Developed countries are failing to live up to their commitments to fund sexual and reproductive health care leaving poorer countries to pick up the bill, says a new UN report. The United Nations Population Fund (UNFPA) report titled 'The Cairo Consensus at Ten: Population, Reproductive Health and the Global Effort to End Poverty' says poor countries themselves are providing around 40 percent of the money spent on reproductive health programmes and HIV/AIDS prevention and treatment.
Equity in Health
Poor funding hampers AIDS vaccine research, says Lewis
The global pursuit of a vaccine against HIV/AIDS is failing due to a lack of funds and commitment, a delegation of researchers heard on Tuesday. Addressing the '2005 AIDS Vaccine International Conference' in Montreal, Canada, Stephen Lewis the UN Special Envoy for AIDS in Africa urged scientists to emerge from their laboratories to become champions for the cause.
Poor mental health and sexual risk behaviours in Uganda: A cross-sectional population-based study
Lundberg P, Rukundo G, Ashaba S, Thorson A, Allebeck P, Ostergren P and Cantor-Graae E: BMC Public Health 11(125), 21 February 2011
In this study, researchers investigated whether depression, psychological distress and alcohol use are associated with sexual risk behaviours in young Ugandan adults. They sampled households in two Ugandan districts, recruiting 646 men and women aged 18-30 years. Participants were assessed for depression and psychological distress, as well as alcohol use and sexual behaviour risk. Researchers found that depression was associated with a greater number of lifetime partners and, among women, with having concurrent partners. Psychological distress was associated with a greater number of lifetime partners in both men and women but was only marginally associated with having concurrent partners among women. Psychological distress was associated with inconsistent condom use among men. Alcohol use was associated with a greater number of lifetime partners and with having concurrent partners in both men and women, with particularly strong associations for both outcome measures found among women. The researchers conclude that poor mental health is associated with sexual risk behaviours in a low-income sub-Saharan African setting. They argue that HIV preventive interventions should consider including mental health and alcohol use reduction components into their intervention packages, especially in settings where depression, psychological distress and alcohol use are common.
Poor Nations Falling Short of UN Health Goals, World Bank Says
Developing countries are falling short of a United Nations goal of reducing child mortality rates by 2015 because of doctor shortages, failure to improve health- care services, and inconsistent funding, the World Bank said. No country in sub-Saharan Africa has made progress in cutting the number of deaths of children under the age of five from preventable illness since the UN issued its 2002 mandate to reduce mortality by two-thirds. More than 11 million young children died that year, with 42 percent in sub-Saharan Africa.
Positioning Health in the Post-2015 Development Agenda
WHO discussion paper, October 2012
In a new discussion paper prepared for the UN consultation on health in the post-2015 development agenda, WHO makes the case for using Universal Health Coverage as single overarching health goal. The current MDGs were conceived as a compact between what developing countries aspired to achieve and what the developed world needed to do to ensure progress. Future goals are argued to be more likely to be framed in terms of global challenges that require shared solutions.WHO argues that health is central to development: it is a precondition for, as well as an indicator and an outcome of progress in sustainable development. Nevertheless, while there is no doubt that health must have a place in the next generation of development, a convincing case needs to be made for how a health goal should be framed. In contrast to the current set of health-related MDGs, there is now a greater recognition of the need to focus on means as well as ends: health as a human right; health equity; equality of opportunity; global agreements (International Health Regulations, Pandemic Influenza Preparedness framework) that enhance health security; stronger and more resilient health systems; innovation and efficiency as a response to financial constraints; addressing the economic, social and environmental determinants of health; and multi-sectoral responses that see health as an outcome of all policies. In the current context promoting a long list of competing health goals will be counterproductive. The alternative is to build the case that health is a concern to all people, and is influenced by and as well contributing to policies across a wide range of sectors. The challenge then becomes one of deciding how “health” in this broad sense can be characterized in a way that is measurable and generates political traction and public understanding. The goal of achieving UHC is argued to have two inter-related components – coverage with needed health services (prevention, promotion, treatment and rehabilitation) and coverage with financial risk protection, for everyone. Universal Health Coverage is argued to be a dynamic process. It is not about a fixed minimum package, it is about making progress on several fronts: the range of services that are available to people; the proportion of the costs of those services that are covered; and the proportion of the population that are covered. Few countries reach the ideal, but all – rich and poor – can make progress. It is thus argued to have the potential to be a universal goal.
Post-2015 health MDGs
Schweitzer J, Makinen M, Wilson L and Heymann M: Overseas Development Institute, July 2012
This report measures progress on the health Millennium Development Goals (MDGs) to 2015 and beyond. The authors gathered data from a combination of literature reviews, interviews with key stakeholders in the health field, and a roundtable discussion. They found that the past decades have seen a gradual shift from a focus on a single disease to a more systemic approach by including a variety of health (and non-health) inputs which have to be integrated at the national, district and local levels. Although the authors predict that achievement of the health MDGs will almost surely be uneven, the available evidence suggests that the health MDGs have been effective in accelerating progress on target indicators, in stimulating global political support in the creation of significant global institutions dedicated to helping countries achieve the MDGs and in stimulating research and debate on systemic approaches to improving health outcomes. The authors argue that the current health MDGs will need continued focus beyond 2015 and must be included in some form in the post-2015 goals. The new goals should be simple enough to be politically intelligible and acceptable, and meaningful to politicians and laypeople. The report recommends that a mechanism be set up to ensure decision-makers and external funders are held accountable and to help countries get back on track.
Post-2015: framing a new approach to sustainable development
Independent Research Forum on a Post-2015 Sustainable Development Agenda: March 2013
This briefing note offers principles and approaches for integrating economic, social and environmental sustainability and equity in a new post-2015 development agenda. It offers guidance on how development processes can help create a foundation for human wellbeing based on economic progress, equitable prosperity and opportunity, a healthy and productive environment and participatory governance. The Independent Research Forum argues that sustainable development can only be achieved when these dimensions of development are all present and mutually reinforcing. But first, eight shifts will be essential: from ‘development assistance’ to a universal global compact; from top-down to multi-stakeholder decision-making processes; from economic models that increase inequalities and risks to ones that reduce them; from business models based on shareholder value to those based on stakeholder value; from meeting ‘easy’ development targets to tackling systemic barriers to progress; from damage control to investing in resilience; from concepts and testing to scaled up interventions; and from multiple discrete actions to cross-scale coordination.
Poverty and Inequity in the Era of Globalization: Our Need to Change and to Re-conceptualize
The best way to improve the health and nutrition of the poor still is to have them move out of poverty. For equity to be achieved, economic growth in the development process needs to be deliberately geared towards the needs of the poor. Focusing on sustainable poverty alleviation is inseparable from bringing about greater equity. A focus on both tasks is necessary to achieve the indispensable reduction in the existing rich-poor gap. Focusing on poverty alleviation alone can end up as charity in disguise. Focusing on equity is a step towards social justice. Equity and social justice in health and nutrition are one and the same thing: in health and nutrition, social inequities are always unfair. This is an extract from an article in the International Journal for Equity in Health 2003.
Prevalence and Factors Associated with Mental and Emotional Health Outcomes among Africans during the COVID-19 Lockdown Period—A Web-based Cross-Sectional Study
Langsi R; Osuagwu U; Goson P; Abu E; et al: International Journal of Environmental Research and Public Health 18(3), 899, 2021
This online study assessed the prevalence of mental health symptoms as well as emotional reactions among 2005 respondents aged 18 years and older in seven African countries between 17 April and 17 May 2020 corresponding to the lockdown period in these countries. Respondents self-reported feeling anxious, worried, angry, bored and frustrated. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Health care workers were less likely to report feeling angry than other types of workers.
Prevalence and risk factors of malaria among children in southern highland Rwanda
Gahutu J, Steininger C, Shyirambere C, Zeile I, Cwinya-Ay N, Danquah I: Malaria Journal 10(134), May 2011
Increased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare, a combined community- and facility-based survey on Plasmodium infection was conducted early in 2010. In this study, a total of 749 children below five years of age were examined including 545 randomly selected from 24 villages, 103 attending the health centre in charge, and 101 at the referral district hospital. The researchers found that one out of six children under five years of age is infected with malaria. The many asymptomatic infections in the community form a reservoir for transmission of malaria. Risk factors for malaria include low socio-economic status and ineffective self-reported bed net use.