There have been dramatic changes to municipal services such as water and electricity since the end of apartheid in South Africa, with considerable research having gone into the impacts of commercialisation and cost recovery on low-income households. The research has revealed a complex and often negative relationship between the marketisation of these services and access and affordability for the poor. It has also been shown to have direct and very negative public health implications, most acutely in low-income township and rural areas.
Less obvious, and much less researched, have been the impacts of changes in service delivery on the mental health of low-income residents and household members. The fact that there is a relationship between poor mental health and poverty in general has now been well established. Common mental disorders (notably, anxiety and depression), while once thought to be the preserve of the rich who could afford the ‘luxury’ of worrying about emotional issues, have in fact been shown to have higher prevalence in low-income households. It has also been suggested that there is a cycle of vulnerability between poverty and marginalization, physical ill health, emotional distress, and mental disorder.
What, then, might be the links between poverty, mental health and the shift towards market-oriented reforms in basic services? A preliminary detailed ethnographic study of ten low-income families coping with a serious mental disorder (schizophrenia) in Cape Town pointed to several problems including:
• Health and safety problems. Household members have difficulties in ensuring appropriate use of medication (due to lack of water), practicing adequate hygiene, growing their own food, and with general comfort (such as being warm and dry). There are also concerns about being forced to use open fires, candles and paraffin stoves for cooking and warmth, leading to additional health and safety worries such as poisoning, fires, and respiratory infections.
• Time and energy. Considerable time and energy are spent searching for alternative sources of water and electricity and having to live with limited supplies of both.
• Social tensions. Respondents expressed concern with having to borrow money or water from neighbours and family members, leading to additional stresses in the lives of
household members and often to tensions within families and neighbourhoods, exacerbating the stigmas typically attached to mental disorders.
• Social activities. Reducing service consumption has implications for people’s social lives and household entertainment. Most of the households interviewed owned a television or radio, for example, but were reluctant to use them due to electricity costs. One family member reported being bored at home and therefore spending time with peers who encouraged him to use drugs. This has important implications for health, as co-morbid substance abuse has been shown to play a role in relapse of schizophrenia as well as being implicated in the onset of psychosis.
• Relapse. The stress of not being able to afford adequate services, or having these services cut off or restricted, would appear to add considerable stress to the person with the mental disorder, possibly contributing to a worsening of the disorder and/or a relapse.
• Impact on care-giving environment. Inadequate services would appear to increase levels of stress and burden for the caregiver(s), with implications for their own mental health. This then impacts on the family member with the mental disorder as well as the household as a whole, as the caregiver’s ability to care for the family may be compromised. Women appear to be the most affected by this as the primary caregivers.
Households experienced considerable financial hardship as a result of cost recovery strategies on basic services, with 29% of household income being spent on water and electricity on average, and arrears on water and electricity bills as high as R18 200. This situation caused anxiety and added considerably to overall family stress.
While households used a range of strategies to minimise water usage, the need to save water was a further source of anxiety and conflict. Similarly, concerns were raised about electricity usage and cut-offs, with disability grants being used to pay for fuel and basic services in many households.
While direct links between experiences of service delivery difficulties and the onset or relapse of mental disorder cannot be drawn, but it is clear that uncertainty about services in the context of poverty add to overall stress levels. Much remains to be done in terms of realising the rights of people with mental disorders (and their families) in South Africa. Without considering the broader context of poverty and service delivery it will not be possible for them to adequately improve their lives.
Editors comment: This issue of the newsletter presents material on mental health and equity, and we note the limited publication found in this area. EQUINET invites further contributions on mental health in Africa, and particularly in relation to equity issues. Please send contributions, feedback or queries on the issues raised in this briefing to the EQUINET secretariat, email admin@equinetafrica.org. Further information on issues raided in the briefing or the Municipal Services Project see http://www.queensu.ca/msp/ Greg Ruiters, Institute for Social and Economic Research, Rhodes University Grahamstown.
1. Editorial
2. Latest Equinet Updates
This call invites applicants to participate and share experiences in a Regional Training Workshop for east and southern African countries on Participatory Methods for research and training for a people centred health system being held on February 14-17 2007. The 2007 training will focus on using participatory methods in strenghtening the relations between communities and frontline health workers. Interested applicants should submit a 1-2 page expression of interest that outlines the research or training work that they are doing or proposing to do on in this area, a personal CV and information on their institution by 15th December 2006 to the EQUINET secretariat. Further information is available at http://www.equinetafrica.org/.
The migration of health professionals trained in Africa to developed nations has compromised health systems in the African region. The financial losses from the investment in training due to the migration from the developing nations are hardly known. The cost of training a health professional was estimated by including fees for primary, secondary and tertiary education. Accepted derivation of formula as used in economic analysis was used to estimate the lost investment. Developing countries are losing significant amounts of money through lost investment of health care professionals who emigrate. This paper quantifies the amount of remittances that developing nations get in return from those who migrate.
3. Equity in Health
The 21st Plenary Assembly of the Southern African Development Community (SADC) Parliamentary Forum was held at Misty Hills Country Hotel, Mogale City, South Africa under the theme: Enhancing the Role of Parliaments in Governance and Development at Regional Level: Trade and Development Issues Relating to the African Caribbean and Pacific (ACP)/European Union (EU) Negotiations. This document highlights the key points raised at the assembly.
There is compelling evidence that in developing countries mental disorders are amongst the most important causes of sickness, disability, and, in certain age groups, premature mortality. Mental health–related conditions, including depressive and anxiety disorders, alcohol and drug abuse, and schizophrenia, contribute to a significant proportion of disability-adjusted life years (DALYs) and years lived with disability (YLDs), even in poor countries. Apart from causing suffering, mental illness is closely associated with social determinants, notably poverty and gender disadvantage, and with poor physical health, including having HIV/AIDS and poor maternal and child health. Yet mental health remains a largely ignored issue in global health, and its complete absence from the MDGs reinforces the position that mental health has little role to play in major development-related health agendas. This article seeks to question this assumption. Using evidence on mental health in developing countries, it argues that addressing mental health problems is an integral part of health system interventions aimed at achieving some of the key MDGs.
This World Health Organisation report focuses on the health of the 738 million people living in Africa. It provides a comprehensive analysis of key public health issues and progress made on them in the Africa region. The report finds that whilst AIDS continues to devastate the region, the number of HIV-positive people on antiretroviral medicines increased eight fold from December 2003 to December 2005. Also, most countries are making good progress on preventable childhood illness: polio is close to eradication and 37 countries are reaching 60 per cent or more of their children with measles immunisation.
Dr Margaret Chan of China will be the next Director-General of the World Health Organization (WHO). After her appointment, she told the World Health Assembly she wanted to be judged by the impact WHO's work has on the people of Africa and on women across the globe. In her acceptance speech, Dr Chan said: "what matters most to me is people. And two specific groups of people in particular. I want us to be judged by the impact we have on the health of the people of Africa, and the health of women. Improvements in the health of the people of Africa and the health of women are key indicators of the performance of WHO."
4. Values, Policies and Rights
The June newsletter of HEPS Uganda outlines civil society poitions on HIV and AIDS fundings, on health rights and on public health policy regarding counterfeit medicines.
Despite international agreements and national laws, marriage of girls under 18 years of age is common worldwide and affects millions. Child marriage is a human rights violation that prevents girls from obtaining an education, enjoying optimal health, bonding with others their own age, maturing, and ultimately choosing their own life partners. Child marriage is driven by poverty and has many effects on girls' health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, and obstetric fistulas. To stop child marriage, policies and programs must educate communities, raise awareness, engage local and religious leaders, involve parents, and empower girls through education and employment.
Muslim clerics from 25 African countries held a five-day population and development meeting in Tanzania's semiautonomous island of Zanzibar, focusing on issues such as HIV/AIDS and gender violence from an Islamic point of view. The participants, from member countries of the Network of African Islamic Faith-based Organisations, are also focusing on social and development problems.
A giant step towards equality for women was recently taken at the United Nations when a High-Level Panel on UN reform recommended to the Secretary General the creation of the world body’s first full-fledged agency for women. The panel, appointed by Secretary-General Kofi Annan earlier this year, recommends “an enhanced and independent” policy, advocacy and operational agency for women’s empowerment and gender equality, to be headed by an Under Secretary-General; and is an inspired and entirely welcome remedy. If implemented and funded as recommended, the new organization will begin to correct over six decades of UN neglect and indifference toward women.
5. Health equity in economic and trade policies
This study involved making freedom of information requests for information on IFIs in five different countries: Bulgaria; Mexico; Slovakia; South Africa and Argentina. The study found that information was difficult to obtain and there were varying degrees of disclosure across countries, with only 22 per cent of the 120 requests resulting in full disclosure and a number of requests being totally ignored by the IFIs. The Charter is the GTI's flagship statement of the standards to which IFI information disclosure policies should conform and a key advocacy tool for the promotion of more progressive policies.
The G20 is a private meeting, hence organisations such as corporations, aid agencies, consumer organisations and other non-government organisations (NGOs) are not eligible to attend as delegates. This report critiques the selective participation of business in the meeting, with some of the world’s largest energy and mining companies reported to have full access to all the delegates at a working lunch. The report noted the cincidental holding of the inaugural meeting of the Energy and Minerals Business Council in the same hotel and dates as the formal meeting of the G20.
The United Nations global climate change conference in Nairobi agreed that African countries remain the most vulnerable to climate change, whose effects are manifested in extreme weather conditions, ranging from prolonged drought to massive flooding. These changes have consequences for food production and for the spread of infectious diseases.
This Oxfam briefing paper discusses the actions that countries have taken towards meeting their obligations made at the Doha Declaration on the TRIPs (Trade-Related Aspects of Intellectual Property Rights) Agreement and Public health in November 2001. The Declaration says that developing countries can enforce public health safeguards to enable price reductions on medicines, and that countries with insufficient drug manufacturing capacity can access generic medicines (medicines produced in developing countries which are cheaper than brand name drugs). The paper finds that although public health safeguards have been weakened or eliminated through bilateral and regional free trade agreements, many developing countries are still managing to enforce them.
6. Poverty and health
World Health Organisation (WHO) together with other key partners have joined forces to develop a new Project "Mental Health and Poverty Project: Improving Mental Health, Reducing Poverty (MHaPP)". The project will undertake an analysis of existing mental health policies in poor countries, provide interventions to assist in the development and implementation of mental health policies in those countries, and evaluate the policy implementation in order to provide new knowledge regarding comprehensive multi-sectoral approaches to breaking the negative cycle of poverty and mental ill-health. The project will be conducted in four African countries: Ghana, South Africa, Uganda and Zambia.
The Millennium Villages Project (MVP), an initiative of the Earth Institute at Columbia University, is an attempt at an integrated and bottom-up approach to getting African villages out of the poverty trap. It involves massive injections of capital targeted at, presently, a handful of villages, combining agricultural support with health, infrastructure and education interventions. Taking a critical stance, this paper finds that although these aims are admirable, significant questions remain with regard to scalability and long-term sustainability of the MVP.
The political foundations of poverty are all too often ignored by poverty analysts. This paper presents, from a political-economy perspective, a critique of mainstream poverty analysis. The author argues that the way mainstream research considers poverty separates it from the social processes of the accumulation and distribution of wealth. This serves to depoliticise poverty, as it becomes a kind of a social abnormality, rather than the reality of modern state and market society functions.
7. Equitable health services
Mental health service planners face critical decisions regarding appropriate and affordable inpatient care. Before a fashion of deinstitutionalisation is followed, effective community services should be in place and sufficient psychiatric beds should remain in hospitals for those who cannot be catered for in the community. In order to maintain the delicate balance between hospital and community-based services, it is essential that useful indicators of inpatient care are established. This study documents current bed/population ratios per 100 000 population in public sector mental health services in South Africa. It found low levels of inpatient service provision in South Africa, and considerable variability between provinces. This study gives further support to the need to develop acute inpatient psychiatric services, reduce levels of chronic care where appropriate, and redirect resources towards the development of community-level residential and day-care services. It is crucial to develop accurate indicators to monitor this process.
Health departments in the new South Africa are undergoing major restructuring and, in some cases, severe financial cutbacks as new policies attempt to redress the inequities of the past. A district system is being phased in, with a shift in funding from academic hospitals to secondary and primary level care. The process is being undermined by the current recession, which also affects Welfare and Education facilities, and by widespread poverty, violence, and other adverse conditions. Child mental health services are discussed in the light of current human resources, epidemiological data, the effects of violence and cultural issues, together with some reflections on their future.
Diabetes is a growing problem in Africa and will continue to be so, as a high risk of diabetes is tied to highly active retroviral therapy for AIDS. Data for diabetes in Africa is small, as the subject has received little attention, and many of the African studies have not been published in Western, peer-reviewed journals. This paper highlights many of the issues surrounding diabetes treatment in Africa.
The Ethiopian health ministry is short of vaccines to contain the spread of meningitis that has so far claimed 10 lives in the Southern Nations Nationalities and People’s Region (SNNPR) and infected 612 more, a health update said. A meningitis outbreak has been reported in Derashe and Selamago areas of Mursi in the SNNPR region. An earlier outbreak in Wolayita zone of the same region was contained due to the quick response of health ministry and humanitarian partners, according to the update by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA).
The World Psychiatry Association program seeks to initiate mental health policies and their integration in primary health care, to promote adoption of mental health legislation, equity in the provision of mental health services and adequate funding of those services. In the early 1990s, only 23% of member states of the African Region of WHO were reported to have a mental health legislation. Mental health legislation in Africa needs to be updated to secure the rights of mentally ill people, and support to their families. An integrated mental health policy reduces morbidity and burden by emphasising primary and secondary prevention and all forms of mental rehabilitative care of the more severely ill. Policy goals may include bringing families with mentally ill members together, encouraging the creation of common interest groups, and developing broader views of rehabilitation.
Little is known about socioeconomic differences in access to life-saving obstetric surgery, yet access to a caesarean for women is essential to achieve low levels of maternal mortality. The study examined population based caesarean rates by socioeconomic groups in various developing countries. In the poorest countries-mostly in sub-Saharan Africa-large segments of the population have almost no access to potentially life saving caesareans, whereas in some mid-income countries more than half the population has rates in excess of medical need. These data deserve the attention of policymakers at national and international levels.
Tanzanian Prime Minister Edward Lowassa has given Dar es Salaam regional administrative officials two weeks to eradicate cholera or lose their jobs. "I give you up to December 3," he told the officials on Monday during a brief health inspection of the city's cholera-infected neighbourhoods of Temeke, Buguruni and Mburahati. Over the past 12 months, the disease has killed 117 people in the city, the nation's commercial capital.
Tuberculosis (TB) remains the leading cause of death from a curable infectious disease, despite the availability of short-course therapy that can be both inexpensive and effective. New diagnostic tests that are simple and robust enough to be used in the field, accurate enough to diagnose all infected individuals, and able to identify drug resistance are desperately needed, and represent an essential complement to new drug development efforts and to effective control and treatment programmes.
8. Human Resources
Mental health services in South Africa increasingly feel the brunt of the AIDS epidemic. Despite the high prevalence of infection in the psychiatric setting, HIV risk reduction interventions targeting South Africans with psychiatric illness remain few and far between. The attitudes of mental health care providers about sexual relations and HIV among people with mental illness continue to influence the extent to which these issues are addressed in care settings. This study examines these attitudes through the use of a semi-structured interview administered to 46 mental health care providers in four provinces of South Africa. I found that personal, contextual and political factors in the clinic and the hospital create barriers to integrating prevention activities. In particular, providers face at least three challenges to intervening in the epidemic among their patients: their own views of psychiatric illness, the transitions occurring in the mental health care system, and shifting social attitudes toward sexuality. Barriers operate at the individual level, the institutional level, and the societal level. At the individual level providers' perceptions of psychiatric symptoms shape their outlook on intervention with psychiatric patients. At the institutional level disruptive transitions in service delivery relegate HIV services to lesser importance. At the societal level, personal beliefs about sexuality and mental illness have remained slow to change despite major political changes. Minimizing barriers to implementing HIV prevention services requires institutional and health care policies that ensure adequate resources for treating people with mental illness and for staff development and support.
The shortage of healthcare workers is a global crisis, but developed countries can afford to throw money at the problem, attracting nurses and doctors from developing countries with vastly better salaries and working conditions. In Malawi, the fourth poorest country in the world, where UNAIDS has put HIV prevalence at 14 percent, the health worker shortage is so acute that the ministry of health and international donors are now treating it as an emergency.
This paper describes the current situation of the health workforce in the public sector in Swaziland. Swaziland, like most other countries in southern Africa, is facing a human resources crisis that is exacerbated by the impact of HIV and AIDS. The paper identifies the major factors that contribute to losses in the health workforce as emigration and attrition due to AIDS. It describes the initiatives that the government has undertaken to tackle the crisis. These include retention strategies such as increased salaries to retain staff, and scaling up anti retroviral therapy (ART) for health-care workers to reduce attrition.
Past attempts to estimate the cost of migration were limited to education costs only and did not include the lost returns from investment. The objectives of this study were: (i) to estimate the financial cost of emigration of Kenyan doctors to the United Kingdom (UK) and the United States of America (USA); (ii) to estimate the financial cost of emigration of nurses to seven OECD countries; and (iii) to describe other losses from brain drain. Results showed that Developed countries continue to deprive Kenya of millions of dollars worth of investments embodied in her human resources for health. If the current trend of poaching of scarce human resources for health (and other professionals) from Kenya is not curtailed, the chances of achieving the Millennium Development Goals would remain bleak.
9. Resource allocation and health financing
This article argues that the suspension of funding to Uganda from the Global Fund could have been avoided. The article outlines how the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) suspended five grants to Uganda following an audit report that exposed gross mismanagement in the Project Management Unit. The authors argue that this could have been avoided if a legitimate and fair decision-making process was used and that this lesson should be applied to other countries.
South Africa’s apartheid health system was grossly ineffective. Private and public health spending combined was among the highest in the world at 8.4% of GDP, yet inequalities in provision, poor efficiency of spending and other factors impacting on health status meant that the country was not among the top 60 in terms of health status indicators (Goudge, 1999). In an attempt to remove obstacles to access to health services, the government introduced free primary health care in 1996. The paper attempts to gauge the impact of these changes. The focus falls on changes in the incidence of South African public health spending.
South Africa's Department of Health confirmed on Thursday that a new social grant system was on the cards for chronically ill people, including those living with HIV/AIDS. At present, government policy stipulates that HIV positive grant recipients be deregistered once antiretroviral (ARV) treatment restores them to good health and they are able to start seeking work. However, local AIDS activists charged that with national unemployment estimated at around 35 percent, most beneficiaries were usually jobless and too ill to work before they started receiving the monthly stipend. The article describes these issues raised.
10. Equity and HIV/AIDS
One of the most puzzling features of the HIV epidemic in sub-Saharan frica is the large variation in its size among countries. For example, the proportion of adults infected ranges from 33% in Swaziland to less than 1% in Mauritania, Madagascar and Senegal. This study investigates the possibility that late age at first marriage, and a long period of premarital sexual activity, may be risk factors for HIV infection. The relationship between marital status and the prevalence and incidence of HIV is examined.
The fourth Africities Summit was held in Nairobi , Kenya from 18-22 September 2006. The theme for the Summit was “Building Local Coalitions for the Implementation of the Millenium Development Goals in African Local Governments”. During the Africities Summit 2006 a series of special and thematic sessions were organisedto provide an opportunity for stakeholders to share information, experiences, good practices, achievements and constraints towards attaining the MDGs and to also table recommendations on ways forward.
Over the past several years, the HIV virus has spread in an alarming, complex and often hidden manner. Ordinary people, local and global communities and various organisations have responded to the epidemic in various ways. They offer many lessons but few have been widely adopted. The latest issue of id21 insights asks: “What can we learn from this diversity of response? Can we find better ways to help scale up the coverage, quality and impact of civil society action?" Guest editor Jerker Edstrom from the Institute of Development Studies says that it is important for health systems to involve clients, communities and affected groups in planning and negotiating HIV testing, treatment, care and social protection arrangements.
It is generally assumed that caring is a substantial burden upon households afflicted by HIV/AIDS. However, as a ‘private’ household responsibility, little is known about the experiences of either those who provide the care, or those receiving care, despite the fact that the process may extend over several years and may have a greater impact upon the livelihood security and well-being of the household than the actual death of the ill person. Drawing upon data collected through solicited diaries, this paper explores how illness and the daily and long-term duties of caring amongst a sample of households in the Caprivi Region of Namibia impacts upon the physical and psychological well-being of ill people and their carers.
Support for Ethiopian families affected by the AIDS pandemic has come from an unexpected source - local funeral associations, known as edirs. An edir is a traditional 'burial society' to which members make monthly contributions and receive a payment to help cover funeral expenses in return. Nearly every modern Ethiopian is thought to be a member of at least one edir, either a neighbourhood association, one based at work, or operating along age or gender lines. Now one edir changed its constitution to allow members to draw a quarter of their 2,000 birr (US$238) funeral payout before death, and permit a small extra fee to be levied to pay for additional social support from Tesfa, an organisation providing help, particularly in the area of HIV, to 26 affiliated edirs.
Since June of this year, the World Health Organization and the UNAIDS Secretariat have been coordinating a consultative process to develop guidance on provider-initiated HIV testing and counselling in health care settings. The latest draft of the guidance document in English is now available. An Executive Summary of the document is available in French, and will soon be available in Spanish. The full text of the document in these languages should be available on the same website by December 18. WHO are now seeking broad public comment on this document. If you wish to provide comments, please follow the instructions that appear on the website and send in your comments according to the following schedule:
o English comments by 5 January, 2007; and
o French and Spanish comments by 19 January, 2007.
Despite being largely preventable, mother-to-child transmission of HIV accounts for 30% of all new infections in Malawi and is the second major mode of transmission after unprotected sex. Every year, an estimated 30,000 babies are born HIV positive. Relatively simple interventions to lower the risk of infection are available to only a small number of women and lag far behind the country's antiretroviral (ARV) treatment programme, which now reaches 70,000 HIV-infected people, or about 40 percent of those who need them.
Sub-Saharan Africa disproportionately represents the largest incidence of both HIV/AIDS and internal conflicts. The impact of conflict on HIV incidence is largely unknown. Current epidemiological evidence paradoxically suggests that in most populations affected by conflict, HIV prevalence is lower than surrounding communities. Together, these dimensions of conflict create a complex and challenging situation for prevention of HIV/AIDS and delivery of care to conflict-affected populations. The authors examine the complexity of monitoring HIV/AIDS in conflict settings, and argue that increased efforts are needed to protect vulnerable populations and design health-delivery systems that are sustainable in settings of conflict.
Women with HIV infection have between 25% and 40% lower fertility than non-infected women. As antiretroviral therapy (ART) becomes increasingly accessible in sub-Saharan Africa, it is important to understand whether and how the associated clinical improvements correspond with changes in the incidence of pregnancy and fertility. Accordingly, this paper reviews the literature on the potential impact of ART on the fertility of women with HIV infection in sub-Saharan Africa. The authors use Bongaarts' proximate determinants of fertility framework (adapted for conditions of a generalised HIV epidemic) to examine the underlying mechanisms through which use of ART may impact the fertility of women with HIV infection.
It is commonly asserted that the sub-Saharan African HIV/AIDS epidemic is predominantly due to heterosexual transmission. However, recent re examination of the available evidence strongly suggests that unsafe health care is the more likely vector. The present report adds to the evidence for health-care transmission by showing that Kenyan women who received prophylactic tetanus toxoid injections during pregnancy are 1.89 times (95% confidence interval [CI]:1.03-3.47) more likely to be HIV-1 seropositive than women who did not receive this vaccination. In contrast, recent sexual behaviour (condom use, number of partners) was not related to HIV status. The results are consistent with health care being a very important vector for HIV in sub-Saharan Africa.
Pages
11. Governance and participation in health
The International Day of No Violence Against Women Campaign does not only concern those sections of civil society dealing feminist issues. Not true. Instead the campaign illustrates the need for all sections of civil society to unite around fundamental issues of human rights, democracy and good governance.
Civil society organisations accused government Monday of misleading President Bingu wa Mutharika and the nation in its dealings on a prospective multi-billion kwacha uranium mining project at Kayelekera in Karonga for the impact it will will have on people’s lives. Civil society questions the Environmental Impact Assessment (EIA) for its lack of independence, participation, inclusiveness, cultural sensitivity and equity.
12. Monitoring equity and research policy
The objective of this study was to study cross-national inequalities in mortality of adults and of children aged 4 times the rate in countries with low mortality. For child mortality, the worse-off group made slower progress in reducing <5 mortality than the better-off group. The study concludes that inequalities in child and adult mortality are large, are growing, and are related to several economic, social and health sector variables.
The paper reviews the experience with the emergency obstetric care (EmOC) process indicators, and evaluates whether the indicators serve the purposes for which they were originally created – to gather and interpret relatively accessible data to design and implement EmOC service programs. The authors conclude that The EmOC process indicators have been used successfully in a wide variety of settings. They describe vital elements of the health system and how well that system is functioning for women at risk of dying from major obstetric complications.
13. Useful Resources
Health Research Policy and Systems anounced through BioMed Central the publication of a special series of reviews 'Improving the Use of Research Evidence in Guideline Development', available from the journal website. The reviews were commissioned by the World Health Organisation (WHO)’s Advisory Committee on Health Research (ACHR). The series examines the methods used by WHO and other organisations to formulate recommendations about health, and is part of the documentation produced to inform ACHR’s advice to WHO in making health decisions.
14. Jobs and Announcements
The NIGH program is a competitive abstract submission and selection program designed to highlight exemplary research, policy and advocacy initiatives of new and future leaders in global health and empower participants with global health advocacy skills. The NIGH Program is open to all students currently enrolled in a degree-seeking program in a health related field OR new professionals within two years of achieving their terminal degree in a health-related field. Winners will receive a scholarship to help facilitate their attendance at the Global Health Council's International Conference on Global Health. The deadline for applications is 1 December 2006.
This new International Award gives advice, support and skills development for the award winner in the areas that are specific to their campaign. For example, the winner might need to develop an understanding of how to communicate in the media or to build alliances with other organisations. In this sense, were an HIV-AIDS campaigner to win it would be ensured that they received skills and advice related to how to influence this policy field. The winner would receive a package of free support including: one to one coaching on campaign tactics and other areas that will help that person's campaign, advice from a senior UK-based campaigner with knowledge of their policy area, the opportunity to spend a day with a decision maker, participation in a skills development weekend in the UK with other campaigners.
The Centre for African Family Studies (CAFS) presents the Proposal Writing training course scheduled to take place in Nairobi, Kenya from 5 to 9 March 2007. This is an intensive one-week learning opportunity for board members, managers and program staff who wish to diversify funding and resources for their organizations. This one-week course is designed to equip the participants with skills to develop a proposal using logical framework approach.
Published by the Regional Network for Equity in Health in east and southern Africa (EQUINET) with technical support from Training and Research Support Centre (TARSC).
Contact EQUINET at admin@equinetafrica.org
To post, write to: equinet-newsletter@equinetafrica.org
Website: http://www.equinetafrica.org/newsletter
Web design from Fahamu
Please forward this to others.
To subscribe, visit: http://www.equinetafrica.org or send an email to info@equinetafrica.org
Please send materials for inclusion in the EQUINET NEWS to editor@equinetafrica.org