mauritius, Nicaragua, and Norway have now agreed to raise or started raising a sum from air tickets to help the poor, they said in a closing statement.
The US may push Africa to accept genetically modified (GM) food now that the World Trade Organisation (WTO) has ruled the EU broke rules by barring GM foods and seeds, however, Africans vowed yesterday to resist.
James Love, describes his "discussion with trade officials and public health groups from Southern Africa about the most recent round of negotiations involving the United States Trade Representative (USTR). Rob Portman, the head of the USTR, is violating a May 10, 2000 Presidential Executive Order, which prohibits the USTR from pressuring countries in Sub-Saharan Africa to have rules for intellectual property rights on medicines that exceed the norms set out in the World Trade Organization (WTO).
Southern African governments have a special need to make or buy low-cost generic drugs to save their citizens. World trade rules are amenable, containing safeguards that allow countries to use generics to preserve public health. But the Bush administration is now negotiating a free trade agreement with the Southern African Customs Union. This article further discusses its implications ; that the United States should not, in the process, restrict the ability of poor people to get generic drugs in these countries.
Yusuf Hamied, head of Cipla, India's huge generic drugs company, has stirred global controversy by promising to supply Aids drugs for less than $1 a day. Now he has announced that he is ready to take on bird flu. At issue, again, is the whole question of generic versus proprietary drugs, an issue that has pitted Western capitalism against Third World campaigners and, perhaps more than any other dispute, cast moral opprobrium on multinationals attempting to protect the fruits of their expensive research.
The World Trade Organisation (WTO) has as its primary goal the liberalisation of world trade. Given the expected accompanying expansion of trade and the enormous potential of such improved trade and investment flows for stimulating economic growth and development, it becomes clear that the activities of the WTO are of central relevance to the implementation of the goals of NEPAD.Recent events in both NEPAD programmes and WTO activities give particular cause to focus on the close linkages between the WTO and NEPAD.
Tanzanian Members of Parliament have expressed disappointment with the influx of substandard and low quality foodstuffs into the country. This brief article voices concern for consequent adverse health outcomes. Sources said that some of the "dumped" foodstuffs were harmful to human life.
Expert evaluations of the safety, efficacy and cost-effectiveness of pharmaceutical and medical devices, prior to marketing approval or reimbursement listing, collectively represent a globally important public good. The scientific processes involved play a major role in protecting the public from product risks such as unintended or adverse events, sub-standard production and unnecessary burdens on individual and governmental healthcare budgets. Most States now have an increasing policy interest in this area, though institutional arrangements, particularly in the area of cost-effectiveness analysis of medical devices, are not uniformly advanced and are fragile in the face of opposing multinational industry pressure to recoup investment and maintain profit margins. This paper examines the possibility, in this context, of States commencing negotiations toward bilateral trade agreement provisions, and ultimately perhaps a multilateral Treaty, on safety, efficacy and cost-effectiveness analysis of pharmaceuticals and medical devices.
Drug companies should not take out patents on their new medicines or enforce patents in poor countries if that is likely to prevent patients from getting them, an influential commission set up by the World Health Organisation said yesterday.
6. Poverty and health
This paper contributes to a nascent scholarly discussion of sex and gender as determinants of health. Health is a composite of biological makeup and socioeconomic circumstances. Differences in health and illness patterns of men and women are attributable both to sex, or biology, and to gender, that is, social factors such as powerlessness, access to resources, and constrained roles. Using examples such as the greater life expectancy of women in most of the world, despite their relative social disadvantage, and the disproportionate risk of myocardial infarction amongst men, but death from MI amongst women, the independent and combined associations of sex and gender on health are explored. A model for incorporating gender into epidemiologic analyses is proposed.
The incidence of extreme poverty is higher among Indigenous and tribal peoples than among other social groups and they generally benefit much less than others from overall declines in poverty. The audit of 14 countries include: Bangladesh, Bolivia, Cambodia, Guyana, Honduras, Kenya, Lao PRD, Nepal, Nicaragua, Pakistan, Sri Lanka, Tanzania, Viet Nam and Zambia. The ethnic audit shows that there are significant differences between regions and, within regions, between countries in terms of whether and how indigenous questions are addressed.
The sight of an elderly person caring for children with AIDS-related illnesses (and grandchildren who may have been orphaned by the pandemic) has become a common one in Namibia, and the Southern African region as a whole. Have policies in Namibia kept pace with the extent to which the aged are taking on responsibility for sick children, and orphaned grandchildren?
In 2005 economist Jeffrey Sachs presented an action plan to meet the UN's poverty-slashing Millennium Development Goals (MDGs) by 2015, which included practical and affordable interventions such as bed-nets to fight malaria, vaccinations to combat infectious diseases, the provision of anti-AIDS drugs, fertilisers to improve crop yields and drilling wells to provide safe drinking water. In this wide-ranging interview with IRIN, Sachs defended his plan and provided some details on how the project is going to help poor countries help themselves.
7. Equitable health services
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.
Home Based Management of fever (HBM) was introduced as a national policy in Uganda to increase access to prompt presumptive treatment of malaria. Pre-packed Chloroquine/Fansidar combination is distributed to febrile children under-five years in the community. Persisting fever or 'danger signs' are referred to the health centre. Functioning referral to health centres is a critical assumption in HBM. We assessed overall referral rate, causes of referral, referral completion and reasons for non-completion under the HBM strategy.
8. Human Resources
Migration of health workers is a hotly debated issue. It has contributed to shortages of medical staff in many regions of Africa, causing additional strain on already overstretched health systems. This article adresses the issue by discussing key arguments presented in several different published papers on the topic.
In recognition of the microbial and societal complexities underlying infectious disease control, this report emphasizes that mounting an effective response to infectious disease threats will require multidisciplinary efforts involving all sectors of the clinical medicine, public health, and veterinary medicine communities. Such a multidisciplinary approach must rest squarely on a well-prepared work-force within each of these communities. However, "the number of qualified individuals in the workforce required for microbial threat preparedness is dangerously low....".
Last year, Medact launched two new papers on the 'skills drain' of health professionals from the developing world, examining the economic, governance and human rights issues that surround this controversial issue. It proposes restitution as a solution and undertakes a comprehensive human rights check.
Pharmacists in hospitals and institutions have dismissed as inaccurate and lacking in detail measures proposed to improve working conditions and stop medical staff quitting SA.
Kenya should ignore donor restrictions and employ health workers needed urgently countrywide, an assistant minister has said. The country needs 10,000 health workers to offer improved services, Health assistant minister Enock Kibunguchy said.
In Tanzania access to urban and rural primary health care is relatively widespread, yet there is evidence of considerable bypassing of services; questions have been raised about how to improve functionality. The aim of this study was to explore the experiences of health workers working in the primary health care facilities in Kilimanjaro Region, Tanzania, in terms of their motivation to work, satisfaction and frustration, and to identify areas for sustainable improvement to the services they provide. The primary issues arising pertain to complexities of multitasking in an environment of staff shortages, a desire for more structured and supportive supervision from managers, and improved transparency in career development opportunities. Further, suggestions were made for inter-facility exchanges, particularly on commonly referred cases. The discussion highlights the context of some of the problems identified in the results and suggests that some of the preferences presented by the health workers be discussed at policy level with a view to adding value to most services with minimum additional resources.
Kenyatta National Hospital, which has over the years solely depended on government budgetary allocations, is now making a huge effort to be self-sufficient. At the same time, KNH chairman, Prof Alfred Mutema, disclosed that the board plans to raise the annual basic salaries for its workers by 15 per cent subject to approval by the Government.
Gauteng Health MEC, Dr Gwen Ramokgopa, has outlined plans to improve the working conditions of health professionals in the province. Presenting the plan to the finance committee of the Gauteng Legislature, Dr Ramokgopa said the department would undertake a series of measures to recruit and retain health professionals in the public health system.
In a bid to overcome the crippling staff shortages facing public hospitals, the health department has proposed doubling the annual supply of doctors, and increasing the yearly supply of new nurses and pharmacists 50%. The proposals are contained in the health department's latest draft of its National Human Resources Plan, released recently by Health Minister Manto Tshabalala-Msimang.
This article from Human Resources for Health outlines the findings of a report on motivation among primary healthcare workers in Tanzania. Despite widespread access to primary healthcare facilities in rural and urban Tanzania there is considerable bypassing of the service. This research looked at the experience of those working in this field to assess how their working conditions could be improved, which would in turn improve the quality of the service for users.
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9. Public-Private Mix
Having endured months of uncertainty in the wake of protracted legal wrangling over government’s initial proposals on dispensing fees, introduced in April 2004, pharmacists say they are uneasy about the latest model unveiled by the health department on Thursday.
Through the theme: "Saving lives, Saving money," Ugandan businesses are being sponsored with modules designed to prevent the spread of HIV/Aids through training programmes and awareness campaigns on better access to ARVs. This presents a detailed argument for the care of employees with HIV/AIDS.
10. Resource allocation and health financing
Identifying new approaches to tuberculosis treatment that are effective and put less demand to meagre health resources is important. One such approach is community based direct observed treatment (DOT). The purpose of the study was to determine the cost and cost effectiveness of health facility and community based directly observed treatment of tuberculosis in an urban setting in Tanzania.
This paper estimates the cost-effectiveness of five interventions that could counter injuries in lower and middle income countries(LMICs): better traffic enforcement, erecting speed bumps, promoting helmets for bicycles, and promoting helmets for motorcycles in China, and storing kerosene in child proof containers in South Africa.
In most countries of the sub-Saharan Africa, health care needs have been increasing due to emerging and re-emerging health problems. However, the supply of health care resources to address the problems has been continuously declining, thus jeopardizing the progress towards achieving the health-related Millennium Development Goals. Namibia is no exception to this. It is therefore necessary to quantify the level of technical inefficiency in the countries so as to alert policy makers of the potential resource gains to the health system if the hospitals that absorb a lion's share of the available resources are technically efficient.
This article describes the methods and findings of a study designed to quantify the resources used in reestablishing contact with women who missed their scheduled cervical cancer screening visits and to assess the success of this effort in reducing loss to follow-up in a developing country setting.
11. Equity and HIV/AIDS
Local non-governmental organizations (NGOs), faith-based organization(FBOs), and community-based organizations (CBOs) have always been and continue to be a driving force in response to the HIV/AIDS epidemic. In many countries, they have been responsible for the majority of the resources reaching individuals and have played a leading role in developing and implementing sustainable strategies to mitigate and prevent HIV/AIDS. In December 2005, Pact's Community REACH program released this important document entitled "Engaging Local NGOs in the Response to HIV/AIDS", highlighting their essential role in the fight against HIV/AIDS.
Major drug companies are still not making life-saving drugs available to millions of people with HIV/AIDS in the developing world, according to the charity Médécins Sans Frontières (MSF). Basic three-drug cocktails in a single pill are being slowly rolled out to some who need them, but doctors fear many of those people will die within a few years if they cannot get hold of alternative drugs that are widely available in Western countries.
There is growing evidence that education improves the chances of girls to build a better future for themselves and their families. The Global Coalition on Women and AIDS argues that abolishing school fees, providing cash grants and introducing flexible schooling are all ways to help increase girls' enrolment in school. Policies and interventions must also take the needs of HIV positive girls into consideration. The International Community of Women Living with HIV/AIDS calls for continued access to education for HIV positive girls, as well as systems to fight discrimination against HIV positive girls.
Recent political events such as the Make Poverty History campaign, the Live8 concerts, the G8 summit in Scotland, the World Trade talks in Hong Kong, and the broader background of "globalisation" have turned attention towards the global picture concerning inequalities in health. In this article we ask two questions: what is the state of inequality in health and wealth across the globe? and, is inequality increasing or decreasing over time?
An Old Mututal Survey of 100 South African companies found that most companies were unaware of the number of HIV-positive people in their workplaces, noting that 25 companies had conducted prior prevalence testing. Compared with a few years ago, companies are more conscious of the risk HIV/AIDS poses to their business, according to the survey. While all employees polled had access to antiretroviral drugs,only a minority of companies had established disease management programs.
The HIV/AIDS pandemic in sub-Saharan Africa is widely recognised as a development disaster threatening poverty reduction, economic growth and not merely a health issue. Its mitigation includes the societal-wide adoption and implementation of specific health technologies, many of which depend on functional institutions and State. For international public health policies to be effective, they must consider a country tailored approach, one that advocates a coordinated strategy designed and led by the State with involvement of wider society specific to each country's particular history, culture, and level of development.
For businesses, the daily cost of managing HIV/Aids can be a bitter pill to swallow. Statistics reveal an alarming situation: the pressure on business is considerable and costs ballooning. If no action is taken to manage the epidemic, profitability will be affected adversely. This article discusses this impact of HIV/Aids on the workplace.
Home based care of HIV/AIDS patients is a health need recommended but not often available in Africa. Population based assessment helps to identify unmet health needs to plan services. Careful assessment and follow up of patients receiving home based care in a defined population of Bangwe, Malawi provides details of the frequency and severity of common symptoms.
Three years ago the Guardian published an award-winning supplement featuring the story of Grace Mathanga, an ordinary African woman with HIV. To launch this year's Christmas appeal, which focuses on Aids in Africa, Sarah Boseley returns to Malawi to find out how Grace is doing now, and what her life can tell us about the future of the continent.
Zimbabwe's National Aids Council (NAC) on Tuesday said it was only ableto provide anti-retroviral (ARV) drugs to one in every 12 HIV/AIDS patients because there is no money to buy adequate supplies. Being the result of funds raised through an aids tax on workers having to be spread out to cover other social sectors requiring support leaving little money to pay for drugs or HIV/AIDS prevention programmes, the article further describes the impact of this news.
12. Governance and participation in health
Tuberculosis (TB) is a curable and preventable disease, yet it is still infecting and killing millions of people throughout the world. This article discusses how more efforts are needed to address the increasing incidence of TB and HIV in many southern African countries. Advocacy efforts need to encourage governments and international funding agencies to develop appropriate responses to urgently address the co-pandemics.
A new report from the Health Evidence Network shows that empowering socially excluded populations is a viable strategy for improving health. While participatory processes make up the base of empowerment, strategies must also build community organizations and individuals capacity to participate in decision-making and advocacy.
13. Monitoring equity and research policy
We propose the "equity effectiveness loop" framework (fig 1) to highlight equity issues inherent in assessing health needs, effectiveness, and cost effectiveness of interventions, and the development and evaluation of evidence based health policy. This framework provides a method to calculate the "equity effectiveness ratio," which assesses the impact of various factors on the gap in the effectiveness of interventions across socioeconomic gradients.
Globalisation and liberalisation (G&L) are two of the defining features of the last couple of decades. Both have given rise to contentious debate, with views ranging from the most optimistic to the most sceptical. This paper reviews the evidence on how the two trends have affected inequality - and thus poverty - at both the global and domestic levels. The absence of consensus on these effects reflects both the dearth of adequate quantitative information and the lack of and difficulty in the analysis of the causal links among the issues.
This article describes the validation of an instrument to measure work group climate in public health organizations in developing countries. The instrument, the Work Group Climate Assessment Tool (WCA), was applied in Brazil, Mozambique, and Guinea to assess the intermediate outcomes of a program to develop leadership for performance improvement. Findings discussed include how the WCA is useful for comparing the climates of different work groups, tracking the changes in climate in a single work group over time, or examining differences among individuals' perceptions of their work group climate.
14. Useful Resources
It is now nearly impossible to be a successful medical or life scientist without basic skills to read and communicate in English. There are, however, many other potential consumers of medical and scientific research results-health-care professionals, educators, and the general public-for whom proficiency in English is a luxury that only some can afford. While basic translation services can help the reader to decide whether to invest the effort and obtain a better translation, proprietary machine translation packages can do quite a bit better.One example relevant to medical content is the Pan American Health Organization (PAHO) machine translation system.
This site lists and bears the various health protocols formulated by the SADC member states.
15. Jobs and Announcements
This conference will bring together researchers and practitioners, from both developed and developing countries, to analyze the causes and consequences of health deprivation and inequality, to examine patterns and trends in these outcomes, to evaluate alternative policy options, and to identify future research directions. All applications must be received by 15 May 2006.
Research Matters in Governance, Equity and Health is proud to launch this Call for Writers: a search designed to deepen the ongoing investigation into health systems and health systems research. Research Matters is currently seeking several writers interested in writing on the topic: "What does an affordable and sustainable 21st-century African health system look like?" The final paper should be submitted no later than 20 May 2006.
CIVICUS is recruiting an MDG Administrative Officer who will report directly to the MDG Campaign Manager, and liaising closely with other Campaign staff. The MDG Administrative Officer is responsible for providing high-quality overall administrative and logistical support to the work of the MDG Department. The closing date for applications is April 7, 2006. For more information click on the weblink.
The Five College African Scholars Program invites applications for competitive residency fellowships for 2007 from junior and mid-level teaching staff employed full-time in African universities. There are two residency periods: mid-January to May 2007 OR mid-August to December 2007. Proposals for the January residency are invited on the topic of Globalization & Development, while the August residency is open to all applicants with projects relevant to the study of Africa in the humanities and social sciences. The deadline for applications is May 1, 2006.
After a long formation process, we are pleased to introduce to you the Southern Africa Trust, an independent, southern African regional non-profit agency established to support organisations in the region to participate more effectively in policy dialogue so that policies and strategies across the region work better to overcome poverty. While the Trust will be formally launched in May 2006, we wanted to inform you now that we are already operational.
The Panos Global AIDS Programme invites print journalists from Eastern Africa; Western Africa; the Caribbean; South Asia to participate in a small grants programme aimed at raising debate at country level on the progress made by their countries in the attainment of the goals of the Declaration of Commitment agreed upon during the United Nations General Assembly Special Sessions (UNGASS) on HIV/AIDS held in June 2001. Panos will be giving out UNGASS Monitoring grants to one journalist each from Zambia, Zimbabwe, Malawi, Botswana and South Africa. To apply, CVs and samples of related published work may be sent not later than 8 April 2006 to the relevant contact for that part of the world.
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